Dr. Shane Speights

01/06/2026

Flu and You Update 1/5/26

Data released from the CDC today shows a national spike in flu cases of 33% compared to last week. That’s a big jump. We are on a steep increase in the number of flu cases across the U.S. and have not seen it this high in over 10 years………. it’s everywhere.

Hospitalizations from the flu are also up 31% compared to last week. Children between the ages of 5-17 have the highest reported number of cases followed by those aged 0-4. Adults over 65 are actually the smallest group, but are at a really high risk of complications including hospitalization.

Arkansas is still reporting “very high” cases of influenza-like-illnesses (ILI) and I suspect this will continue for several weeks. In addition to flu, RSV has also been an issue in the state according to our Children’s Hospitals.

We can expect all these numbers will go higher now that the holiday travel period has passed and people are getting back to work and school.

As I’ve mentioned in other posts, the cause of this bad flu season is the H3N2 Subclade K variant (90% of flu cases). It’s a genetic variant that surfaced over the summer, after we started producing our current flu vaccine. The current flu vaccine is not a match for this variant, but still offers some protection from hospitalization and death.

If the flu vaccine is not a match then how does it help, and why would I still take it?

Your body is uber smart. Like really. We know a lot about how the body works, but we don’t know jack in terms of how it really works. We’re still learning. One of the things we have discovered is how your body responds to a vaccine, or foreign invader. You already know that your body creates memory cells to that invader, or vaccine particle. However, what we found out is that your super smart body also creates some memory cells to genetic variants of that invader or vaccine particle. Your body actually thinks ahead that there might be a genetic change! That’s way cool, and a pretty good design if you ask me. So, get a flu shot. Your smart body will figure it out and still provide you some protection.

Whatever you do, absolutely get your kids vaccinated. This flu strain is hitting them hard this year. We are seeing pediatric hospitalizations across Arkansas, and the country, going up. With schools in Arkansas starting back this week, we can expect that will get worse.

When will this flu season peak?

Not really sure at this point, but best guess from what I have read is sometime in early February. There are so many factors involved that it can be hard to predict with any accuracy.

If you get the flu Xofluza still seems to be helping, and there are no reports of resistance to any of the current flu medications.

Hope this helps. Stay safe.

https://www.cdc.gov/fluview/surveillance/2025-week-52.html

https://healthy.arkansas.gov/wp-content/uploads/Viral-Respiratory-Diseases-Weekly-Report-Week-Ending-Saturday-December-27-2025.pdf

Seasonal influenza activity is low.

01/03/2026

Mental Wellness

Are you running your life, or is your life running you?

As I stated in my first post, it’s really not your imagination, you are busier now than you were in the past, and the number of things you are juggling has increased significantly. Some of it is just part of the world, and the time, we live in. But some of it is from our own doing in not taking care of what’s important…….you. You can’t be a good wife, husband, parent, boss, employee, friend, caregiver, etc. if you don’t take care of yourself first. When it comes to your health and wellness, be selfish.

Approximately 20% of Americans will have clinical depression sometime during their lifetime. From August 2020 to February 2021, between 36-41% of adults in the U.S. reported feelings of anxiety or depression. Recognizing that we were in the middle of a pandemic, I’m surprised the numbers weren’t higher. However, those statics were based on survey data, and we’re not the most honest group when it comes to our mental health. Nationally, almost 20% of visits to see a physician have an underlying mental health component. I suspect that number is actually much higher. In my own practice I would guess it’s closer to 30%. Which brings me to my first point.

Everybody needs a therapist. Seriously. Some people need to see one once a week, some once a month, and some just once a year, but everybody needs to see one. You need a neutral third party (not a friend, spouse, family member, etc.) that’s going to listen to you, and offer honest feedback. Someone that can validate your feelings, but also tell you things you may not want to hear. Finding a therapist that you “click” with can be difficult. I tell my patients that finding a therapist is like trying on shoes. Not every pair will fit, just keep trying different ones. But remember, just because one pair doesn’t fit doesn’t mean you don’t need shoes…….

The longer you live, the more likely you are to have an accumulation of unresolved, unprocessed mental trauma. Humans are really good at putting traumatic events into a box, and putting it up on a shelf. It’s a defense mechanism so we can go on with our lives. However, over time that shelf can get full of boxes, and eventually break, which results in various responses. Relationship issues, anger, depression, anxiety, problems sleeping, addiction….. the list is long. No one is immune from it, but people that interact with the public on a daily basis have higher rates of depression, and are really good at “shelving things”. As you might expect, the medical profession, police, fire, EMS, 911, and the military, but also food services, personal care services and those in entertainment. As a society we have done a bad job of recognizing mental health. In fact, it’s historically been looked at as a weakness to even talk about, especially among men.

Untreated depression or anxiety, can have a significant effect on our overall wellness. Moderate to severe depression, that isn’t treated, almost doubles the risk of all-cause mortality (dying from any reason) from 5.62 to 9.48 per 1,000-person years. Most of the issues are related to an increase in cardiovascular disease (a 40-50% increase) and death.

Here’s how it works. Depression, anxiety, and/or stress set up a chronic state of hormonal imbalance (mismatches in serotonin, dopamine, norepinephrine, and cortisol) that physically affect our entire body system (called allostatic load) from cognition and memory, to routine organ growth and repair. Remember, hormones are part of the signaling system in the human body that tells it how to perform routine functions, and how to respond to external stimuli. When those hormones are out of balance, the whole system gets affected. This is why you can physically feel bad when stressed.

Not managing stress, in particular, can lead to early decline in cognition, increased risk of heart disease, disruption of immune system function and it can actually accelerate aging (shortening of the telomeres in your genetic code). In terms of cognition, during periods of stress cortisol hormone levels are increased. Over time, that constant increase affects the brain and causes cognitive decline and dementia. We’ve seen this time and time again in people that live in wartime settings, but now we’re seeing that it can happen with things we read, watch on TV, or see on social media (I’ll come back to this one).

The Blue People……. not the ones you’re thinking of in Vegas (great show if you get a chance to see it).

When we look at community clusters of people that live up into their 90’s and 100’s (i.e. Blue Zones), there are some commonalities we see. No surprise to you at this point, diet and activity are big factors, but equally important is the community they live in. These groups don’t just focus on diet, or their activity. They put an emphasis on the connections to others around them (friends and family). It’s a wholistic approach that includes attention to the body, mind, and spirit (a core principle of osteopathic medicine). Humans are communal by nature. We like being around other people, and there is evidence that our happy hormones (dopamine and serotonin) increase in social settings. We also know that isolation is a risk factor for dementia and cognitive decline.

Does having a “Purpose Driven Life” make a difference?

We actually have data on this. There was a systematic review and meta-analysis of 37 different research studies in adults aged 50 or older that found that having a “meaning in life” or “purpose in life” was cross-sectionally associated with better performance on verbal fluency and memory. Positive affects also correlated with global cognitive scores (overall cognition), suggesting that having a purpose in life can support cognitive/mental health.

Do people of religion/faith have better mental wellness?

Generally speaking, “yes”. However, the devil is in the details (pun intended). Having religious or spiritual beliefs is associated with lower rates of depression, anxiety, su***de and substance abuse (especially among teenagers). There is also data on improved quality of life, and faster recovery from depressive episodes. (APA 2021, JAMA 2022). Specifically, regular attendance to religious services has the most correlation with positive outcomes linking a 27% reduction in all-cause mortality (dying from any cause) and a 33% reduction in depressive episodes. That’s pretty impressive. You actually do get points for showing up!

Now for the “devil”. Faith can also have a negative effect on mental wellness. Especially if it leads to shaming, isolation and patterns of abuse within a religious sect. There are tons of examples where religion went awry because of a few bad actors, and I'm not being dismissive of the gravity of those groups, but don’t throw out the baby with the bathwater.

Overall, having a positive connection to faith can be a plus for your mental wellness.

https://jamanetwork.com/journals/jama/article-abstract/2794049?utm_source=openevidence&utm_medium=referral

Social Media

It’s no secret that companies, politicians and influencers have wanted our attention for decades, but social media opened a new door for literally anyone to reach anyone and, as expected, it has been abused. There are a lot of factors to consider when looking at the actual effect social media has had on mental health. For example, teenagers spending more than 3 hours a day on social media have a much higher risk for depression and anxiety compared to those who don’t. Passive (doom) scrolling has a negative effect on mental health, but direct texting can enhance social connections. Cyberbullying, shaming, embarrassing AI generated videos/photos all add to the negative effects social media has on our mental state, but reconnecting with a colleague from high school or college can be positive.

Just by design social media platforms reduce your ability to have empathy. We’re human. We rely on facial cues, vocal tone, body language and a host of other interactions to communicate. Social media removes that, but the big issue seems to be the computer algorithms that track our viewing, and “feed” us content. Unfortunately, that “fed” content taps into our emotions, and changes how we see the world. Suddenly, finding out that a friend or family member “liked” something we disagree with creates a divide in our relationship. We then, fed by our algorithm, find other reasons to disagree and before you know it you’re estranged from that person without ever having a conversation. Strangely, in today’s world, negativity sells. That means you have to fight against it. In a study looking at how, and why, posts are shared, it found that a negative political post about the “out-group” (the other guy, who’s an idiot) was 67% more likely to be shared compared to any other post, and it was found to be almost 7 times stronger versus content that had a moral basis. (Nat. Acad. Sciences 2021). Between the ability to be anonymous, that it’s not real-time communication, the computer algorithm that amplifies negative posts and that the human brain is inherently lazy (it searches for the fastest answer, regardless of accuracy, and then moves on), it’s no wonder we’re so divided.

As a skeptical optimist, my advice – find the positive and break your algorithm. Follow content, watch channels and seek out opinions that you don’t inherently agree with. It will be uncomfortable (which is why most people don’t do it and the Catholic Church created a position around it - “Devil’s Advocate”), but I suspect you’ll find the same thing I did. The truth seems to always be somewhere in the middle.

https://mhanational.org/resources/31-tips-to-boost-your-mental-health/

2. Spend some time in nature today. Whether it’s taking a walk, smelling the flowers, or sitting by a tree, nature can make you feel calmer.

12/30/2025

Flu update (new data just in from the CDC today – 12/30/25)

Across the country we’ve seen a 25% increase in flu cases with about 20 states reporting high (or very high) cases of influenza. Louisiana is getting hammered with about 7% of all ER visits across the state being related to flu symptoms. The Arkansas Department of Health is currently reporting “very high” cases of influenza for our state. Hospitalizations from the flu are also going up with the two largest groups being those over the age of 65, and those younger than 18 (the numbers in children are really high). The only “good” thing is that schools are out for the holidays so the spread has been somewhat blunted, but that will change starting next week. Be prepared for that.

For the United States, the CDC is reporting that 92% of the influenza cases are “type A”, and that about 90% or more of those cases are the H3N2 (subclade K) variant – this is new variant that hit our radar over the summer and caused bad flu cases across Europe and Canada. We were hoping we wouldn’t see it, but it’s here. As a reminder, H3N2 is a tough strain of flu on its own, but this new strain is worse.

The CDC estimates the U.S. has seen about 7.5 million flu cases so far with 81,000 hospitalizations and 3,100 deaths.

Does the current flu vaccine work? Can I still get it?

Yeah but....... let me start by saying that, in prior years, even when the circulating flu strain didn’t match the vaccine, the flu vaccine still offered some protection from hospitalization and death. With this new flu variant everyone wants to know if the vaccine will help.

Because it’s a variant, that means it has genetically changed from the original, it will not be a match for our current flu vaccines (that were manufactured back in the spring of 2025). Ok, so it’s not a match, then how well does it work? The frustrating thing is, we don’t really know. We calculate vaccine effectiveness after the season has ended. That’s really the only way to have reliable data.

However, we can look at other places that have already had this H3N2 subclade K variant and see what their data says…… Europe.

The preliminary data from Europe is saying that the current flu vaccine is about 50% effective in preventing hospitalization or death. Honestly, that’s better than I expected based on the genetic changes of the virus. Bottomline, get a flu shot. It’s not too late and it’s better than nothing.

Do the anti-flu medications work?

The current CDC information says that the approved medications (Oseltamivir, Peramivir, Zanamivir, Baloxavir) for influenza are not showing any resistance to current strains of flu. However, in terms of how effective they are, I will mention a study that came out in JAMA Internal Medicine in January of 2025.

It looked at 73 randomized controlled trials from 1971 to 2023, the results were less than positive. It said Oseltamivir (Tamiflu) and Zanamivir (Relenza) had little to no effect on symptom duration, hospitalization or mortality. Peramivir (Rapivab) had little to no effect on symptom duration and mortality rate, but no data on hospitalizations. However, Baloxavir (Xofluza) was the only one that had some evidence of making a difference. If you really need it, and get a choice (and can afford it) go with that one.

Does the flu vaccine give you the flu?

No. It doesn’t. Remember, the flu vaccine is not a live virus, there is no flu virus in the vaccine. It’s just “pieces” of the virus. It’s like saying you can drive a car engine to work. You can’t, the engine is not the whole car. It’s just a part of the car, and it doesn’t work by itself. Here are the two most common reasons people believe that the flu vaccine gives them the flu:

1. When you get vaccinated your body responds by creating memory cells of the virus, that “response” causes your body to get all amped up and mad at this foreign invader (the vaccine). That’s what you want to happen, that means the vaccine is working. Feeling achy or a little under the weather for 24-48 hours after the vaccine is common, but it shouldn’t be a full-on illness. You just may feel meh.

2. You already had the flu when you got the vaccine (or soon after) and you didn’t know it. This is surprisingly more common than expected. You’re at some social gathering or family event and someone is sick. Seeing that person cough and sneeze reminds you that you need to go get a flu shot (you’re too late). You go to the clinic a day or two later and get the flu shot, then the next day…..BAM. You’re sick in bed. Stupid flu shot. I’m never doing that again.

What actually happened: It can take 24-72 hours for you to start having symptoms after you get infected with the flu. You got sick at the social gathering and didn’t know it. That flu shot didn’t give you the flu any more than brushing your teeth did.

Also, remember that it can take about 10-14 days for the vaccine to be fully effective once you get it. You can absolutely still get the flu during that period. That’s why we recommend getting a flu shot before the flu season starts. How long does the flu vaccine last? Current data says you’ll have protection for about 4-5 months depending on your immune status (aka how healthy you are).

What else can I do if I get sick?

Homemade chicken soup (noodle or rice). Seriously. There is data that supports its ability to boost immune function. Specifically, those soups containing celery, carrots, chicken, bone broth, garlic, etc., and homemade is better than store bought. It’s not a cure, but it helps.

Stay hydrated. Water is preferred. Stay away from energy drinks and sodas. Your body sucks up a ton of water when it's fighting off an illness.

Stay active. Try not to lay around too much. Even if it’s just walking around the house, you need to keep up some type of movement. If you workout regularly, and still feel up to it, you need to cut it in half. It’s a balance, activity is good but your body needs rest to fight off the infection and heal itself.

Sleep. Big deal here. Try not to get too off schedule with your sleeping. You don’t want to get your days and nights mixed up. Keep the blinds open and shades up (vitamin D). If you have a lot of sinus drainage, you can raise your head at night with a couple of pillows.

I’m not opposed to some of the over-the-counter medications for symptom relief. Mucinex (or the generic) has pretty good data behind it, and ibuprofen for the muscle and body aches. Not a fan of supplements (remember, they are basically unregulated and untested, so there’s no telling what’s really in there). If you’re not eating much, a multi-vitamin is not a bad idea, but get a brand you trust and remember that a vitamin is no substitute for the real thing (e.g. an orange).

Seek medical attention for worsening or trouble breathing, chest pain, or changes in mental status.

Good luck.

https://www.ecdc.europa.eu/en/news-events/early-estimates-seasonal-influenza-vaccine-effectiveness-against-influenza-requiring

https://www.cdc.gov/fluview/surveillance/2025-week-51.html

Seasonal influenza activity is low.

12/14/2025

Sleep, it’s a thing. Don’t ignore it.

As a country we don’t get good sleep, and unfortunately it seems to be getting worse. There are lots of reasons we’re not sleeping well including chronic diseases, work schedules, partner snoring (sorry sweetheart), etc., but the biggest reason seems to be stress (financial, social, political, personal, etc.).

Sleep affects everything. Are you having trouble losing weight despite diet and exercise? It could be your sleep cycle, seriously.
Very little was really known, or taught, about the impact of sleep when I attended medical school. However, over the last ten years we have really seen a large amount of research come out about how much our sleep (or lack of it) affects everything from weight loss to our ability to fight cancer.

A lot of people struggle with getting quality sleep, specifically deep sleep. In June of 2025, an article came out that looked at 79 different scientific studies on sleep. It found that getting less than seven hours of sleep a night was related to a 14% increase in all-cause mortality (death for any reason) and that sleeping more than nine hours per night was associated with a 34% increase risk of all-cause mortality. You need between 7-9 hours of sleep each night with the “sweet spot” being 8 hours. Less than 5-6 hours per night, or more than 10 hours per night significantly increases the risk of pre-mature death (death before the age of 75).

Per the CDC, about a third of the U.S. population gets less than seven hours a night of sleep (too little), and an estimated 3-8% of the population are “long sleepers”, meaning they sleep longer than 9 hours a night (too much).

https://pubmed.ncbi.nlm.nih.gov/40072785/

Is all sleep the same? Nope. Let’s look at a breakdown of the two different phases of sleep – Non-REM and REM (rapid eye movement). You actually cycle through those two phases throughout the night. A cycle starts over about every 80-100 minutes, and you go through anywhere from 4-6 cycles in a given night.

- Non-REM has three separate stages.
Stage 1 (N1) – when you’re falling asleep (shortest period)
Stage 2 (N2) – when you’re asleep, light sleep (longest period)
Stage 3 (N3) – Deep sleep; this is where body repair occurs (critical to your health)
- REM Sleep – usually dreaming occurs in REM sleep, muscles are limp (so you don’t act out your dreams – sleep paralysis also occurs here).
- Your circadian rhythm is your body’s natural sleep/wake cycle. Everyone is a little different.

- https://www.sleepfoundation.org/stages-of-sleep
- https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep #:~:text=Email%20Print,from%20acting%20out%20your%20dreams.

What happens if I don’t get good sleep?

As I mentioned earlier, we’re now seeing more and more research that ties disease to poor sleep. Specifically:
- Increases in the risk of obesity, high blood pressure, type 2 diabetes, stroke, coronary heart disease, accelerated brain aging (visible on MRI), aortic stenosis, cognitive decline/early dementia, gastrointestinal issues (via the gut-brain interaction), atrial fibrillation, and fatty liver disease just to name a few.

Gut-brain? Have I mentioned that despite everything we know, we still don’t know jack about how the body really works? Like how one system affects another, and how a change in one area causes an issue with a totally separate area of the body? Here’s some quick news on that. Researchers looked at gut bacteria of people with insomnia and found that there are 14 different bacteria that are linked to an increased risk of having insomnia, they also found 8 bacteria that were linked to a decreased risk of having insomnia. In total, they found 41 different gut bacteria that have some effect or association with sleep. Remember, your gut bacteria can change, and are highly dependent on what you ingest (food, drink, medicines, supplements, etc.). Just one more reason to maintain a healthy diet.

https://gpsych.bmj.com/content/38/4/e101855

- Poor sleep is absolutely tied to our overall mental health, and can worsen depression and anxiety symptoms. Unfortunately, it can catch up to you. A study in the journal Nature found that people that had regular, interrupted sleep in their 30’s and 40’s were more than twice as likely to have problems with memory and cognition 10 years later. Booooooo.

- This one is very interesting; a single night of bad sleep actually impacts the composition of your blood. In a small study of 8 women, researchers looked at their blood after they only got 6 hours of sleep a night. They found changes in 66 different proteins that negatively affect the blood’s clotting system, cholesterol synthesis and immune function (specifically wound healing). More studies still need to be done, but that is fascinating.

So, how do you get better sleep?

Sleep hygiene is a really important place to start. You have to set yourself up to have good sleep.

- Pitch dark room, no ambient light. Your brain doesn’t “turn off” completely when you sleep, the hypothalamus is monitoring your surroundings for you (that’s why you wake up at that “bump” in the middle of the night). Having light shine into your room can keep that alert center engaged and upset your sleep cycle. There is also new evidence that ambient light can increase the risk of atrial fibrillation (the most common heart arrhythmia).

- Cold (like really cold – low 60’s); you shouldn’t be physically cold, but the room should be.

- Don’t use any electronic device 45 minutes before bed. As I said previously, your brain is not like a light switch, you can’t just turn it off at the end of the day. It needs time to wind down. How long? At this point we believe that you need around 45 minutes of downtime before going to bed. That’s no screens (iPad, cell phone, TV, or whatever digital screen is keeping your emotions and cortisol levels up – the same goes for reading an action packed or stress provoking book/article).

- Don’t eat, read, watch TV in bed. Remember, your brain (and your body) craves a regular schedule. This sounds weird, but your brain needs to know that when you get into bed, it’s time to go to sleep.

- If you have to get up and p*e in the middle of the night, stop drinking any liquids after your evening meal. If you continue to get up to p*e after making that change, go see your doctor.

- Your diet affects sleep. For realsies……
In a small study, 34 people were assigned different diets, and then wore a wrist monitor to gauge how it affected their sleep. Those that ate more fruits and vegetables during the day had fewer nighttime disruptions in sleep. (Reason #5,821 to eat more fruits & vegetables)

https://www.sleephealthjournal.org/article/S2352-7218(25)00089-0/abstract

- No caffeine after 3:00 p.m., for some people you shouldn’t have it past noon. Remember, the half-life (how long it takes your body to break down ½ of the drug) of caffeine is about 6 hours (varies from 2-12 hours). You don’t need caffeine in your system or it will delay your ability to hit REM sleep and makes it harder to get deep sleep.

- Exercise. It improves your sleep quality. Most people do better when they exercise in the morning, but some do better in the evening. There’s not a right or wrong answer on when to workout, Just Do It (pun intended, unfortunately no Nike endorsements to date….).

What about sleeping supplements?

Short answer – most don’t work, and can actually worsen your overall health. Even they help you fall asleep, they are probably interrupting your natural circadian rhythm (that’s why you may still wake up tired or get fatigued during the day).

Melatonin

Short version - Don’t take it, and don’t give it to your kids. If you’re on it, find a way to get off it.

What is it? It’s a hormone that is naturally produced by your body (from the pineal gland) which helps you go to sleep, and stay asleep. Hey! Let’s just turn it into a pill (by synthetically creating it in a lab or from yeast/bacteria) and take it!.....Meh, not so fast. As is typical with most things, it doesn’t always work out when we do that.

Big study on Melatonin.
Here’s the deal. Melatonin slipped through the cracks in terms of federal oversight. They got labeled as a “food” which means they don’t have to really test their product, and they can pretty much mislead you without worrying about getting their hand slapped.

In April of 2023 a JAMA study looked at 25 different melatonin gummy products found on the shelf of your local pharmacy. NONE of them had the advertised amount of melatonin they claimed to have. None…… like nada, zero, goose egg. They either had more (one had up to 347% more than what was listed on the label) or much less. One claimed to have 5mg of melatonin, but had none. However, it did have 31 mg of CBD….. This is another reminder about vitamins, supplements, herbals, etc. The federal government (FDA) considers them “food” and they are not required to go through the testing your aspirin and Tylenol do. There is no guarantee you’re getting what’s listed on the bottle. How can you tell? If the back of the label says “Serving Size” then it’s a supplement (food).

https://jamanetwork.com/journals/jama/fullarticle/2804077?guestAccessKey=f66dce36-77ca-4bdc-a6bc-4978d8a66ed2&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042523

Newly found association with heart failure - Study of 130,000 adults with half of them taking melatonin and half not; after taking other factors into consideration (age, gender, race, other cardiac risk factors, etc.), the melatonin users were 3.5 times more likely to be admitted to the hospital for heart failure.

The American Academy of Sleep Medicine (the experts in sleep medicine) advises against the use of melatonin for sleep. https://pubmed.ncbi.nlm.nih.gov/27998379/

“Bitter Cherry Juice”?

Sweet and tart cherries actually contain a natural form of melatonin (and tryptophan). There was a review of six studies that seemed to show some positive outcomes in terms of helping with getting to sleep, and staying asleep. The quality of the studies varied from fair to good, but there’s a catch…… You’d have to eat like 50 pounds of cherries to get the effect. That means you’re stuck in the supplement isle trusting some big company that’s trying to make a buck. Cherry juice might be an option to try. I’d trust it over a supplement version.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12438961/ #:~:text=Also%2C%20the%20anthocyanins%20in%20this,2018).

Diphenhydramine (Benadryl)

This one has been popular for a while, but new evidence has emerged on its harms. It absolutely makes you sleepy. It works by blocking histamine (H1 and H2 receptors) which interferes with the pathways in your brain that cause stimulation (wakefulness).

Here’s the issue. Long term use of diphenhydramine is linked to higher rates of dementia and memory loss. It can also worsen heart arrhythmias, especially atrial fibrillation.

This one is also not recommended by the American Academy of Sleep Medicine.

https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-to-increased-dementia-risk-20150128812

Magnesium?

There’s not a lot of data on the use of magnesium to help with sleep, but that hasn’t stopped us before. It’s a mineral, important to your body, that many have used with some success in helping with insomnia.

A double-blind study of 46 adults where half took 500 mg of magnesium, and half were given a sugar pill showed that the magnesium group had a little better improvement in sleep compared to the sugar pill group, but the difference wasn’t huge.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3703169/ #:~:text=No%20significant%20differences%20were%20observed,serum%20cortisol%2C%20in%20elderly%20people.

In 2021 there was a review of 3 studies, with a total of 151 people, that showed a possible link to improved sleep in older adults. Another review of 9 studies with 7,582 people produced mixed results, with some showing a positive effect and others showing no effect. The quality of the studies was low.

Magnesium-L-threonate seems to be the popular form. What is it? They took magnesium and chemically bonded to L-Threonate. That supposedly allows the magnesium to move into the brain, and theoretically increases its impact. Not sure if that’s really true, but there have been a couple of studies that showed a positive outcome. Nothing that convinces me to recommend it at this point.

The American Academy of Sleep Medicine has no position on the use of magnesium for use as a sleep aid. They state that there is not enough data to say one way or another.

Bottomline, you probably won’t hurt yourself by trying it, but buyer beware. We really need larger, randomized controlled trials to figure out if there truly is a benefit, and who really benefits at what dose.

Here are some “viral” sleep aids that aren’t a good idea: inhaling aerosols or essential oils, “sleepy girl Mocktails”, CBD, “bed rotting”, or mouth taping…….. you can’t make this stuff up.

Sleep Apnea, is it really a big deal?

Untreated sleep apnea can be a killer, seriously. Basically, what happens is that you stop breathing (aka no oxygen to the brain) throughout the night while sleeping. The low oxygen level triggers your brain to wake up, and breathe. (Otherwise your first episode of sleep apnea would be your last.) In addition to interfering with getting quality sleep, that constant “low oxygen to the brain” cycle throughout the night is really bad for you. Luckily there are treatments that can make a big difference. I’m really intrigued by the new implantable devices that stimulate you to body to keep your airway open while sleeping.

Sleep apnea increases the risk of Parkinson Disease
I see the connection, but it was still a surprise to read this one. A new study of 11 million veterans found an association with sleep apnea and the development of Parkinson disease. Apparently, the low oxygen episodes during the night can be a risk factor for Parkinson Disease.

https://jamanetwork.com/journals/jamaneurology/article-abstract/2841763?&utm_source=BulletinHealthCare&utm_medium=email&utm_term=112525&utm_content=MEMBER&utm_campaign=article_alert-morning_rounds_daily&utm_uid=3535069&utm_effort=DAMR01

Brain bleeds?
Another surprising study that’s worth mentioning. In this paper, 1441 adults with sleep apnea were run through a MRI machine. Those that were diagnosed with moderate to severe sleep apnea had almost a 4-fold higher incidence of small bleeding in the brain that was detected by the MRI. From what I can tell in the article, none of them had stroke-like symptoms, but you have to wonder if this is the reason behind the associated stroke risk for sleep apnea patients. Untreated sleep apnea increases the risk of stroke by 2-4 times compared to those who don’t have it.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2840617

Sleep loss. Can’t I just catch-up on the weekends?

Yes, and No. Again, staying on a schedule for your body is really important. That includes weekends, holidays and vacations. We all want to sleep in during those times, but it’s not really a good idea if you can help it.

For the most part, if you stay up later than normal one night, your body will want to catch up on that missed sleep the next morning, or the next day. That should seem pretty obvious. However, your body can’t “wait” forever and catch up on accumulated missed sleep. That sleep is just lost, and the damage is done. There is a study that looked at 91,00 people and found that sleeping in on the weekends can help you catch up on some of that sleep, and reduce your risk of heart disease by about 20% (European Society of Cardiology). That being said, the extra hour of sleep on the weekends is not a bad idea.

I work at night, what do I do?

If you work at night, you are underpaid. I don’t care what you’re getting, it’s not enough. I know that we live in a 24-hour world that requires it (ER, Police, Fire, EMS, factories, construction, etc.), and that some people actually prefer working at night, but it’s absolutely not good for your health.

As we look at the data on night workers, we see that, depending on how many years they perform night work (seems to really go up after 5 years), they average 15 years of lost life.

Tips for those keeping the world going at night.

Ensuring that when you sleep, you get quality sleep is the best advice. Complete covering of the windows to prevent any sunlight, keeping your room cold, etc. You certainly need to ensure you’re hitting the other big three – good diet, regular exercise, attention to mental wellness. Don’t forget vitamin D – an important vitamin for overall health, humans get most of their needed vitamin D by absorption through the skin from the sun (hmmm……getting energy/power from the sun to make us stronger….sounds like a “super” movie plot).

What about taking naps?

Naps are good, but too many, and too long, are bad.

Taking a nap allows you to get a quick rest and recharge to continue your day, and can be really beneficial. However, naps lasting longer than 45 minutes, or going beyond two per day have been linked to poorer health outcomes.

Should you track your sleep?

Yes. I’m actually a fan of the fitness trackers that includes tracking your sleep at night. There are lots of these on the market, and they all have different features, but having something that can monitor your heartrate, number of steps taken per day, oxygen saturation and sleep can be really helpful in giving you direction on where to focus for better health outcomes.

One word of caution. Don’t go crazy with it. You can get consumed by looking at that data and start obsessing over the numbers. You should be more interested in long-term trends. Looking at your health status over weeks, months and even years will give you a better picture of your overall health and areas you can work on. Generally speaking, quick changes are usually not sustainable, and rarely contribute to long term health benefits. Slow, consistent, intentional changes are the way to go.

Still awake after reading this?

Don’t forget, sleep is just as important and diet and exercise. I know it’s not as glamourous to talk about, but you can’t choose one area over the another. You have to commit to being mindful of all four – diet, activity, sleep and mental wellness. Next up…….mental wellness.

https://aasm.org/