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American Medical Association Family Medical Guide - American Medical Association [50]

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cortisol into the bloodstream. This, in turn, causes a rise in glucose in the blood that prompts the body to release more and more insulin in an attempt to lower the glucose level. Over time, the increased production of insulin leads to insulin resistance, a condition in which the cells no longer respond to the effects of insulin; insulin resistance usually leads to type 2 diabetes. An excess of insulin in the blood also encourages the body to store fat, boosting the risk of obesity.

The chronic release of stress hormones caused by sleep deprivation affects your immune system, making you more susceptible to colds and infections. Also, because your immune system helps your body fight cancer, reduced immune system function from insufficient sleep can put you at increased risk of developing cancer.

Chronic lack of sleep can also accelerate the aging process. When you don’t get enough sleep, your brain doesn’t make the normal amounts of hormones, producing hormone levels similar to those of a much older person. However, subsequently getting a full night’s sleep reverses this aging effect, returning hormone levels to normal.

To get a full night’s sleep, try going to bed earlier than you usually do. Use some of the time you might spend relaxing in front of the TV for needed sleep. Keep your bedroom cool (but not cold); most people find it difficult to sleep in a room that is too hot.

If you have trouble getting a good night’s sleep, the following strategies may be helpful:

• Go to bed and get up at the same time every day—even on weekends—so you can program a sleep schedule into your body’s biological clock.

• Allow enough time each day for at least 8 hours of sleep.

• Engage in relaxing activities before bed. Read a book, listen to soft music, or do relaxation exercises (see page 59).

• Use your bed only for sleep and sex so your mind associates your bed with sleeping and relaxation.

• Drink a glass of fat-free milk before bed. The amino acid tryptophan in the milk will help make you feel sleepy.

• Don’t take work-related reading material to bed with you.

• Don’t watch an exciting TV show or read a book that is stimulating, frightening, or violent right before bed.

• Don’t exercise late in the day. Exercise increases alertness.

• Don’t drink alcohol late in the evening. Alcohol disrupts the sleep cycle.

• Don’t drink anything containing caffeine and don’t smoke for a few hours before bed. Caffeine and nicotine both stimulate the central nervous system.

• Don’t go to bed hungry or on a full stomach. Being hungry stimulates you, while being full can make you uncomfortable and restless.

If you continue having difficulty sleeping and it affects your daily routine, talk to your doctor. Insomnia may signal an emotional problem such as anxiety (see page 718) or depression (see page 709). For other possible causes of sleep problems, see the symptom chart on page 212.

How to Handle Stress


No one can avoid stress, but you can deal with it in effective ways that can help prevent health problems. You can learn coping mechanisms to help you manage your time better and change your response to situations that tend to cause you stress. You also can learn how to relieve stress and tension by counteracting the stress response with the relaxation response.


Manage Your Time

You will feel that you have more control over things if you manage your time better. Set goals and break large projects down into smaller, more manageable tasks so you feel that you’re accomplishing something. Organize your closet, your desk, your kitchen, and any other storage area so you can find things right away. Plan what you’re going to wear the next day the night before so you don’t have to rush in the morning. Do tedious tasks first to get them out of the way and limit procrastination. Establish a routine and follow it. If you can, delegate tasks to others. All these techniques can save time and minimize stress.


Exercise Regularly

Regular, vigorous exercise defuses stress by boosting the brain’s output of chemicals that

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