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Sleep is an essential component of health and well-being along with nutrition, exercise and managing stress. Too often time for sleep is sacrificed for completing other tasks that require wakefulness. It is becoming increasingly clear that there a host of negative consequences for our health and well-being when adequate sleep is lacking. Honoring our body’s need for sleep is important.

It is estimated that almost 40% of Americans get less than 7 hours of sleep a night. Experts generally agree that adults need 7-9 hours of sleep each night. Quality of sleep is just as important. The Centers for Disease Control and Prevention has called insufficient sleep a public health epidemic citing societal factors such as 24/7 access to technology, and the incidence of sleep disorders such as sleep apnea and chronic insomnia.

Researchers are looking into the relationship between sleep deprivation and several health issues. Many studies have demonstrated that there are long term consequences of regular sleep deprivation including: increased risk of diabetes and cardiovascular disease, decrease in immune function, increased risk of developing major depression and links to obesity.

Not getting adequate sleep also leads to feeling more stressed, irritable and a decreased ability to concentrate. There is also an impact on our relationships as research suggests that inadequate sleep can impair our ability to appreciate our loved ones which can lead to increased relationship stress. As you begin to pay attention to your own sleep pattern, you will discover how different areas of your life are being affected.

The good news is that there are many strategies to improve sleep. Some of these include:
- Regular physical exercise during the day
- Yoga and Tai Chi may have tremendous benefits as they offer physical activity and relaxation
- Avoiding caffeine later in the day (See Coffee article below)
- Nurturing healthy relationships
- Developing a sleep routine (See Healthy Sleep Habits article)
- Mindfulness/meditation practice (Links to resources in the Healthy sleep Habits article)
- Consider enjoying a relaxing nighttime herbal tea in the evening as part of a bedtime routine
- There are several dietary supplements that may also be part of a comprehensive plan to improve sleep-discuss with your health care practitioner/physician what would be best for you

Interested in additional information? A helpful resource is: http://www.healthysleep.med.harvard.edu

Getting the sleep we need is essential to our health and well-being. If you are experiencing challenges with sleep, speak with your physician to assess your unique situation and develop an individualized plan.

In good health,

Sandra Murray, MD and the Integrative Health Center Team

Our sleep can be disrupted or enhanced by what we do (our habits/behaviors) before bedtime. The environment we sleep in can also impact the quantity and quality of our sleep. These factors are known as “sleep hygiene” and are often largely under our control, which is great news! Often, shifts in our bedtime behaviors can positively impact our sleep. Below are a few suggestions for improving sleep hygiene and in turn improving the quantity and quality of your sleep.

Prioritize Sleep. Sleep is a key factor in our overall health, yet it is often the first thing cut when we want to accomplish other tasks.  Prioritizing sleep benefits not only our physical health, but also our mental health--both factors in getting more done (and enjoyed!) during our wake time.

Create a sleep routine. Having a healthy bedtime routine allows our minds and bodies to unwind and prepare for sleep. A healthy routine would include relaxing activities in the hour or so before bed. (Additional suggestions are discussed below.) Maintaining a fairly consistent bedtime and wake time are also helpful to getting quality sleep. Banish smartphones and other devices with screens (including TV!) from your bedroom.  Numerous research studies note that these devices are not only overstimulating, but the blue light emitted from the screen interfers with our bodies' ability to recognize night from day.

Power down and unwind. You need to prepare for a quality night’s sleep. The most effective way is to start slowing down an hour before your usual bedtime. That last Facebook or text message can wait until the morning. Put your cell phone on “Silent” mode and otherwise turn off electronics an hour or more before bedtime.

Identify what you can control. Earplugs and a white-noise machine help drown out extraneous noise, for instance, and a pitch-black room makes for sounder sleep. Discuss the importance of these things with a partner if they are not yet on board with their importance to your sleep.

Calm your mind. Replace the hour you spend watching reruns with a mind-calming routine. For example, meditation, progressive muscle relaxation, a hot bath with chamomile tea and a good mindless book, or deep breathing. It is important to find what works for you to shut down your mental chatter so you can drift into a solid night’s sleep.

Avoid a nightcap. That second glass of chardonnay might knock you out, but it also causes dehydration and poor sleep. If you have a drink with or after dinner, pair it with 2 glasses of water.

Limit caffeine. Especially if you’re a slow metabolizer, a mid-afternoon java jolt can leave you jittery before bed. Keep the caffeine to morning hours and switch to decaf green tea by afternoon.

Stop eating 2-3 hours before bedtime. The 11 p.m. cravings for left-over chocolate cake or potato chips inevitably crashes your blood sugar and cuts into quality sleep. If you’re hungry before bed, you may not have eaten dinner right or you may benefit from having a small protein snack. You also could be thirsty. Try drinking a small glass of water before going to bed. Be careful of the amount you drink, because if you drink too much, your bladder will wake you and disrupt your sleep.

Keep exercise early (but don’t skip out!). Exercising too late in your day can leave you wired before bed. Keep exercise during the morning or early afternoon hours, if possible.

Only sleep or experience intimacy in your bedroom. Typically, watching T.V. or other activities that stimulate your mind tend to be a barrier to quality sleep.

Sleep is essential to our health and wellness. Try out some of these suggestions and see if they positively impact your sleep. Sweet Dreams!

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by Tracy Baginski, CCN

If you are one of the 83% of Americans who drink coffee this article is for you, especially if you suffer from insomnia or occasional sleeplessness.

Some Interesting Facts About Coffee

According to a March, 2013 Bloomberg article, American’s are the world’s biggest consumers of coffee, followed by Brazil and then Germany.  Just how much does the biggest consumer spend annually?  Try $40 billion dollars!

On average, coffee drinkers consume just over 3 cups (9 ounces/each) of coffee daily.

Daily consumption is decreasing in younger (under 39 years old) age groups and increasing in those aged 40 and over.

There is 260 mg of caffeine in a tall cup (12 ounces) of brewed coffee from Starbucks.

Health Effects

If you’ve been following the research, then you’ve noticed that there have been several studies published in peer-reviewed journals touting the health benefits of caffeine, including improved mental and physical performance, lower rates of diabetes and Parkinson’s.

Negative reports include increased calorie consumption from the cream, sugar, syrup and baked goodies that often accompany the aromatic beverage, but that’s not all:

According to a February, 2010 article in the European Journal of Clinical Nutrition (EJCN), coffee consumption appears to make insulin less effective and has an unfavorable impact on arterial function (more specifically, the endothelium).  It also raises homocysteine (EJCN, 2003).  High levels of homocysteine are associated with increased risk of both heart attacks and strokes.

Coffee and Sleep

It’s no surprise that coffee has consistently been shown to have a detrimental effect on sleep. According to the Institute for Scientific Information on Coffee (ISIC), coffee impacts sleep in a variety of ways:
- Falling asleep: falling asleep takes longer.  This effect is also known as sleep latency
- Sleep duration: length of sleep is decreased when caffeine is consumed
- Sleep quality: increases ‘light sleep’ and decreases ‘deep sleep’ duration

According to the National Sleep Foundation, it takes about 6 hours to eliminate 1/2 of the caffeine in a cup of coffee. The rate that caffeine is metabolized varies between individuals based on their genetic make up and other factors.

Fret not!  Sleep experts report that you can still enjoy a cup of coffee, obtain the health benefits and get a good night sleep by following these suggestions:

- Drink your coffee in the  morning
- Avoid caffeine after 2:00pm
- Taper coffee/caffeine intake as the day progresses
- Avoid extra-large, ‘grande’ and ‘venti’ sized beverages.

Keep in mind, a cup of coffee is-by definition-8 ounces. Enjoy responsibly!

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"Sleepy Tea" from nourishedkitchen.com

A soothing herbal tea of lemon balm, mint, fennel, licorice and flowers, this tea is a calming bedtime tea for children (and grownups, too).

Ingredients

•     1 tablespoon dried lemon balm
•     2 teaspoons dried peppermint
•     1 teaspoon fennel seeds
•     1 teaspoon dried rose petals
•     1 teaspoon dried lavender flowers
•     2 slices dried licorice root
•     honey (as needed)

Instructions

•  Place a kettle of filtered water onto the stove and bring to a boil.
• While the water comes to a boil, place herbs and spices into a mortar and crush with a pestle until roughly combined. Transfer to a teapot, pour boiling water over the herbs and steep for three to five minutes.
•  Strain and serve with honey, as you like it.

Please join us in welcoming Emily Jane Zaragoza, M.D. to the Integrative Health Center!

"Dr. Z" was born and raised in the Midwest state of Ohio. She received her Bachelor of Arts degree in Biology at The College of Wooster in Wooster.  She earned her medical degree at the Medical College of Ohio (MCO) as well as completing her residency training as an accelerated family practice resident at the MCO/ St. Vincent Medical Center Family Practice Residency. She completed a faculty development fellowship in curriculum design at Michigan State University. She has taught medical students, resident physician and physician assistants for nearly 20 years. She earned a master in medical management from the University of Southern California Marshall School of Business. She has served as Medical Director at various clinics. She is currently a fellow at the University of Arizona Integrative Medicine Program.

She has special interest women’s health care issues and working with patients to find balance and wellness in their lives through integrative medical practice. She has a strong commitment to teach and empower her patients to live healthier lives.

Our Medical Director, Heidi Rula MD, is leading a discussion titled "Healthcare for the Optimal You" at the Arizona Science Center on Thursday, May 22, 2014. Her talk will examine how dementia and other neurological deaths have dramatically increased over the last 30 yrs and will review integrative medicine strategies to help keep your brain healthy for the years to come. Find out additional information and register for this free event here.

We are pleased to announce that we will again be offering HeartMath as a class choice for our enrolled members.

HearthMath is a collection of tools and technologies especially designed to lower stress and increase emotional and physical resilience. HeartMath interventions help to establish a new physiological baseline - a measurable change in heart rate variability (HRV) that you can both see (on a computer screen) and experience. You will learn to sustain this change in the midst of your challenging daily lives.

As a result of using HeartMath interventions you may experience better sleep, more energy, improved mood, less stress, less anxiety, more joy, greater mental clarity, improved intuition, improved concentration, more optimism, improved performance and greater overall well-being. These factors naturally enhance physical and mental health.

Kathy Engles, PA will be leading the class.  Each participant will be able to use a HeartMath "gadget" (an Emwave 2 or a connector compatible with their personal Iphone) to practice and monitor their HeartMath experience. The class will meet for 3 weeks on Thursdasy beginning on June 12 and ending June 26.  Participants can choose either the 10:00-11:00 am session or the 5:30-6:30pm session. Please call 602-470-5577 to register!

Want to find out more? Check out the HeartMath site here.

Several recent articles have examined the idea that we are denying the importance of sleep and try to "catch up" on the weekend.  Unfortunately, this often leads to a groggy Monday morning as our catching up actually disrupted our internal clock. Learn more about sleep debt, how to manage it (here too) and our internal clocks here and  here.

Dr. Weil is also reporting recent findings about sleep:

"Researchers at Louisiana State University have shown that insomnia-plagued seniors can sleep nearly an hour and a half longer nightly by drinking two eight-ounce glasses of tart Montmorency cherry juice daily. The cherries are a natural source of melatonin, a hormone that regulates the sleep/wake cycle, and the juice also contains proanthocyanidins (a type of antioxidant) that the research team credits with helping to promote sleep." Read Dr. Weil's ttake on the research here.

Reminder: Yoga, Tai Chi and MBSR classes now meet in the DMG building, 3141 N. 3rd Avenue, Phoenix, AZ  85013

Please click to our online Class Schedule for a monthly view of our classes. Current members, please register for all classes at the front desk or call 602-470-5577 .

• The next  Nutrition 101 session will meet on Wednesdays, beginning June 4. Participants can choose either a 10:00AM or a 5:30PM class. Classes are held inside the Center.
• Heart Math will meet on Thursdays for three weeks beginning on June 12. Participants can choose either a 10:00AM or a 5:30PM class. Classes are held inside the Center.  
• Mat Yoga (every Monday at 5:30) and Tai Chi (every Thursday at 5:30) will meet in the DMG building, 3141 N. 3rd Avenue, Phoenix, AZ  85013. These 2 courses are ongoing and meet every week, all year. All other classes are held inside the clinic.

For additional detail, access our online Class Schedule.

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Mat Yoga

This is a basic, self-paced class emphasizing the fundamental poses of yoga to reinforce foundation and focus. Appropriate for all levels of student. Meets weekly. Taught by Dawn Rutledge

Tai Chi

Tai Chi and Qigong are a gentle series of circular and stretching movements that help relieve stress while increasing one’s natural energy. Benefits of a regular practice include improved blood pressure, circulation, muscle and joint flexibility, balance, mental clarity, and peace of mind. This class is appropriate for all levels and experience, including seniors and those with physical challenges. Meets weekly. Taught by Don Fiore

HeartMath

HearthMath is a collection of tools and technologies especially designed to lower stress and increase emotional and physical resilience. HeartMath interventions help to establish a new physiological baseline - a measurable change in heart rate variability (HRV) that you can both see (on a computer screen) and experience. You will learn to sustain this change in the midst of your challenging daily lives.

As a result of using HeartMath interventions you may experience better sleep, more energy, improved mood, less stress, less anxiety, more joy, greater mental clarity, improved intuition, improved concentration, more optimism, improved performance and greater overall well-being. These factors naturally enhance physical and mental health.

Nutrition 101

Our Nutrition 101 class provides a 6 week tour of our foundational program: The Mediterranean Plate.  This class is designed for anyone who seeks a deeper understanding of the role that foods play in inflammation, healthy aging, and overall health.  We will review the practical, hands-on aspect of gradually transitioning your kitchen (meals and food choices included) into a healthy and delicious food pharmacy.  Taught by Tracy Baginski, BS, CCN

Seasonal Foods

This is a hands-on, experiential class centered on preparing meals using seasonal, fresh, local foods. In this year long, 4-class series, you will have an opportunity to roll up your sleeves, don your apron, and get some ideas for incorporating seasonally-based foods into your meals. Recipes and tastings are included. Taught by Tracy Baginski, CCN

Mindfulness Based Stress Reduction

Mindfulness practice is ideal for cultivating greater awareness of the connections between mind and body, as well as of the ways our unconscious thoughts, feelings, and behaviors can undermine physical health and mental wellness. Mindfulness can be helpful for reducing stress, relaxing your mind and calming the internal chatter we often experience during our hectic lives.  MBSR was developed in 1979 by Dr. Jon Kabat-Zinn at UMASS Medical School. This is a manualized, evidence-based, 8-week program. MBSR is highly participatory and deeply engaging experiential learning.

Our MBSR course is taught by Thomas Best M.D., who is board-certified in two medical specialties and has practiced mindfulness meditation for over a decade. Dr. Best has attended numerous training programs across the world in preparation to assist each participant of this course into a mindfulness practice and has spoken nationally on mindfulness meditation and many other topics