Orange glasses improve sleep

Over the last few years my sleep can go through bad patches and during these times I can have difficulty falling asleep or wake through the night. I no longer feel stressed by this as I once did and I have done much to improve my sleep however I am always interested in research about improving sleep quantity and quality. So as someone that can be found on my ipad watching SBS Nordic Noir of an evening I read this recent trial published in Ophthalmic & Physiological Optics with interest.

The study followed 22 people between the ages of 17 and 42. For 2 weeks the participants wore blue light blocking glasses for 3 hours before bed while participating in usual digital screen activities (TV, phone, tablet or other). The outcomes were significant and showed an average of 58% increase in melatonin levels, an effect that is greater than over the counter melatonin supplements. Melatonin is our key sleep hormone and it signals to our bodies when it is time to sleep. During the trial the participants reported better sleep, decreased sleep latency (faster sleep onset) and increased sleep duration of up to 24 minutes per night.

Blue light exposure comes from sunlight and LED devices. Exposure during the day is healthy as it boosts alertness and regulates our internal body clock (circadian rhythm) essentially telling us when to sleep and when to wake. However artificial blue light exposure at night has been shown to reduce sleep quality and quantity, as well as the regenerative quality of sleep. Artificial blue light activates photoreceptors in the brain which suppress melatonin, which is ideal during the day but at night impacts on our sleep regulation. Less melatonin is produced or it is produced later in the evening, which in the short term means we get reduced sleep signals or get them later in the evening and in the long term can disrupt sleep and wake cycles.

Based on this study I am participating in my own clinical trial with an ‘n’ of 1 (n = 1 means there is only one person in the trial so this is a bit of a nerdy research joke). A very un-cool pair of orange glasses arrived in the mail and I have been wearing them as per the trial over the last week. They look particularly good over my reading glasses! The first few nights of wearing them I was feeling sleepy up to an hour earlier than usual. Time will tell if they are effective in the long term but when I give into the sleep signals I am getting to sleep earlier and thus sleeping longer overnight. So far so good. I think orange glasses may just become de rigueur in my household!

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Black Seed Oil – the skin wunderkind

nigellaCorticosteroids are a cornerstone of topical treatment in most inflammatory skin conditions. However, this treatment comes with the potential for significant risk including thinning of the skin, development of spider veins and suppression of normal stress responses via the hypothalamic-pituitary-adrenal axis. So recently when a client of mine (thank you!) sent through a study outlining the use of Nigella sativa seed oil (Black seed oil) on psoriasis-like lesions I was thrilled. I then went searching for other reports of its use for similar conditions and came up with lots of research with great potential.

Black seed oil is native to Asia and has been used traditionally in the Middle East and Southeast Asia as a topical and oral herbal medicine. Studies on Black seed oil have showed that it has a wide range of potentially therapeutic effects: immune-stimulatory, anti-inflammatory, antimicrobial and antioxidant. Even more significant, the specific potential of Black seed oil with regard to skin health is extensive:

  • Anti-microbial – studies have shown Black seed oil to be anti-microbial against a wide range of microbes, particularly multiple-antibiotic resistant bacteria (Staphylococcus aureas, pseudomonas and e. coli). A study in newborn babies with pustular Staph infections showed that use of a low dose 33% concentration of Black seed oil was nearly as effective as a standard topical antibiotic with no side effects.
  • Anti-fungal against Candida yeasts.
  • Promotes wound healing by reducing inflammation and local infection, allowing the skin to heal.
  • Anti-inflammatory in a range of skin conditions including psoriasis and acne (10% lotion over 2 months reduced lesion counts and resulted in satisfaction of 67% of patients).
  • Black seed oil inhibits histamine release in the skin and as such can be used to reduce hypersensitivity reactions.
  • A study in hand eczema showed significant improvement in quality of life and severity when Black seed oil ointment was applied twice daily for 4 weeks.
  • Cosmetically it also showed benefit when combined with Borage oil, reducing skin irritation and improving skin hydration and barrier function when compared with a placebo.

Some of these studies don’t outline specific topical concentrations and none of the studies compare it to corticosteroids however, the risk profile of Black seed oil is minimal. So overall I think the potential benefit for such a wide range of skin conditions is heartening and assessing individual clinical benefit may be the key until we see more specific research in this area. If you have used Black seed oil to help manage a skin condition, I would love to hear from you – please comment below.

Email Sign Up Button [April 2013]References:

Aljabre, S.H., Alakloby, O.M. and Randhawa, M.A., 2015. Dermatological effects of Nigella sativa. Journal of Dermatology & Dermatologic Surgery, 19(2), pp.92-98.

Rafati, S., Niakan, M. and Naseri, M., 2014. Anti-microbial effect of Nigella sativa seed extract against staphylococcal skin Infection. Medical journal of the Islamic Republic of Iran, 28, p.42.

Yousefi, M., Barikbin, B., Kamalinejad, M., Abolhasani, E., Ebadi, A., Younespour, S., Manouchehrian, M. and Hejazi, S., 2013. Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema. Journal of the European Academy of Dermatology and Venereology, 27(12), pp.1498-1504.

Posted in acne, Psoriasis, Sensitive Skin, Skin Health | Tagged , ,

Holistic Pain Management – Part 1

In this podcast I discuss the origins and assessment of chronic pain with Andrew Whitfield-Cook. It was important for me to get across that chronic pain persists for reasons beyond peripheral input. While that may be part of the issue, or even the origin, the reason chronic pain persists is about a myriad of factors including central nervous system input, neuro-inflammation, attention, beliefs, emotions, lack of human connection to name a few. This podcast discusses some of these factors.

Holistic-pain-management-Pain-origins

Transcript and content:

The agony of chronic pain is a huge burden on many, on both a personal and societal level. Today, in part one of Holistic Pain Management, we welcome back Ananda Mahony, an expert in the assessment and treatment of pain. In this episode, Ananda takes us through the neurobiology and theories of pain, various assessment tools and the issues of pain in our society. Ananda also discusses what worsens and what alleviates the sensation of pain, and we’ll gain some insight into integrative treatments which can offer help, especially when orthodox measures fail to relieve pain.

Covered in this episode:
[01:02] Welcoming back Ananda Mahony
[02:39] What is the societal burden of pain?
[07:56] Contributors to pain mismanagement?
[11:18] How should pain be assessed?
[16:54] What actually is pain?
[20:41] Theories of pain
[24:21] Factors influencing pain perception?
[35:19] Why medical care misses the mark
[40:58] Holistic approaches to care
[42:26] Inviting Ananda back to continue to discussion for Part 2.

Subscribe to the podcast: fxmedicine.com.au

Posted in Chronic pain management, pain psychology | Tagged

Awe-inspiring

Im significantFor Christmas I received a subscription to New Scientist. It is my favourite magazine and prior to getting my own copy each week I regularly pilfered my Mum’s copy (thanks for the present Mum). In a recent edition (Issue 3136) I read an article about the benefits of feeling small as a human when compared to nature, Earth, the sun, other planets and space itself. The article goes onto discuss the concept of awe, not just with things bigger than us but anything that truly inspires awe; a full moon rising, a stunning view, a beautiful piece of music, art or an idea.

The feeling of being awestruck has powerful effects not only our mind and body but also on our sense of self. True awe can dissolve our sense of self, allowing a greater sense of connection with others and nature. It can lower stress, boost creativity and even make us nicer people. So what is the feeling exactly? Researcher’s studying awe describe it as ‘an emotion that combines amazement with an edge of fear’, and is a feeling we get when ‘confronted with something vast, that transcends our frame of reference’.

Part of feeling awe is a move of focus away from our own self-interests and to a bigger picture, which has shown to help us feel happier, less stressed and even improves immune function by reducing inflammation. This effect doesn’t just last in the moment, if cultivated, awe can have lasting effects. It can also help switch us out of ‘fight or flight’ mode by stimulating parasympathetic nervous system responses (rest and digest mode).

Contemplating awe I thought back over recent history to moments that I identified with feelings of awe and a few came to mind; St Peter’s Basilica in Vatican City, a recent full moon rising that seemed to take up half the skyline, and every time I really think about what it would be like to be Dr Who’s companion in the Tardis (yep, I’m a fan and it’s a big concept!).

There are ways of cultivating awe on a regular basis. The article infers that we could stop looking at images of nature and space on our smart phones and starting looking at the real thing. Yes, yes we all say! Fortunately awe isn’t necessarily rare and can be manifested in more ways than just seeing amazing things. To do this we need to raise our expectations of feeling awe in the first place, and then think about what we individually find awe-inspiring, whatever that may be. Then we can make it part of the every day.

Feel free to comment below – what makes you feel awe?

Reference:

Marchant, Jo. Awesome Awe, New Scientist ISSUE 3136 | MAGAZINE COVER DATE: 29 July 2017

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Stress gets under the skin

From a health perspective, my skin is my vulnerable organ; for me everything shows up on the surface. Stress in particular is a ‘skin trigger’. I have changed my health significantly since the days of breakouts and chemical sensitivity so they aren’t issues anymore, but my skin still tends to be reactive in response to stress looking drier and flushing easily.

Skin Stress

Skin is one of the key defence systems of the body with the outermost layer providing a natural barrier to water loss and potential toxins or microbes. It is exposed to numerous daily stressors such as infections, toxic agents (artificial fragrances), allergens, UV light and mechanical damage and is usually well equipped to respond and protect from these environmental factors. However, in those with skin conditions such as psoriasis, chronic itching, eczema and rosacea, both environmental and psychological stress can be a trigger for acute flare-ups as well as sustaining chronic issues.

Stress impacts aren’t just about major life events. It is often the ongoing daily pressures of life that creates a chronic stress burden, eventually leading to less overall stress resilience. The depth of this impact is in part a reflection of genetics, but also of cumulative experiences over time. Of considerable influence are individual health behaviours such as sleep, hygiene, activity levels, diet and substance abuse (alcohol, excess sugar intake, recreational drugs, cigarettes etc). The more we move away from healthy practices such as enough sleep, regular exercise and a healthy diet, the more burden on the body and the more likely maladaptive stress responses will develop.

When stress is constant, individuals with skin conditions can lose resilience at a local skin level as well. As a consequence there is less innate ability to regulate immune and inflammatory responses within the skin. Essentially stress leads to increased inflammation and potentially worse disease severity.

The specific impacts of stress on skin include:

  • Reduced skin barrier leading to trans-epidermal water loss (TEWL) so skin looks and feels dry and dehydrated. Dry/dehydrated skin skin also becomes more sensitive to environmental stressors e.g. topical creams or temperature changes.
  • Reduced local antimicrobial defence leading to greater risk of infection from microbes residing on the skin e.g. staphylococcus aureus, a common cause of secondary infection in those with eczema.
  • A significant increase in pro-inflammatory chemicals in the skin contributing to both acute and chronic inflammatory responses – skin may present as more red, more reactive, itchier or with increased plaques in the case of psoriasis.
  • Delayed recovery time.

For example, the general psoriasis population is vulnerable to the exacerbation of inflammation such that a stressful event/s can significantly aggravate the course of the condition. Up to 80% of individuals with psoriasis report a stressful life event prior to a flare up and 45% prior to the onset of the disease.

Fortunately there are many positive skin benefits associated with improved stress resilience and while there is no doubting the benefit of enough sleep, a healthy diet and exercise, adding regular mindfulness practice to usual treatment can have significant benefit. For example, in a group of psoriasis patients’ regular mindfulness practice led to a 4 fold increased clearing rate of skin lesions. Mindfulness based practice has also been shown to reduce post-stress inflammatory responses and increase symptom relief following skin damage.

There are numerous ways to improve stress resilience using self care and mindfulness but I find while many may work in the short term, sustained practices are those that really make the difference…practices that, while they may take time and effort, really make you feel good. I find that implementing mindfulness and self-care is less prescriptive and more a journey of discovery, trying new techniques or remembering things you used to do regularly and enjoy. Many of the practices are quite simple:

  • Green therapy – a favourite of mind, which is spending time in nature
  • Mindful breathing practices
  • Meditation
  • Mindful walking – being present and observing your movement
  • Head to toe scanning to tap into body sensations
  • Regular magnesium baths or foot soaks
  • Journalling – thoughts, frustrations, things to be thankful for
  • Practicing gratitude
  • Reading for pleasure

I generally encourage patients to pick one and ‘try it on to see if it fits’. While it may take sustained effort something will feel good. The aim then is to make it part of a daily, weekly or regular practice and this is when the benefits will be felt, and seen on the skin.

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More benefits of Vitamin D

Memory and Vitamin D

In other memory related news (see previous post), a 2017 randomised trial in healthy adults showed that high levels of vitamin D improved visual and non-verbal memory, resulting in higher-level cognitive function. This trial was conducted in healthy adults so the mechanism isn’t necessarily about correcting disordered function related to a disease state. However, the impact of higher doses (4000iu daily) was greater in those with lower baseline levels of vitamin D (75 nmol/L). Interestingly most Australian pathology labs indicate that a vitamin D level between 50-100 nmol/L is sufficient. On this basis a proportion of adults that have ‘normal’ levels of vitamin D may benefit from increasing their level to the high-normal range.

Vitamin D, Sleep and Pain

I have previously discussed before the relationship between sleep, mood and pain (listen here or read here) but a recent paper (Oliveira D, et al, 2017) provides the possibility that vitamin D might provide an important interface between sleep and pain. Vitamin D shows sleep modulation effects and lower levels have been liked to sleep disorders. The link between vitamin D, sleep and pain may in part be the impact this nutrient has on shared brain neurotransmitter pathways. The anti-inflammatory impact of Vitamin D may also help reduce nociceptive (danger signals) input, which the brain interprets as pain.

sunshineI will add my usual caveat with vitamin D, which is to establish baseline serum levels before taking higher doses and it is worthwhile seeing a health care professional such as your naturopath or nutritionist to do so, particularly if you are having memory or pain-related issues. Sunshine can and vitamin D rich foods are also important for maintaining healthy levels.

References:

de Oliveira, D.L., Hirotsu, C., Tufik, S. and Andersen, M.L., 2017. The interfaces between vitamin D, sleep and pain. Journal of Endocrinology, 234(1), pp.R23-R36.

Pettersen, J.A., 2017. Does high dose vitamin D supplementation enhance cognition?: A randomized trial in healthy adults. Experimental gerontology, 90, pp.90-97.
Posted in Uncategorized

Memory enhancing EVOO

Olive-OilI am regularly regaled with the benefits of Coconut oil (predominantly a saturated fat) but personally I am not a fan. By all means moisturise with it, use it as a mouth cleanser, rub it through hair etc, but don’t eat too much of it. The purported health benefits just don’t stack up in the research. On the other hand Olive oil (a mono-unsaturated fat) has a bucket of research showing positive health benefits including this recent report indicating that extra-virgin olive oil (EVOO) protects memory and learning ability and further, decreases the risk of brain changes commonly associated with Alzheimer’s.

EVOO achieves these protective benefits by reducing brain inflammation and activating a process called autophagy, which clears old cells and toxins (garbage disposal) from the tissues. Researchers now think that the protective effects of the Mediterranean diet against dementia are equally from EVOO as they are the high intake of fresh fruit and vegetables. Go EVOO!

As it is the season for brussels sprouts (I love them!) I have included a recipe that includes them and lashings of lovely olive oil. I like to use Australian olive oil as the olive tree groves tend to be younger and thus richer in polyphenols and antioxidants, the important plant chemicals that contribute to the health benefits of EVOO.

Shaved brussels sprouts, olive oil, lemon and pecorino

Serves 4-6
450g brussels sprouts
5 tbsp extra virgin olive oil
½ tsp salt
3½ tbsp fresh lemon juice
½-1 tsp whole black peppercorns, crushed
115g pecorino cheese, grated or shaved

1 Rinse the sprouts, then pat dry with kitchen roll. Remove any discoloured outer leaves, then cut the sprouts in half, lengthways. Very thinly slice them the sprouts crossways, transferring to a large, shallow serving bowl as you go.

2 Drizzle the oil over the sprouts, sprinkle with salt and toss well. Add the lemon juice and pepper and toss again. Lay the cheese on the top of the salad and serve immediately.

Recipe from: The Perfectly Tossed Salad by Mindy Fox

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