Forget common folklore about the safety of weed. Marijuana harms babies, research shows
'The most striking finding is the increased risk of perinatal mortality — death either during the pregnancy or shortly after the pregnancy,' said obstetrician and lead study author Dr. Jamie Lo, an associate professor of obstetrics, gynecology and urology in the School of Medicine at Oregon Health & Science University in Portland.
'Prior work we've done shows prenatal cannabis use impacts fetal lung function and development, reducing the baby's lung volume,' Lo said. 'We've also found that there is significantly decreased blood flow and oxygen availability in the placenta. These are the likely underlying mechanisms driving some of our findings.'
The placenta is a critical link between the mother and the developing fetus, delivering oxygen, nutrients and hormones necessary for growth. When that link is damaged, both the mother and the fetus are at risk.
Despite the potential harms to the baby both before and after birth, use of marijuana during pregnancy is rising. A 2019 analysis of over 450,000 pregnant American women ages 12 to 44 by the National Institute on Drug Abuse found cannabis use more than doubled between 2002 and 2017.
The majority of marijuana use occurred during the first three months of pregnancy, the study found, and it was predominantly recreational rather than medical.
'There is a mistaken perception that because marijuana is natural and plant-based, it's not harmful,' Lo said. 'I remind my patients that opium and heroin are also plant-based. Tobacco is a plant, and alcohol is also made from plants.'
Using alcohol during pregnancy causes fetal alcohol syndrome. Smoking damages a fetus's developing lungs and brain — it is also a cause of SIDS, or sudden infant death syndrome, according to the US Centers for Disease Control and Prevention.
Taking opioids, such as fentanyl, heroin or cocaine, are well-known causes of birth defects, poor fetal development and stillbirth, plus there's a high risk the baby will be born addicted and have to undergo withdrawal.
These medical outcomes are known despite the lack of gold-standard clinical trials asking pregnant women to drink alcohol, smoke tobacco, take heroin, cocaine, oxycodone or fentanyl and then compare the outcomes to pregnant women who abstained. Such research, of course, would be grossly unethical.
Thus, because a randomized clinical trial of the impact of cannabis on a fetus will never occur, scientists focus on the outcome of self-reported use by pregnant mothers.
'This systematic review is unique in that we only reviewed studies in which cannabis was used during pregnancy,' Lo said. 'Prior work has included studies which also looked at cannabis use along with other substances such as nicotine or alcohol.'
The new research, published Monday in JAMA Pediatrics, analyzed 51 studies with over 21 million participants.
Use of marijuana during pregnancy was linked to a 52% higher risk of preterm delivery before 37 weeks — full term is 40 weeks of gestation — and a 75% higher risk of low birth weight, which is less than 2,500 grams, or roughly 5.5 pounds at delivery, the study found.
Only six studies looked at the impact of cannabis on mortality. Those studies found a 29% higher risk of infant death associated with the use of marijuana during pregnancy.
The new meta-analysis used the GRADE (grading of recommendations assessment, development, and evaluation) approach to rating the quality of each study. In a prior analysis published in 2024, Lo and her team rated available studies as very low or low certainty, which means the evidence in the studies was limited and the findings not reliable.
Just a year later, existing evidence was upgraded to low to moderate certainty. A moderate grade indicates researchers are reasonably confident in using that information for decision-making but recognize that future research might refine conclusions or recommendations.
'Research is evolving quickly in this area,' said Brianna Moore, assistant professor of epidemiology at the Colorado School of Public Health Anschutz Medical Campus in Aurora. She was not involved in the new study.
'This review found that as more studies are conducted with consistent results, there is more certainty that there is an association between prenatal exposure to cannabis and adverse birth outcomes,' Moore said in an email.
In addition to believing that marijuana is safe because it's natural, expectant parents are also getting mixed messages about the health harms of cannabis.
'Perceptions of safety are compounded by the increased availability and legalization of cannabis,' Lo said. 'In addition, health care providers are poor at counseling due to confusion over conflicting studies. Therefore, there's no clear public health messaging.
'We're trying to change that by updating systematic reviews and producing peer-reviewed clinician briefs to help guide clinical counseling and management.'
Historically it has been difficult to investigate cannabis use because weed has been illegal — and still is — in many states, while any studies that were undertaken had to follow strict federal regulations.
Modern research into the potential harms of cannabis is still in its infancy. Older studies, often done in the 1980s when marijuana was much less potent, may not reflect today's reality, experts say.
Research over the last decade has linked marijuana use to cognitive decline and dementia, complications during elective surgery, and an increased risk of some cancers. Weed users are nearly 25% more likely to need emergency care and hospitalization, according to a 2022 study.
Any level of marijuana use may raise the risk of stroke by 42% and heart attack by 25%, even if there is no prior history of heart disease and the person has never smoked or vaped tobacco. Weed has also been linked to cardiac arrhythmias such as atrial fibrillation; myocarditis — an inflammation of the heart muscle — spasms of the heart's arteries and a higher risk of heart failure.
Young people who use marijuana are more likely to develop long-lasting mental disorders, including depression, social anxiety and schizophrenia, and drop out of school, the CDC said. Studies show overuse of marijuana by youth with mood disorders leads to a rise in self-harm, suicide attempts and death.
Daily use by adolescents and adults can result in another unpleasant side effect: uncontrollable vomiting, according to a 2021 study. And a 2020 study found children born to marijuana users had more psychotic-like behaviors and more attention, social and sleep problems, as well as weaker cognitive abilities.
'Ideally, it's best not to be exposed to THC, which is the psychoactive ingredient of cannabis, no matter what form you're using,' Lo said.
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an hour ago
- Yahoo
Insomnia is a global epidemic. How do we fix it?
On a special episode (first released on July 24th) of The Excerpt podcast: The question is: Why do we struggle to sleep? Jennifer Senior, a staff writer at The Atlantic, joins The Excerpt to talk about insomnia and what we can do about solving our sleep issues. Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text. Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here Taylor Wilson: Hello, I'm Taylor Wilson, and this is a special episode of the Excerpt. According to a report released by the American Medical Association earlier this year, one-third of American adults experience acute insomnia, an inability to fall or stay asleep for several days at a time, but one in 10 adults suffer from chronic insomnia. That's an inability to fall or stay asleep three nights a week for three months or more. The condition has potentially debilitating health impacts, including an increased risk of depression, anxiety, substance abuse, and even car accidents. So the question is, why can't we sleep? Here to help me dig into the issue is Jennifer Senior, a staff writer at The Atlantic who recently went on her own journey to solve her insomnia and who shared her story in the magazine. Thank you for joining me, Jennifer. Jennifer Senior: Thanks for having me. Taylor Wilson: So let's start with I guess a 30,000-foot view of the issue. I know you spoke with a lot of sleep specialists, did a lot of independent research for your piece. Jennifer, what's the big picture here on American's trouble with sleep? Jennifer Senior: Right. Yeah. What's funny, I think the story was a little misnamed. I mean, this is really more story about, well, if you can't sleep, don't feel awful about it because there are so many shaming stories about people, whatever solutions people seek out. I do talk in the beginning about the way that the modern world absolutely conspires against sleep, that it just lays waste to your circadian rhythms. That people work two jobs, 16.4% of us work non-standard hours. If you're a white collar kind of professional, you've got these woodpecker like peck, peck, peck, incursions into your life all night and weekend long from your boss's work sort of never ends. I mean, we're just no longer yoked to the rhythms of the earth anymore. We're just part of this whirl of a wired world. Taylor Wilson: In the course of doing your research, was there something in particular that surprised you most about the problem? Jennifer Senior: I'll tell you what surprised me most, just generally. Whenever I interviewed any expert about this, and it didn't matter what species of expert, they could be an epidemiologist, they could be a neurologist, they could be a psychiatrist, they could be a clinician. Most of them said the same thing. There is a slight misconception that you need eight hours of sleep. There is some data saying this. There is another equally robust data set saying 6.5 to 7.4 is associated with the best health outcomes. Now it's very hard to tell. These studies are observational. They're not randomized. There was all sorts of confounds and problems with this, but this one study in particular had a million people in it. It's been replicated. There are plenty of people who believe this data and people vary. And over the course of a lifetime, your individual sleep capacity could change. In a funny way, that was what surprised me most. Right? This mantra, which is kind of a tyranny, get eight hours or else. Taylor Wilson: Well, you talked Jennifer about the modern world conspiring against us and our sleep, and I guess let's try to outline a few of the possible causes of what you call a public health emergency, right? What can you share with us here on this? Jennifer Senior: About other causes, you mean besides the kind of modernity itself and kids working on... Kids being assigned homework online, kids socializing online. I mean, adolescents are desperate for sleep. They're so hungry for it, and modern high schools and middle schools have them waking up preposterously early when their circadian rhythms are pitched forward. We've got a substantial sandwich generation that's taking care of young kids and their elderly parents. That's going to conspire against it. These are all immutable things. Also, there are elevated levels of anxiety now in our world, and anxiety itself is a huge source of... Or can be a source of sleeplessness, certainly can make one prone. So I mean, those are additional examples I suppose. Taylor Wilson: Let's talk through your story a bit here. When did you first realize that you had an issue with sleep? And walk us through your experience with insomnia. Jennifer Senior: It was 25 years ago and it was a very mysterious onset. I cannot tell you what brought it on to this day. It is a mystery. I had this extremely well-regulated kind of circadian clock. I fell asleep every night at 1:00. I woke up every day at 9:00. I lost my alarm clock. I still woke up at those times. I didn't have to buy a new alarm clock until I had an early flight one day, and yet sometime very close to my 29th birthday when virtually no circumstances in my life had changed one iota, I had a bad night, fell asleep at like 5:00. Thought nothing of it until they became more regular, and then I started doing all-nighters involuntarily, and I felt like I'd been poisoned. And to this day, I don't know what happened, but once that happens, the whole cycle starts to happen, then people suddenly become very afraid of not falling asleep and whatever kicked it off whether it's mysterious or known becomes irrelevant because then what you do is you start getting very agitated and going, oh my God, I'm not sleeping. Oh my God, I'm still not sleeping. Now it's 3:00 in the morning. Now it's 4:00 in the morning. Now it's 5:00 in the morning. Oh my God, I have one more hour, et cetera. Taylor Wilson: Well, you did write in the piece about the many different recommendations that she tried to solve your own sleep issues. What were some of them, Jennifer, and did any of them help? Jennifer Senior: Oh God, I tried all the things. This is before I sought real professional help, but I did all the things. I would took Tylenol PM, which did not work. I did acupuncture, which were lovely, but did not work. I listened to a meditation tape that a friend gave me, did not work. I listened to another one that was for sleep only that did not work. I ran. I always was a runner, but I ran extra, did not work. Gosh, changed my diet. I don't remember. I did all sorts of things. I tried different supplements, Valerian root, all these things. Melatonin, nothing, nothing. Taylor Wilson: You wrote in depth about one therapy that was recommended to you, and that was CBTI. That's cognitive based therapy for insomnia. Jennifer, first, what is this? And second, did you find any success by using this? Jennifer Senior: So cognitive behavioral therapy for insomnia, as you said, is the gold standard for treating insomnia. It's portable. You can take it with you. It's not like if you leave your sleep meds at home. The main tent pole of it, which is sleep restriction, which I'll get to in a minute, is very hard to do. I found it murder, the kind of easier parts, although they're still in a funny way, kind of paradoxical, are you have to change your thinking around this is the cognitive piece around sleeping and insomnia. You have to decide, okay, I'm not sleeping. So what? Now, this is kind of funny because there's this din surrounding us that says, oh my God, you're not sleeping. You're going to die of a heart attack. You're going to die of an immune disease. You're going to get cancer. All these things, right? You have to set that all aside and decide one more night's sleep that I can't sleep. So what? Right. That's one thing. You have to change your behaviors, deciding that you are going to consistently go to bed at the same time, wake up at the same time, all that, and not use your bed for anything other than just for sleeping and sex. The hard part and the most powerful part that I found it brutal was the part that said you have to restrict your sleep. If you had only five hours of sleep, but you're in bed for nine hours, you have to choose a wake-up time. Let's say it's 7:00 and then you have to go to bed five hours earlier, 2:00 to s7:00. That's all you can give yourself, and you cannot stop with that schedule until you've slept for the majority of those hours. That's very hard for a sleepless person. And then once you've succeeded, all you get to add on is 15 more minutes of sleep, and then you have to sleep the majority of those hours for three nights running. This is always for three nights running, and the idea is to build up a enough sleep pressure to regularize yourself. You basically capitulate to exhaustion and you start to develop a rhythm. I couldn't stick with it. I was so kind of stupid and depressed with sleeplessness by the time I started it that it probably was impractical and I refused to take drugs to help me fall asleep at the exact right hour, which many clinics recommend. If you're going to go to bed and sleep from 2:00 to 7:00, take something at 1:30 so that you fall asleep at two. But I was afraid of being dependent on drugs, and you can really wean yourself if you do it for a limited amount of time. You can wean yourself anytime really, if you're shrewd about it and if you taper. But I think that I would tell people to try it and to try it sooner rather than later, and to be unafraid of doing it in combination with drugs so that the schedule worked. Taylor Wilson: Well, I am happy you brought up drugs. I did want to bring that up just in terms of what experts are saying about their impact. Even just drugs and alcohol kind of writ large, but sleeping pills specifically. What did you find in researching this in terms of drugs and alcohol? Jennifer Senior: Well, there's a real stigma taking sleep medication, and I'm frankly a little sick of it. I'm not sure why this is so very stigmatized. Like, oh, they're drug addict. They're hooked on sleeping pills. It's framed as addiction, and no one says that someone is addicted to their Ozempic, even though a lifestyle change could perhaps obviate the need. No one says that they are addicted... Oh, that person is totally addicted to their blood pressure medication, even though maybe a change in lifestyle would help change that. Or that they're addicted to their statins, So I sort of bristle. And those who prescribe these medicines say like, look, if the benefit outweighs the risk and they're used properly, sometimes the real side effect is just being dependent on these drugs, and there's a difference between dependence and addiction. A surprisingly small number of people who take these drugs regularly, like benzodiazepines, like Ativan and Ambien and Klonopin, all these things, a surprisingly small number, like 7% increase their doses if they take it every night. So that's very small. However, there are cognitive decrements over time... Or not decrements. It can interfere with your memory and it can increase your odds of falling as you get older. And those are, to me, the real persuasive reasons to get off. Taylor Wilson: I want to back up a minute here to talk about something many may not be aware of, and that's that historically, at least in some eras, people used to sleep in two blocks. What do you know about this? How did this function and really why did this kind of sleep pattern work for some folks? Jennifer Senior: Well, it was sort of, I think, natural. It seemed that this is, and it has not been proven everywhere, but there's plenty of both historical evidence and also some in a lab by this wonderful guy named Tom Ware that shows that if you sort of just put someone in a room, 14 hours of darkness, what will happen is that their sleep will naturally split into two. They'll sleep for a phase, wake up for a phase, and then sleep for a phase again. And historically, there's all sorts of evidence that people would sleep for a phase, get up and read for a while, do some quiet things, do light tasks, maybe sing, maybe have sex, and then go back to bed. So there seemed to be two phases, and this was much easier to do when midnight was actually midnight. You were going bed when the sun had set, or just after were you were tethered to the rhythms of the earth as opposed to a wired electricity run world. Taylor Wilson: What is something you wish you knew when you first started on this journey? Jennifer Senior: To get on it earlier and to not be as afraid... Cognitive behavioral therapy is, I think, often done in conjunction with taking something like Klonopin or Ativan or Ambien, and I was so petrified of becoming hooked on them that I didn't... I refused to take them and I couldn't get my sleep to contract as a result of it. My body was so completely dysregulated and confused about it was so all over the place that I really needed something to regularize it and stabilize it, and I flipped out, and I think if anybody goes and tries CBT, I and their practitioner says to them, and I'm going to have to be on their recommendation, do this in concert with a drug, because you really need it. Don't sit there and freak out and think that you can't or shouldn't, because it happens a lot and people freak out a lot. Taylor Wilson: All right, Jennifer Senior, thank you so much for coming on the Excerpt. Jennifer Senior: Thank you so much for having me. Taylor Wilson: Thanks to our senior producers, Shannon Rae Green and Kaylee Monahan for their production assistance. Our executive producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcasts@ Thanks for listening. I'm Taylor Wilson. I'll be back tomorrow morning with another episode of USA TODAY's the Excerpt. This article originally appeared on USA TODAY: Insomnia is a global epidemic. How do we fix it? | The Excerpt
USA Today
an hour ago
- USA Today
Insomnia is a global epidemic. How do we fix it?
On a special episode (first released on July 24th) of The Excerpt podcast: The question is: Why do we struggle to sleep? Jennifer Senior, a staff writer at The Atlantic, joins The Excerpt to talk about insomnia and what we can do about solving our sleep issues. Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text. Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here Taylor Wilson: Hello, I'm Taylor Wilson, and this is a special episode of the Excerpt. According to a report released by the American Medical Association earlier this year, one-third of American adults experience acute insomnia, an inability to fall or stay asleep for several days at a time, but one in 10 adults suffer from chronic insomnia. That's an inability to fall or stay asleep three nights a week for three months or more. The condition has potentially debilitating health impacts, including an increased risk of depression, anxiety, substance abuse, and even car accidents. So the question is, why can't we sleep? Here to help me dig into the issue is Jennifer Senior, a staff writer at The Atlantic who recently went on her own journey to solve her insomnia and who shared her story in the magazine. Thank you for joining me, Jennifer. Jennifer Senior: Thanks for having me. Taylor Wilson: So let's start with I guess a 30,000-foot view of the issue. I know you spoke with a lot of sleep specialists, did a lot of independent research for your piece. Jennifer, what's the big picture here on American's trouble with sleep? Jennifer Senior: Right. Yeah. What's funny, I think the story was a little misnamed. I mean, this is really more story about, well, if you can't sleep, don't feel awful about it because there are so many shaming stories about people, whatever solutions people seek out. I do talk in the beginning about the way that the modern world absolutely conspires against sleep, that it just lays waste to your circadian rhythms. That people work two jobs, 16.4% of us work non-standard hours. If you're a white collar kind of professional, you've got these woodpecker like peck, peck, peck, incursions into your life all night and weekend long from your boss's work sort of never ends. I mean, we're just no longer yoked to the rhythms of the earth anymore. We're just part of this whirl of a wired world. Taylor Wilson: In the course of doing your research, was there something in particular that surprised you most about the problem? Jennifer Senior: I'll tell you what surprised me most, just generally. Whenever I interviewed any expert about this, and it didn't matter what species of expert, they could be an epidemiologist, they could be a neurologist, they could be a psychiatrist, they could be a clinician. Most of them said the same thing. There is a slight misconception that you need eight hours of sleep. There is some data saying this. There is another equally robust data set saying 6.5 to 7.4 is associated with the best health outcomes. Now it's very hard to tell. These studies are observational. They're not randomized. There was all sorts of confounds and problems with this, but this one study in particular had a million people in it. It's been replicated. There are plenty of people who believe this data and people vary. And over the course of a lifetime, your individual sleep capacity could change. In a funny way, that was what surprised me most. Right? This mantra, which is kind of a tyranny, get eight hours or else. Taylor Wilson: Well, you talked Jennifer about the modern world conspiring against us and our sleep, and I guess let's try to outline a few of the possible causes of what you call a public health emergency, right? What can you share with us here on this? Jennifer Senior: About other causes, you mean besides the kind of modernity itself and kids working on... Kids being assigned homework online, kids socializing online. I mean, adolescents are desperate for sleep. They're so hungry for it, and modern high schools and middle schools have them waking up preposterously early when their circadian rhythms are pitched forward. We've got a substantial sandwich generation that's taking care of young kids and their elderly parents. That's going to conspire against it. These are all immutable things. Also, there are elevated levels of anxiety now in our world, and anxiety itself is a huge source of... Or can be a source of sleeplessness, certainly can make one prone. So I mean, those are additional examples I suppose. Taylor Wilson: Let's talk through your story a bit here. When did you first realize that you had an issue with sleep? And walk us through your experience with insomnia. Jennifer Senior: It was 25 years ago and it was a very mysterious onset. I cannot tell you what brought it on to this day. It is a mystery. I had this extremely well-regulated kind of circadian clock. I fell asleep every night at 1:00. I woke up every day at 9:00. I lost my alarm clock. I still woke up at those times. I didn't have to buy a new alarm clock until I had an early flight one day, and yet sometime very close to my 29th birthday when virtually no circumstances in my life had changed one iota, I had a bad night, fell asleep at like 5:00. Thought nothing of it until they became more regular, and then I started doing all-nighters involuntarily, and I felt like I'd been poisoned. And to this day, I don't know what happened, but once that happens, the whole cycle starts to happen, then people suddenly become very afraid of not falling asleep and whatever kicked it off whether it's mysterious or known becomes irrelevant because then what you do is you start getting very agitated and going, oh my God, I'm not sleeping. Oh my God, I'm still not sleeping. Now it's 3:00 in the morning. Now it's 4:00 in the morning. Now it's 5:00 in the morning. Oh my God, I have one more hour, et cetera. Taylor Wilson: Well, you did write in the piece about the many different recommendations that she tried to solve your own sleep issues. What were some of them, Jennifer, and did any of them help? Jennifer Senior: Oh God, I tried all the things. This is before I sought real professional help, but I did all the things. I would took Tylenol PM, which did not work. I did acupuncture, which were lovely, but did not work. I listened to a meditation tape that a friend gave me, did not work. I listened to another one that was for sleep only that did not work. I ran. I always was a runner, but I ran extra, did not work. Gosh, changed my diet. I don't remember. I did all sorts of things. I tried different supplements, Valerian root, all these things. Melatonin, nothing, nothing. Taylor Wilson: You wrote in depth about one therapy that was recommended to you, and that was CBTI. That's cognitive based therapy for insomnia. Jennifer, first, what is this? And second, did you find any success by using this? Jennifer Senior: So cognitive behavioral therapy for insomnia, as you said, is the gold standard for treating insomnia. It's portable. You can take it with you. It's not like if you leave your sleep meds at home. The main tent pole of it, which is sleep restriction, which I'll get to in a minute, is very hard to do. I found it murder, the kind of easier parts, although they're still in a funny way, kind of paradoxical, are you have to change your thinking around this is the cognitive piece around sleeping and insomnia. You have to decide, okay, I'm not sleeping. So what? Now, this is kind of funny because there's this din surrounding us that says, oh my God, you're not sleeping. You're going to die of a heart attack. You're going to die of an immune disease. You're going to get cancer. All these things, right? You have to set that all aside and decide one more night's sleep that I can't sleep. So what? Right. That's one thing. You have to change your behaviors, deciding that you are going to consistently go to bed at the same time, wake up at the same time, all that, and not use your bed for anything other than just for sleeping and sex. The hard part and the most powerful part that I found it brutal was the part that said you have to restrict your sleep. If you had only five hours of sleep, but you're in bed for nine hours, you have to choose a wake-up time. Let's say it's 7:00 and then you have to go to bed five hours earlier, 2:00 to s7:00. That's all you can give yourself, and you cannot stop with that schedule until you've slept for the majority of those hours. That's very hard for a sleepless person. And then once you've succeeded, all you get to add on is 15 more minutes of sleep, and then you have to sleep the majority of those hours for three nights running. This is always for three nights running, and the idea is to build up a enough sleep pressure to regularize yourself. You basically capitulate to exhaustion and you start to develop a rhythm. I couldn't stick with it. I was so kind of stupid and depressed with sleeplessness by the time I started it that it probably was impractical and I refused to take drugs to help me fall asleep at the exact right hour, which many clinics recommend. If you're going to go to bed and sleep from 2:00 to 7:00, take something at 1:30 so that you fall asleep at two. But I was afraid of being dependent on drugs, and you can really wean yourself if you do it for a limited amount of time. You can wean yourself anytime really, if you're shrewd about it and if you taper. But I think that I would tell people to try it and to try it sooner rather than later, and to be unafraid of doing it in combination with drugs so that the schedule worked. Taylor Wilson: Well, I am happy you brought up drugs. I did want to bring that up just in terms of what experts are saying about their impact. Even just drugs and alcohol kind of writ large, but sleeping pills specifically. What did you find in researching this in terms of drugs and alcohol? Jennifer Senior: Well, there's a real stigma taking sleep medication, and I'm frankly a little sick of it. I'm not sure why this is so very stigmatized. Like, oh, they're drug addict. They're hooked on sleeping pills. It's framed as addiction, and no one says that someone is addicted to their Ozempic, even though a lifestyle change could perhaps obviate the need. No one says that they are addicted... Oh, that person is totally addicted to their blood pressure medication, even though maybe a change in lifestyle would help change that. Or that they're addicted to their statins, So I sort of bristle. And those who prescribe these medicines say like, look, if the benefit outweighs the risk and they're used properly, sometimes the real side effect is just being dependent on these drugs, and there's a difference between dependence and addiction. A surprisingly small number of people who take these drugs regularly, like benzodiazepines, like Ativan and Ambien and Klonopin, all these things, a surprisingly small number, like 7% increase their doses if they take it every night. So that's very small. However, there are cognitive decrements over time... Or not decrements. It can interfere with your memory and it can increase your odds of falling as you get older. And those are, to me, the real persuasive reasons to get off. Taylor Wilson: I want to back up a minute here to talk about something many may not be aware of, and that's that historically, at least in some eras, people used to sleep in two blocks. What do you know about this? How did this function and really why did this kind of sleep pattern work for some folks? Jennifer Senior: Well, it was sort of, I think, natural. It seemed that this is, and it has not been proven everywhere, but there's plenty of both historical evidence and also some in a lab by this wonderful guy named Tom Ware that shows that if you sort of just put someone in a room, 14 hours of darkness, what will happen is that their sleep will naturally split into two. They'll sleep for a phase, wake up for a phase, and then sleep for a phase again. And historically, there's all sorts of evidence that people would sleep for a phase, get up and read for a while, do some quiet things, do light tasks, maybe sing, maybe have sex, and then go back to bed. So there seemed to be two phases, and this was much easier to do when midnight was actually midnight. You were going bed when the sun had set, or just after were you were tethered to the rhythms of the earth as opposed to a wired electricity run world. Taylor Wilson: What is something you wish you knew when you first started on this journey? Jennifer Senior: To get on it earlier and to not be as afraid... Cognitive behavioral therapy is, I think, often done in conjunction with taking something like Klonopin or Ativan or Ambien, and I was so petrified of becoming hooked on them that I didn't... I refused to take them and I couldn't get my sleep to contract as a result of it. My body was so completely dysregulated and confused about it was so all over the place that I really needed something to regularize it and stabilize it, and I flipped out, and I think if anybody goes and tries CBT, I and their practitioner says to them, and I'm going to have to be on their recommendation, do this in concert with a drug, because you really need it. Don't sit there and freak out and think that you can't or shouldn't, because it happens a lot and people freak out a lot. Taylor Wilson: All right, Jennifer Senior, thank you so much for coming on the Excerpt. Jennifer Senior: Thank you so much for having me. Taylor Wilson: Thanks to our senior producers, Shannon Rae Green and Kaylee Monahan for their production assistance. Our executive producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcasts@ Thanks for listening. I'm Taylor Wilson. I'll be back tomorrow morning with another episode of USA TODAY's the Excerpt.
Medscape
3 hours ago
- Medscape
Improve Asthma by Targeting Common Triggers
This transcript has been edited for clarity. Asthma is a disease that affects 20% of the American population. This means that 20% of people wake up with shortness of breath, wheezing, or tightness in their chest, which is extremely uncomfortable. Common triggers that we can modify to help these patients include GERD (gastroesophageal reflux disease), which is the most common. Acid reflux can backflow into the lungs causing bronchoconstriction, shortness of breath, and wheezing, especially when someone is laying down. Treating GERD with diet modification and sometimes Pepcid or Protonix can be beneficial. Other triggers that we look for include postnasal drip or allergies. Allergies and postnasal drip can significantly impact asthma by once again leading to bronchoconstriction through mucus congestion, causing more buildup within the lungs and the smaller airways that can cause decreased breathing and shortness of breath. By treating them with Singulair — montelukast over the counter — Allegra, or even Flonase for nasal symptoms and sinus symptoms, this can significantly impact and decrease shortness of breath. The last trigger that we do look at is weight associated with obstructive sleep apnea. Sleep apnea can increase CO 2 within the body as ventilation decreases, and this can also lead to wheezing, shortness of breath, and increase asthma symptoms. Weight can significantly impact a patient's ability to inhale and exhale that can then, once again, induce asthmatic symptoms.
