This tasty salad is perfect for a light spring or summer starter, and is super quick and easy to prepare. Add grilled or broiled chicken, seared tofu, or grilled grass-fed steak to make it a main.

Yield: 2 – 3 servings
Time: 5 minutes

Recipe Ingredients
4 cups arugula
4 medium radishes, thinly sliced
3 tablespoons pine nuts, toasted
2 tablespoons herbed goat cheese
2 tablespoons flaxseed oil
Juice of one lemon
1 teaspoon brown mustard
1 teaspoon raw honey
Salt and pepper to taste

Recipe Preparation
1. Toast pine nuts in a small pan on medium heat, stirring occasionally for 3 minutes or until golden. Set aside.
2. In a small bowl, whisk together flaxseed oil, lemon, mustard, honey, salt and pepper. Set aside.
3. Plate four cups arugula on a serving platter. Thinly slice radishes with a mandolin or grater and scatter the slices on top of the arugula.
4. Top the salad with toasted pine nuts and goat cheese, and lightly drizzle the vinaigrette over the top. Serve and enjoy!

Guest blogger Ashley Burnett is a certified health and body transformation coach, motivational speaker, and founder of virtual health and wellness company Strong Body Love.

We’ve already highlighted some of the best-known wrist-worn fitness trackers like the Nike Fuelband and Jawbone UP. Here’s a look at some of the newest devices that will be hitting the market soon (and one that’s available now!).

1. BodyMedia Fit Core 2

As seen on NBC’s “Biggest Loser,” the BodyMedia Fit Core fitness device is worn on your arm. The Fit Core 2 is a dramatic upgrade from its predecessor, with a longer battery life, wireless data syncing, and reduced size (about the size of a quarter). It’s equipped with temperature, heat flux, galvanic skin response, and 3-axis accelerometer sensors that measure calories burned, exercise intensity, and sleep patterns.

Pros:

• Measures how many steps you’ve taken, two activity levels (moderate or vigorous), sleep patterns, calories burned, and calories consumed
• Connects wirelessly via Bluetooth to the iOS or Android app (mobile/tablet)
• Online dashboard interface shows all your data
• Coaching/training feature recommends activity and dietary adjustments based on your data
• Offers progress sharing on Facebook
• Interchangeable color faceplates and straps to match your style

Cons:

• Somewhat conspicuous; must be worn on your arm all day
• No display; you can’t track your progress directly from the device
• Requires purchasing an additional accessory to measure heart rate
• Monthly subscription required
• Doesn’t offer progress sharing on Twitter
• Not waterproof, so you can’t wear it in the shower or while swimming

Where to Find It: bodymedia.com – August 2013

Cost: $119 – $149

2. Viiiiva

If you’re a data-driven runner/cyclist, the Viiiiva might be the right device for you.

The Viiiiva is a heart rate monitor that connects directly to your iPhone. The monitor measures your heart rate in real time and sends the data via Bluetooth to the Viiiiva iOS app, iOS fitness apps, or smart watches such as those from Garmin, Adidas, or Timex. When paired with a foot sensor pod for runners or bike sensor for cyclists, the app can monitor your heart rate, speed, cadence, power, calories burned, and distance traveled. There are also optional Sportiiiis glasses that can provide you with visual/audio suggestions to keep you on track for your goals.

Pros:

• Transmits heart rate in real-time to the iOS app
• Monitors speed, cadence, power, calories burned, and distance (requires foot pod or bike sensors)
• Links with other iOS fitness apps like Strava and RunKeeper
• Links and displays with ANT+ enabled smart watches like Adidas, Garmin, and Timex

Cons:

• Only compatible with iOS devices
• Requires additional equipment like the foot pod or bike sensors to fully measure your activity
• Requires a standard disc battery (not rechargeable)
• Comes only in black
• Doesn’t measure food intake or sleep patterns
• Doesn’t offer progress sharing on social media sites like Facebook and Twitter

Where to Find It: 4iiii.com - available now

Cost: $79

3. Withings Smart Activity Tracker

Similar to the Fitbit One, Withings Smart Activity Tracker is a small clip-on device that monitors your pulse (via heart sensor on the back), number of steps taken, strides run, distance covered, activity type, stairs climbed, calories burned, and quality of sleep. The device automatically syncs with either iOS or Android apps via Bluetooth. A key feature: It automatically links to your online Withings profile. You can then send your data in real time to your dietitian or physician to help them keep track of your progress and make suggestions based on your behaviors.

Pros:

• Small design, easy to clip on
• Provides a small front display to see your progress with a touch interface
• Measures pulse, steps taken, strides run, distance, type of activity, number of stairs climbed, calories burned, and quality of sleep
• Sends data via Bluetooth to iOS or Android app
• Reminds you to exercise if you haven’t been active in a while
• Offers progress sharing on social media sites like Facebook and Twitter
• Progress can be shared via the Withings network to your physician or dietitian
• Long battery life — can last 2 weeks on one charge

Cons:

• Isn’t waterproof, so you can’t wear it while swimming or in the shower
• Comes only in black
• Doesn’t monitor food intake
• Monitors weight but needs to be paired with the Withings scale (sold separately)

Where to Find It: withings.com – Summer 2013

Cost: TBA

4. LG’s Smart Activity Tracker

The LG Smart Activity Tracker looks very similar to the Nike Fuelband but comes with a lot more features. A wrist-worn waterproof device, it has a touch screen that displays your progress throughout the day. What sets the Smart Activity Tracker apart from other fitness devices is its internal GPS for accurately tracking your physical activity when you’re running or biking. It also integrates with your phone to show incoming calls, text messages, and control your music. Finally, the LG tracker can link to your LG smart TV and track your activity when you participate in LG’s fitness TV apps like Let’s Dance — when you dance along with your favorite music videos, the tracker tells you how many calories you’re burning and gives you motivational cues.

Pros:

• Compatible with iOS and Android devices — compare goals with your friends
• Displays your progress on a Touch screen LED display
• Monitors steps taken, distance run, pace, stairs climbed, goals tracked
• Controls music and displays call info/text messages
• Contains a built-in GPS receiver
• Syncs wirelessly to smartphone apps via Bluetooth
• Connects with LG smart TVs and fitness apps
• Waterproof, so you can wear it in the shower or when swimming
• Comes in multiple sizes and colors: red, black, blue, and orange

Cons:

• Short battery life — lasts 2-3 days on a single charge
• Requires an additional accessory (TBA) to measure heart rate
• Doesn’t offer progress sharing on social media sites like Facebook and Twitter
• Doesn’t have food tracking feature

Where to Find It: lg.com – Summer 2013

Cost: TBA

5. Amiigo

The Amiigo will hit the market this summer. Started via the Indiegogo crowdfunding service, it blew past its $90,000 goal in just a few days. The device comes with two components: a bracelet for upper body activity measurement and a shoe clip for lower body activity. Amiigo automatically measures your activity (e.g., bicep curls, running on a treadmill, dumbbell fly, etc.) based on your movements, eliminating the time-consuming process of manually recording your exercises. Paired via Bluetooth, the two devices will automatically send your data to Amiigo’s iOS or Android app and update your results and goals in real time so you can share them with friends.

Pros:

• Doesn’t require manual exercise entry
• Measures specific exercises, reps, sets, heart rate, speed, intensity, duration, blood oxygen levels, skin temperature, overall activity level, and calories burned
• Waterproof, so you can wear both devices in the shower or when swimming
• Learns from your workouts, so the more you work out, the more data Amiigo has to recommend other workouts for you
• Tracks your progress in real time through the mobile app–you can even challenge friends to competitions
• Earn points for working out and redeem them for health-related discounts/goods
• Syncs automatically via Bluetooth to both iOS and Android devices

Cons:

• No display on the band to track your progress
• Shoe clip is small and might be easy to lose
• No info on battery life
• No info on progress sharing with social media networks like Facebook and Twitter
• No word on food tracking feature
• No word on sleep tracking feature

Where to Find It: amiigo.co – Summer 2013

Cost: $125-$150

We want to know: What kind of fitness devices have you used?

The Problem with Red Meat

We know that the Mediterranean diet, low in red meat and dairy products, increases life expectancy (and, according to new evidence, may lessen the risk of dementia), and that the reverse is true: a diet high in red meat appears to decrease life expectancy. For a long time, we thought that this was a result of the fat and cholesterol in red meat. While fat and cholesterol may play a role, recent research has revealed a fascinating new connection between red meat consumption and atherosclerosis, the process that leads to vascular blockage and subsequent heart attacks and strokes.

What the New Findings Mean

According to this new work, first released in the biomedical research journal Nature Medicine, the bacteria in the intestines of meat eaters convert carnitine, a chemical abundant in red meat, into trimethylamine-N-oxide (TMAO), which increases cholesterol deposition and decreases cholesterol removal from arterial cell walls. Interestingly, when vegetarians eat a large meal of red meat, their TMAO levels don’t rise. The implication is that our eating patterns influence the bacteria we carry in our digestive tracts, and that this affects the way we metabolize our food, which in turn affects our cholesterol metabolism. Scientists have discovered a similar result with lecithin, which is abundant in eggs.

Although high TMAO levels are associated with an increased risk of atherosclerosis, we don’t know whether lowering TMAO levels can reduce the incidence of cardiovascular disease. That’s the next step in pursuing this line of research to a point where clinical intervention may be possible. Notably, the study’s investigators found that when they gave regular red meat eaters an antibiotic followed by a steak, the participants’ TMAO levels did not rise. So perhaps—this is pure speculation at this point—in the future, we could alter the bacteria in our guts (with antibiotics, probiotics, or by some other means) and prevent heart disease!

What You Can Do to Reduce Your Risk

Right now, your best bet is to eat a healthy diet low in red meat, such as the Mediterranean diet, and to exercise regularly, maintain a healthy weight, manage stress, and to quit smoking. We’ll keep you posted on the future of this unexpected research into cardiovascular disease prevention.

Yield: 3 – 4 servings
Total time: 15 minutes

Recipe Ingredients
For the salad:
2 – 3 golden baby beets, peeled and thinly sliced
1 1/2 cups cooked quinoa
2 cooked chicken breasts, sliced
1 – 2 heads of romaine lettuce, washed, dried, and roughly chopped
1 zucchini, thinly sliced on the diagonal
1 yellow squash, thinly sliced on the diagonal
1 bunch chives, finely chopped

For the dressing:
3 tablespoons champagne vinegar
1 – 1 1/2 teaspoons honey
1 1/2 teaspoon Dijon mustard
1 small shallot, finely chopped
1/4 cup extra-virgin olive oil
Salt and pepper to taste

Recipe Preparation
1. Chop the shallot. In a small bowl, mix all of the dressing ingredients and set aside.
2. Wash, dry, and roughly chop the romaine lettuce. Add to a large mixing bowl.
3. Slice the zucchini, squash, and beets. Add all three ingredients the mixing bowl.
3. Chop the chives and set aside.
4. Slice the chicken breasts. Add the chicken and quinoa to the large bowl and toss all of the salad ingredients (except the chives) together.
5. Lightly dress the salad and toss well to coat evenly. Add more dressing if necessary and season with salt and pepper to taste.
6. Garnish with chives and serve immediately.

Recipe Notes
A mandolin creates beautifully sliced produce, but if you don’t have one, a vegetable peeler is just as effective (and much less hassle!).

According a recent report from the Census bureau, the national average commute time is just under half an hour. A 150-pound bicycle commuter burns about 550 calories an hour at a moderate speed (about 12-14 miles per hour). That means in a 30-minute bike commute, you can expect to burn nearly 275 calories before checking email at your desk! And if you commute five days a week, you’ve met the CDC’s recommended goal of two and a half hours of activity.

Health Benefits of Bicycle Commuting

While biking to and from work five days a week is great for physical health, it can also do wonders for your mental health. Exercise boosts metabolism and increases blood flow, which can help with concentration.  And with one in four American adults suffering from a mental health issue in a given year, finding ways to deal with stress is vital. Bicycling home after a long day at work is a great way to  decrease stress. Additional health benefits include lowering cardiovascular risk and building lean muscle. Beyond benefiting body and mind, biking is also good for your wallet, the environment, and the community. Bicycle commuters save money on gas and bus fare, and decrease their carbon footprints.

New Bikers: Getting Started

Beginner bicycle commuters can ease into the habit by taking part in National Bicycle to Work Day on May 17th. It doesn’t take much to get started. In fact, all you need are these items:

• A bicycle
• A helmet
• A bicycle lock
• A front and back bike light if you’re going to ride in the dark

A carbon-fiber road bike isn’t necessary; any bicycle with a proper tune-up will do the trick for a beginner. Bicycle tune-ups ensure that your brakes and gears are working. After a tune-up, put on your helmet, grab your lock, and pack your lights for the commute home, because you’re ready to plan your route.

If you prefer going old school, buy a road bicycle road map to tuck in your pocket as you ride. Road bike maps typically show elevation, so you can plan a route with or without hills. With your smartphone, you can also search for cyclist routes on Google Maps or download an app such as Ride the City, which will route paths for you in 27 major cities.

Know Before You Go

Get to know your bike before you start riding. Are your tires and seat quick-release? If you don’t know, ask the mechanic during your tune-up. At most bicycle shops, you can buy a lock to prevent your seat or wheels from being stolen if you park your bike on the street. Many office buildings in major cities allow bicycles to be parked inside. Check with your building and office prior to your first ride to ensure that space is available. When parking on the street in public places, have a solid lock and remove any quick-release parts.

The benefits of bicycle commuting are well worth the initial investment and planning. Regular riding may even have you looking forward to your morning commute. Happy riding!

Riding Resources

For more information about riding to work in your city, check out the following resources:

Boston
Chicago
DC
New York
San Francisco

Ambien is the most commonly prescribed prescription drug for insomnia in the US. If you’re one of the millions of Americans suffering from insomnia and using sleep medications, here’s a look at what these new FDA recommendations mean for you.

What Sleep Medications Were Included in the New Dosing Recommendations?

The FDA’s new dosing recommendations affect all drugs containing Zolpidem (brand names Ambien, Ambien CR, Edluar, and Zolpimist). These medications are used to decrease the time it takes to fall asleep and to improve quality and duration of sleep. Other sleep medications, such as Lunesta and Sonata, weren’t affected by the dosing change.

What Are the New Dosing Recommendations?

The change lowers the recommended dose by half–from 10mg to 5mg for immediate-release formulas (Ambien and its genetic form) and from 12.5mg to 6.25 mg for controlled-release formulas (Ambien CR). The rationale behind the new recommendations is that using lower doses will decrease the level of the drug that remains in the bloodstream in the morning, reducing the risk of impaired driving.

Why the Change in Dosing Now?

Since Ambien hit the market in the early nineties, the FDA received numerous reports of unsafe driving incidents among patients taking Ambien, but the link between the two had been difficult to prove. The growing number of reports placed the labeling of adverse side effects for sleep medications under scrutiny, making it clear that there was a need for labeling changes and further investigation on the safety of these drugs.

Why Are Women at Greater Risk than Men?

New clinical studies revealed that women taking Ambien are more likely than men to have high levels of the drug remaining in their bloodstream the morning after taking the medication.

Ambien is metabolized primarily in the liver, and since women have lower concentrations of liver enzymes than men, they metabolize the drug more slowly. This results in higher levels of the drug remaining in their bodies in the early morning, increasing the risk of falling asleep at the wheel.

Note: While the decreased dosing is aimed primarily at women, the FDA suggests the lowest effective dose for men as well.

What Are the Other Side Effects of Sleeping Medications?

In addition to morning sleepiness, Ambien and similar sleep medications have a lot of other known side effects. About 10 percent of people taking Zolpidem experience headaches, dizziness, and somnolence (drowsiness). Abnormal dreams, depression, rash, and gastrointestinal irritation (gas, bloating, and abdominal pain) are slightly less common side effects. More serious but far less common reactions include thoughts of suicide, aggressive behavior, and complex sleep behaviors such as sleep-eating and sleepwalking; these occur in fewer than 1 percent of patients.

If I’m Currently Taking Ambien Should I Cut My Dose in Half?

The short answer: You should take the lowest amount of medication that is effective, for the shortest amount of time.

However, finding the right dosing regimen may be complicated if you’ve been using the medication at a higher dose for a long period of time. In addition, the effectiveness of the medication at a lower dose may vary from person to person. Certain situations may warrant a higher dose; for example, if you have clearly documented insomnia, have been on the medication for a long period of time, and/or have tried other treatment regimens without success.

Ultimately, the decision to use Ambien or similar medications at a particular dose is an individual one. Talk to your provider about your dosing, and remember:  It may take time and practice to discover what works best for a good night’s rest.

What Causes Insomnia?

Insomnia is a complex diagnosis that often stems from organic causes such as thyroid disturbances and depression or anxiety. A health care provider can help rule out these and other causes for sleeplessness with a thorough examination. If the provider doesn’t find an organic cause for insomnia, there are many steps you can take that don’t involve regular use of a prescription-strength sleep aid.

A more effective, long-term treatment strategy for insomnia is understanding the principles of sleep hygiene and practicing good sleep habits. If sleep hygiene isn’t enough to solve the problem, cognitive behavioral therapy for insomnia (CBT-I) may be beneficial. Finally, there are also a lot of over-the-counter natural sleep aids that may be effective for occasional bouts of insomnia.

Yield:  4 – 6 servings
Total time: 25 minutes

Recipe Ingredients
For the salad:
10 small new potatoes, scrubbed clean
1 large bunch of asparagus
3 slices of nitrate-free bacon
2 tablespoons mustard seeds, lightly toasted
3 – 4 green onions, finely chopped (both white and green parts)
1/4 cup fresh parsley, finely chopped

For the dressing:
1/2 cup extra-virgin olive oil
1/4 cup raw apple cider vinegar
1 tablespoon Dijon mustard or whole-grain mustard
1 tablespoon garlic, finely minced/crushed
Salt and pepper to taste

Recipe Preparation
1. Boil potatoes in a large pot until tender when pierced with a fork, about 15 to 20 minutes.
2. While the potatoes are boiling, cook bacon and drain on paper towels to minimize grease.
3. Next, steam the asparagus until fork-tender, about 3 to 5 minutes for thin stalks, or 6 to 8 minutes for thick stalks.
4. While the asparagus is steaming, fill a very large bowl about 1/4 full of cold water and ice. Then place a medium bowl inside the large bowl.  The ice water should come up around the sides of the medium bowl but shouldn’t spill over into it.
5. As soon the asparagus is done, run the spears under cold water to stop the cooking, and place them in the medium bowl to cool further.
6. Over low heat in a small pan, lightly toast the mustard seeds until you hear them pop.  Set aside.
7. Chop parsley and green onions and add to a large salad bowl. Chop the cooled bacon into bite-sized pieces and add to the bowl.
8. In a small bowl, mix oil, vinegar, mustard, garlic, and cooled mustard seeds and set aside.
9. Chop the asparagus on the diagonal into 1-inch pieces and place in salad bowl with parsley and green onions.
10. Roughly chop the potatoes and add to the salad bowl. Gently toss everything together with the dressing and serve immediately.

Recipe Notes
Blanching asparagus (or any other vegetable) maintains the vegetable’s bright color and slows the cooking process so you get a perfectly crisp-tender result. The process appears complicated but once you’ve done it, you’ll see just how easy it is!

Editor’s Note: How do you prepare asparagus? Share your tips in the comments!

In the first installment of this series on insomnia, we talked about sleep hygiene, the first step in treating insomnia without medication. Insomnia has many possible causes, including sleep apnea, restless leg syndrome, thyroid issues, or other underlying medical conditions. Most people who struggle with sleep, however, don’t have an underlying medical problem, and for them,  sleep hygiene alone will often restore their ability to achieve a sound, restful sleep each night. But when good sleep hygiene isn’t enough to solve your insomnia, working with a therapist who specializes in cognitive behavioral therapy for insomnia (CBT-I) may be helpful.

What Is Cognitive Behavioral Therapy for Insomnia?

CBT-I is a method of addressing both the behaviors that prevent you from sleeping effectively as well as the thoughts that can interfere with sleep. The behavioral aspect of CBT-I focuses on stimulus control and sleep restriction.

How Does Stimulus Control Work?

CBT-I goes beyond basic sleep hygiene principles–such as reducing caffeine intake and creating a “wind-down” period before bedtime–to delve deeper into stimulus control. The goal is to strengthen the bed as a cue for sleep and weaken it as a cue for wakefulness. These are the fundamental principles of stimulus control:

• Establish a regular wake-up time. Despite what you may have been told about establishing a regular bedtime being key to avoiding insomnia, it’s more effective to set a regular wake-up time. Maintain your rising time even on weekends. This will help you get plenty of morning light, which helps regulate your body’s natural sleep/wake cycle.
• Go to bed only when sleepy. It’s essential to distinguish between fatigue and sleepiness. Fatigue is a low state of physical and mental energy, but it isn’t a reason in itself to try to sleep. Sleepiness is a struggle to stay awake, such as dozing off while watching television or during a train ride.
• Eventually establish a regular bedtime. Once you’re sleeping soundly through the night, you’ll have a good idea of what your “natural” bedtime should be. Stick to your bedtime unless you’re truly not sleepy.
• Don’t lie awake in bed. If you’re unable to fall asleep, or if you wake up in the middle of the night and can’t immediately get back to sleep, get out of bed and do something quiet and relaxing, such as reading. Return to bed only when you feel sleepy again.
• Avoid napping during the day. For people without insomnia, an afternoon nap isn’t necessarily a bad thing. But for folks with sleeplessness issues, a nap can further disrupt the body’s sleep/wake cycle. For the purposes of CBT-I, don’t sleep during the day.

The Core of CBT-I: Sleep Restriction

Sleep restriction as a treatment for insomnia might seem counterintuitive. However, this therapy is very effective for putting sleeplessness to rest (so to speak). Studies indicate that 75 to 80 percent of people see significant improvement within four weeks of starting sleep restriction with a CBT-I therapist. Because it’s difficult to properly maintain a sleep restriction schedule while working through the issues causing your insomnia, it’s important to practice sleep restriction only with a trained CBT-I therapist or health care provider who can help you navigate potential challenges.

Here’s how sleep restriction works:

1. Your therapist will ask you to calculate how much sleep you get on an average night. In a bedside journal, record how much time you spend sleeping per night. After a week, calculate the average number of sleep hours you got each night. That’s your starting point.
2. Let’s say you calculated an average of 6 hours of sleep per night in that first week. For the next week, if your alarm is set for 8:00 a.m., get into bed 6 hours before that time. In this example, you’d go to bed at 2:00 a.m. After a few days of doing this, you should notice a decrease in your middle-of-the-night wakefulness. If you don’t, talk to your therapist.
3. After one week of sleep restriction, your therapist will advise you to add 30 minutes to your sleep time (assuming your nighttime wakefulness remains minimal). In this example, you’d now go to bed at 1:30 a.m.
4. After one week of going to bed at 1:30 a.m., add another 30 minutes to your sleep time. Continue adding 30-minute increments to your sleep time each week until you’re getting about eight hours of restful sleep per night.
5. If you begin to experience significant wakefulness in the middle of the night, your therapist will likely advise you to return to more sleep restriction to get back on track.

Don’t be discouraged if you feel tired in the first few weeks of sleep restriction. This is very common. In resetting your body’s sleep clock, you’ll slowly begin to experience more restful sleep.

Don’t Forget the Basics of Good Sleep Hygiene

CBT-I works best if you’ve already established great sleep hygiene. It’s important to reduce arousal and activation, as well as avoid ingesting certain substances. Here’s a brief recap:

• Maintain a bedtime ritual that involves an hour of wind-down time to relax and induce sleepiness.
• Avoid exercising within four hours of bedtime.
• Avoid exposure to bright light (especially TV or computer screens) within an hour of bedtime.
• Create a comfortable, pleasant, quiet sleep environment in your bedroom.
• Avoid clock-watching, which can cause anxiety.
• Make the cognitive switch from “trying hard to sleep” to “allowing sleep to happen.”
• Avoid caffeinated food and beverages after noon.
• Avoid taking medications that contain caffeine when it’s near bedtime.
• Don’t eat a meal close to bedtime, and don’t snack in the middle of the night.
• Ease up on alcohol. Alcohol may make falling asleep easier, but it increases tossing and turning in the second half of the night.
• Don’t smoke. Smoking and nicotine withdrawal (from quitting smoking) can both interfere with sleep. Your best bet is to quit smoking before starting CBT-I.

Unhelpful Thinking Can Prevent Sleep

Where does therapy fit into the equation? Beyond behaviors, your thoughts about sleep can often prevent you from achieving restful sleep. A therapist trained in CBT-I can help you identify harmful thoughts and teach you how to challenge and change them. For continued sleep worries, your therapist might recommend a “worry journal” to write down everything that’s bothering you, or prescribe a designated time to worry. The goal with both tactics is to think about all of these issues before you go to bed. If nightmares or anxiety interrupt your sleep, there might be more appropriate therapies for you.

CBT-I Isn’t a Do-It-Yourself Project

Depending on your specific needs, CBT-I may involve more than sleep restriction and stimulus control, such as light therapy in conjunction with other techniques. When looking for a CBT-I therapist, be sure to find out how and where the provider received his or her training. Being trained in cognitive behavioral therapy alone doesn’t qualify a person to administer CBT-I, which requires additional education specifically in insomnia.

The length of CBT-I depends on the issues underlying your insomnia. It typically consists of four to eight 50-minute sessions with a clinical psychologist who understands the specifics of sleep issues. Because sleep restriction is particularly challenging, select a provider who will work closely with you to help you achieve your sleep goals.

Steamy night? Wondering whether you should get tested? One Medical’s Kristen Foskett, RN, covers the basics of STD screening, including how long you’ll have to wait for accurate results for the most common STDs.

Did you know that all organic produce labels begin with #9? Get even more earth-friendly health tips in this Earth Week interview series with One Medical’s Mark Berman, MD.

Our #MyHealthyHabit contest is open through May 9th! Win an exclusive sailing experience for two with the ORACLE TEAM USA sailors on the San Francisco Bay, including dinner, and a two-night hotel stay.

Stay tuned next month for the announcement of our contest winner and more healthy living tips, news, and advice.

Eat Well

Massaged Kale Salad with Avocado and Apple by Samantha Treyve, MS, RD

Wild Salmon and Spinach in Parchment by Alice Stern

Asparagus Kale Salad with Slivered Almonds by Ashley Burnett

Hungarian Vegetable Soup by Alice Stern

Live Well

STD Screening: The Basics by Kristen Foskett, RN

Earth Week Q&A with a Vegan Doctor: Part 1 by Nikki Jong

Earth Week Q&A with a Vegan Doctor: Part 2 by Nikki Jong

How to Treat Insomnia Without Medication: Part 1 by Ellen Goldstein, MD

Health Headlines

For Men Only: The Hair Loss-Heart Disease Connection by Malcolm Thaler, MD

Some Unexpected Good News About Stress by Malcolm Thaler, MD

One Medical News

One Medical in Your Pocket by Kameron Kitajima

#MyHealthyHabit Photo Contest: Win an Exclusive Sailing Experience by Kameron Kitajima

Editor’s Note: Looking for more wellness tips and healthy recipes? Become a fan on Facebook, and follow us on Twitter and Pinterest!

What Is Insomnia?

Many people think the term “insomnia” refers to a complete lack of sleep. In truth, insomnia encompasses a host of sleep problems, including:

• Difficulty falling asleep
• Waking up in the middle of the night
• Early morning awakening
• Non-restful sleep

Don’t Be a Hero: The Negative Effects of Insomnia

Ever heard someone brag that he or she only needs six hours of sleep? While it’s admirable to try to put a positive spin on a negative situation, taking a heroic attitude toward sleeplessness can be bad for your health. Most people need between seven and nine hours of sleep. Getting insufficient sleep can:

• Cause fatigue, irritability, and excessive daytime sleepiness
• Cause weight gain and make it difficult to lose weight
• Weaken the immune system, making you more susceptible to getting sick
• Cause elevated blood pressure and can increase the risk of diabetes and heart disease
• Contribute to chronic pain
• Exacerbate mental illness, including depression and anxiety
• Reduce focus and concentration, leading to decreased performance at work
• Decrease motor function, making driving hazardous

Techniques for Relieving Insomnia without Medication

Meds can be good for some things. And certainly some natural or herbal sleep products may help you get some rest. But prescription pills for sleeping aren’t always the best solution.

Unfortunately, some sleep medications can actually make the problem worse. Sleep aids frequently disrupt sleep cycles, causing less restorative sleep. Even if they help you sleep through the night, the sleep is not necessarily deep or restful. People can become dependent on these meds, requiring them to sleep, and many develop a tolerance to sleep meds over time, requiring more medication to get the same effect. These meds can also cause rebound insomnia, meaning it becomes even harder to fall asleep without the medication. So before you pop that pill for your sleep problems, try these methods instead:

1. Sleep Hygiene
2. Brief Cognitive Behavioral Treatment Intervention for Insomnia (also called “CBT-I”), which will be covered in part two of this series on insomnia.

What Is Sleep Hygiene?

Sleep hygiene is a collection of habits that can help you fall asleep more easily and sleep more deeply. You can develop good sleep hygiene on your own. Try following our 7 Habits of Highly Successful Sleepers and this list of do’s and don’ts.

Sleep Hygiene: Do’s & Don’ts

The Do’s:

• Stick to a regular sleep schedule (same bedtime and wake-up time), seven days a week.
• Exercise at least 30 minutes per day most days of the week. Restrict vigorous exercise to the morning or afternoon. More relaxing exercise, like these yoga poses to help you sleep, can be done before bed.
• Get plenty of natural light exposure during the day. Open your blinds first thing in the morning and get outside during the day. You can even try using a light box first thing in the morning during dark winter days to help your brain wake up and regulate your body’s rhythms.
• Establish a regular, relaxing bedtime routine.
• Take a warm bath or shower before bed.
• Do relaxation exercises before bed, including mindful breathing and progressive muscle relaxation.
• Make sure your sleep environment is pleasant and relaxing. Your bed should be comfortable, and your room shouldn’t be too hot, too cold, or too bright. If necessary, use earplugs and an eyemask. Be sure your pillow is comfortable.
• Associate your bed with sleep and sex only. Don’t work, eat or watch TV in bed.
• Go to bed when sleepy, and get out of bed if you’re tossing and turning.
• Turn your clock around so you can’t see the time.
• Turn off the alert for texts and emails on your phone.
• Keep a “worry journal.” If something’s on your mind as you’re trying to fall asleep, write it down on a pad of paper so you can revisit it the next day.
• If you’re unable to fall asleep after about 20 minutes, leave bed and do something relaxing (like reading); return to bed later.
• Download free screen-dimming software for your computer. Two popular programs are f.lux and Dimmer. These nifty programs help you avoid the stimulation of bright light if you’re using your computer late at night. Better yet: Put the computer away an hour before bedtime!

The Don’ts:

• Don’t ingest caffeine after noon. This includes coffee, tea, iced tea, energy drinks and soda.
• Don’t have that second glass of wine with dinner. While alcohol is known to speed the onset of sleep, it also disrupts sleep–especially causing arousal during the second half of the night, when the body should be entering deep sleep.
• Don’t take other stimulants close to bedtime, including chocolate, nicotine and certain medications.
• Don’t eat a large, heavy meal close to bedtime.
• Don’t watch TV, use the computer or spend long periods on a mobile device before bed. These activities stimulate the brain and make it harder to fall alseep.
• Don’t use your phone, laptop, or other mobile device in bed.
• Don’t give in to the urge to nap during the day; it can disturb the normal sleep/wakefulness pattern.

If Sleep Hygiene Isn’t Enough

Sleep hygiene alone is often enough to get you sleeping better. The tricky part is maintaining your good sleep habits—it can be hard to have the self-discipline to stick with good sleep hygiene.

If you’ve diligently applied good sleep habits and still find you’re not sleeping well on a regular basis, it might be time to think about Cognitive Behavioral Therapy for Insomnia, or CBT-I. Stay tuned for more information in our next installment on insomnia.