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Healthwatch
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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.
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Healthwatch
Measles Is Making A Comeback: Can We Stop It?
~6.0 mins read
Seven things to know about the recent measles outbreaks.
brain inflammation (encephalitis), which can lead to seizures, hearing loss, or intellectual disability
pneumonia
eye inflammation (and occasionally, vision loss)
poor pregnancy outcomes, such as miscarriage
subacute sclerosing panencephalitis (SSPE), a rare and lethal disease of the brain that can develop years after the initial measles infection.
Vaccination. Usually, children are given the first dose around age 1 and the second between ages 4 and 6 as part of the Measles-Mumps-Rubella (MMR) vaccine. If a child — or adult — hasn’t been vaccinated, they can have these doses later.
If you were born after 1957 and received a measles vaccination before 1968, consider getting revaccinated or tested for measles antibodies (see below). The vaccine given before 1968 was less effective than later versions. And before 1957, most people became immune after having measles, although this immunity can wane.
Isolation. To limit spread, everyone diagnosed with measles and anyone who might be infected should avoid close contact with others until four days after the rash resolves.
Mask-wearing by people with measles can help prevent spread to others. Household members or other close contacts should also wear a mask to avoid getting it.
Frequent handwashing helps keep the virus from spreading.
Testing. If you aren’t sure about your measles vaccination history or whether you may be vulnerable to infection, consider having a blood test to find out if you’re immune to measles. Memories about past vaccinations can be unreliable, especially if decades have gone by, and immunity can wane.
Pre-travel planning. If you are headed to a place where measles is common, make sure you are up to date with vaccinations.
Has the recent news about measles outbreaks in the US surprised you? Didn’t it seem like we were done with measles?
In the US, widespread vaccination halted the ongoing spread of measles more than 20 years ago, a major public health achievement. Before an effective vaccine was developed in the 1960s, nearly every child in the US got measles. Complications like measles-related pneumonia or hearing loss were common, and 400 to 500 people died each year.
As I write this, there have been 1,227 confirmed cases in 36 states, mostly among children. The biggest outbreak is in west Texas, where 97 people have been hospitalized and two unvaccinated school-age children recently died, the first measles deaths in the US since 2015. Officials in New Mexico have also reported a measles-related death.
Can we prevent these tragedies?
Measles outbreaks are highly preventable. It’s estimated that when 95% of people in a community are vaccinated, both those individuals and others in their community are protected against measles.
But nationally, measles vaccination rates among school-age kids fell from 95% in 2019 to 92% in 2023. Within Texas, the kindergarten vaccination rates have dipped below 95% in about half of all state counties. In the community at the center of the west Texas outbreak, the reported rate is 82%. Declining vaccination rates are common in other parts of the US, too, and that leaves many people vulnerable to measles infections.
Only 3% of the recent cases in the US involved people known to be fully vaccinated. The rest were either unvaccinated or had unknown vaccine status (95%), or they had received only one of the two vaccine doses (2%).
What to know about measles
As measles outbreaks occur within more communities, it’s important to understand why this happens — and how to stop it. Here are seven things to know about measles.
The measles virus is highly contagious
Several communities have suffered outbreaks in recent years. The measles virus readily spreads from person to person through the air we breathe. It can linger in the air for hours after a sneeze or cough. Estimates suggest nine out of 10 nonimmune people exposed to measles will become infected. Measles is far more contagious than the flu, COVID-19, or even Ebola.
Early diagnosis is challenging
It usually takes seven to 14 days for symptoms to show up once a person gets infected. Common early symptoms — fever, cough, runny nose — are similar to other viral infections such as colds or flu. A few days into the illness, painless, tiny white spots in the mouth (called Koplik spots) appear. But they’re easy to miss, and are absent in many cases. A day or two later, a distinctive skin rash develops.
Unfortunately, a person with measles is highly contagious for days before the Koplik spots or skin rash appear. Very often, others have been exposed by the time measles is diagnosed and precautions are taken.
Measles can be serious and even fatal
Measles is not just another cold. A host of complications can develop, including
Complications are most common among children under age 5, adults over age 20, pregnant women, and people with an impaired immune system. Measles is fatal in up to three of every 1,000 cases.
During the latest outbreaks, 148 cases — about one in eight — have required hospitalization.
Getting measles may suppress your immune system
When you get sick from a viral or bacterial infection, antibodies created by your immune system will later recognize and help mount a defense against these intruders. In 2019, a study at Harvard Medical School (HMS) found that the measles virus may wipe out up to three-quarters of antibodies protecting against viruses or bacteria that a child was previously immune to — anything from strains of the flu to herpesvirus to bacteria that cause pneumonia and skin infections.
“If your child gets the measles and then gets pneumonia two years later, you wouldn’t necessarily tie the two together. The symptoms of measles itself may be only the tip of the iceberg,” said the study’s first author, Dr. Michael Mina, who was a postdoctoral researcher in the laboratory of geneticist Stephen Elledge at HMS and Brigham and Women’s Hospital at the time of the study.
In this video, Mina and Elledge discuss their findings.
Vaccination is highly effective
Two doses of the current vaccine provide 97% protection — much higher than most other vaccines. Rarely, a person gets measles despite being fully vaccinated. When that happens, the disease tends to be milder and less likely to spread to others.
The measles vaccine is safe
The safety profile of the measles vaccine is excellent. Common side effects include temporary soreness in the arm, low-grade fever, and muscle pain, as is true for most vaccinations. A suggestion that measles or other vaccines cause autism has been convincingly discredited. However, this often-repeated misinformation has contributed to significant vaccine hesitancy and falling rates of vaccination.
Ways to protect yourself from measles infection
If you were born after 1957 and received a measles vaccination before 1968, consider getting revaccinated or tested for measles antibodies (see below). The vaccine given before 1968 was less effective than later versions. And before 1957, most people became immune after having measles, although this immunity can wane.
The bottom line
While news about measles in recent months may have been a surprise, it’s also alarming. Experts warn that the number of cases (and possibly deaths) are likely to increase. And due to falling vaccination rates, outbreaks are bound to keep occurring. One study estimates that between nine and 15 million children in the US could be susceptible to measles.
But there’s also good news: we know that measles outbreaks can be contained and the disease itself can be eliminated. Learn how to protect yourself and your family. Engage respectfully with people who are vaccine hesitant: share what you’ve learned from reliable sources about the disease, especially about the well-established safety of vaccination.
profile/5170OIG3.jpeg.webp
Healthwatch
Measles Is Making A Comeback: Can We Stop It?
~6.0 mins read
Seven things to know about the recent measles outbreaks.
brain inflammation (encephalitis), which can lead to seizures, hearing loss, or intellectual disability
pneumonia
eye inflammation (and occasionally, vision loss)
poor pregnancy outcomes, such as miscarriage
subacute sclerosing panencephalitis (SSPE), a rare and lethal disease of the brain that can develop years after the initial measles infection.
Vaccination. Usually, children are given the first dose around age 1 and the second between ages 4 and 6 as part of the Measles-Mumps-Rubella (MMR) vaccine. If a child — or adult — hasn’t been vaccinated, they can have these doses later.
If you were born after 1957 and received a measles vaccination before 1968, consider getting revaccinated or tested for measles antibodies (see below). The vaccine given before 1968 was less effective than later versions. And before 1957, most people became immune after having measles, although this immunity can wane.
Isolation. To limit spread, everyone diagnosed with measles and anyone who might be infected should avoid close contact with others until four days after the rash resolves.
Mask-wearing by people with measles can help prevent spread to others. Household members or other close contacts should also wear a mask to avoid getting it.
Frequent handwashing helps keep the virus from spreading.
Testing. If you aren’t sure about your measles vaccination history or whether you may be vulnerable to infection, consider having a blood test to find out if you’re immune to measles. Memories about past vaccinations can be unreliable, especially if decades have gone by, and immunity can wane.
Pre-travel planning. If you are headed to a place where measles is common, make sure you are up to date with vaccinations.
Has the recent news about measles outbreaks in the US surprised you? Didn’t it seem like we were done with measles?
In the US, widespread vaccination halted the ongoing spread of measles more than 20 years ago, a major public health achievement. Before an effective vaccine was developed in the 1960s, nearly every child in the US got measles. Complications like measles-related pneumonia or hearing loss were common, and 400 to 500 people died each year.
As I write this, there have been 1,227 confirmed cases in 36 states, mostly among children. The biggest outbreak is in west Texas, where 97 people have been hospitalized and two unvaccinated school-age children recently died, the first measles deaths in the US since 2015. Officials in New Mexico have also reported a measles-related death.
Can we prevent these tragedies?
Measles outbreaks are highly preventable. It’s estimated that when 95% of people in a community are vaccinated, both those individuals and others in their community are protected against measles.
But nationally, measles vaccination rates among school-age kids fell from 95% in 2019 to 92% in 2023. Within Texas, the kindergarten vaccination rates have dipped below 95% in about half of all state counties. In the community at the center of the west Texas outbreak, the reported rate is 82%. Declining vaccination rates are common in other parts of the US, too, and that leaves many people vulnerable to measles infections.
Only 3% of the recent cases in the US involved people known to be fully vaccinated. The rest were either unvaccinated or had unknown vaccine status (95%), or they had received only one of the two vaccine doses (2%).
What to know about measles
As measles outbreaks occur within more communities, it’s important to understand why this happens — and how to stop it. Here are seven things to know about measles.
The measles virus is highly contagious
Several communities have suffered outbreaks in recent years. The measles virus readily spreads from person to person through the air we breathe. It can linger in the air for hours after a sneeze or cough. Estimates suggest nine out of 10 nonimmune people exposed to measles will become infected. Measles is far more contagious than the flu, COVID-19, or even Ebola.
Early diagnosis is challenging
It usually takes seven to 14 days for symptoms to show up once a person gets infected. Common early symptoms — fever, cough, runny nose — are similar to other viral infections such as colds or flu. A few days into the illness, painless, tiny white spots in the mouth (called Koplik spots) appear. But they’re easy to miss, and are absent in many cases. A day or two later, a distinctive skin rash develops.
Unfortunately, a person with measles is highly contagious for days before the Koplik spots or skin rash appear. Very often, others have been exposed by the time measles is diagnosed and precautions are taken.
Measles can be serious and even fatal
Measles is not just another cold. A host of complications can develop, including
Complications are most common among children under age 5, adults over age 20, pregnant women, and people with an impaired immune system. Measles is fatal in up to three of every 1,000 cases.
During the latest outbreaks, 148 cases — about one in eight — have required hospitalization.
Getting measles may suppress your immune system
When you get sick from a viral or bacterial infection, antibodies created by your immune system will later recognize and help mount a defense against these intruders. In 2019, a study at Harvard Medical School (HMS) found that the measles virus may wipe out up to three-quarters of antibodies protecting against viruses or bacteria that a child was previously immune to — anything from strains of the flu to herpesvirus to bacteria that cause pneumonia and skin infections.
“If your child gets the measles and then gets pneumonia two years later, you wouldn’t necessarily tie the two together. The symptoms of measles itself may be only the tip of the iceberg,” said the study’s first author, Dr. Michael Mina, who was a postdoctoral researcher in the laboratory of geneticist Stephen Elledge at HMS and Brigham and Women’s Hospital at the time of the study.
In this video, Mina and Elledge discuss their findings.
Vaccination is highly effective
Two doses of the current vaccine provide 97% protection — much higher than most other vaccines. Rarely, a person gets measles despite being fully vaccinated. When that happens, the disease tends to be milder and less likely to spread to others.
The measles vaccine is safe
The safety profile of the measles vaccine is excellent. Common side effects include temporary soreness in the arm, low-grade fever, and muscle pain, as is true for most vaccinations. A suggestion that measles or other vaccines cause autism has been convincingly discredited. However, this often-repeated misinformation has contributed to significant vaccine hesitancy and falling rates of vaccination.
Ways to protect yourself from measles infection
If you were born after 1957 and received a measles vaccination before 1968, consider getting revaccinated or tested for measles antibodies (see below). The vaccine given before 1968 was less effective than later versions. And before 1957, most people became immune after having measles, although this immunity can wane.
The bottom line
While news about measles in recent months may have been a surprise, it’s also alarming. Experts warn that the number of cases (and possibly deaths) are likely to increase. And due to falling vaccination rates, outbreaks are bound to keep occurring. One study estimates that between nine and 15 million children in the US could be susceptible to measles.
But there’s also good news: we know that measles outbreaks can be contained and the disease itself can be eliminated. Learn how to protect yourself and your family. Engage respectfully with people who are vaccine hesitant: share what you’ve learned from reliable sources about the disease, especially about the well-established safety of vaccination.
profile/5170OIG3.jpeg.webp
Healthwatch
A Low-tech School Vacation: Keeping Kids Busy And Happy Without Screens
~3.5 mins read
Nine ways to encourage children to connect, create, and play off-screen.
School vacation coming up? Wondering how to spend that time? Given how tiring holidays can be — especially for parents who are working — it's understandable why children are often allowed to spend hours with the TV, tablet, or video games. After all, happy, quiet kids make for happy parents who can finally get stuff done — or relax.
Except kids are spending way too much time in front of screens. According to the American Academy of Child and Adolescent Psychiatry, kids ages 8 to 12 are spending four to six hours a day watching or using screens — and tweens and teens are spending nine hours.
Given how enticing devices and social media can be, those numbers can easily go higher during unscheduled times like weekends and school vacation. That's why it's good to be proactive and come up with other activities. Below are some ideas for parents and caregivers to try. These are mostly good for kids through elementary school, but tweens and teens may enjoy some of them too.
Spending time off the screen
Go outside. This sounds obvious, but spending time outdoors is something kids do less than they used to — and it can be really fun. If you have a yard, go out into it and play hide-and-seek or build a fort from snow or anything else that's around. If you don't have a yard, go to a local park or just go for a walk. A scavenger hunt up and down the block or game of I Spy may be a good enticement.
Go to the library. Do this early on in vacation, so that your child has lots of books, puzzles, and games to pass the time. Check out as many as they allow and you can carry. Ask if a Library of Things is available at a branch near you: crafts, tools, musical instruments, birding kits, telescopes — even metal detectors may be checked out for free.
Build a fort in the living room. Use blankets or sheets over chairs; if you have a small tent, set it up. Bring in pillows, sleeping bags, and flashlights; let the kids sleep in it at night. Let it stay up all vacation.
Build a city in the living room. Use blocks, Legos, boxes (or anything else), and add roads, cars, people, animals, trains, and other toys. Let it stay up all vacation, and make it bigger every day.
Getting creative off the screen
Get creative. Go to the craft store and stock up on inexpensive supplies. Buy things like poster board, huge pieces of paper (you could use those for your city, too, to make parks, roads, and parking lots), paints, and markers. You can make a paper mural, a comic book, a story, posters, or whatever catches your child's imagination. If you know how to knit or sew, think about teaching your child or making a simple project together. Play music while you create.
Read out loud. There are so many books that are fun to read aloud. When my children were younger, we read the Harry Potter series out loud, as well as the Chronicles of Narnia and books by E.B. White and Roald Dahl. Act out the voices. Have some fun.
Have a puppet show. If you don't have puppets, you can make some with socks — or you can hold up dolls or action figures and do the talking for them. You can make a makeshift stage by cutting out the back of a box and taping cloth (like a pillowcase) to fall over the front.
Get out the games. There are so many that work across the ages, like checkers, chess, Uno, Connect 4, Sorry, Twister, Clue, Scrabble, or Monopoly. We forget how much fun these can be.
Bake. You don't have to get fancy — it's fine to use mixes or pre-made cookie dough. There's nothing better than baked goods straight from the oven, and adding frosting and decorations makes it even more fun. Turn on music and dance while things bake.
While parents or caregivers need to be involved with some of these activities (like the ones involving the oven, or reading out loud), kids can do many of them independently once you have it started. Which, really, is what children need: time to use their imagination and just play.
But you just may find that once you have things started, you'll want to play, too.
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