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Harvard Health Publications has the latest word on napping and your health. Read the article below from Harvard Health Letter to find out why short daytime naps may be good for business’ bottom line!

Napping may not be such a no-no

Research is showing that the daytime snooze may have benefits and not interfere with nighttime sleep.

At work, if you get caught napping, it could get you into trouble or, more mildly, sully your reputation for diligence. In studies, naps have been linked to ill health, although usually as a consequence, not a cause. And in sleep recommendations, naps have taken a back seat — or been cast as a threat to nighttime sleep.

But lately, naps have been shedding some of their bad-for-you image. Researchers are finding benefits. A few employers have become accommodating of the quick snooze. And some research suggests that instead of fretting about napping more as we get older, we should plan on adding daytime sleep to our schedule as a way to make up for the normal, age-related decay in the quality of our nighttime sleep.

Getting over the hump

Naps, of course, can be an antidote to daytime sleepiness, and we get sleepy during the day for a wide variety of reasons. There is, in fact, a biological clock located in a cluster of cells in the hypothalamus of the brain. Those cells orchestrate the circadian (that is, daily) ups and downs of many physiological processes (body temperature, blood pressure, secretion of digestive juices), including sleep and wakefulness. As you might expect, the usual circadian pattern is wakefulness during the day followed by gradually increasing sleepiness in the evening, but it’s also common to have a little “hump” of midafternoon sleepiness programmed into the circadian schedule. An afternoon nap is one way to accommodate that hump.

In 2008, British researchers reported results of a study that compared getting more nighttime sleep, taking a nap, and using caffeine as ways to cope with the afternoon hump. The nap was the most effective.

Another factor in daytime sleepiness is the number of hours you’ve been awake. After about 16 consecutive hours without sleep, most of us will start to feel tired. Ideally, this homeostatic sleep drive, as it is called, is in sync with the one set by our circadian rhythm, so they’re mutually reinforcing. But if you work a night shift, or have problems sleeping at night, your 16-hour allotment of wakefulness may begin — and end — earlier, which can set you up for grogginess in the late afternoon or early evening. A short nap won’t completely reset the timer, but it can buy you some time before the grogginess sets in again.

How to take a good nap

Keep it short. The 20- to 30-minute nap may be the ideal pick-me-up. Even just napping for a few minutes has benefits. Longer naps can lead to sleep inertia — the post-sleep grogginess that can be difficult to shake off.

Find a dark, quiet, cool place. You don’t want to waste a lot of time getting to sleep. Reducing light and noise helps most people nod off faster. Cool temperatures are helpful, too.

Plan on it. Waiting till daytime sleepiness gets so bad that you have to take a nap can be uncomfortable and dangerous if, say, you’re driving. A regular nap time may also help you get to sleep faster and wake up quicker.

Time your caffeine. Caffeine takes some time to kick in. A small Japanese study published several years ago found that drinking a caffeinated beverage and then taking a short nap immediately afterward was the most restful combination because the sleep occurred just before the caffeine took effect. We’re not so sure about that approach — the mere suggestion of caffeine, in the form of coffee taste or smell, wakes us up. Regardless of the exact timing, you need to coordinate caffeine intake with your nap.

Don’t feel guilty! The well-timed nap can make you more productive at work and at home.

On the job

Since 2000 or so, researchers at Harvard and elsewhere have conducted dozens of experiments that have shown that sleep improves learning, memory, and creative thinking. In many cases, the edifying sleep has come in the form of a nap. For example, several studies have shown that if people are asked to memorize something — say, a list of words — and then take a nap, they’ll remember more of it than they would have if they hadn’t taken the nap. Even catnaps of six minutes (not counting the five minutes it takes to fall asleep on average) have been shown to make a difference in how well people retain information.

Robert Stickgold, a Harvard sleep researcher, says napping makes people more effective problem solvers. His research group has shown that taking a nap seems to help people separate important information from extraneous details. If the nap includes REM sleep — the phase during which dreaming occurs — people become better at making connections between seemingly unrelated words.

Stickgold says his and others’ findings argue for employer policies that actively encourage napping, especially in today’s knowledge-based economy. Some companies have set up nap rooms, and Google has “nap pods” that block out light and sound.

Understandably, employers are concerned about abuse: employees catching up on sleep they should be getting on their own time. But there may be a place for “strategic napping,” especially among people who work a night shift. Results from a New Zealand study published in 2009 showed that air traffic controllers working the night shift scored better on tests of alertness and performance if they took advantage of a planned nap period of 40 minutes. Researchers in the Harvard Division of Sleep Medicine are working with fire departments to improve sleep policies. One of their recommendations is that firefighters on the night shift take a nap in the late afternoon before their shift starts.

Read entire article in Harvard Health Letter here.

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By Harvard Health Publications

Since the 1970s, meditation and other stress-reduction techniques have been studied as possible treatments for depression and anxiety. One such practice, yoga, has received less attention in the medical literature, though it has become increasingly popular in recent decades. One national survey estimated, for example, that about 7.5% of U.S. adults had tried yoga at least once, and that nearly 4% practiced yoga in the previous year.

Yoga classes can vary from gentle and accommodating to strenuous and challenging; the choice of style tends to be based on physical ability and personal preference. Hatha yoga, the most common type of yoga practiced in the United States, combines three elements: physical poses, called asanas; controlled breathing practiced in conjunction with asanas; and a short period of deep relaxation or meditation.

Many of the studies evaluating yoga’s therapeutic benefits have been small and poorly designed. However, a 2004 analysis found that, in recent decades, an increasing number have been randomized controlled trials — the most rigorous standard for proving efficacy.

Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.

Taming the stress response

By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration. There is also evidence that yoga practices help increase heart rate variability, an indicator of the body’s ability to respond to stress more flexibly.

A small but intriguing study further characterizes the effect of yoga on the stress response. In 2008, researchers at the University of Utah presented preliminary results from a study of varied participants’ responses to pain. They note that people who have a poorly regulated response to stress are also more sensitive to pain. Their subjects were 12 experienced yoga practitioners, 14 people with fibromyalgia (a condition many researchers consider a stress-related illness that is characterized by hypersensitivity to pain), and 16 healthy volunteers.

When the three groups were subjected to more or less painful thumbnail pressure, the participants with fibromyalgia — as expected — perceived pain at lower pressure levels compared with the other subjects. Functional MRIs showed they also had the greatest activity in areas of the brain associated with the pain response. In contrast, the yoga practitioners had the highest pain tolerance and lowest pain-related brain activity during the MRI. The study underscores the value of techniques, such as yoga, that can help a person regulate their stress and, therefore, pain responses.

Improved mood and functioning

Questions remain about exactly how yoga works to improve mood, but preliminary evidence suggests its benefit is similar to that of exercise and relaxation techniques.

In a German study published in 2005, 24 women who described themselves as “emotionally distressed” took two 90-minute yoga classes a week for three months. Women in a control group maintained their normal activities and were asked not to begin an exercise or stress-reduction program during the study period.

Though not formally diagnosed with depression, all participants had experienced emotional distress for at least half of the previous 90 days. They were also one standard deviation above the population norm in scores for perceived stress (measured by the Cohen Perceived Stress Scale), anxiety (measured using the Spielberger State-Trait Anxiety Inventory), and depression (scored with the Profile of Mood States and the Center for Epidemiological Studies Depression Scale, or CES-D).

At the end of three months, women in the yoga group reported improvements in perceived stress, depression, anxiety, energy, fatigue, and well-being. Depression scores improved by 50%, anxiety scores by 30%, and overall well-being scores by 65%. Initial complaints of headaches, back pain, and poor sleep quality also resolved much more often in the yoga group than in the control group.

One uncontrolled, descriptive 2005 study examined the effects of a single yoga class for inpatients at a New Hampshire psychiatric hospital. The 113 participants included patients with bipolar disorder, major depression, and schizophrenia. After the class, average levels of tension, anxiety, depression, anger, hostility, and fatigue dropped significantly, as measured by the Profile of Mood States, a standard 65-item questionnaire that participants answered on their own before and after the class. Patients who chose to participate in additional classes experienced similar short-term positive effects.

Further controlled trials of yoga practice have demonstrated improvements in mood and quality of life for the elderly, people caring for patients with dementia, breast cancer survivors, and patients with epilepsy.

Benefits of controlled breathing

A type of controlled breathing with roots in traditional yoga shows promise in providing relief for depression. The program, called Sudarshan Kriya yoga (SKY), involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating, and is taught by the nonprofit Art of Living Foundation.

One study compared 30 minutes of SKY breathing, done six days a week, to bilateral electroconvulsive therapy and the tricyclic antidepressant imipramine in 45 people hospitalized for depression. After four weeks of treatment, 93% of those receiving electroconvulsive therapy, 73% of those taking imipramine, and 67% of those using the breathing technique had achieved remission.

Another study examined the effects of SKY on depressive symptoms in 60 alcohol-dependent men. After a week of a standard detoxification program at a mental health center in Bangalore, India, participants were randomly assigned to two weeks of SKY or a standard alcoholism treatment control. After the full three weeks, scores on a standard depression inventory dropped 75% in the SKY group, as compared with 60% in the standard treatment group. Levels of two stress hormones, cortisol and corticotropin, also dropped in the SKY group, but not in the control group. The authors suggest that SKY might be a beneficial treatment for depression in the early stages of recovery from alcoholism.

Potential help for PTSD

Since evidence suggests that yoga can tone down maladaptive nervous system arousal, researchers are exploring whether or not yoga can be a helpful practice for patients with post-traumatic stress disorder (PTSD).

One randomized controlled study examined the effects of yoga and a breathing program in disabled Australian Vietnam veterans diagnosed with severe PTSD. The veterans were heavy daily drinkers, and all were taking at least one antidepressant. The five-day course included breathing techniques (see above), yoga asanas, education about stress reduction, and guided meditation. Participants were evaluated at the beginning of the study using the Clinician Administered PTSD Scale (CAPS), which ranks symptom severity on an 80-point scale.

Six weeks after the study began, the yoga and breathing group had dropped their CAPS scores from averages of 57 (moderate to severe symptoms) to 42 (mild to moderate). These improvements persisted at a six-month follow-up. The control group, consisting of veterans on a waiting list, showed no improvement.

About 20% of war veterans who served in Afghanistan or Iraq suffer from PTSD, according to one estimate. Experts treating this population suggest that yoga can be a useful addition to the treatment program.

Researchers at the Walter Reed Army Medical Center in Washington, D.C., are offering a yogic method of deep relaxation to veterans returning from combat in Iraq and Afghanistan. Dr. Kristie Gore, a psychologist at Walter Reed, says the military hopes that yoga-based treatments will be more acceptable to the soldiers and less stigmatizing than traditional psychotherapy. The center now uses yoga and yogic relaxation in post-deployment PTSD awareness courses, and plans to conduct a controlled trial of their effectiveness in the future.

Cautions and encouragement

Although many forms of yoga practice are safe, some are strenuous and may not be appropriate for everyone. In particular, elderly patients or those with mobility problems may want to check first with a clinician before choosing yoga as a treatment option.

But for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.

Where To Find Yoga Classes

Yoga Chicago magazine is a free publication distributed around the Chicagoland area. It contains a directory of all yhe known yoga classes in the city and suburbs of Chicago. Other cities may have similar publications or online services. For the Yoga Chicago main class directory go to this link here.

There are also a number of great yoga DVD’s available from Amazon, or you may find them at Target, Best Buy or Whole Foods Markets:

Yoga for Beginners from Amazon here.

Yoga for Stress Relief from Amazon here.

Yoga for Every Body from Amazon here.

and Yoga for Inflexible People from Amazon here.

Working Well Massage also provides certified yoga instructors for your home or office.

Sources:

Brown RP, et al. “Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part I — Neurophysiologic Model,” Journal of Alternative and Complementary Medicine (Feb. 2005): Vol. 11, No. 1, pp. 189–201.

Brown RP, et al. “Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II — Clinical Applications and Guidelines,” Journal of Alternative and Complementary Medicine (Aug. 2005): Vol. 11, No. 4, pp. 711–17.

Janakiramaiah N, et al. “Antidepressant Efficacy of Sudarshan Kriya Yoga (SKY) in Melancholia: A Randomized Comparison with Electroconvulsive Therapy (ECT) and Imipramine,” Journal of Affective Disorders (Jan.–March 2000): Vol. 57, No. 1–3, pp. 255–59.

Khalsa SB. “Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies,” Indian Journal of Physiology and Pharmacology (July 2004): Vol. 48, No. 3, pp. 269–85.

Kirkwood G, et al. “Yoga for Anxiety: A Systematic Review of the Research,” British Journal of Sports Medicine (Dec. 2005): Vol. 39, No. 12, pp. 884–91.

Pilkington K, et al. “Yoga for Depression: The Research Evidence,” Journal of Affective Disorders (Dec. 2005): Vol. 89, No. 1–3, pp. 13–24.

Saper RB, et al. “Prevalence and Patterns of Adult Yoga Use in the United States: Results of a National Survey,” Alternative Therapies in Health and Medicine (March–April 2004): Vol. 10, No. 2, pp. 44–49.

For more references, please see www.health.harvard.edu/mentalextra.

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