S2E52. The 2022 ‘Journey Awards’

The end of the year is traditionally a time to compile ’10 Best’ and ‘Best and Worst’ lists, so I thought I’d take a crack at it with some of the best and worst brain health events of the year for each of the 5 pillars of brain health. I thought about calling the list the ‘MOTYs’ for ‘Mistakes of the Year’ awards, but that didn’t seem to leave much room for celebrating the good news, so I went with the ‘Journeys’ instead.

Here they are:

1. Cognitive Challenge

There was plenty of competition in this category: playing computerized games on BrainHQ, traveling to foreign lands, reading books, writing this blog, and learning to play the recorder. As stimulating as they all were, I’m going with learning to play the recorder as the most rewarding cognitive challenge pursuit of 2022. It’s there for me nearly every day and it’s a rush to be able to play a piece or hit notes that I wasn’t able to master a month before. Learning to play meaningful melodies from across my lifespan never gets old. All in all, a pretty nice experience for a guy whose musical aptitude probably falls in the bottom twenty-five percent!

2. Exercise

One of my favorite lifetime brain health pursuits became an unexpected challenge. I was barreling along during the first three months of the year, working out 5-6 days/week, gaining strength, feeling great and losing weight. Then in April we went out to Minneapolis for the NCAA Women’s Basketball finals and I came down with COVID, which knocked me for a loop. It left me with a weakness that persisted for nearly 6 months. Working out was hard and definitely not enjoyable and I never got back into it consistently. My workouts now, when I do them, are shorter and slower. The weights I lift are lighter. So exercise definitely gets the ‘worst performance in a brain health pillar’ Journey Award for 2022.

3. Sleep

There really was only one contender for this award: my month-long experiment to change my circadian rhythm and sleep pattern in preparation for our Mediterranean cruise. It led to quite novel experiences, like going to bed at 6pm and waking up at 2am, but I think it worked. Upon arriving in Greece, I was tired pretty much when I was supposed to be tired and woke up within an hour of when I was supposed to wake up. The results, though, were somewhat confounded by the fact that I didn’t sleep at all on the plane and spent a couple of days recovering from that sleep deprivation. So now that I’ve figured out the circadian rhythm thing, I’ll have to work a little harder on the sleeping-on-the-plane thing next time we travel abroad.

4. Social Engagement

Thank goodness for Sally! She sets my social calendar and keeps me engaged. Without her efforts, I would definitely meet criteria for ‘hermit.’ But I don’t feel as though I’m meeting my obligations here. I enjoy being out with people and I enjoy listening to the conversations, but I’m finding myself talking less, so much so that Sally has commented on it several times. In fact, it’s gotten to the point that I’m not talking as much at home, either. I can’t quite put my finger on what it is. My mind is going all the time, I can hear just fine, I don’t have any word-finding difficulties and I have no problem following conversations. It’s just that I don’t often feel the need to say anything. Isn’t that weird? Becoming more subdued and withdrawn are often listed as warning signs of an impending dementia and fall under the category of ‘personality changes,’ so there’s that. Come to think of it, I get frustrated and irritated more easily than I did a year ago, so maybe this is something to keep an eye on.

5. Diet

This is a no-brainer: the 2022 Journey Award for best brain health dietary contribution goes to granola! (See S2E50: Granola Revisited). On the other hand, there have been several notable lapses in my regimen. I gave up overnight fasting, not for any empirical reason, but just because I lost the will power to do so once I reached my weight loss target. And now Sally and I are treating ourselves to an ice cream sandwich nearly every night. Again, no reason to do that except for the sheer delight of indulging in a guilty pleasure. This year’s Journey Award, though, for the biggest diet disappointment, was my attempt to drink a small glass of red wine with dinner each night. I conducted a noble months-long search for a palatable, organic pinot noir, but alas, to no avail. As good as it was, I just didn’t like it. And to make matters worse, even nursing a 4-ounce ‘dose’ left me a little tipsy. I reviewed the recommendations on drinking red wine and the bottom line was if you don’t already drink, then don’t start. In my case, it appeared that the neuro-toxic effect of the alcohol was greater than the augmentation of resveratrol effect. Since I eat red grapes every morning in my granola and I’m not a fan of supplements, I dropped red wine from the menu. 

And that’s my brain health year-in-review best and worst list, the 2022 Journey Awards.

Thank you so much for reading the blog. I hope it’s been helpful, interesting and/or entertaining. If so, I’d appreciate it greatly if you’d recommend it to your friends and family at www.MistakesOnTheJourneyToNowhere.com. It might be a nice change for them from bingeing on Netflix.

Wishing you a happy and brain-healthy New Year!

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S2E44. Greece!

We made it! We’ve spent the last several days island-hopping around Greece and as I write this we’re docking in Dubrovnik. I’ll be honest: I haven’t focused much (if at all) on brain health. I’ll assume you can understand why. Nonetheless, I’ll try to put together a few thoughts before heading out on our next excursion.

I felt I was prepared for the flight last Friday, having adjusted my sleeping and eating rhythms to accommodate 5 of the 7 hours we would cross during the flight. Serendipitously, Greece set its clocks back by one hour for daylight savings time the night we arrived, so I was gifted one more hour of transition time. What was left to absorb, then, was minimal: just 1 hour, or the equivalent of flying from Chicago to New York.

Unfortunately, I wasn’t able to get much sleep on the plane. I used a neck pillow, lavender oil, loose-fitting clothes, and I ate a banana, but all to no avail. The engine noise, fellow passengers conversing loudly, and the impossible task of getting comfortable all conspired against me. Consequently, I was not a happy camper the next morning when we landed in Athens.

The good news, though, is that I don’t think I felt any effect of the time zone changes. Once I caught up on my sleep, I was fine.

Sally, on the other hand—having not made any effort at all to prepare for the time-shift—was…fine!

It seems that for both of us, the quality of the previous night’s sleep was far more impactful than the 7 time zones we had crossed.

Traveling is a brain-healthy activity because it presents a variety of unique cognitive challenges. Going on a cruise provides those opportunities in spades.

First off, there’s getting oriented on the ship. It took me several days to figure out how to find the important locations: our room, the different restaurants, and the theater. Oh, you could find your way around by reading the signage, but I wanted to be able to do it on my own.

First, I figured out that the various restaurants, although they were on different decks, were all at the back of the boat while the theater and the main lounge were at the front. These landmarks replaced north (theater) and south (restaurants) in my personal navigation system. Then I noticed that the even numbered rooms were ‘west’ and they got higher as you traveled from ‘north’ to ‘south.’ So as long as I could keep an image in my head of where the theater was (‘north’), I could figure out where anything else was whenever I emerged from an elevator.

Conversely, after only 2 days, Sally just knew which way to turn to get to where we were going.

Then there are the excursions with guides who present volumes of information along the way, on-board lectures, adjusting to at least a dozen different accents spoken by members of the crew, and absorbing the sights and vistas themselves. Add to that sampling new foods and meeting new people and you’ve created an intense synapse-stimulating environment.

On the other hand, maintaining a brain-healthy diet just ain’t gonna happen! I’ve been like a kid in the proverbial candy store pigging out at the buffets on sweets, pastries, carbs, meat and more alcohol than I’d consumed in a very long time. Leafy green vegetables? Nope. On the positive side, I am eating a boatload of fish and I’m making an effort to dose myself with fruits every morning at breakfast. I’m not at all looking forward to stepping on the scale when we get home.

We walk a lot on our daily excursions. Even though I don’t find myself breathing hard, I’ll assume that I’m getting my 30-minutes of cardio every day. There is a ¼-mile jogging track around the boat and a fitness center with treadmills and resistance machines, but I’m tired enough at the end of the day without pushing my limits with intentional exercise.

So I hope you’ll excuse me if I leave it at that for now and get back to the task of thoroughly enjoying this trip. I know…it’s a tough job…but somebody has to do it!

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S2E43: Three…Two…One…Liftoff!

Undaunted, I stumbled forward with a mild case of sleep deprivation into my 3rd week of attempting to reset my circadian rhythm to accommodate the 7-hour time difference I will experience when the plane lands in Athens tomorrow.

I took a closer look at our flight itinerary and saw that the flight leaves at 5:50pm eastern on Friday and arrives at 10:10am Saturday morning (9 hours in flight plus 7 time zones). It occurred to me that it would be wonderful if I could fall asleep right after boarding and get a full 8 hours of sleep during the flight, but, as we all know, sleeping on an airplane is spotty at best. What to do?

It turns out that Sally has a prescription for medical marijuana to help her sleep at night and so I thought it might work for me, too. The idea was that I would take one of her gummies as the plane was taking off and, hopefully, it would knock me out for the next 7-8 hours.

But what if it didn’t work? I was terrified at the thought of being seat-bound at 39,000 feet for 9 hours while high! My god, it would feel like all eternity before we landed!

So I decided to give it a test run this past Saturday night. Since it takes about an hour to kick in, I took it at 6pm and got in bed at 7pm, hoping to sleep through to 3am. 

Wow…was that ever a mistake! Oh, I fell asleep quickly enough, but it was a nightmare the rest of the way. Every time I started to dream I would be shocked into awareness by the intensity of the dream. Sometimes it was just the vibrancy of the colors; sometimes it was the emotional content. Once awake, I became hyper-aware of my body which seemed to be making a lot of noise. I have no idea what that was about, but the bottom line was that it was keeping me awake. To make matters worse, I would check the clock after I thought I had gotten some sleep only to discover that not even half an hour had passed.

It was a long night, indeed.

I got out of bed at 3:30am feeling exhausted and a little wobbly on my feet. I bailed out on exercising and then slogged my way through the day.

Remind me never to do pot before going to bed!

So although taking a little something to help me sleep on the plane was a good thought, it definitely wasn’t going to work for me. As miserable as I was, I was thankful that I had done the experiment now rather than trying it for the first time on the flight.

I googled ‘sleeping on a plane’ to see if there were any helpful hints and, indeed, I found several in a nicely researched article (https://casper.com/blog/how-to-sleep-on-a-plane/). I’m pretty sure I’ll go with its recommendations to wear socks, dress in light layers, eat a banana, keep my legs uncrossed and wear a dab of lavender oil. I’ll also forego my morning green tea that is caffeinated. 

My experience on Sunday night could not have been more profoundly different…or more welcome! I got in bed at 7pm and slept straight through until half-past three. More than 8 hours of sleep…it was glorious! I woke up bright and alert and couldn’t wait to hit the hall for my half-hour walk and then go down to the fitness center for another half-hour on the resistance machines.

I was a little surprised to find another resident in the fitness center at 4:30am, but then again, people work all kinds of schedules. Another resident showed up at 5am and headed for the treadmill. He lives on the same floor as I do and I had passed him every day I walked the halls as he made his way down to the fitness center.

I couldn’t wait to tell Sally about my sleeping triumph, but drowsiness overtook me a little while after she woke up. I unexpectedly found myself napping at 8am. What was up with that?

Doing the math, I realized that 8am eastern was 3pm in Athens. Knowing that my natural napping window was between 1pm-3pm gave me cause for celebration: although I still had 4 more nights to complete my adjustment, my napping schedule had already made the transition. This was certainly a good sign, no?

On Tuesday night, I went to bed while it was still light out (6pm) and got up at 2am the next morning. In case you were wondering, no, there was no one else working out in the fitness center at 2:30.

On Wednesday, the roll-on lavender oil I ordered arrived and I applied it to my temples before getting in bed. It smelled ok and I fell asleep without any trouble and I slept well. There’s no way to tell if it actually helped, though, but since nothing bad happened, I’ll use it on the plane today.

Reflecting back, making that first 2-hour time shift was brutal and my circadian rhythm fought me every minute of the day for several days, but the shift from going to bed at 8pm to 6pm was a breeze. Is it possible that my suprachiasmatic nucleus (which controls the circadian rhythm) has learned a new trick?

So that’s it. I’ve transitioned 5 hours out of the 7-hour time difference. I’m ready. I’ve trained hard. I can do this. 

Look out, Athens, here I come!

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S2E42. Time Zones: Week 2

I’m sorry to foist this on you, but my experiment in preparing for a 7-hour time zone shift prior to our cruise is pretty much consuming my waking hours. And my sleeping hours, too, come to think of it.

This week was really rough on me. The good news is that I got into a rhythm of waking up at 4am as opposed to my normal 7:30am routine. But that was leaving me sluggish and pretty much wiped out during the day, even when I took a nap around noon.

It really had me perplexed because it was only 12 years ago that, following my first wife’s passing, I was on a regular schedule that had me getting up at 4:30am, working out on a treadmill and weight machine in my basement for an hour before showering and going to work. And I would feel physically fine and cognitively alert the whole morning (I had to be as I was a clinical psychologist on an acute care inpatient unit). Then I would take a nap in my office at noon and finish out the day, even putting in an extra hour or two at times.

So why was this so difficult? It appears that our circadian rhythms get a little cranky and less flexible as we age, but I didn’t think the difference between being 59 and 71 would have such a dramatic effect. Apparently, it does on me.

My new routine has me waking up at 4am and immediately walking for half an hour at a brisk pace. I moved my workout to first thing after waking up because I found I was too tired later on in the day to convince myself to do it.

Luckily for me, the new management company for our apartment building is renovating. They are painting the hallways a lighter color and changing the lighting so that it is like daylight out there…and early morning light is exactly what is called for when trying to fool your sleep-wake system into re-setting itself.

So my morning exercise of walking the halls (where 1 lap around is about 200 yards) is serving a dual purpose. If the hallways weren’t so fortuitously bright, I’d probably have to buy a light box and sit in front of it for a while after waking up. Thank goodness I lucked out and avoided that fate!

After my walk, I sit down with my computer, turn the brightness up full, and do The New York Times crossword puzzle, Spelling Bee, Wordle and Nerdle. It’s about then that Sally wakes up and I make her coffee and my tea to initiate our normal morning ritual. By then, the sky is starting to brighten and it feels like things are almost back to normal.

Sally is not all that enthusiastic about my attempt to prepare my body for Athens. Her natural rhythms would have her going to sleep around midnight, but she also likes to go to bed when I do, so my new hours have thrown a major monkey wrench into her routine. She reminds me that we went to Paris a few years back (6-hour time difference) and really didn’t do anything to fend off jet lag and neither of us can recall any severe effects. She has a point.

By 11am, I’m getting groggy and thinking about taking a nap. It takes me a while to appreciate the fact that I’ve already been up for 7 hours and I’ve worked out, so napping at 11am isn’t such an off-the-wall idea.

I’m eating dinner a little earlier than before (around 5:00pm instead of 6:30pm. After all, it’s not just your sleep but your hunger/digestive rhythms that need to adjust, as well.

Bedtime is the biggest problem. Early to bed means I can’t watch most of the Phillies games in the playoffs. Bummer! My compromise has been to get in bed around 9ish so I could at least watch a few innings. But that only left me the potential for 7 hours of sleep and, with the usual time it takes to fall asleep and the usual number of nighttime awakenings, I was only getting about 6 hours of actual sleep…and that just wasn’t enough for me, even with a mid-day nap.

So on Wednesday of this week, I moved my bedtime back to 8pm…and it worked like a charm! I got a good 7 hours of sleep and I felt fine the rest of the day. Now I know that I need to lock-in 8 hours in bed, no ifs, ands or buts!

As of today (Friday), I’ve got just 7 more days available to adjust. I’ve picked up half of the 7-hour transition I’ll be making, leaving a 3½-hour difference. I know I won’t be able to get all the way there, but I think I’d like to transition 1 more hour before we board the plane. That would be a 7pm bedtime and 3am awakening. Somehow, doing that never made it onto my bucket list!

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S2E41. Time (Zone) Travel

No sooner had I finished writing last week’s blog about sleep than it dawned on me that I had to start preparing for our upcoming Mediterranean cruise. We fly to Athens on October 29th which means that we have 3 weeks to adjust our sleep patterns to compensate for the 7 hours we’ll lose on the flight.

We booked the cruise months ago and I have been eagerly looking forward to it, but now all of a sudden it is imminent, and now, also, I am acutely aware that having my circadian rhythm out-of-joint for a week while I adjusted 1 hour per day was not the best way to get the most out of the trip. So I began the transition this week.

The task before me is pretty daunting. I normally go to bed around 11:30pm and get up at 7:30am. But in Greek time, that would be like going to sleep at 6:30am after pulling an all-nighter. Not good.

It’s my understanding that the kinder-and-gentler way to prepare for a trip like this is to start several weeks before the flight by going to bed 15 minutes earlier every night and waking up 15 minutes earlier until you are on schedule in your destination’s time zone. Compensating for the 7-hour difference, then, would take about 28 days using this system. I only had 21 days left until departure, though, so I figured I had to accelerate the pace a little.

The first night, I got in bed at 10:30pm and got up at 6:30am. Unfortunately, I had a lousy night’s sleep and was miserable most of the day. The good news here, though, is that since I’m retired, I can just take it easy and nap when the spirit moves me, which is what I did.

Then we went to the Jersey shore for two days. We picked the time to coincide with the October full moon. We thought it would be fun to watch it rise over the ocean, so we got a beachfront hotel room with a balcony on the 3rd floor with a pristine view of the ocean.

The sky was cloudless and the view of the red moon hurdling over the horizon at about 6:30pm was spectacular. It was shortly thereafter that I realized, “Hey…we can watch the sunrise tomorrow morning, too!”

Which is what we did. I only needed to get up by 6:00am to see it, but I happened to wake up at 4:30am and decided not to go back to sleep. Bundled up and sitting on our balcony, I was treated to the full spectrum of the sunrise. It began around 5:30am with a deep red-violet glow at the horizon that gradually brightened to a red-orange wash as the sky above it lightened to turquoise. The light show went on for an hour before the sun finally crested onto an already day-lit sky. Just beautiful!

And I did it again on Tuesday morning, going to bed at 9:30pm that night, and getting up at 4:30am on Wednesday. 

We were back home in the apartment by then, so I turned on all the lights in an attempt to fool my body clock into believing that it was time to get up. I turned the brightness on my computer screen up as high as it would go and did crossword puzzles while waiting for the sun to rise. The view isn’t nearly as spectacular from the apartment balcony as it was from the shore, but the colors are just as rich and they provide a modicum of reward for the abuse to which I’m subjecting my body.

Getting up at 4:30am isn’t really agreeing with me…yet. I have to believe though, that it will get better with each passing day. I’ve made up nearly 3 of the 7 hours I’ll lose, so at least there’s that. I’ll admit, though, that I can’t really imagine myself going to sleep at 4pm (11pm in Greece) by the end of the month and feeling good about it. 

And then there is the issue of food. I also have to change the times that I’m eating so that I’ll want breakfast and dinner at the right times while on the cruise. 

For now, I’m feeling ok for about 4 hours after I get up, but then I fade fast. I’m eating whenever I get hungry, which now seems to be most of the time. I have no energy to exercise, but I at least try to take a walk every day. The fitness center in our apartment building is open 24/7, so maybe I can try to work out in the wee hours. It might be worth a shot. Bottom line: once your sleep rhythm is out of wack, it’s really hard to maintain a brain-healthy daily schedule.

Playing with all of my bio-rhythms at the same time is a strange experiment. I suppose it’s better to get all of this discomfort out of the way now rather than to find myself walking around in a fog as we visit the ancient empires of the eastern Mediterranean. 

Lord, I hope so!

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S2E40. Going Back To Sleep

It was just 9 weeks ago that I posted a blog about sleep (S2E31. Sweet Dreams Are Made Of This) in which I described my lifetime relationship with sleeping and napping.

I thought I had said all I needed to say about sleep’s importance as one of the five pillars of preserving brain health, but The Universe seemed to have a different idea. All of a sudden my inbox and social media feeds were full of articles about sleep and sleep hygiene…and it wasn’t even National Sleep Awareness Week!

So I played along and watched a webcast of an interview with Matt Walker, Ph.D., a sleep scientist at the University of California-Berkeley (you can watch the 1-hour event here: youtube.com/watch?v=ZaxGiYyUcyI).

A lot of the information he presented was new to me, so I read his book Why We Sleep.

WOW…was I ever impressed! It was a real page-turner! He keeps his use of jargon and scientific terminology to a bare minimum and has a knack for selecting just the right analogies to make the research he details come to life. But it’s the content he covers that is truly mind-boggling. It was humbling to discover how little I knew about sleep.

Did you know that all creatures who live more than a day sleep? Including insects and worms?

Did you know that only one side of a dolphin’s brain sleeps at a time because it has to stay awake to surface and breathe?

Did you know that just one hour of lost sleep can significantly impair your cognitive abilities and possibly even kill you? Apart from all the laboratory studies that demonstrate this, we have an unintended real-life experiment that is run every year. It turns out that the day after daylight savings time goes into effect (and we lose an hour of sleep by turning our clocks forward), there is a spike in the number of fatal heart attacks and car accidents. Conversely, when we turn our clocks back in the fall (and gain an hour of sleep), there is a corresponding drop in heart attacks and traffic accidents. 

Fascinating!

Apart from fun facts to know-and-tell, the research he described was simply amazing. He would begin by asking what happens when we sleep, then progress to how it happens, and end up answering the ultimate question: why does it happen?

For the purposes of this blog, though, the meaty part of the book involves sleep’s effects on memory.

Dr. Walker explains that the hippocampus maintains traces of your experiences each day and then, during sleep, it empties itself by sending important information out to a variety of cortical areas where it is permanently stored in the form of memories. It’s kind of like downloading the contents of a thumb drive onto your hard drive and then erasing it from the thumb drive so it has its full capacity available for the next day. One stage of sleep is responsible for transmitting the data and a different stage of sleep takes on the task of cementing it in place by strengthening the synapses where the information is stored.

If your early sleep is disturbed enough, the information won’t be transmitted and you won’t remember much the next day. If your sleep later in the night is disturbed, the newly planted memory won’t be consolidated and you won’t remember much, either.

So if you want to be able to remember more about what happened today, you’ll need a good 7-9 hours of high-quality sleep tonight…and for the next couple of days, as well.

If you don’t get good early sleep, the hippocampus won’t empty out and it will have limited storage space available the next day. That’s part of the dullness you feel when you haven’t slept well and accounts for some of the difficulty you have learning new information that day.

Unfortunately, once we get into our 60s, our sleep patterns begin to change…and not for the better. We tend to sleep fewer hours and the quality of that sleep is compromised by more awakenings…all of which wreaks havoc on our memory, immune system, emotional reactivity and judgement. 

It also compromises the nightly cleansing of the day’s chemical detritus which includes beta amyloid and tau particles, the accumulation of which are associated with Alzheimer’s pathology.

The take-home message here is that it’s not true that we need less sleep as we age. We need the same amount of sleep that we needed when we were younger to allow all of these crucial processes to be executed every night. The problem is that we don’t get the sleep we need as often as we should.

Putting all this together, it’s no surprise that getting fewer than the recommended number of hours of sleep on a regular basis is a risk factor for dementia. The relationship is so strong that researchers are now exploring whether sleep patterns can be used to predict whether or not you will develop a dementia a few years down the road.

Dr. Walker ends the book with a listing of things you can do to maximize your chances of getting the sleep you need (spoiler alert: taking sleep medication is not one of them). Here’s a link where you can review them: https://www.nhlbi.nih.gov/files/docs/public/sleep/healthysleepfs.pdf

The one change I made after reading the book had to do with my computer usage. 

I’m usually on the computer right up until bedtime, but it turns out that that’s a terrible thing to do. You see, the LED screen of a computer emits strong light waves at the blue end of the spectrum. It is this wavelength of light that triggers your circadian rhythm which tells you when to wake up and when to go to sleep. 

By bathing myself in blue light late at night, I was telling my brain that it was still daytime and so it delayed sending out the signal to initiate the sleep cycle until after I turned off the computer and went to bed.

I thought about changing my end-of-day routine, but realized I’m pretty much addicted to my computer use. Fortunately, the people at Apple have provided a solution. There is a program built into their computers and phones that will change the color emitted by their screens in the evening, going from blue-white to a soft yellow-amber. Problem solved! The program is called ‘Night Shift’ and you can find it by clicking on the ‘Display’ icon in System Preferences or Settings.

Alternatively, you can buy glasses that block the harmful wavelengths.

I’ll close with one more snippet from the book:

So, you ask, why is it that our circadian rhythm is triggered by blue light and not by full-spectrum sunlight?

You might recall that we are descended from fish and their aquatic predecessors. The circadian rhythm was an adaptation that evolved while we were living in water. But water filters out the other wavelengths of natural light leaving only the blues and greens. Eons ago, then, our evolutionary ancestors lived in a world that oscillated from darkness to blue and back again. And that’s the light pattern that controls your circadian rhythm to this very day!

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S2E31. Sweet Dreams Are Made Of This

When I was growing up, my mother valued her children’s sleep above all other bodily functions. When I was 12, I used that to my advantage when I wanted to play hooky from Hebrew school by staying up late the night before and then pretending not to wake up the next morning when she called me.

In college, a had a fierce bout of depression and found myself sleeping 12-16 hours every day. My therapist told me it was a defense mechanism whereby I tried to escape from reality. It sounded plausible at the time.

I used to wake up most nights at 3am. My best guess was that it was a little bit of residual trauma from when I was 6 or 7 and I was startled awake by the phone ringing. It was the hospital calling to tell us that my grandmother had died. My mother jumped out of her bed, wailing and crying hysterically. I glanced at the clock in my room and saw that it was 3am. Just recently, I learned that about 35% of us habitually wake up at 3am…and a related trauma is not a prerequisite at all.

In my early 30s, when I was the executive director of a performing arts center, I used to doze off in my office every afternoon. I fought it for a long time in the belief that I shouldn’t  be sleeping on the job, but then I decided, screw it! As soon as I’d start to get drowsy, I would buzz my secretary and ask her to hold my calls, lean back in my chair and nod off.

My afternoon napping habit never left me. When my first wife and I ran a B&B in northeastern Pennsylvania, I would retreat to the rope hammock hung between a pair of birch trees or lie down on the porch swing on most days in the late spring, summer and early fall. Those were the best naps of my life!

Fifteen years later, as the staff psychologist on an inpatient behavioral health unit, I took my nap a little earlier to coincide with my lunch break. Without my asking, our director sent out a notice that staff should not disturb Dr. Braffman during lunch unless there was an emergency and a patient was in crisis. Now that’s how you value nap time!

In graduate school, I learned about the 4 phases of sleep. Later studies revealed that you cycle through these phases 4-6 times every night, and that you can dream at any time, not just during REM sleep. 

New research published last month reported that there is a noradrenaline cycle that wakes you up as many as 100 times during the night. The awakenings are measured in milliseconds, so you are unaware of the vast majority of them.

Although we appear quiescent while we sleep, there’s actually a lot of important business going on under the hood. It’s the time when we consolidate memories and new learning and replenish our available stores of vital neurotransmitters. If you don’t sleep well or long enough, you’re going to have cognitive problems the next day, e.g., brain fog and you’ll be prone to making a lot of mistakes.

Another critical function of sleep is to clean up the chemical detritus left over from your brain’s daily activities. There is a whole separate network in your head that performs this task, running in parallel with the neural networks with which we are all so familiar. It’s called the brain’s glymphatic system.

It’s hypothesized that your brain’s ability to clean up the daily messes that it makes plays a critical role in preventing dementia. One way this might work would be by removing beta amyloid that is created as part of an immune response like a fever. 

What I haven’t been able to find anywhere in the literature, though, is a description of the magnitude of this cleaning power. Can your brain completely clean house every day? Is there enough residual power to clean up festering messes that overwhelmed the system on earlier occasions? In other words, is it destiny that our brains eventually be overrun with chemical garbage? Or can we chip away at accumulations of waste products until all our neural pathways are functioning again? Or is breaking even on a daily basis the most we can hope for?

We don’t know the answer to those questions yet, but we do know that somewhere between 7-9 hours of restful sleep on a regular basis helps tremendously. And naps are good for you, too (thank you, lord!), so long as you don’t overdo it to the point where they start to affect your nighttime slumber.

The impact of consistently high-quality sleep on your brain’s health can not be overstated. If you aren’t sleeping well (i.e., less than 6 hours each night), you might want to consider implementing some behavioral changes now that will reduce your risk of dementia by 30-50% later on.

To sleep better, lay off the alcohol in the evening and no more caffeine after 12 noon. Set a fixed schedule for going to bed and waking up. Stow your electronic devices about an hour before bedtime. Make a list of all the things you want to do the next day so you don’t lie awake thinking about them. You might want to do a meditation/relaxation/deep breathing exercise just before bedtime. Make sure your bedroom is dark and the temperature is somewhere in the 60s.

If you do all of these things and still have trouble sleeping, it will be well worth your while to get evaluated. There are a range of products out there—both natural and pharmaceutical—that can offer you support, if you need it.

Pleasant dreams!

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S2E17. Backsliding

The last 6 weeks have not been kind to the brain-healthy lifestyle to which I aspire. 

During the months that I was trying to lose weight, it seemed easy to establish new habits and maintain them. My motivation was clear and there was positive reinforcement when I weighed myself each morning. There was the added excitement of learning new things and implementing them as I went along. That went for food, sleep, exercise and learning to play the recorder. They were heady times, indeed!

There was a comfort in the routine that emerged, from my morning granola ritual to getting into bed every night at 10:30pm.  Every hour of my day seemed purposeful and, more importantly, healthy. 

All that began to change, though, after I reached my weight loss goal. I had to figure out how to stop losing weight. (Nice problem to have, eh?) I thought that just exercising a little less (i.e., burning fewer calories each day) might take care of it, but to my surprise, it didn’t. 

Although it wasn’t my intention, I stopped exercising altogether, which is obviously not part of any brain health plan. It began on the 3 extended weekends we were traveling to go to UConn women’s basketball games. Although all of our hotels had fitness centers where I could have worked out, I just didn’t feel compelled to use them. It was as if I were on vacation and exercising would have been akin to bringing my job with me. Strange, right?

Around the same time, I noticed that my body was starting to complain about working out. I was having fantasies about running 5k races again and trying to regain what little speed I had 5 years ago. It wasn’t long after I began increasing the intensity of my workouts that I tweaked something in my left hip. Then I noticed that there were a couple of spots in my shoulder and back that resented my weight workouts.

I decided that discretion was the better part of valor and that it would be smart, not brave, if I took a week or two off and let my body heal.

That was the plan I was implementing when COVID knocked me for a loop and kept me from working out for another two weeks.

But it wasn’t just about exercising. I went off my brain-healthy diet, too. 

Since we were traveling, we ate out all the time. For unknown reasons, I felt that this gave me license to eat anything. And I did: corned beef, bread with butter, cheese danish, deep-fried walleye, bratwurst, bacon, stadium pizza, french fries, coffee with half&half and sugar, ice cream…all the banned food groups found their way down my gullet.

It would have been easy to eat much more healthily as just about all the restaurants had vegan items on the menu. But when I saw them, a wave of ‘I can make that at home’ would sweep over me and I would move on to the taboo side of the menu. It wasn’t pretty. And it didn’t feel good, either.

Our sleep hygiene went out the window, as well. Instead of getting in bed at 10:30pm, we’d stay up as long as we needed to relax after the excitement of the basketball games. We’d get up whenever we got up. Intermittent overnight fasting went by the wayside, too, as did chilling the rooms down to the high 60s before bedtime because we didn’t have our heated sheets to jump into when the time came.

It’s not easy being brain-healthy on the road!

But now we’re home and healthy and I’m getting back in the groove. This week I made granola, sauerkraut and kefir and I’ve worked them all back into my diet. I faltered again, though, when we went out for dinner and I had a hamburger, of all things. But I’m doing better. Honest!

I had to start from ground zero with exercising by walking on the treadmill for half an hour. I was actually sore the day after my first workout! We’ve restored sleep hygiene to our life, and that’s a good thing.

We’ve got more trips planned in the months ahead and so I’m going to have to steel myself to maintain brain-health discipline while on the road. I don’t think my backsliding hurt my brain, but I’m pretty sure it didn’t help it, either. My sense is that I lost about a month in the long-term project of cleaning up whatever toxic waste sites that have amassed during my first 70 years. What I need to do going forward is to find a way to treat myself occasionally without running amok.

That’s probably easier said than done!

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S1E48. Winter Air

“Close the door! You’re letting all the heat out!”

I can hear my father’s words echoing down the decades. He’d chastise us like this on winter days whenever we came in to warm up from playing in the snow.

“In or out…make up your minds!”

There’s a fine line between cheap and frugal. In hindsight, I suppose he met criteria for frugal. I recalled his words this week as I wrestled with trying to regulate the air quality in the apartment.

If you’ve been following this blog for a while, you’ll remember from Episode 36 that I bought an air quality measuring device to see if there were any hidden environmental dangers in our new apartment.

Although I was able to take measurements, I didn’t see how I could improve the air quality if it was problematic, and so I decided to return the monitor the next day. Thankfully, I never did. By a process of trial and error, I learned to keep the air in the apartment pristine by leaving a window open to provide ventilation that flushed away elevations in formaldehyde and total volatile organic compounds (TVOC). And it seemed to work without running up a big air conditioning bill, too.

Now that we’re into the heating season, though, the problem has re-emerged.

Honoring my father’s wishes and respecting my own desire not to waste energy, I closed all the windows when it got cold outside. When I did, I saw that the air pollutants spiked as soon as the heat kicked on. It didn’t get up to dangerous or unhealthy levels, but the readings for both formaldehyde and TVOC were significantly higher.

What to do?

My first thought was that, since we want the bedroom relatively cool at night (~65 degrees) to promote a good night’s sleep, maybe I could open one of its windows and close the door to the rest of the apartment. This would give us clean air overnight air without triggering the thermostat in the living room.

Both of those goals were achieved, but at the cost of forfeiting our sleep: the second I opened the window, the din from the steady stream of cars on Route 202 flooded the room. I did my best to give it a fair shot, but I finally closed the window at around 3am after the driver of a car without a muffler gunned it when the light at the intersection turned green.

Hmmm…

This would be easy if my father hadn’t taught me so well.

This would be easy if I didn’t care about conserving energy.

I’d just open the window, crank up the heat, and pay the bloated electric bill each month.

But he did teach me well and I do care about energy conservation, so back to the drawing board I went.

I came up with the idea of leaving the bedroom window  open a little (~2 inches) during the day, from noon to 4pm when it’s as warm as it will get, and leaving the door into the living room open as well.

It worked. Air quality was good all day and the cold air flowing in from outside only triggered the heat once or twice. It remains to be seen, though, what will happen when it gets down into the teens during the day instead of the mid-40s that we had this week.

“What, are you crazy? Close the window…you’re letting the heat out!”

I went back to the bedroom problem and tried something a little different. I opened the window at 7:30pm (about 3 hours before our bedtime) and closed the door. I figured this would chill the room and lock-in good overnight air quality without triggering the thermostat.

Although it got a little too cold in there, the concept clearly worked. Over the next few days, I’ll play around with how long I refrigerate the bedroom before bedtime in order to get a good sleeping temperature.

My father would never have embraced the idea of opening a window in the winter with the heat on, not even for the worthy purpose of preventing cognitive decline. Knowing that I used an electric mattress pad to warm the bed in the room I just chilled would have driven him to distraction! 

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S1E41. A Brain-Healthy Lifestyle Is…

…a full-time job!

When I first started learning about brain health back in May, I would come across the phrase ‘lifestyle changes’ pretty often. It referred to the likelihood that if you were a typical American, you would probably have to adopt several changes to your current lifestyle if you wanted to ward off cognitive decline and dementia.

These were things like changing your diet to minimize intake of sugars and saturated fats, and getting off your butt and exercising several times each week.

I thought: “Piece of cake…I can do this!”

I’ve been implementing those ‘lifestyle changes’ for about six months now and…you know what? Those changes make up the better part of my day! Don’t get me wrong. I’m not complaining. I enjoy implementing the recommendations… but it’s turned into a full-time job.

Here is an accounting of what my new ‘lifestyle’ looks like from the perspective of the number of hours per day devoted to each of the five pillars of brain health:

1. Exercise: 1.7 hours. I’m working out six days each week. My workouts themselves take between 40-60 minutes, so I’m easily surpassing the 150-minutes/week brain health recommendation. But let’s add to that total my cool-down time (when I drink a pint of pomegranate juice mixed with filtered water) and the time it takes to shower. That gives me about 12 hours/week, or 1.7 hours/day devoted to my exercise regimen.

2. Diet:  2.0 hours. I’m still learning how to eat right which means that I’m still researching diet recommendations and recipes. Then there’s the grocery shopping, prep time (I’m now making my own granola and sauerkraut), cooking, and the actual eating. I’d say that this consumes an average of 2 hours each day.

3. Cognitive Challenge: 6.0 hours. I start my day by doing crossword and jigsaw puzzles. Figure 2½ hours there. I try to get half an hour of recorder practice in daily (but don’t always succeed) and then Sally and I listen to a vinyl album each night after dinner. Let’s call it 1 hour daily for music. Add another hour for reading books. I would like this to be a daily routine, but so far it’s more likely to be binge-reading the week before book club meets. I’ll add an hour for on-line activities like social media and reading the newspaper. Finally, I spend about half an hour each day thinking about, researching and writing this blog. If my math is correct, that adds up to 6 hours/day.

4. Social Engagement: 1 hour. This is my brain health weak spot. Compared to Sally who is out-and-about most of the day nearly every day, I am a veritable recluse. But I do manage to get together with others about twice each week. Although I work out in our apartment’s fitness center, there is rarely anyone else there. Same for when the pool was open. On nice days, my jogging path is the ⅓ mile loop around the building and I wave or say hello to everyone I see. On rare occasions, I will share the elevator with someone. None of this adds up to a ‘relationship,’ though, nor does it meet the criteria for ‘social engagement.’ So let’s be generous and round up to an average of 1 hour/day of ‘real’ social interaction with someone other than Sally.

5. Sleep: 9 hours. No…I don’t get 9 hours of sleep each night. It’s more like 7-8. But we do get in bed at 10:30pm and usually get up around 7:30am. This allows for time to fall asleep, wake up a few times in the middle of the night, lie awake for a little while in the morning before getting up, and still log the recommended 7-9 hours of solid sleep. It also facilitates our intermittent fasting schedule which has us stop eating at 7:30pm which is 3 hours before going to bed.

Here’s what it all adds up to:

1.7 Exercise

2.0 Diet

6.0 Cognitive Challenge

1.0 Social Engagement

9.0 Sleep

There you have it: 19.7 hours per day devoted to my newly-adopted brain healthy lifestyle. That leaves about 4 hours free for other pursuits. In the spirit of full disclosure, though, I’ll admit that I allocate about 1½ of them to my nap!

Now the question is: What will I do with all that free time?  😀

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S1E34. The End Of Alzheimer’s Program

This week, I read the book so you don’t have to. Here are my take-aways:

Dr. Dale Bredesen is a leading advocate of a comprehensive approach to treating symptoms of dementia. The book The End of Alzheimer’s Program is an update of his 2017 publication The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline and includes lessons learned from 8 years of treating patients with the protocols he developed.

He rejects the notion of a single cause of Alzheimer’s and other dementias in favor of a holistic approach that focuses on the things your brain needs to function and the things that get in the way of its doing so. The program seeks to protect your brain and ward off cognitive decline by using diet and behavioral changes to support its essential activities while minimizing toxins that impair its ability to function properly.

He argues that the effort to find a drug that eliminates beta amyloid, for example, is misguided. You have to ask “How did it get there in the first place?” It turns out that beta amyloid is produced as part of the brain’s immune system to combat toxic invaders. So a remedy that is available to you right now is to identify the toxins (both chemical and biological, like rogue microbes that escape from you intestines and break through the blood-brain barrier) that are affecting you and eliminate them. Once you’ve done that, your brain’s immune response will not be triggered as often and you will not produce as much amyloid. It turns out you can manage a lot of this through diet.

Moreover, your brain has a natural way of removing beta amyloid after it has been created. It happens when you sleep. Therefore getting 7-9 hours of sleep each night can help ward off cognitive decline.

Bottom line: to a great extent, you can determine your own cognitive future by adopting a brain healthy diet and adding behavioral elements like exercise, sleep hygiene, stress management, cognitive challenge and social interactions.

Sound familiar?

He makes his case with meticulously documented references to the existing and emerging body of research and supplements it with case studies of people who were able to reverse their cognitive decline using his program. At times, it reads like an episode of “Grey’s Anatomy” or “House” where the doctors are unable to cure the illness until someone discovers that a rare toxin is causing the symptoms. They eliminate the toxin and the patient recovers.

As it pertains to dementia, the idea that you can reverse symptoms is pretty radical and flies directly in the face of the old notion that dementia is an unavoidable part of aging. As Dr. Bredesen documents, though, there are a large number of dementias that can be traced back to chemical, environmental or behavioral causes that can be rectified.

Which brings us to his program. It begins with an extensive battery of tests to identify the pathogens that might be affecting you as well as determining your levels of good chemicals and compounds. Once these factors are identified, you can design a diet that will correct imbalances and eliminate neurotoxins at their source. Progress is documented through ongoing testing and tweaks are made as you chart your reactions to the changes you have implemented.

Most of the book is spent going into great detail about how your diet affects long-term brain function. I’ll admit, I glazed over at the extended paragraphs laden with scientific terminology describing the chemical compounds and intra-cellular functions that were involved. Although he says he intends the book for consumers, it seems his real audience is physicians who he hopes will adopt his program. I can see how the book would be a great resource for someone who is guiding you through the process, but it definitely contains way too much information for most of us. Nonetheless, there are plenty of general recommendations and steps you can take to get started.

The chapters on exercise, sleep, stress management and cognitive challenge are informative, brief and a lot more digestible than the diet section!

Finally, Dr. Bredesen emphasizes that dementia is a process that takes years to develop. Your brain does its best to ward off attackers and to clean up the detritus after each daily battle. Over time, though, debris piles up and at some point the accumulation begins to take a toll on your cognitive functioning.

The good news is that most of this seems to be reversible if you start working on it soon enough.

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S1E32. The Fifth Pillar Of Brain Health

Different authors present the data and their conclusions about brain health research in a variety of ways, but they all pretty much cover the same material. What differs is the number of factors they identify. Since people can keep about 7 things (plus or minus 2) in short-term memory, I decided I’ll go with 5 so that 97.5% of us will have an easier time remembering them.

In previous posts, I’ve talked about 4 of the 5 pillars of brain health: diet, exercise, cognitive challenge and social engagement. In my way of looking at things, the fifth pillar is a twofer: sleep and stress.

We all know that we don’t function well and we make a lot of mistakes when we don’t get a good night’s sleep. Another way of describing that experience is to say that our brains are compromised when we don’t get adequate sleep and that is what causes the errors in our waking performance. 

A lot goes on in our brains when we sleep, including the cleaning up of chemical waste generated during the day, pruning of unnecessary synapses, and consolidation of long-term memory. Need I say more about the need to establish a healthy sleep regimen?

I used to teach sleep hygiene on the inpatient behavioral health units where I worked. As a cognitive-behavioral psychologist, I emphasized habits you could develop to help you get a good night’s sleep which is critical for those battling mental illness. I talked about no caffeine after 12 noon, setting a fixed time to get into bed each night, establishing a going to bed routine (e.g., reading or listening to music for half an hour before getting in bed), writing down everything you need to do the next day so you don’t think about it, etc.

I told my patients it was important to only use the bedroom for sleeping. The idea was that you would develop an association between the room and sleep and so just walking into the room at bedtime would trigger a sleep response. They would invariably ask about sex and I would tell them that if you really are having trouble sleeping, then move the sex to the living room or anywhere else other than the bedroom. That suggestion never failed to generate hoots and howls!

The brain healthy recommendation is 7-9 hours of good sleep. I’m not getting that consistently, so we’re trying a couple of things. We’ve set bedtime at 11pm. We don’t eat anything after 8pm (it turns out that this is really good for losing weight, too!). The recommendation for sleeping room temperature is 65-75, so I set the thermostat at 73 just before getting into bed. I just ordered blackout curtains from Amazon to try to help extend our sleep in the morning. As for bedroom sex…well, we’ll see how these other adjustments work out first!

The relationship between stress and brain health is a little more complicated. There’s good stress and bad stress. The good kind motivates you to achieve your goals. The bad kind triggers your fight-or-flight system and doesn’t feel good. Chronic bad stress releases cortisol which, over time, can be toxic to your brain, so you want to keep it at a minimum.

I used to teach stress management techniques several times each week in group therapy at the hospitals where I worked. The go-to skill that everyone should have is deep breathing. Back in 2006, I taped my presentation and put it on YouTube so patients could access it after they left the hospital. It’s been viewed nearly 139,000 times since then. You can check it out here. (Warning: I recorded this in one take and didn’t realize that there would be a ghostly ultraviolet glow once I turned out the light. You might want to watch it with your eyes closed!)

I can’t say that I’m experiencing much bad stress at all these days. So I’ll just leave it at that. Life is good!

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S1E14. That Was Then. This Is Now.

I wrote this about my parents when I was 22:

‘They’ve been grandparents almost two years now. Grandparents twice over, that is, and a third expected momentarily. As I stepped through the doorway I was met by a heavy-sweet menagerie of home-cooked aromas. Outside, it was a crisp spring afternoon. Inside, it was a trifle too warm. They had both mellowed in recent years, but just now, for the first time, I felt as though I were entering a grandparents’ home. They’re growing old.’

When I wrote that closing line, I meant ‘old’ as a pejorative, not as a compliment.

My father was 52 at the time. He died at 60. My mother lived to be 85, developing dementia a few years before she died.

Paul Simon wrote this lyric into the song ‘Old Friends’ when he was 27 years old:

“Can you imagine us

Years from today

Sharing a park bench quietly?

How terribly strange

To be seventy”

Sally and I are 70. We quietly share park benches. It’s not strange at all.

On the other hand, Paul Simon will be 80 in October.

Our view of aging is curious, isn’t it? How must today’s 20-somethings view us? If we asked Paul McCartney today, would he say that 84 is the new 64? 

In any event, heading toward our ninth decade, the goal is to be active, engaged, wise and interesting…a group of adjectives we don’t normally associate with the degenerative effects of dementia. The good news is that there appear to be things we can do to increase our chances of achieving those goals and of sidestepping our worst nightmare. In fact, we can now reduce our risk of dementia by some 40% by adopting a brain-healthy lifestyle. We can fight back against the prejudices and preconceptions of our younger selves!

Spoiler alert: I’m not one for miracle cures or for buying into ‘secret information that you can’t find anywhere else.’ As a former psychologist and researcher, I trust the science and want to see multiple studies heading in the same direction before I accept a conclusion as valid. So here are 4 recommendations for which there is a body of evidence supporting their efficacy:

  1. Take care of your heart. Your brain depends upon blood flow to provide nutrients and remove debris. There are 400 miles of blood vessels in your brain. You want every inch of them pumping at peak efficiency to prevent neuron damage and maintain synaptic connections. Adopt a heart-healthy diet; keep your stress levels in-bounds; keep your blood pressure and cholesterol levels in check.
  1. Exercise. The current guideline is about 150 minutes of ‘huffing & puffing’ each week (e.g., 30 minutes/day x 5 days). Walking is fine, but you need to work up a sweat and breathe hard. Obviously, this is good for your heart, but I also suspect that its moderating effect on cognitive function is also related to the fact that it engages so many areas of your brain.
  1. Challenge yourself cognitively. Read books. Learn new skills. Change your routine. Solve puzzles. Take on-line courses or, better yet, once we are COVID-clear, take courses in person. There seems to be a ‘use-it-or-lose-it’ aspect to how well our brains age, so try to be open to new experiences and challenges.
  1. Socialize. We are social animals and engaging with others engages our brain in ways well beyond any other activity. Just take a moment to think about all the ways you use your brain when sitting down for a meal with a group of friends. The complexity of negotiating a social context is stunning, invigorating, challenging…and fun! 

That’s roughly where the research stands today. You can reduce your risk of developing dementia by about 40% if you adopt a lifestyle that also happens to be associated with increased longevity. You get double the bang for the buck: more years and better years.

Bottom line: We don’t have to accept the dire predictions of our younger selves. We can marshal the resources that got us this far to get us through the final years of our journey in good stead. It’s definitely worth a shot.

All of which gives a brand new meaning to Bob Dylan’s 1964 lyric:

“…I was so much older then

I’m younger than that now.”

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