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Health
Healthwatch
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Healthwatch
Are You Getting Health Care You Don't Need?
~6.1 mins read
Knowing which types of care you can safely skip might actually improve your health — and could save you money and time.
Older recommendations favored daily low-dose aspirin to help prevent cardiovascular disease, including first instances of heart attack and stroke.
New recommendations favor low-dose aspirin for people who've already experienced a heart attack, stroke, or other cardiovascular disease. Adults ages 40 to 59 who are at a high risk for these conditions and low risk for bleeding also may consider it.
The discomfort or complications of testing. If you're needle-phobic, getting a blood test is a big deal. And while complications of noninvasive testing are rare (such as a skin infection from a blood test), they can occur.
The anxiety associated with waiting to find out test results
False reassurance that comes with false negatives (results that are normal or nearly so, suggesting no disease when disease is actually present)
All treatments have side effects. Even minor reactions — like occasional nausea or constipation — seem unacceptable if there's no reason to expect benefit from treatment.
Ever wonder if every medical test or treatment you've taken was truly necessary? Or are you inclined to get every bit of health care you can? Maybe you feel good about getting the most out of your health insurance. Perhaps a neighborhood imaging center is advertising discounted screening tests, your employer offers health screens as a perk, or you're intrigued by ads touting supplements for a seemingly endless number of conditions.
But keep in mind: just because you could get a particular test or treatment or take a supplement doesn't mean you should. One study suggests that as much as 20% of all health care in the US is unneeded. In short: when it comes to health care, more is not always better.
Isn't it better to be proactive about your health?
We're all taught that knowledge is power. So it might seem reasonable to want to know as much as possible about how your body is working. And isn't it better to take action before there's a problem rather than waiting for one to develop? What's the harm of erring on the side of more rather than less?
The truth is that knowledge is not always power: if the information is irrelevant to your specific situation, redundant, or inaccurate, the knowledge gained through unnecessary health care can be unhelpful or even harmful. Unnecessary tests, treatments, and supplements come with risks, even when they seem harmless. And, of course, unnecessary care is not free — even if you're not paying a cent out of pocket, it drives up costs across health systems.
Screening tests, wellness strategies, and treatments to reconsider
Recommended screening tests, treatments, and supplements can be essential to good health. But when risks of harm outweigh benefits — or if proof of any benefit is lacking — think twice. Save your time, money, and effort for health care that is focused on the most important health threats and backed by evidence.
Cancer screening: When to stop?
Screening tests for some cancers are routinely recommended and can be lifesaving. But there's a reason they come with a recommended stop age. For instance, guidelines recommend that a person at average risk of colorectal cancer with previously normal colonoscopies stop having them once they turn 75. Similar limits apply to Pap smears (age 65) and mammograms (age 75). Studies suggest that beyond those ages, there is little benefit to continuing these screens.
Watch out for wellness marketing
Dietary supplements are a multibillion-dollar industry. And a whopping 70% or more of US adults take at least one, such as vitamin D, fish oil, or a multivitamin. People often consider them as insurance in case vital elements are missing from their diet, or they believe supplements can prevent dementia, heart disease, or another condition.
Yet little evidence supports a benefit of routine supplement use for everyone. While recent studies suggest a daily multivitamin might slow cognitive decline in older adults, there's no medical consensus that everyone should be taking a multivitamin. Fish oil (omega-3) supplements haven't proven to be as healthful as simply eating servings of fatty fish and other seafood low in toxic chemicals like mercury and PCBs. And the benefits of routinely taking vitamin D supplements remain unproven as well.
It's worth emphasizing that dietary supplements clearly provide significant benefit for some people, and may be recommended by your doctor accordingly. For example, if you have a vitamin or mineral deficiency or a condition like age-related macular degeneration, good evidence supports taking specific supplements.
Reconsider daily aspirin
Who should be taking low-dose aspirin regularly? Recommendations have changed in recent years, so this is worth revisiting with your health care team.
Yet according to a recent study, nearly one-third of adults 60 and older without past cardiovascular disease take aspirin, despite evidence that it provides little benefit for those at average or low risk. Aspirin can cause stomach bleeding and raise risk for a certain type of stroke.
Weigh in on prostate cancer screening
Men hear about prostate cancer often. It's common, and the second leading cause of cancer deaths among men. But PSA blood tests and rectal exams to identify evidence of cancer in the prostate are no longer routinely recommended for men ages 55 to 69 by the United States Preventative Services Task Force.
The reason? Studies suggest that performing these tests does not reliably reduce suffering or prolong life. Nor do possible benefits offset downsides like false positives (test results that are abnormal despite the absence of cancer). That can lead to additional testing, some of which is invasive.
Current guidelines suggest making a shared decision with your doctor about whether to have PSA testing after reviewing the pros and cons. For men over age 70, no screening is recommended. Despite this, millions of men have PSA tests and rectal examinations routinely.
Not everyone needs heart tests
There are now more ways than ever to evaluate the health of your heart. But none are routinely recommended if you're at low risk and have no signs or symptoms of cardiovascular disease. That's right: in the absence of symptoms or a high risk of cardiovascular disease, it's generally safe to skip EKGs, stress tests, and other cardiac tests.
Yet many people have these tests as part of their routine care. Why is this a problem? Having these tests without a compelling reason comes with risks, especially false positive results that can lead to invasive testing and unneeded treatment.
Four more reasons to avoid unnecessary care
Besides the concerns mentioned already, there are other reasons to avoid unnecessary care, including:
The bottom line
You may believe your doctor wants you to continue with your current schedule of tests and treatments, while they might think this is your preference! It's worth discussing if you haven't already, especially if you suspect you may be taking pills or getting tests you don't truly need.
If your doctor says you can safely skip certain tests, treatments, and supplements, it doesn't mean that he or she is neglecting your health or that you don't deserve great health care! It's likely that the balance of risks and benefits simply doesn't support doing these things.
Less unnecessary care could free up resources for those who need it most. And it could save you time, money, and unnecessary risks or side effects, thus improving your health. It's a good example of how less can truly be more.
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Healthwatch
Should You Be Sleepmaxxing To Boost Health And Happiness?
~6.1 mins read
This viral wellness trend may be more hype than substance.
taping your mouth shut while sleeping
not drinking anything during the two hours before bedtime
a cold room temperature
a dark bedroom
using a white noise machine
not setting a morning alarm
showering one hour before bedtime
eliminating caffeine
eating kiwis before going to bed
taking magnesium and melatonin
using weighted blankets
getting 30 minutes of sunlight every day
meditating daily for 30 minutes.
Taking melatonin is recommended by the American Academy of Sleep Medicine to treat circadian rhythm disorders such as jet lag. But it's not recommended for insufficient sleep, poor sleep quality, or difficulty with falling asleep or staying asleep.
Is it healthier to be asleep by 10 p.m.? One video that garnered more than a million views claims it is. While it is important to maximize morning sunlight exposure and minimize evening light exposure to regulate circadian rhythms, there is such variability in how much sleep someone requires and individual chronotypes (not to mention varying personal and professional responsibilities!) that it is difficult to state there is an ideal bedtime for everyone.
While intriguing research has been done on weighted blankets, there is no convincing evidence that they are truly effective for the general adult population.
Overall, it's important to be cautious about the impact of the placebo effect on how someone sleeps. An analysis of more than 30 studies showed that roughly 64% of the drug response for a sleep medication in insomnia patients could be due to the placebo effect. A key takeaway is that studies that are not randomized controlled trials — such as this small study on 24 people suggesting that kiwi fruit may improve sleep — should be interpreted with a grain of salt.
If you've been on TikTok lately, you know it's hard to avoid countless influencers touting a concept called sleepmaxxing. Their posts provide tips and tricks to get longer, better, and more restorative sleep. And why not? Sleep is considered a pillar of good health and is related to everything from brain health to cardiovascular health, and even diabetes.
But what exactly is sleepmaxxing? And how likely is it to deliver on claims of amped-up energy, a boost to the immune system, reducing stress levels, and improving your mood?
What is sleepmaxxing?
Depending on which social media platform you happen to be looking at, the recommended strategies for maximizing sleep differ. Tips include:
Does any research support sleepmaxxing?
A thorough search through PubMed, PsycNet, and Google Scholar reveals zero results for the terms "sleepmaxx" and "sleepmaxxing." But wait — this certainly doesn't mean that some influencer-recommended strategies are not evidence-based, just that the concept of sleepmaxxing, as a defined package, has not been scientifically studied. But yes, some of the strategies — including one uncomfortable, though popular, choice — lack evidence.
Can mouth-taping improve your sleep?
TikTok users have claimed that taping your mouth while you sleep has benefits, such as reducing snoring and improving bad breath. A team from the department of otolaryngology at George Washington University was prompted by all of the social media buzz on the topic to review research on the impact of nocturnal mouth taping. Spoiler alert: the authors note that most TikTok mouth-taping claims aren't supported by research.
If you do snore, it's important to discuss this with your medical team. Even if taping your mouth reduces your snoring, it can't effectively treat a potential underlying cause of the snoring, such as allergies, asthma, or sleep apnea.
Sleepmaxxing or basic sleep hygiene?
Many strategies recommended by sleepmaxxers are essentially what sleep experts prescribe as good sleep hygiene, which has plenty of research backing its value. Common components of sleep hygiene are decreasing caffeine and alcohol consumption, increasing physical activity, sleep timing, reducing evening light exposure, limiting daytime naps, and having a cool bedroom.
While tips like these help many people enjoy restful sleep, those who have an insomnia disorder will need more help, as described below.
Melatonin, early bedtime, weighted blankets, and — kiwi fruit?
Other strategies suggested by sleepmaxxers are based on limited scientific data. For example:
Could you have orthosomnia?
The expectation of flawless sleep, night in and night out, is an unrealistic goal. Orthosomnia is a term that describes an unhealthy pursuit of perfect sleep. The pressure to get perfect sleep is embedded in the sleepmaxxing culture.
With more and more people able to access daily data about their sleep and other health metrics through consumer wearables, even a person who is objectively sleeping well can become unnecessarily concerned with optimizing their sleep. While prioritizing restful sleep is commendable, setting perfection as your goal is problematic. Even good sleepers vary from night to night, experiencing less than desirable sleep a couple of times per week.
It is also noteworthy that some of the most widely viewed recommendations on TikTok are not supported by scientific evidence.
Do you really need to fix your sleep?
A good first step is to understand whether or not there is anything that you need to fix! Consider tracking your sleep for a few weeks using a sleep diary, and pair this data with a consumer wearable (such as a Fitbit or Apple Watch). Both imperfectly capture sleep data when compared to the gold-standard tool sleep experts use (polysomnography, or a sleep study). However, combining the information can give you a reasonable assessment of your sleep status.
Regularly getting restful sleep can indeed boost health and mood. And all of us can benefit from following basic sleep hygiene tips. But if it takes you 30 minutes or more to fall asleep, or if you are up for 30 minutes or more in the middle of the night, and this happens three or more times per week, then consider reaching out to your health care team to seek further evaluation.
There are effective, nonmedication treatments that are proven to help you sleep better. One example is cognitive behavioral therapy for insomnia, which can dramatically improve insomnia symptoms in a matter of weeks.
Want to learn more about cognitive behavioral therapy for insomnia? Watch this video from the Division of Sleep Medicine at Harvard Medical School with Eric Zhou describing how it works.
profile/5170OIG3.jpeg.webp
Healthwatch
Should You Be Sleepmaxxing To Boost Health And Happiness?
~6.1 mins read
This viral wellness trend may be more hype than substance.
taping your mouth shut while sleeping
not drinking anything during the two hours before bedtime
a cold room temperature
a dark bedroom
using a white noise machine
not setting a morning alarm
showering one hour before bedtime
eliminating caffeine
eating kiwis before going to bed
taking magnesium and melatonin
using weighted blankets
getting 30 minutes of sunlight every day
meditating daily for 30 minutes.
Taking melatonin is recommended by the American Academy of Sleep Medicine to treat circadian rhythm disorders such as jet lag. But it's not recommended for insufficient sleep, poor sleep quality, or difficulty with falling asleep or staying asleep.
Is it healthier to be asleep by 10 p.m.? One video that garnered more than a million views claims it is. While it is important to maximize morning sunlight exposure and minimize evening light exposure to regulate circadian rhythms, there is such variability in how much sleep someone requires and individual chronotypes (not to mention varying personal and professional responsibilities!) that it is difficult to state there is an ideal bedtime for everyone.
While intriguing research has been done on weighted blankets, there is no convincing evidence that they are truly effective for the general adult population.
Overall, it's important to be cautious about the impact of the placebo effect on how someone sleeps. An analysis of more than 30 studies showed that roughly 64% of the drug response for a sleep medication in insomnia patients could be due to the placebo effect. A key takeaway is that studies that are not randomized controlled trials — such as this small study on 24 people suggesting that kiwi fruit may improve sleep — should be interpreted with a grain of salt.
If you've been on TikTok lately, you know it's hard to avoid countless influencers touting a concept called sleepmaxxing. Their posts provide tips and tricks to get longer, better, and more restorative sleep. And why not? Sleep is considered a pillar of good health and is related to everything from brain health to cardiovascular health, and even diabetes.
But what exactly is sleepmaxxing? And how likely is it to deliver on claims of amped-up energy, a boost to the immune system, reducing stress levels, and improving your mood?
What is sleepmaxxing?
Depending on which social media platform you happen to be looking at, the recommended strategies for maximizing sleep differ. Tips include:
Does any research support sleepmaxxing?
A thorough search through PubMed, PsycNet, and Google Scholar reveals zero results for the terms "sleepmaxx" and "sleepmaxxing." But wait — this certainly doesn't mean that some influencer-recommended strategies are not evidence-based, just that the concept of sleepmaxxing, as a defined package, has not been scientifically studied. But yes, some of the strategies — including one uncomfortable, though popular, choice — lack evidence.
Can mouth-taping improve your sleep?
TikTok users have claimed that taping your mouth while you sleep has benefits, such as reducing snoring and improving bad breath. A team from the department of otolaryngology at George Washington University was prompted by all of the social media buzz on the topic to review research on the impact of nocturnal mouth taping. Spoiler alert: the authors note that most TikTok mouth-taping claims aren't supported by research.
If you do snore, it's important to discuss this with your medical team. Even if taping your mouth reduces your snoring, it can't effectively treat a potential underlying cause of the snoring, such as allergies, asthma, or sleep apnea.
Sleepmaxxing or basic sleep hygiene?
Many strategies recommended by sleepmaxxers are essentially what sleep experts prescribe as good sleep hygiene, which has plenty of research backing its value. Common components of sleep hygiene are decreasing caffeine and alcohol consumption, increasing physical activity, sleep timing, reducing evening light exposure, limiting daytime naps, and having a cool bedroom.
While tips like these help many people enjoy restful sleep, those who have an insomnia disorder will need more help, as described below.
Melatonin, early bedtime, weighted blankets, and — kiwi fruit?
Other strategies suggested by sleepmaxxers are based on limited scientific data. For example:
Could you have orthosomnia?
The expectation of flawless sleep, night in and night out, is an unrealistic goal. Orthosomnia is a term that describes an unhealthy pursuit of perfect sleep. The pressure to get perfect sleep is embedded in the sleepmaxxing culture.
With more and more people able to access daily data about their sleep and other health metrics through consumer wearables, even a person who is objectively sleeping well can become unnecessarily concerned with optimizing their sleep. While prioritizing restful sleep is commendable, setting perfection as your goal is problematic. Even good sleepers vary from night to night, experiencing less than desirable sleep a couple of times per week.
It is also noteworthy that some of the most widely viewed recommendations on TikTok are not supported by scientific evidence.
Do you really need to fix your sleep?
A good first step is to understand whether or not there is anything that you need to fix! Consider tracking your sleep for a few weeks using a sleep diary, and pair this data with a consumer wearable (such as a Fitbit or Apple Watch). Both imperfectly capture sleep data when compared to the gold-standard tool sleep experts use (polysomnography, or a sleep study). However, combining the information can give you a reasonable assessment of your sleep status.
Regularly getting restful sleep can indeed boost health and mood. And all of us can benefit from following basic sleep hygiene tips. But if it takes you 30 minutes or more to fall asleep, or if you are up for 30 minutes or more in the middle of the night, and this happens three or more times per week, then consider reaching out to your health care team to seek further evaluation.
There are effective, nonmedication treatments that are proven to help you sleep better. One example is cognitive behavioral therapy for insomnia, which can dramatically improve insomnia symptoms in a matter of weeks.
Want to learn more about cognitive behavioral therapy for insomnia? Watch this video from the Division of Sleep Medicine at Harvard Medical School with Eric Zhou describing how it works.
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