Interesting – research on insomnia & depression

I’ve written about depression and insomnia before.  Also that I can induce depression symptoms by shorting myself on sleep.

Now the NIMH is studying interactions between depression and insomnia. 

Doctors have long considered poor sleep to be a symptom of depression that would clear up with treatments, said Rachel Manber, a professor in the psychiatry and behavioral sciences department at Stanford, whose 2008 pilot trial of insomnia therapy provided the rationale for larger studies. “But we now know that’s not the case,” she said. “The relationship is bidirectional — that insomnia can precede the depression.”

Full-blown insomnia is more serious than the sleep problems most people occasionally have. To qualify for a diagnosis, people must have endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships. Several studies now suggest that developing insomnia doubles a person’s risk of later becoming depressed — the sleep problem preceding the mood disorder, rather than the other way around.

I doubt there’s a magic bullet here, but it is interesting and encouraging to see this sort of research.  (And on a more humorous note, check out Candorville.)

In The News

The AMA has endorsed the idea that “obesity” is a disease, not a “condition”.  (Personally I consider it a characteristic.)  Forbes states that this is “a move member physicians hope will spur better reimbursement for treating overweight Americans and create better health outcomes.”  Exactly how it’s supposed to “create better health outcomes” when commonly prescribed treatments do not work long-term or create good health outcomes is not addressed.

In good things, Shakesville’s Fatsronauts 101 series continues to hit it out of the park.

The NY Times does a piece on Melissa McCarthy that doesn’t focus on her weight.  That’s allowed?

The NY Times also reminds people go get some sleep.

Big Fat Sleep

No, it’s not news that lack of sleep is tied to fat.

What sleep researcher Dr. Orfeu Buxton found is more information on how this occurs.

The resting metabolic rate of the volunteers by the end of the five weeks was 8% lower than where they had started. […]  That could explain why night shift workers tend to gain more weight and have a higher likelihood of obesity than day workers; such weight gain is linked to an increased risk of diabetes and heart disease.

Wow, it’s like the number of calories burned isn’t standard across all bodies at all times!  Or not just affected by exercise!

The scientists learned something else interesting about another mechanism that put the disrupted sleepers at higher risk of diabetes: the combination of having their circadian clocks reversed (sleeping during the day and waking at night) and the poorer sleep they got as a result had an effect on their insulin levels. After three weeks in the lab, the participants produced about a third less insulin from the pancreas in response to meals; with less insulin available to break down glucose, blood glucose levels started to rise and three of the 21 volunteers showed high enough levels to qualify them as pre-diabetic.

Two things struck me about this.  First is that it occurred after 3 weeks.  Second is that only 3 of the 21 volunteers reached the pre-diabetic range, even though they were all living in the same lab undergoing the same regimen.  Again, it’s like they’re individuals or something.

Anyone who uses an alarm clock ”is by definition sleep-deprived”

Quoting this here, because sometimes I need the reminder that I don’t control my sleep needs.

S]ocietal pressure [to go short on sleep], what nationally recognized sleep expert Dr. Mark Mahowald calls “the pervasive, erroneous attitude that sleep is not a biological imperative, that it is negotiable. We have raised sleep deprivation to a badge of honor.” […]

Most adults need seven to nine hours of sleep a night. The amount a person needs is genetically determined, Mahowald said. “Some people might need four hours on the short end, up to 10 on the high end. We have absolutely no control over this.”

Anyone who uses an alarm clock ”is by definition sleep-deprived,” Mahowald said, “because if the brain had received the amount of sleep it wanted, you would have woken up before the alarm went off.”

– from “We are a sleep-deprived nation

I don’t always control when I’m sleepy or how much sleep I need.  But I do know that not getting enough sleep is the easy way to induce depression symptoms in myself.

Reality

I’m not sure when I realized that yes, maintaining a regular schedule is GOOD FOR ME, if only because it helps me sleep regularly. Adrenaline does not automatically kick in to cover for lack of sleep now — perhaps it’s getting older?

But anyway. Regular schedules. Regular sleep is good. Regular schedules also means I take my asthma meds regularly (even more important when I have a cold) and, oh yes, my antidepressants.

Regular meals is also good. This spring, with my dad in the hospital and later a nursing home (all as I was starting a temp job after a stint of unemployment) I wasn’t exactly eating regularly: Too much to do, not enough time to think about it, and I definitely didn’t want to take the time to plan meals ahead of time. Lately I’ve taken an idea from The Fat Nutritionist and set an alarm on my phone to remind me to eat lunch. (The man of the house usually puts dinner in front of me, and breakfast I more or less grab automatically.)

It seems both incredibly mundane and incredibly frustrating to me to realize that my life works better with structure. It feels like too much structure to me. I want to be free to do what I want, to be able to make evening plans on the spur of the moment instead of “Oh, dinner’s in the crockpot and will be overdone if I stop for dinner near work.”

But, y’know, I’m over 40. Maybe one of these days I should grow up or something.

What’s Important?

My mother was fat, though she lost weight shortly before she died.  My father, by contrast, was always thin and muscular.  Yes, he drank like the Navy seaman he’d been and smoked 1-2 packs a day, but he was strong and healthy.  He gained some weight when he retired and quit smoking, but not much.  Heck, he’s  lost some in the last few years. Why?

He wasn’t exercising as much.  Turns out he’s anemic.  Why?  Bleeding from a cancerous tumor.  Oh, and he has some short-term memory problems, which means he shouldn’t live alone.

I’ve been spending a fair amount of time in hospitals and nursing homes and doctor’s offices lately.  I keep expecting to hear “Oh, and you should lose weight because ___________” …. but I’m not.

Maybe it’s because I’m not the one who’s sick.

Maybe it’s because the main risk factor for his cancer is smoking, not weight.

Maybe it’s because I don’t have a history of drinking, and he does.

I can say it’s been interesting dealing with the medical profession in a situation where it’s not about my weight.

I can also say this sort of experience can help focus on what’s important to me.  I’ve alluded in the past to not having the world’s best relationship with my parents, but I’m also not willing to just walk away.  Making the time to deal with this has been challenging.  It’s also made me focus on organizing my life to help me stay sane enough to do what needs doing — priorities like

  • The man of the house.
  • Close friends.
  • Work.
  • Eating regularly.
  • Sleep.
  • Exercise.

These are things that help me stay sane and to have the energy to deal with the other stuff.  (Yes, there’s a reason I’ve been posting about managing stress lately.)  Even so, it’s still been getting me down.  About 2 months ago I saw my ARNP with “Hi, here’s what’s going on.”  We determined that yes, I’m having insomnia, anxiety, and depression symptoms.  She started me on ambien (to help me sleep) and celexa (for depression and anxiety).   The ambien helped almost immediately; the celexa, as is usual for SSRIs, took longer to kick in.   I am feeling more able to cope now, which is good.

Has this changed my priorities or my sense of what’s important?  Yes.  And no.  As is common when I’m stressed, I’m more focused on self-care; this has all narrowed my focus, often to just  “what tasks I need to get done today” and “what I need (to take of myself) so I CAN get through today.”   But the things that I most want to do, and that I find most rewarding, haven’t changed.

Thankful Thursday

[An occasional exercise in gratitude.]

At the moment I’m thankful for:

  1. My temp gig is continuing to go fairly well.
  2. My father is doing better.
  3. I got over my “but things can’t get better” thinking and saw my ARNP about my anxiety, insomnia, and depression symptoms.  My ARNP prescribed Celexa (for depression) and Ambien (for insomnia).
  4. Ambien does help me sleep.  Celexa does seem to help my depression.
  5. I am continuing to do other things to take care of myself.
  6. The man of the house loves me.
  7. Our friends are also supportive and helpful.

Overall: my life is not perfect. My life is not terrible.  I am coping — sometimes day by day, sometimes minute by minute, but coping.

How’s y’all?

Things That’s Up

New job is going well.   It’s my first completely non-managerial job in years.  Even when I was a “department of one” I was was still doing a lot of project / process management. I’m enjoying just doing things.

I also like this “getting paid” thing.  ;)

My commute is about an hour each way, sometimes longer, depending on bus connections. This is longer than I’m used to, and I’m glad I get to read or noodle on the computer during the long bus ride.

On the fitness front, I’m adapting well to the daily walking-between-buses routine, even with my backpack weighing 16lbs once I add the work equipment I may need at home.  (I carried a heavier backpack in college, but I was more used to it then.  I’m being careful while I adapt now, and doing more tummy crunches and other core work.)

I’m also focusing on being sure I can do tomorrow what I did today — in other words, I’m totally agreeing with Noël on her recent “go hard or go home” rant.

My work desk situation isn’t perfect from an ergonomic point of view, but I’ve made some adjustments that help (raising the monitor & getting a mouse pad).  I also find getting up and walking around a bit every few hours does wonders.  I’m in a rather large office building, so a trip to the bathroom or to refill my water bottle tends to get the kinks out.

I am also dealing with some family stuff.  My father’s been sick lately, and I finally convinced him to see a doctor, so I’ve been ferrying him to and from various appointments.  I wish he’d been willing to see a doctor before, when I was unemployed, but no.  Le sigh.   I’m also finding that being paid hourly makes me worry less about taking time off than when I salaried.  Interesting…

What is frustrating is that 8 hours of work + lunch + 2 (or more) hours of commute  = more of my day that I’d like.  Meeting the man of the house for dinner and a soccer game at the pub?  Fun.  Also takes up most of my “down” time.  My schedule has also been shifted earlier than I prefer.   The temptation to short myself on sleep is strong in the evening, but I know damn well I won’t be happy (or productive) if I do.

So. Off to sleep.  Be good, y’all.

Some Good Things

Riot Nrrd explains why  judging other people’s health can be inaccurate.

Despite turning my ankle a couple times Monday (and working too much and walking too little these past weeks) I didn’t have problems walking over a mile at the Sounders game Tuesday night :)

Manufacturer's pic of my preferred CPAP mask

My new CPAP mask arrived! Somehow I’d broken the widget that connects the nose piece to the headgear.  I’ve got another mask which is smaller and has fewer breakable parts and drives me NUTS because it vents “down” from my nose, thus sending a steady stream of air ONTO MY BODY to KEEP ME AWAKE.  So once again I got a replacement of my preferred mask.  (Among other features, it vents “up” from my nose.)

Searching this blog tells me this last happened in May 2009.

I find it interesting that I didn’t even try to sleep without my CPAP.  I used the backup mask a few nights and the broken taped-together mask a few nights, but no non-CPAP nights.

Last weekend the man of the house and I spent a night at the Seattle Westin Hotel. We did one of the “romance” packages, with sparkling wine, breakfast in bed, and a late checkout.   I enjoyed it immensely, and I’m really glad we got to do it.

Oh, and the view wasn’t bad either.  The only camera I had was my cell, which wasn’t the best, but it’s a nice memento of the weekend.

Elliott Bay and some of West Seattle

Elliott Bay and some of West Seattle

Sleep-Deprived Teens May Pay A Hefty Price

That’s the title of this piece on Yahoo! news about teens who sleep less eating more fats.  (Eating more fat = the “hefty price”.  Geddit?  Amazing how reporters think nobody’s ever made a fat joke before them.)

In the study, adolescents who slept fewer than eight hours on a weeknight consumed more of their daily calories from fat and fewer calories from carbohydrates than teens who slept eight hours or more. […]

However, the researchers note that their study only shows an association and cannot say for certain whether sleep loss did in fact cause the teens to eat more fatty foods.

The correlation between sleep dep and weight gain has been noted before.  (So’s the correlation between weight gain and stress.  And sleep deprivation is also linked to stress.)   Whether it’s the 2.2% increase in fat intake doing it or not is unclear.

But what had me rolling my eyes was the speculation on why this might be.   Sleep deprivation’s effects on hormones?  Being up longer might provide more time to eat?  The time of day that one is eating might have an effect? Seeking a boost in “reward-seeking behavior”?   I wonder if the researchers ever were sleep-deprived as teens.  I certainly was; I remember the fatigue, falling asleep in class, feeling like I’d never be rested.  I also remember that food would give me energy.  Energy to finish my homework, energy to get through gym class, energy to walk home from school, energy for my after-school cleaning-woman job.  Caffeine was my friend too, but it worked much better with food.

When I was on a diet, of course, I was even more tired—and thus craved food even more.  I’d skip breakfast, have a salad for lunch, and wonder why I was so exhausted at dinnertime.  By college I’d routinely stop for a snack on the way home from work.  Two-packs of Hostess cupcakes; a Twix bar; a single-serving bag of Bugles;  I loved them all, even as I was ashamed of what I then considered binges. (Now that I’ve learned more about eating disorders, I realize that while I might have been “cheating” on my diet, those weren’t binges.)

It’s frustrating, though, that the article doesn’t mention other effects of sleep deprivation: cognitive impairment, increased risk of occupational or automobile accidents, high blood pressure, impaired immune systems — all of which are much more serious to me than being fat.  Or that many teens naturally have a later “sleep phase” than younger kids or adults, which makes it harder for them to get to sleep earlier.   Maybe those weren’t in the press release.

Thankful Thursday

[a not-always-weekly exercise in gratitude]

Not too hot today, so the HVAC system at work going out for most of the day didn’t lead to sweltering….

Helped the man of the house move some equipment that I distinctly remember was really heavy … only it didn’t seem that heavy when I was carrying it tonight. (The dumbbell workouts are paying off!)

Fun time with friends watching the Sounders game.

I’m getting better at cutting back the blackberry canes in our back yard without scratching myself.  (Blackberries are weeds here.)

Getting enough sleep.  :)

Sleep Eating and Fat Dissolvers

On the one hand, I think it’s great that more sleep research is going on and that it’s possible to treat those who become violent in their sleep or who sleepwalk (or drive).  Busting myths can definitely be a good thing (“violence during the night does not signify lurking aggression.”)  Communicating that yes, some people do eat during their sleep, and it doesn’t necessarily signal a daytime eating disorder, will probably make those who do that feel less alone.  I’m certainly happy to treat my sleep apnea with a CPAP instead of a tracheostomy

On the other hand, I’m just wondering who’s going to be the first to decide that sleepeating is why I’m so fat.

And: I always scoffed at the idea that an injection could dissolve fat, but it’s nice to know the FDA (not the most fat-accepting organization) agrees.

What’s Up With You?

Hi y’all. Feel like it’s been a while since I had a real post. So.

  • Still here.
  • Still fat.

What’s changed:

Started walking again. The hip pain I referenced about 10 days ago?  Still here.  Still decreasing, thank heavens, but still here.  I took nearly two weeks off from walking every day.  I have begun doing very short walks again, and have continued to do leg lifts and extra stairs and other strength exercises.   Pro: Knees are fine, hip is improving, going for walks again.  Con: New Year’s resolution didn’t make it past 1 month.   Oh well :)

The music convention 2 weeks ago was notable for lack of knee pain and ease of walking (at least until the bed screwed up my hip).  I also realized, partway through Friday’s setup, that I hadn’t needed to use my inhaler Friday or during Thursday’s carry-lots-of-things mission. I took this to mean my current asthma preventive regime* is working well.   :)

We have decided to not renew our membership at Fitness World, mainly because we haven’t been using it much.  This is probably as much a factor of it’s location as anything else — I have been using the much smaller gym at work, which I think is telling.  The man of the house is both going for walks and walking more at his job (he’s in a hillier part of Seattle).

Spring appears to have come to Seattle.  The roses in our yard have new growth and the neighbor’s rhododendron is in full bloom.  Today the man of the house stooped down to the wildly blooming heather and admonished, “It’s February.”   I don’t think it cared.   Hence my updating the blog banner.

I’ve been getting new clothing catalogs and … I’m really glad I have plenty of clothing already.  How terrible is that?  I’m not seeing much that I would want to wear, much less buy.  (This IS great for my savings account.)  I’m also being a bit crafty — my pants tend to develop wear holes around the pockets first, so I’ve been mending them.

In other crafty news: I’m knitting a dark gray, nearly black, scarf.  The pattern isn’t much (knit first 2 stitches; knit 2 together, yarn over, repeat to 2 stitches from the end of the row; knit last 2 stitches) but I’m having fun.  An advantage to knitting it myself is that I can make it as long as I’d like, to fit my torso and frame. :)

Valentine’s Day was pretty low-key this year.  We went out for a nice seafood dinner (with appetizers and dessert sampler) Thursday, in part because Thursday tends to be a much-less-busy night for going out.   (Practicality wins.)  But we had a nice relaxed weekend, too.

I’ve started doing my taxes with TurboTax, but I’m a little nervous that I haven’t gotten a 1040 booklet in the mail.  Are they not sending them this year?

I routinely feel I’m not getting quite enough sleep during the week.  I’m starting to inch my bedtime earlier again.

How’s with you all?


*Current asthma routine: Advair 250/50 twice a day; Singulair once a day; Allegra once a day; Albuterol inhaler as needed.

Thankful Thursday

[a not-always-weekly exercise in gratitude]

1) Able to slowly and gently dance around the living room this week :)

2) Life expectancy keeps going up.

3) Enjoyable walk today despite the sometimes-rain sometimes-drizzle.  (I picked a shopping area, so I could spend a lot of time inside or under eaves.)

4) How cleaning my bedroom and CPAP mask/hose can make me feel so much better when I wake up.  Yes, my allergies do include dust …

5) Long, warm hugs from the man of the house at the end of a stressful workday.  Or any other time, really :)

Things That Make Me Go “Hm”

With the fall TV season starting, it might be good to think about which TV shows you actually want to watch.  Kate and Marianne point out in Lessons from the Fat-o-Sphere that watching TV encourages you to compare your body to the people on TV – who with very few exceptions are underweight and fat-shaming, or fat-shaming commercials.   I’m not saying you should give up something you love, but you could mute commercials or turn it off if there’s not something on that you do love and gain a bit more time to do things you do want to do.

Based on the The American Time Use Survey comes this widget that lets you see how Americans use their day on average.   Clicking on a category, like Work, gives you more information about it; clicking on a group (employed, unemployed, not in labor force, etc) shows the data just for that group.  I get so lost in this thing ;)   Some examples:

  • The Other Leisure category includes reading for personal interest and playing games, including computer games, and averages about 45 minutes a day.  (I average more.)
  • The Personal Care category also averages 45 minutes a day, and includes showering,  grooming, and “an average of 54 seconds spent on ”personal or private activities,’ like having sex.”
  • Socializing — talking with friends or family or attending parties — averages a little less than 45 minutes  a day.   “Phone calls” with friends and family is a separate category and averages 8 minutes a day.
  • TV and Movies averages 2 hours and 45 minutes, though some of that could be combined with socializing.  For men it’s an average of 3 hours, for women it’s an average of 2:32.
  • Computer Use, which includes surfing and updating blogs (but not computer games) averages 8 minutes a day…which seems really really low to me.  Maybe I’m weird? ;)
  • Household Activities clocks in a 1 hr 46 minutes overall, with women spending more time on it than men (2:11 vs 1:19).

Oh, and with flu coming around again, it appears that data actually supports the notion that getting less sleep impairs the immune system.

Side Benefits to Exercise

…and I’m not saying anyone has to exercise.   Goodness knows a lot of the “Exercise Shoulds” do nothing but spoil the party.  But as I’ve tried to let go of the Shoulds and exercise for my own reasons, I’m discovering some things I didn’t expect.

  • I’m generally sleeping better.
  • Less low back pain.
  • Walking or aerobics tends to get rid of my nervous energy; I find weight lifting and yoga both help me meditate.  Both cause stress to dissipate.
  • I often get semi-“alone time” with some favorite tunes.
  • I usually have a warm, relaxed feeling after a workout.

My muscles get warmed up and feel happier, though I wouldn’t call it a “runner’s high”.  Perhaps that’s because I’m not a runner.  Or, to quote someone who was a runner and eventually a racewalker:

I’d spent the previous two decades ingesting various mood-altering substances, and I damn well knew what it was to be high, and that you couldn’t manage it by running around in circles.

Lawrence Block wrote that in his engaging memoir Step by Step. I certainly don’t have grounds to disagree with the man.  :)

I also want to note that feeling good when exercising is only something I’ve found when I’m choosing to exercise, myself — not when I’ve been pushed to exercise (by teachers, by parents, by other relatives).   Let’s face it, it’s hard to feel GOOD when you’re feeling BAD about not losing weight.  If your emotions are on overload you may not necessarily notice how your body feels when moving around.

What about you?  If you choose to exercise, do you find yourself reaping benefits you didn’t expect?

Fun with Breathing

Manufacturer's pic of my CPAP mask    
Manufacturer’s pic of my CPAP mask

Sunday night (and Monday morning) I kept waking up due to my CPAP mask blowing a stream of cold air on my lip.   I thought it was perhaps an inadequate seal between the rubbery “nasal pillows” and my nostrils, but futzed around and eventually got back to sleep. 
 
Monday night as I took my book to bed, I put my mask on, turned on the CPAP…and discovered yes, a steady stream of air blowing on my lip.  I tried my usual adjustment tricks, no dice.  But in feeling around to see where the air was coming from (and helped by the fact that I was much more awake than previously) I realized it was coming from just below where the rubbery nasal pieces connect. 

In fact: There’s a wee crack in the hard plastic of the nose piece.  

A wee crack in what the man of the house pointed out was an eminently duct-tapable hard plastic surface….  

I slept much better last night.  Yay duct tape!   


My geek side wants to add that it’s very appropriate to use duct tape on Star Wars Day since it has a light side and a dark side and it binds the universe together.   *boom-tish*


 

Not that I won’t be getting a new mask.  But I can shop around online instead of paying OMG prices at the sleep doctor’s office.  In other health-related stuff:
 

  • I often go days, nay, a week without my right knee hating me.  Once it loosened up from the car ride it had no problems with sloped aisles at the Seattle Rep or  at Safeco Field last weekend.  (My hips even cleared the box seats!)   This is mainly because I have been exercising enough to keep my knee happy …
  • But not enough that walking a mile is easy.  This makes walking with someone else tiresome, since my pace is usually slower.   I’m not sure how much of this is due to …
  • My allergies kicking my ass.  I’ve doubled up on my “one a day” antihistamines and using my inhaler once or twice a day and still can’t take a deep breath half the time. 

So I have an appointment with my ARNP to talk about more asthma-treatment options.   I’m a little worried that I’ll just be told to lose weight, but given my previous experience I don’t really expect it.  :)