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Barbara Rutkowski, EdD, MSN, CCM – Vice President, Clinical Operations, Advanced Plan for Health

Many of our clients offer incentives and programs to enhance employee and family health. However, too often these initiatives focus on nutrition, activity, rightsizing and common chronic health conditions like hypertension, hyperlipidemia, obesity and diabetes. Less attention is placed on brain health, even though our brains must work at peak performance for a lifetime to guide our bodily operations and functions, store our memories and be our control center. Our brains mold themselves constantly to a life of change and give meaning, direction and sense to life as we navigate our world.

A healthy brain optimizes how we think, remember, learn, plan, concentrate and have a clear, active mind. As a matter of fact, the brain also manages our automated functions – like breathing, blood pressure, mood, reflexes, heartbeat, cellular functions, digestion and many other activities that happen without our active thought or intervention. Throughout our lives, our brains change and adjust. Finally, in old age they decline, but prudent health measures can slow this downhill course and prevent some avoidable damage.

The National Sleep Foundation shares that during sleep, the brain stores memories, removes toxic waste that has built up during the waking hours and restores feel-good chemicals like serotonin. Although sleep is still somewhat mysterious, feeling rested requires about 5 cycles of sleep. During sleep, the immune system is also strengthened, blood pressure drops, and muscles, bones and tissues are restored, all of which are essential to well-being.

This blog discusses what we can do to improve brain health which enables us to manage information, be logical, judge situations, keep our perspective and grow in wisdom as we experience life and work productively.

The Mayo Clinic published an article titled “Want a healthy brain as you age? Live a healthy life” that points out risks that decrease optimal brain functions so that we can live life to the fullest. They said that their research shows that: “Adopting a healthy lifestyle can protect the brain against several risk factors for Alzheimer’s disease… Controlling blood pressure and cholesterol and avoiding obesity, smoking and diabetes are among the steps that can help preserve brain health, according to the study, published in JAMA Neurology.”

Our health behaviors are connected – affecting multiple systems and the brain itself.

Life Can Get in the Way

With most adults working one or more jobs, caring for children and even multigenerational family members, and trying to squeeze personal time into the day, the daily grind can become detrimental. Many adults believe that they can cut back on sleep, be sedentary, skip life balance, stay stressed and pick up fast food to accomplish more – but they pay a price for that.

According to WebMD, most adults need 7 to 9 hours of sleep at night, whereas seniors over 65 years need 7 to 8 hours (a stat that is important as more businesses have increasing numbers of seniors in the workforce). Pregnant women need more sleep, especially in the early months of gestation.

What Happens when we get Inadequate Sleep?

Sleep deprivation adversely impacts our reaction time, work culture, judgment, memory, and it also promotes depression, weakens immunity, augments the sense of pain, and magnifies effects of alcohol consumption, to name a few effects. According to the National Highway Traffic Safety Administration, at least 803 people died from accidents involving driver fatigue in 2016—the number is probably higher.

Drowsy driving is impaired driving, whether from sleep deprivation, medications, drugs, alcohol or untreated sleep conditions. If you are yawning, drifting between lanes, trying to dose, unable to remember driving the last few miles, daydreaming or otherwise fatigued, pull off the road in a safe spot to get some sleep. See a comprehensive document on drowsy sleeping here.

Though many people “get by” on less sleep, they build up a sleep debt, which requires them to sleep longer to catch up. When they fail to get restorative sleep, they may begin to experience physical, safety and emotional symptoms alerting them to this deficit which worsens if not remedied. That creates a particularly serious problem for employers, whose management team needs to be alert to individuals who are not functioning optimally for whatever reason, especially if they are in safety sensitive jobs.

According to the National Sleep Foundation, about 15% of the workforce are affected by rotating shift changes, working at night or in the early morning hours. While most workers have some sleepiness and adjustment, about 10% have a more serious disorder known as Shift Work Disorder Symptoms (SWDS) which may include excessive sleepiness, desire to nod off, lack of energy, irritability, trouble concentrating, issues with relationships, depression, difficulty getting to sleep or waking before feeling rested and changes in response times.

Hints to Help you Sleep Better

To cope with this sleep disruption, eat and sleep on a regular schedule, and practice good sleep habits. Here are some suggestions that may help:

  • Have a quiet, dark, cool sleep area
  • Avoid alcohol before sleeping
  • Wear a sleep mask to block the light
  • Turn off your electronic devices at least an hour before going to bed
  • Avoid caffeine several hours prior to sleeping
  • Try adding lavender to your pillow or bed clothes

Physicians have medication to help, but some people cannot adjust to changing schedules or working non-traditional hours, with or without medication or be safe after taking it, because of continuing slow reflexes, excessive sleepiness, or responses that make them accident-prone or safety risks. In addition, some individuals may not be suited to working nights or rotating shifts for a long period without having an increased risk for health problems long-term like judgment errors, accidents, heart disease, disruptions in social relationships, certain cancers, metabolic problems, gastrointestinal issues, changes in appetite and obesity.

Energy Drinks and Amphetamines are not the Answer

When adults work two or more jobs, or otherwise work excessively, they often have a poor diet and sleep deprivation to say nothing of lacking time to foster work and social relationships. To keep this routine, some turn to energy boosting drinks, or amphetamines to delay sleep, boost energy and increase attentiveness. While this can work well in the short run for long distance drivers, people working long hours and single parents who work and maintain their family, there is a heavy price to pay in the long run. The effective dosage keeps getting higher, and symptoms like irritability, hyperactivity, insomnia, depression, cardiac problems and GI disturbances may occur. With continued use of amphetamines, users can become paranoid and hallucinate. Serious medical intervention is needed at this point, as the individual’s life and performance start falling apart. Because procurement of drugs may be illegal, if not ordered by a medical professional, legal consequences may also be involved.

Young people and adults are often drawn to high caffeine products to boost their energy and wakefulness. The National Sleep Foundation says that adults can safely handle up to 500 milligrams of caffeine or about four 8-ounce cups daily. According to Consumer Reports, many of the caffeine boosters under-reported the amount of caffeine in their product. By testing 27 caffeine drinks and shots, Consumer Reports concluded that the labels may not help, as they are often inaccurate. There are 242 milligrams of caffeine in 5-Hour Energy Extra Strength. Side effects from too much caffeine may include restlessness, nervousness, insomnia, and tremors. Excessive caffeine may also trigger a seizure or result in an abnormal heartbeat.

Tips to Boost Your Brain Health

To boost your brain health, getting adequate sleep is number one, followed closely by prudent dietary habits, stress reduction, life balance, socialization and daily exercise.

Did you know that the JAMA Internal Medicine Network stated that taking 4,400 steps per day reduces cardiovascular risk? For many, it is much more realistic start than the popular 10,000 steps/day in the general literature (which lacks a scientific basis). In this particular study of 16,741 women, who had a mean age of 72 years and averaged about 4400 steps / day, had significantly lower mortality rates during a follow-up of 4.3 years compared with the least active women who took approximately 2700 steps / day. Mortality rates for this study progressively decreased before leveling off at 7,500 steps / day.

Controlling diabetes, blood pressure, obesity, cholesterol and other chronic conditions is also vital, as all of these impact brain integrity and functions. For example, a high intake of sugar prevents the brain from absorbing protein and other essential nutrients, not to mention being bathed in sugar thickened blood that cannot get into the smallest blood vessels.

It is also important to eat breakfast, as the brain requires fuel for the activities and functions it performs when you awaken. Depriving the brain of a healthy breakfast following sleep may result in the brain lacking the nutrients needed for proper development and functioning.

Strengthen performance by doing one thing at a time. Avoid multi-tasking to avoid interfering with such brain functions as normal emotional control, decision making and empathy. Stopping the frenetic activity and reducing the number of half-done projects are also useful ways to reduce stress and enhance pride in job completion.

The Electronics Addiction Factor

Addiction to electronics is causing changes to the brain itself and the way it functions. This is of particular concern for young people with developing brains, who may play online games for hours daily. High use of electronics may also be a work requirement for many adults, who need to counterbalance the high online use with life balance, socialization and physical activity. Further, experts recommend turning off the blue lights from television, computers, tablets and cell phones at least an hour before trying to sleep, as the blue light signals the brain to reduce melatonin and stay wakeful. That interferes with the ability to get to sleep and stay asleep.

When working too hard and too many hours, take breaks, get your sleep, eat well and take good care of yourself, as overwork can negatively impact health.

Strike a Better Life Balance

Talk, read, laugh, love, create, interact with others, be charitable, be a team player, think deeply, solve problems, challenge yourself, play games. All of these activities keep your brain actively engaged and slow its decline from non-use. Use it or lose it is the operative phrase!

Drink enough water as it is needed for many bodily processes to function normally, and for the kidneys to remove toxins from the blood. Dehydration can be a serious medical emergency causing changes in sensorium and body functions. Another key healthy habit is to control and conquer chronic stress, since it actually causes untoward changes in the brain affecting emotion, learning memory and metabolism.

Breathe fresh or circulating air and take deep breaths often to be certain that your brain and body get enough oxygen. Otherwise, you may feel sluggish and irritable. Move around, as sitting too long or being in one position is a major health risk. Physical activity gets your blood flowing and the oxygen moving through your body and it changes your chemistry to achieve a reset that makes you feel better.

We are comprised of mind, body and spirit.

The last point is to treat yourself and your brain to uplifting experiences, spirituality, activity, innovation, play, stimulation, reading, learning, challenges and people. Novel experiences, nature and positive thoughts optimize your energy and your brain’s potential, all of which lead to top performance and a better life. Make each day count and go to sleep with a good thought in your mind. Always think positively, because you do not want your brain to send out negative signals to your body. Negative self-talk can become self-fulfilling prophesy.

We can Help!

At Advanced Plan for Health, we help our clients establish a total approach and baseline for the Plan and its members, utilize our Poindexter analytics to find individuals who could benefit from clinical intervention, work with members to set S.M.A.R.T goals and help them devise and execute a plan that works for them as individuals.

Our focus is on analytics, changing member health behaviors and supporting them as they reach favorable health outcomes. Training is available to assist onsite clinicians in fully deploying all of Poindexter’s analytic tools as well as learning the methodology for improving both individual and plan financial and clinical results. Contact us to learn more about these capabilities, and how we can help you make a difference in your populations.


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