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I’m Still a Mother Even If My Son Is No Longer Living

I'm Still a Mother Even If My Son Is No Longer Living
Kasiam via Getty Images

I dedicate this to each and every mother who lives without her precious child(ren), to every mother who has no living children, and to every woman who longs to be a mother. We see you. We remember you. And we honor your motherhood. You are a beautiful, beautiful mother.

I'm Still a Mother Even If My Son Is No Longer Living

Mother’s Day can be a wonderful day for many women. A day of celebration, honor and love. But for those of us who are mothers of children gone too soon, Mother’s Day is often filled with dread, sorrow and insatiable longing. It’s marked by a visceral ache that spills from our heart to the depths of our bones. It’s punctuated by an ever-present hole in our hearts, in our lives, so deep and wide, that no one and nothing can fill it.

Our arms are empty, yet we long for them to be full. We are mothers, but the world often forgets- especially if we no longer have living children to carry and hold outside our hearts.

It’s hard being a bereaved mother on Mother’s Day, being a mother to a child who is no longer living.

. . .

As bereaved mothers, our deepest cry and longing is for our motherhood to be honored and recognized. For all our children, in heaven or on earth, to be remembered. Honored. Celebrated. For someone to yell from the rooftops, or to quietly whisper in the silence: Yes, you are still a mother!!!

You’d think this would be a simple request, something that would surely happen. You’d think anyone and everyone would give us this gift. But year after year, on this seemingly special day, bereaved mothers feel left out. We’re left out of the pastors’ sermons at church. Left out of the montage of flowers and chocolate and Mother’s Day well-wishes. Left out of the conversations and celebrations of motherhood. Left out of the “Happy Mothers’ Day” messages that flood social media.

And we bleed.

. . .

It’s hard being a bereaved mother on Mother’s Day, being a mother to a child who is no longer living. By hard, I mean torturous, and even that word falls short.

You want your child recognized by name, validated as a real person who lived. You want someone to step in and offer to carry a piece of your pain for just a minute, an hour, a day- especially on this day. This day that is supposed to honor and celebrate all mothers. You want a shining soul to see you, to truly get it, (for even just one second.) You want a brave and daring heart to compassionately climb in the ditch with you, lie down beside you, and just be with you, smack in the middle of your whirlpool of Mother’s Day tears.

The sad truth?

There are few who can do this. And even fewer who will.

We know on Mother’s Day people will forget how to count. All our children. (In my case that only means counting up to three.)

. . .

I remember my first Mother’s Day after the death of my only son like it was yesterday. Every cell in my body was dreading the day. The mere thought of Mother’s Day filled me with palpable anxiety from the tips of my hair all the way down to my toes.

You see, as loss moms we know and anticipate that the world will forget us. We know. We know because it happens all day, every day in our post-loss life. Our motherhood denied. Ignored. Stomped on. Crushed. Not recognized, honored or even simply stated. We know on Mother’s Day people will forget how to count. All our children. (In my case that only means counting up to three.) We know our children gone too soon will no longer be included in the routine ‘how-many-kids-do-you-have’ count. We know the gaping hole in our family tree will go unnoticed. We know the most important names will be missing from our Mother’s Day cards. We know it’s going to happen. Our children, forgotten- their existence, denied.

And yet? No amount of preparing prepares the broken heart for the excruciating pain of more salt poured in its wounds. Even if it is with the best of intentions.

It burns.

. . .

Knowing our motherhood and our children won’t be recognized does not make it one ounce more bearable. At all. In fact, it makes the anticipation of, and the day itself, filled with dread.

The thought of “celebrating” Mother’s Day feels impossible. Surviving it is generally the goal. And even that feels like a lofty one. The Mother’s Day landmines are too many to count.

For some, staying in bed with the covers overhead until the day passes is the most reasonable solution.

Having your motherhood ignored on a daily basis is torture; but on Mother’s Day, the one day of the year all mothers should be celebrated, honored and recognized? There aren’t words for the ache, for the pain of being forgotten, for the dread of knowing you will be.

. . .

All I wanted my first Mother’s Day after the death of my son, was simple: for someone to remember him, for someone to remember I was a Mother, with a capital-M. To have both my motherhood and my son acknowledged was the only gift I wanted and needed that year. For anyone to kindly say, “Yes, you are still a mother.” For someone to say, “I see you. I love you. You are an amazing mother to your precious son.”

Unfortunately, most people didn’t remember that year. Most people didn’t remember I ever had a son. Even though it had only been a few short months since he had walked the earth beside me. Most people forgot I was ever a mother, and still a mother, on a day that ironically was in fact founded by bereaved mothers themselves.

The world’s message to me was loud and clear: “No, you are not still a mother.”

You will always be your precious child’s mother. Always. Even though heaven and earth separate you, even if no one remembers, even if the world tells you you’re not.

. . .

That year I received one Mother’s Day card.

One.

It came from someone I didn’t even know well, but let me tell you, that card made my year. It made my life. It made breathing a little easier, a little lighter, every hour of that wretched day, and every day for the rest of that year. Inside the fibers of that paper held hope.

I still have that card. And I will always keep it. That one acquaintance decided to step out in bravery and in love to acknowledge what no one else could or would: not only was I still a mother, but I always would be. Always.

It was a message my heart longed for and desperately needed to hear. One I clung to and cling to still.

That $3.99 Mother’s Day card became my lifeline.

It gilded the cracks of my heart with love. With honor. With pride. To be acknowledged as the mother of my precious son still- and always- was the gift of all gifts.

Someone finally saw me, all of me, and my broken open heart will never, ever forget it.

. . .

To every courageous loss mama, with an aching heart and empty arms, I leave you with this: Yes, you are a still a mother, and you always, always will be. The love you two share is forever, just as your motherhood is forever. No one can take that away from you. Not today, not on Mother’s Day, not ever. You will always be your precious child’s mother. Always. Even though heaven and earth separate you, even if no one remembers, even if the world tells you you’re not.

You are.

You are.

You are.

. . .

Angela Miller is the author of You Are the Mother of All Mothers: A Message of Hope for the Grieving Heart, which has comforted almost 10,000 grieving moms worldwide. Follow Angela at A Bed For My Heart.

This piece was originally published at A Bed For My Heart.

This post is part of Common Grief, a Healthy Living editorial initiative. Grief is an inevitable part of life, but that doesn’t make navigating it any easier. The deep sorrow that accompanies the death of a loved one, the end of a marriage or even moving far away from home, is real. But while grief is universal, we all grieve differently. So we started Common Grief to help learn from each other. Let’s talk about living with loss. If you have a story you’d like to share, email us at [email protected].

Follow Angela Miller on Twitter: www.twitter.com/ABedForMyHeart

What We Can Learn About Sleep From Pro Athletes

What We Can Learn About Sleep From Pro Athletes
Getty Images/Blend Images

The San Jose Sharks hold the NHL’s road record for the 2015-2016 season, meaning they’ve won the most games away from home. If you ask their leadership team, the secret to that success is clear: They prioritize sleep.

Sleep expert Cheri D. Mah of the Human Performance Center at the University of California, San Francisco advises the team on how to use sleep to optimize performance both on the road and at home. Turns out, west coast teams need it more than most. They play through more different time zones than other teams, Mike Potenza, the Sharks’ strength and conditioning coach, told The New York Times.

How athletes benefit from extra sleep

While sleep is important for everyone, it may play a specific role for elite performers, Mah told The Huffington Post. “Sleep is particularly important for athletes striving to be at their peak performance, as sleep can impact cognitive and physical performance, as well as training, recovery and overall health.” 

Some research has shown that even as little as one night of partial sleep deprivation can affect peak heart rate levels, plasma lactate concentrations and ratings of perceived exertion, which all affect exercise performance.  

But not all research is so conclusive: “It is plausible that athletes would need more sleep, but there is not good evidence,” warned sleep researcher Shawn Youngstedt, a professor in the college of nursing & health innovation at Arizona State University, told HuffPost.

Several studies suggest that partial sleep restriction and sleep deprivation may not influence performance — like one that showed even three nights of restricted sleep did not affect endurance running performance — but findings like those may be a result of small study size and short time frames that the studies looked at, according to a 2014 review of research on sleep and athletic performance in the journal Sports Medicine.

There are many ways to measure performance and the effect of sleep deprivation may also depend a lot on the athletic activity, according to William G. Herbert, professor emeritus in the department of human nutrition, foods & exercise at Virginia Tech and fellow of the American College of Sports Medicine. 

While he agreed that aerobic and muscular power may not be affected by sleeplessness, most complex athletic activities require fine motor skills, such as visual tracking, decision making, vigilance, and others, which are affected by sleep loss.

“In the case of elite professional athletes, significant travel across time zones and related disruptions in sleep-wake cycles do likely affect sports where cognitive, fine motor skills and emotional factors are especially important,” he said.

How to sleep like a pro-hockey player

In other words, athletes are just like the rest of us. Sleeplessness affects cognitive, fine motor skills and/or emotional factors in athletes — and in people who work a desk job. Here are three essential sleep tips straight from the San Jose Sharks’ playbook. Chances are, they’ll help anyone feel and perform better:

What We Can Learn About Sleep From Pro Athletes
David Crespo

 

1. Make sure you get enough hours of sleep every single night

Mah recommends 8 to 10 hours of sleep for her players, but the National Sleep recommends 7 to 9 for most adults

2. Follow a wind down routine

“A wind down routine is key for transitioning from the day to preparing for sleep,” Mah said. She recommends that the athletes she works with spend 20 to 30 minutes stretching or practicing yoga before hitting their sheets and use the time strategically to process their thoughts.

3. Nap when needed

Naps are very commonplace for professional athletes, Mah said. Athletes often nap after practice, before games, on flights or during any down time they have. She added that many athletes find it easiest to nap in the afternoon because there is aleeps dip in the circadian clock then.

Sarah DiGiulio is The Huffington Post’s sleep reporter. You can contact her at sarah.digiulio@huffingtonpost.com.

This Type Of Birth Control Could Be Making You Crave Junk Food

This Type Of Birth Control Could Be Making You Crave Junk Food
Jamie Grill via Getty Images
Yep, you might be more interested in this if you’re on Depo-Provera. 

The best birth control is easy to use and effective, but nearly all of these medications can come with side effects. The Depo-Provera shot, an effective, discreet and easy to use hormonal birth control method that requires a shot once every three months, causes one in particular: Significant weight gain for about 25 percent of the women who use it.

Back in 2009, a large study showed that Depo-Provera was linked to an average weight gain of 11 pounds across all users over three years. However, this was concentrated in only a quarter of the women who used the shot, meaning that the average amount that this subgroup gained was significantly higher. 

In a new pilot study of eight healthy women, researchers set out to find out why this occurs. They discovered that the shot led to heightened activity in the parts of the brain that are linked to food cravings, making it harder for women on the medication to resist junk food.

In the course of the study, the women who received the Depo-Provera shot had more activity in parts of the brain that govern appetite when looking at delicious high-calorie foods compared to baseline measurements that were taken before they received the shot.

If these results are confirmed in more wide-ranging studies, it could be that there’s a neural explanation, not a metabolic one, for why some women gain weight on the Depo-Provera shot. The researchers hope that this discovery may also provide women and their healthcare providers with more tools to avoid weight gain while using the birth control method. 

What we knew before:

Women who have had the Depo-Provera shot, a contraceptive that lasts for three months and is administered by a healthcare provider, sometimes complain that they gain weight afterward

Previous studies have tried to understand the mechanisms behind this Depo-linked weight gain, but have come up short. A 2001 study that measured women’s food intake and resting energy expenditure before and after getting the shot found that women’s metabolisms did not change or slow down after getting the Depo-Provera shot. 

The study details:

Researchers recruited eight healthy women, aged 18 to 37, who wanted to get on the Depo-Provera shot. To establish baseline measurements, the researchers drew blood from women, weighed them, assessed total body fat and gave them an fMRI brain scan while showing them pictures of food (both high- and low-calorie items) and non-edible objects. These high-calorie foods included cheeseburgers, pasta, ice cream sundaes, candy and chicken wings. Photos of low calorie foods were things like salads and fruits. The non-edible objects were things like bikes, baskets and rocks.

Then they gave them a shot of Depo-Provera.

Eight weeks later, the participants returned to give all the same measurements and view the same images again while getting fMRI scans. The researchers found that there was no significant change in participants when it came to weight, BMI, body fat percentage or hormone levels related to hunger and fullness (ghrelin and leptin, respectively).

But they did notice a change in the fMRI scans. When viewing the high-calorie foods, there was significantly more blood flow to parts of the brain that govern appetite, food desire, motivation and inhibition — all parts of the brain that have to do with food cravings. This blood flow was significantly higher than both the participants’ baseline measurements and brain activity levels when viewing low-calorie food or non-edible objects.  

What the researcher says:

It’s important to note that this is a very small pilot study of just a handful of women. However, Dr. Penina Segall-Gutierrez, senior author of the study and an associate professor of obstetrics and gynecology at USC, is excited about the possibility for future research on how to mitigate weight gain while on Depo-Provera, as well as a wider understanding of how being on different kinds of hormonal birth control can affect women’s brains.

“We’re starting to understand how and why some people gain weight on Depo-Provera as a birth control method,” said Segall-Gutierrez.

Knowing the mechanisms behind the link between the Depo-Provera shot and weight gain could help women be more prepared when they get it, she said.

“This preliminary study really does have the potential to help people who want to use [Depo-Provera] as a birth control method to be able to use it successfully and not gain weight,” said Segall-Gutierrez.  “Just as there are behavioral interventions to prevent other diseases, we can tell people hey, you might be more hungry when you’re on Depo.”

How this could affect you:

For women who want to use the Depo-Provera shot now, Segall-Gutierrez says they should have a conversation with their doctors about the risks of weight gain and how to avoid it. Now that there is preliminary evidence that the birth control method might have an effect on the brain, doctors can offer more insight beyond the fact that Depo-Provera does not affect metabolism, she said.

“There’s the potential out there that we’ll be able to mitigate the weight gain through anticipatory guidance and just letting people know what to expect,” she concluded.

Pfizer, the makers of the Depo-Provera shot, did not immediately respond to a request for comment.

Online Self-Help Is Surprisingly Good At Reducing Depression Risk

Online Self-Help Is Surprisingly Good At Reducing Depression Risk
Sam Edwards via Getty Images

People who may be sliding toward depression might be able to prevent the full-blown disorder by completing some self-help exercises online, a new study suggests.

Researchers found that men and women who had some symptoms of depression and used a web-based mental health program that was supported by an online trainer were less likely to experience a major depressive episode during a 1-year follow-up period, compared with people who also had symptoms of depression but were only given online access to educational materials about the signs of depression and its treatment. The findings were published today (May 3) in the journal JAMA.

The results of the study suggest that a web-based, guided self-help intervention could effectively reduce the risk of major depressive disorder or at least delay its onset, said lead study author Claudia Buntrock, a doctoral student in psychology at Leuphana University in Lueneburg, Germany.

In the study, the researchers tracked about 400 adults in Germany who met the criteria for having some symptoms of depression but were not considered to have a major depressive disorder. The participants had not received any psychotherapy in the six months prior to enrolling in the study.

About half the participants were assigned to participate in a web-based training program that taught them behavioral and problem-solving skills, such as how to brainstorm solutions to a problem, make time for enjoyable activities and practice relaxation techniques. The program consisted of six half-hour sessions and self-help exercises, along with support from an online trainer who offered written feedback to participants after each session. 

The rest of the study participants had access to online information about depression, but there were no exercises for them to complete and no trainers were involved.   

Preventing depression

When researchers followed up by telephone with the study participants one year later, they found that 27 percent of the people in the online self-help group experienced symptoms of major depression, compared to 41 percent of the people in the group that simply had access to information.

The findings show that the delivery of preventive mental health interventions via the Internet may be a promising way to reach individuals who are at an early stage of depression, and that it may also help prevent their transition to a full-blown depressive disorder, Buntrock told Live Science. Online programs cost less than traditional mental health services and allow participants to work through the information and exercises at their own pace, according to the study. 

In addition, since research is showing that treatments for major depression are not always successful at improving health outcomes — such as premature death and disability — its prevention is becoming more important, the researchers said.

The researchers said that one of the limitations of the study is that they could not rule out the additional attention that some participants received as a result of feedback from the online trainer could be a factor in that group’s reduced risk for depression.

Future studies should clarify whether web-based, guided self-help programs are effective at preventing the first onsetof depression as well as its recurrence, Buntrock said.

She also said that because individualized feedback from an online trainer can make the specific training program harder to replicate with a larger number of participants, more studies are needed to evaluate the preventive effects of a web-based intervention that does not have any online trainers helping participants.

The online, self-help program developed for this study is currently in use by a health insurance company in Germany. That company was involved in the research and made the program available to its members who might be at risk for depression, Buntrock said.  

Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.

U.S. Regulators Ban E-Cigarette, Cigar Sales To Minors

U.S. Regulators Ban E-Cigarette, Cigar Sales To Minors
MOHD RASFAN via Getty Images
Promoters smoke electronic cigarettes during the VapeFair in Kuala Lumpur on December 5, 2015.

The U.S. Food and Drug Administration on Thursday banned sales of e-cigarettes, cigars, pipe tobacco and hookah tobacco to people under age 18, in line with cigarette rules, a move aimed at preventing a new generation from becoming addicted to nicotine.

The agency said it also will require companies to submit these products to it for regulatory review, provide it with a list of product ingredients and place health warnings on their product packages and in advertisements.

The FDA’s regulation had been highly anticipated after the agency issued a proposed rule two years ago on how to oversee the $3 billion e-cigarette industry and these other products.

Cigars had previously not been regulated by the FDA. Their makers had lobbied for their more expensive, typically hand-rolled products to be excluded from such oversight.

The FDA said in a statement that the regulations will bring all these products in line with how it oversees other tobacco products such as cigarettes, smokeless tobacco and roll-your-own tobacco.

E-cigarettes are handheld electronic devices that vaporize a fluid typically including nicotine and a flavor component. Using them is called “vaping.”

In 2009, the FDA began focusing on e-cigarettes as the product began appearing in the U.S. market. That year, President Barack Obama signed the Family Control Act, a law that gave the agency authority over cigarettes, smokeless and roll-your-own tobacco products. Congress also gave authority to the agency to assert jurisdiction over other tobacco products.

The FDA is trying to limit teen use, which has been soaring, by prohibiting sales to those under 18 and the distribution of free samples. But the agency does not directly limit flavors in e-cigarettes, which vary from bacon to bubble gum and have been popular with teens.

The use of e-cigarettes is on the rise among U.S. middle and high school students, according to government figures, and officials said they are now the most commonly used tobacco product among youth.

Data from the U.S. Centers for Disease Control and Prevention and the FDA’s Center for Tobacco Products released in April showed that 3 million middle and high school students reported using e-cigarettes in 2015, compared with 2.46 million in 2014.

The FDA established a staggered review period for products introduced after Feb. 15, 2007, of between 12 and 24 months. The FDA had proposed a two-year grace period.

(Reporting by Caroline Humer and Jilian Mincer in New York and Toni Clarke in Washington; Editing by Will Dunham)

5 Expert-Backed Tips For Fighting Flight Anxiety

Vacation season is upon us (we see you, warm weather) but for some people, jet-setting off to a relaxing destination can be anything but.

While data on the subject is sparse at best, some research suggests that an estimated 40 percent of people experience some level of anxiety when they fly, The New York Times reported. For those with a severe phobia of plane travel, the issue can result in panic attacks or make individuals physically sick. It’s also coupled with crippling thoughts. 

“Anxiety when flying can be dissociating,” Nathan Feiles, a licensed psychotherapist who specializes in fear of flying, told The Huffington Post. “There is this sense of losing control. People can feel at their most vulnerable when they’re in an airplane.”

While clinical phobias like a fear of traveling require effective treatment and care through a mental health professional, Feiles says there are ways to manage or ease your worries when you’re in the air or on the move. Below are a few expert-backed tips on how to abate your anxiety:

1. Work to normalize the event.

5 Expert-Backed Tips For Fighting Flight Anxiety
Hero Images via Getty Images

Your brain prompts anxiety by responding to perceived “threats,” Feiles explained. That may include activities you don’t do on a regular basis.

Think of it this way: Many of your daily behaviors hardly produce a panicked response because you engage in them frequently. The key is to normalize travel just as you would your regular activities.

“It’s all about getting your brain to understand that flying is normal and routine,” Feiles said. “There are things you do every day that contain risk — even showering — but you still do it because it’s a habit and there’s a very minimal risk. The same goes for this.”

To normalize air travel, Feiles recommends exposing it to yourself as much as possible and in small ways. Track a flight for a few days or a few weeks. You’ll soon notice that it comes and goes with success each time.

2. Focus on your breathing.

Don’t underestimate the power of the inhale. If you’re feeling fearful in the air, Feiles suggests trying some meditation or breathing exercises to calm your panic. 

“The best thing for someone to do when they’re feeling panic in the air is to get themselves into a more relaxed place physiologically,” Feiles said. “Extend your breath by inhaling and exhaling longer than normal or think of pleasant images.”

3. Educate yourself.

5 Expert-Backed Tips For Fighting Flight Anxiety
Photo by Andrew Xu via Getty Images

As they say, knowledge is power. It may help your anxiety by studying up on flying, airplanes and flight patterns. This will also help contribute to the normalization of air travel, Feiles said.

“People perceive threats due to an active imagination,” he explained. “But for example, learning about modern airplanes and how they’re built and that, say, the wing won’t break off, may help ease those fears over a period of time. If people have imaginative fears, it helps to have actual knowledge.” 

4. Acknowledge your panic.

One of the worst things you can do is avoid your fear. The sooner you accept that your panic is occurring, the sooner you can combat it.

“Trying to run from your emotions only makes it worse,” Feiles said. “Acknowledge on a real level what you’re feeling and note that it’s not easy but you will get through it. That can help dissolve some of the pressure.” 

5. Turn it into a “game.”

5 Expert-Backed Tips For Fighting Flight Anxiety
Maksim Shebeko via Getty Images

Take stock of the realities around you when you start to feeling nervous, Feiles said. Focus on the flight attendants, the seat in front of you, your feet on the floor — anything that will help ground you in the present moment. 

“If turbulence is what’s causing your fear, tell its story,” Feiles suggested. “Instead of going to bad place, tell yourself what’s happening. If you feel plane bumping up, then acknowledge that you just ascended. Thinking with the plane and detailing what’s actually going on helps instead of letting your mind wander away.”

Ultimately, Feiles wants individuals to know that anxiety when traveling is something that one can manage and overcome. Treatment or coping techniques can help you fully live your life (which hopefully includes vacationing somewhere on a warm, sunny beach).

Need a Good Night’s Rest? Choose Therapy Over Pills, Doctors Group Says

By Andrew Joseph

Put down the sleeping pills and pick up that sleep diary.

According to new guidelines released Monday from the American College of Physicians, chronic insomnia should not be treated with drugs like Ambien or Lunesta, but instead with a specially designed form of psychotherapy known as CBT-I, which blends talk therapy and sleep tutorials, and has been shown to help a majority of patients recover some normalcy in their sleep quality and duration.

Both meds and psychotherapy can improve sleep, the ACP said, but drugs come with a range of side effects — including next-day drowsiness and other problems that send tens of thousands of Americans to the emergency room each year. Drugs also aren’t recommended for long-term use.

But drugs are easy to come by since any physician can write a prescription for a sleeping aid. CBT-I, by comparison, typically requires a trained clinician, of which there are few in even the country’s biggest cities — which could make it hard for the nation to wean itself off prescription sleeping pills and adopt psychotherapy.

The ACP recommendation, which was published in the journal Annals of Internal Medicine, applies only to adults with chronic insomnia, defined as sleep problems that cause distress or impairment, and that occur at least three times a week for at least three months. The physician group also issued a second, “weak” recommendation that doctors should talk with patients about incorporating drugs into their treatment if CBT-I doesn’t work alone.

CBT-I, which is short for cognitive behavioral therapy for insomnia, works by changing insomniacs’ behaviors and thoughts about sleep and what they do during their waking hours, with a treatment plan tailor made for each patient.

Some of the steps at first seem counterintuitive. If you’re exhausted from months of bad sleeping, for example, don’t try to go to bed earlier. Instead, if you can only sleep for five hours and want to get up at 6 a.m., avoid your bed until 1 a.m.

Patients also keep sleep logs and will typically become more fatigued in the initial steps of the treatment. Some patients and even doctors are also resistant to the idea of going to therapy for a sleep problem.

“We’re still on the cusp of getting people to understand that, ‘Hey, the proper treatment for you might be seeing a psychologist,'” said Mark Gorman, director of behavioral sleep medicine at Massachusetts General Hospital.

The treatment can take weeks, but, experts said, it provides lessons and techniques that patients can apply after they stop going to sessions to address future sleep problems.

“No medication on this planet can do that,” said Michael Perlis, director of the behavioral sleep medicine program at the University of Pennsylvania Perelman School of Medicine.

John Cormier, 56, started receiving CBT-I last year after 25 years of sleeping problems and a desire to give up medications. During the treatment, he would give himself 30 minutes to fall asleep. If he was still awake, he made himself get up and go do something else for 30 minutes before trying again. He repeated the pattern if sleep didn’t come.

“I had a few nights of almost sleepless nights,” he said. “It brought me back to my days in college.”

After some time, however, Cormier started to see progress. He can now typically get more than 6 1/2 hours of quality sleep and hasn’t taken sleep medication since last summer.

But Cormier also spent about five months going to sessions with a sleep psychologist.

“It’s not easy, and it’s not an instant fix,” he said. “It requires a huge time commitment.”

Cormier lives in Boston, so he was able to find a therapist trained specifically in CBT-I. But according to Perlis, even many large cities don’t have clinicians trained in behavioral sleep medicine and four states — New Hampshire, Hawaii, South Dakota, and Wyoming — have no such providers at all.

The ACP guidelines say that CBT-I can be offered in a primary care setting and that patients can use online and phone-based methods, as well as self-help books. Some studies have found that these other strategies can be somewhat helpful, but some apps, including one designed by the Department of Veterans Affairs and Stanford University researchers, are meant to be used by patients working with a clinician.

“Anything is better than nothing,” said Dr. Josna Adusumilli, a neurologist at MGH focused on sleep disorders. “Obviously, having a meeting with a sleep psychologist in person is the gold standard, but if that’s not possible, an online program would be a good choice.”

Follow STAT on Twitter: www.twitter.com/statnews

How Empathy Can Change Your Life, According To Science

It’s time to show off your compassionate side.

Practicing empathy can do a world of good. It allows you see someone else’s perspective — and that could do wonders for your relationships, your stress and more.

Happify, a website and app dedicated to helping people build skills for happiness through science-based activities and games, created an infographic that details all the ways empathy can transform a person’s life. Take a look at it below. Perhaps it’s time to start seeing the world through someone else’s eyes?

–Lindsay Holmes

How Empathy Can Change Your Life, According To Science
Happify

7 Expert-Backed Tips For How To Make A New Habit Permanent

If you’ve ever set out to transform your fitness habits, you probably know that achieving consistency can be a terribly difficult feat — it’s always easy to find an excuse to stay in bed or retreat to the couch with a glass of wine.

But if humans are creatures of habit, why is it so hard to make the healthy habits stick?

For advice, we looked to masters of habit-forming who’ve made self-improvement their life’s work. Below are seven expert-backed tips that will turn any new practice into a permanent part of your life:

7 Expert-Backed Tips For How To Make A New Habit Permanent
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1. Create a personalized plan.

Design a fool-proof plan ahead of time instead of throwing yourself into a new endeavor unprepared.

Research shows it works: When University of Hertfordshire professor Richard Wiseman tracked 5,000 people who were attempting to fulfill their New Year’s resolutions, he found that those who did not have a plan had a harder time achieving their goals.

Want to workout more consistently? Set up a workout schedule or sign up for a weekly class. Want to eat healthy homemade meals instead of going out to lunch? Do meal prep the night before work. Whatever you come up with, make sure you create a personalized plan that makes sense for your lifestyle, according to Gretchen Rubin, author of Better Than Before: Mastering The Habits Of Our Everyday Lives.

“We won’t make ourselves more creative and productive and healthy by copying other people’s habits, even the habits of geniuses,” Rubin wrote on her website. “We must know our own nature, and what habits serve us best.”

2. Focus on one goal at a time.

You may have a laundry list habits you want to change — eat less junk food, do yoga daily, go to bed early — but taking them on all at the same time may set you up for failure, according to Charles Duhigg, author of The Power Of Habit.

“If you try to transform everything at once, it tends to be very, very destabilizing,” Duhigg told the behavioral research blog Barking up the Wrong Tree. He suggests working on one habit a month instead.

It may seem daunting to change several habits in several months, but if the change is important to you, it will have a big impact on your life.

“It’s worth spending a month to change on behavior permanently,” Duhigg said. “You’re going to be reaping the benefits of that for the next decade.”

7 Expert-Backed Tips For How To Make A New Habit Permanent
Thomas Barwick via Getty Images

3. Remind yourself why you’re making a change.

According to behavioral scientist BJ Fogg, founder of Stanford University’s Persuasive Technology Lab, having motivation is a key factor when trying to effectively change your behavior.

To keep yourself motivated, ask yourself why you want to make a change in the first place. Thinking about your long-term goals and the results you will one day achieve will help you power through that 6 a.m. CrossFit session, especially when you feel like giving up. 

“Make sure that what you’re trying to change is something YOU really want to do, not something you feel you SHOULD do,” Christine Whelan, a public sociologist at the University of Wisconsin-Madison, told the Washington Post. “You’re much less likely to accomplish a change if you don’t want to do it, and it’s not in keeping with your values.”

4. But don’t rely on willpower alone.

Studies show that people who think they have the most willpower are the most likely to give in to temptation because they “fail to predict when, where and why they will give in,” according to The Willpower Instinct by psychologist Kelly McGonial.  

Instead of relying on your willpower alone, consider all the obstacles you might run into and figure out how you can prevent them. After all, you’re only human, which means being prone to setbacks and mistakes. 

5. Start a new habit during a vacation.

If you want to pick up a new habit (or kick a bad one) start when you’re out of your normal routine. According to Duhigg, forming a new habit while you’re on a trip is “one of the proven, most successful ways to do it” because you’re in an environment that’s totally different than the one you have at home.

All your old cues and all your old rewards aren’t there anymore,” he told NPR. “You have this ability to form a new pattern and hopefully be able to carry it over into your life.”

7 Expert-Backed Tips For How To Make A New Habit Permanent
Adam Hester via Getty Images

6. Give in to peer pressure.

If you want to make a habit stick, make sure there are people to hold you accountable. Rubin suggests finding a support group or sharing your goals with your friends to help keep you on track.

“One of the best ways to build good habits and happiness effectively — also one of the most fun ways — is to join or start a habits group,” Rubin wrote on her website. “People in the group don’t have to be working on the same habits; it’s enough that they hold each other accountable.”

7. Make sure you’re happy.

According to Shawn Achor, former Harvard psychology lecturer and author of The Happiness Advantage, research shows that the brain is 31 percent more productive when it’s in a positive state than when it’s in a neutral or stressed state.

“Dopamine, which floods into your system when you’re positive, has two functions,” Achor said during a TED talk. “Not only does it make you happier, it turns on all of the learning centers in your brain allowing you to adapt to the world in a different way.”

When you take on a new challenge — like being more consistent with a new fitness routine — with a positive mindset, you’re more likely to be successful at it. 

“If you cultivate happiness while in the midst of your struggles, work, at school, while unemployed or single, you increase your chances of attaining all the goals you are pursuing,” Achor wrote on Psychology Today.

7 Expert-Backed Tips For How To Make A New Habit Permanent
Thomas Barwick via Getty Images

We want to help you feel stronger, happier and more empowered. Sign up for our newsletter and join our 30-Day Move More, Feel Better challenge. We’ll deliver tips, challenges and advice to your inbox every day.  

Use our challenge calendar below to stay on track — it can even sync to your own schedule and send reminders to your phone:

This Technique Should Be The Front Line Defense Against Insomnia

This Technique Should Be The Front Line Defense Against Insomnia
Image Source via Getty Images

(Reuters Health) – People with chronic insomnia should try cognitive behavioral therapy before medications, suggests a prominent group of U.S. doctors.

While the American College of Physicians (ACP) can’t say cognitive behavioral therapy (CBT) outperforms medications for chronic insomnia, the group does say psychotherapy is less risky than drugs.

“Sometimes we forget that sleep medications have the potential for serious side effects in some patients, while cognitive behavioral therapy is very low (risk) to patients,” said Dr. Wayne J. Riley, ACP president.

“The evidence is clear that CBT and sleep hygiene can be long lasting, life long, durable and delivered at a lower cost,” said Riley, who is also affiliated with Vanderbilt University in Nashville.

About 6 to 10 percent of people in the U.S. have insomnia. Through loss of productivity, the condition is estimated to have cost the country about $63 billion in 2009, according to the ACP committee that wrote the new guideline, which is published in the Annals of Internal Medicine. 

Chronic insomnia is defined as at least three restless nights per week for at least three months.

“We wanted to take a deep dive into the literature for what makes a big difference with insomnia,” Riley told Reuters Health.

The ACP commissioned two reviews of insomnia treatments. One focused on medications, and the second focused on psychological and behavioral treatments. 

Overall, the first review found that some medications may improve sleep over a short period of time, but those come with the potential for changes in thinking and behavior. Additionally, there is a risk for infrequent but serious harms.

The U.S. Food and Drug Administration says medications for insomnia should only be used for short periods. The agency warns those drugs may impair people during the daytime, lead to “sleep driving,” behavioral changes and worsening depression. 

The review of psychological and behavioral treatments found that CBT for insomnia improved overall sleep with a low risk of harms, the researchers report. 

Evidence collected separately for the two reviews found that “side effects can be quite severe with the use of insomnia medications in contrast to CBT, where there are minimal side effects,” said Riley.

CBT for insomnia is typically delivered in four to six one-hour weekly sessions. People are taught behavioral techniques such as sleep restriction and stimulus control, and they are also taught sleep hygiene.

When chronic insomnia isn’t helped by CBT alone, the ACP advises patients and doctors to consider a short course of medication. That discussion should touch on the potential benefits, harms and costs of medication, the ACP says. 

Doctors should encourage patients with insomnia to engage in CBT, according two researchers whose editorial was published with the reviews and the guideline.

But, they admit, CBT for insomnia might not be covered by insurance and is likely not available at doctors’ offices, write Dr. Roger Kathol, of the University of Minnesota in Minneapolis, and J. Todd Arnedt, of the University of Michigan Medical School in Ann Arbor.

“Unless access to and unencumbered payment for value-based behavioral interventions, such as CBT (for insomnia), in medical settings become a reality, patients with chronic insomnia will continue to receive suboptimal treatment and experience suboptimal outcomes,” they write.

Alternatives to in-person CBT for insomnia include group therapy session, telephone counseling, online lessons and self-help books, Riley said.

The ACP recommendations are similar to that of the American Academy of Sleep Medicine (AASM), said Dr. Alcibiades Rodriguez, who is medical director of NYU Langone Medical Center’s Comprehensive Epilepsy Center—Sleep Center in New York City.

The AASM’s 2008 practice guidelines for treating chronic insomnia endorse psychotherapy as a first-line treatment and suggests it be used when medications are prescribed.

“The recommendations made by the ACP will appeal to a broader group of physicians to make them aware of this,” said Rodriguez, who was not involved with the new recommendations. “Then the doctors know just giving patients who come to their office with sleep problems a prescription is not the best solution in the long term.”

SOURCE: bit.ly/Ms1ZbQ Annals of Internal Medicine, online May 2, 2016.