Emer McLysaght: Sleeping in the heat is no joke, so I pulled out the big guns
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I, like many of my country people no doubt, was finding it difficult to sleep. Our homes are built to thrive, for the most part, in colder and damper weather. We are not an air-conditioned nation. Visitors to our shores from much warmer climes often find themselves struggling in the high humidity, brought about by our proximity to the Atlantic Ocean.
On the night in question, I had tried everything. I swapped the duvet for a sheet. I flapped around with one leg in, one leg out. Both legs out. One foot on the ground. An extremely brave move given it's a sure-fire way to invite a creature from the underworld to wrap its claws around your ankle. I tried window open, but swiftly had to revert to window closed because a cat that does not belong to me attempted to move in.
At my wits end, at about 3am, I pulled out the big guns. I took my pillow, put it down at the bottom of the bed where the feet usually go, and I slept upside down.
Until recently I would have believed that I was among a small cohort of people who rely on this method in times of insomnia. Of course it was TikTok that rid me of that assumption.
TikTok
is wonderful for reminding you that you've never had a unique experience in your entire life. I saw a TikTok once that described that feeling when the palm of your hand is itching and you try to scratch it, only to realise that the itch is actually off in a different dimension. Turns out, lots of people experience the phantom palm itch, just as a lot of people employ the pillow switch.
READ MORE
I started doing the pillow switch organically as a child. I have no memory of how I discovered it and no idea why it works. Presumably it helps to reset your brain and set it on a new path towards sleep. Experts say that if you're lying in bed struggling to sleep for 30 minutes or more it's essential to change something – get out of bed for a few minutes, perhaps change your pyjamas.
Another unorthodox method I've tried when sleep has evaded me is to lie on the floor. This involves, no surprises here, getting out of bed to lie on the hard floor for a good 15 or 20 minutes, enough so you're uncomfortable. Then when you get back into bed, your body realises that bed is the business and slips happily into sleep.
A few years ago, during an extended stay in hospital I was struggling to sleep at night. Hospitals, despite being places that are supposed to encourage healing, are often the antithesis of getting a good rest, between the oven-like temperatures, the woeful beds and the nurses waking you up to tell you it's time to go to sleep. In desperation I asked for something to help me drift off and was prescribed promethazine, an antihistamine and anti-nausea drug which comes with terrific sedating effects. Unfortunately for me one of its potential side effects is to aggravate restless leg syndrome, a condition I am tormented by.
Restless leg syndrome manifests as an uncomfortable and uncontrollable urge to move and stretch your legs. It's a creeping, crawling feeling in your lower limbs, often made worse by sitting or lying down. I've had some of my worst attacks in cinemas and on aeroplanes. On this night in question in the hospital I took the promethazine and went off to bed full of hope. Fast forward 40 minutes and my brain is trying to sleep while my legs just wanted to dance. I was scuttling around the room like a super speedy zombie from 28 Days Later.
A recent addition to my insomnia arsenal is cognitive shuffling. It involves choosing a random everyday word like door and taking each letter from the word and naming as many words as you can that start with that letter, before moving on to the next. The mental exercise helps to calm racing thoughts and ease your brain into sleep. I've tried it, and it does work. A word of warning though: don't get competitive with yourself, nothing says 'up until 4am' like trying to think of 40 words that start with the letter Q.
When all else fails I return to the old favourite of the pillow swap. Will you get a fright when you wake up? Yes. Is it worth it for the best sleep of your life? Also yes.
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The Irish Sun
41 minutes ago
- The Irish Sun
I realised I'm a ‘Mounjaro lifer' after stopping for 8 weeks – I lost 5st but now my tummy is a ‘bottomless pit' again
A FAT jab user has revealed that after stopping the injections for eight weeks, she has now realised she is a 'Mounjaro lifer.' Laura, who lost five stone in 13 months thanks to Advertisement 3 A fat jab user has confessed to being a "Mounjaro lifer" Credit: Tiktok/@itslauraunfiltered 3 Laura opened up on stopping the injections for eight weeks and confessed to having a "bottomless pit" feeling she simply can't shift Credit: Tiktok/@itslauraunfiltered 3 Mounjaro is typically used to treat type 2 diabetes Credit: Getty The brunette beauty, who was diagnosed with bowel cancer at the age of 38, recently stopped injecting herself with the weight loss jabs for two months whilst she undergoes cancer treatment. Prior to the pause, she had been using Posting on social media, the content creator explained that once she finishes cancer treatment, she plans to go back on the When she first started Mounjaro, she weighed 18 stone 5 lbs, but has since managed to slim down to just 13 stone 5 lbs. Advertisement Read more on Mounjaro But after losing 5 stone and coming off of She admitted: 'It has been super, super hard - the food noise has returned fully, the bottomless pit feeling when I eat is there.' As a result of stopping Mounjaro she acknowledged that she can eat 'endlessly.' Laura has plans to get down to her goal weight of 10 stone 7 lbs, but stressed that she'll need Mounjaro to do so, as she continued: 'I 100% now know I will be staying on Advertisement Most read in Fabulous Now, Laura 'can't wait to restart' the fat jabs and plans to start back at 12.5mg. She confessed: 'I'll be starting back at 12.5mg, which in a way, I'm kind of glad for, so maybe it'll give the lower doses a new lease of life, but what I've learned over the eight weeks is 100% I'm a Weight Loss Jabs - Pros vs Cons Other Mounjaro 'lifers' react Laura's TikTok clip, which was posted under the username @ Not only this, but it's also amassed 1,757 likes, 220 comments and 162 saves. Advertisement And it's clear that Laura isn't the only Mounjaro user who has concerns about being a 'lifer', as numerous One person said: 'I am definitely going to be a lifer. I've battled with obesity for 30 years until now. I can't do it without Mounjaro.' Advertisement Everything you need to know about fat jabs Weight loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases. Wegovy – a modified version of type 2 diabetes drug Ozempic – and Mounjaro are the leading weight loss injections used in the UK. Wegovy, real name semaglutide, has been used on the NHS for years while Mounjaro (tirzepatide) is a newer and more powerful addition to the market. Mounjaro accounts for most private prescriptions for weight loss and is set to join Wegovy as an NHS staple this year. How do they work? 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Irish Times
2 hours ago
- Irish Times
What to do when you've had a poor night's sleep
Ah, sleep – 'nature's soft nurse' to Shakespeare, 'the foundation of our mental and physical health' to the less poetically minded neuroscientist and podcaster Andrew Huberman. By now, you hopefully know that getting a consistent seven to eight hours of shut-eye is crucial for everything from your short-term decision-making to your long-term health, and you're familiar with all the usual advice on getting it (have a consistent bedtime, make your bedroom really dark, no double espressos at 9pm). But one question that's considered less is -what if you have one restless night? How do you best get through the day – and what can you do to avoid a single interrupted slumber snowballing into several? Let's take it one hour at a time. READ MORE When you first drag yourself out of bed, it's tempting to click the kettle straight on – but should you hold off your first hot drink of the day until you're a bit less bleary-eyed? Increasingly, influencers advise delaying your first hit of tea or coffee for anywhere between 30 and 90 minutes after you wake up – the rationale being that caffeine mostly works by blocking the brain's receptors for a molecule called adenosine, which ordinarily promotes relaxation by slowing down neural activity. Adenosine levels are at their lowest when you wake up, and so in theory, you might be 'wasting' your first brew of the day by glugging it when there's nothing for the caffeine to block. This seems plausible, but it's also worth noting that caffeine's effects take about 10 minutes to kick in, and it's about 45 minutes before levels peak in the bloodstream. Caffeine's also not just good for getting you going: if you're planning a workout or a morning walk, it can help things along by producing feelgood endorphins and increasing the amount of fat you're able to burn. Some people suggest that waiting a while before your first cup helps to avoid afternoon drowsiness, but according to an evaluation of the scientific literature published last year: 'There is no evidence that caffeine ingestion upon waking is somehow responsible for an afternoon 'crash'.' 'Keep your caffeine intake limited to your usual amount – or one cup of coffee or tea if you don't normally rely on caffeine – and make sure it's before noon to avoid damaging your sleep the next night,' says longevity specialist Dr Brittany Busse. 'But drink a decent amount of water alongside your morning brew to make sure you're adequately hydrated.' Stick to the one-water-per-caffeinated drink rule throughout the day to keep your energy levels up – and if you happen to have any on hand, consider a scoop or two of the workout supplement creatine, which a 2024 study suggests is 'a suitable candidate for reducing the negative effects of sleep deprivation'. Most commonly used by bodybuilders, creatine works by 'buffering' the body's energy stores, and it now turns out that this process occurs in the brain as well as the muscles, which might help you focus after a fitful night. Your next job is to get out in the sun as soon as possible. Exposure to morning sunlight signals the brain to reduce melatonin production (the sleep hormone) and increase cortisol, making you feel more alert. 'When you see sunlight, either by walking outside or sitting next to a sunlit window for about 10 minutes, this helps to keep your body's sleep cycle online,' says Shawna Robins, author of, Powerful Sleep. 'It's like setting a sleep-wake timer inside your brain.' Sunlight also stimulates the production of serotonin, a neurotransmitter linked to mood, alertness and a sense of calm and focus. Some of these effects might be more noticeable if you go outside – window glass blocks some of the wavelengths of light that help to produce vitamin D, for instance – but research continues. In general, popping outside is probably a better bet, but if all you can do is see a bit of sun while you're doing the washing up, it's better than nothing. Do cold showers help to wake you up? It could depend on how you feel about them. A short, sharp blast of cold water can give you a boost of endorphins and adrenaline, and up your oxygen intake and levels of alertness. On the other hand, if it's already cold in your house or you can't stand cold water, the cure might be worse than the problem. If you're looking for the best of both worlds, consider a contrast shower, or alternating between hot and cold for intervals of 15-60 seconds – it's a lot more psychologically manageable to sluice yourself with chilly water when you know that relief is on the way. The toaster is probably your next temptation, but don't over-rely on carbs to energise you through the day. 'What you eat and drink can really influence recovery after a bad night's sleep,' says Dr Rostislav Ignatov, chief medical officer at The Haven Detox in Massachusetts, US. 'I recommend you focus on foods that provide steady energy and support your brain, like fruits or leafy greens. Lean proteins such as eggs, chicken or yoghurt help maintain your energy without the crashes you get from sugary snacks.' One five-minute option: scramble a couple of eggs in a pan, and pour half a boiled kettle over a colander of spinach to wilt it. Supplements can help too, but choose wisely. 'Magnesium is a great option if you're feeling tired or wired,' says Dr Ignatov. 'It promotes relaxation and can help improve the quality of your next sleep cycle. A small dose of vitamin B12 can also fight off fatigue and support energy production without overstimulating your system like caffeine might – the key is to keep your body's natural rhythms intact so you don't disrupt your sleep later at night.' If caffeine makes you jittery, there's some evidence that taking L-theanine, a supplement that commonly comes in capsule form, alongside it can mitigate its negative effects on your attention, and make you better at cognitively demanding tasks. Should you work out? If you're already running on fumes, this is probably not the best day to shoot for a personal best in the 5k, but there's a simpler option. 'When people are feeling very tired, I recommend 'exercise snacks' – short bursts of physical movement throughout the day,' says wellness expert Dr Megan Lyons. 'That could mean one to two minutes of activity, like standing up to do 20 jumping jacks, 20 bodyweight squats, or walking around the office for two minutes. Even better is getting outside.' If you're in the mood for something more sedate, something as simple as a short burst of yoga might help – one small study suggests that a guided sun salutation can reduce stress and get your parasympathetic nervous system (which favours relaxation) online for the rest of the day. Once you've made it to the office – or through the school run – try to avoid the lure of almond croissants and easy energy. 'What people tend to do after a bad night is turn to a lot of caffeine and sugar, because our brains crave quick energy when we feel low on it,' says Dr Lyons. 'While these things may work in the moment, they're setting you back in the long run – caffeine lets us borrow energy rather than create it. And sugar can set us on a blood sugar rollercoaster, which leads to crashes and cravings for more. 'Focus on stabilising blood sugar by getting adequate protein and fibre throughout the day – these nutrients don't provide that immediate burst of energy, but many of the things that provide them, such as vegetables and fruits, also provide phytonutrients that give us sustained energy. Protein also keeps us satisfied throughout the day, reducing cravings for sugary or processed foods.' If you're really struggling (and you've got the option) a power nap can be just what you need to get through the afternoon. Just don't make it too long. 'Limit naps to 15-30 minutes a day, ideally before 3pm,' says Dr Marissa Alert, a psychologist and sleep expert. 'Longer or late-afternoon naps could make it harder to fall asleep at night.' Set an alarm and use box breathing to get yourself in a good state for sleep – picture a square, and visualise yourself travelling along the sides of it as you take a deep breath in for a count of four, hold it for the same count, breathe out, and hold again. Alternatively, if setting up pillows on your desk isn't an option, just trying this without letting yourself nod off can leave you refocused and ready for any unfortunate last-minute meetings. Once you've made it through the work day, your next priority should be setting yourself up for a restful evening – though that doesn't necessarily mean going to bed extra-early. 'You should be looking to stick to your normal bedtime,' says Dr Alert. 'As tempting as it may be to crash early, it's best to tough it out – going to bed too early can leave you tossing and turning since your body isn't used to being asleep at that time. It's also important to remember that sleep can't be forced, so try to avoid worrying about whether you'll get enough rest, especially close to bedtime. Fixating on how well you'll sleep or how much you'll sleep right before bedtime can trigger physical arousal and heighten anxiety, making it even harder to fall asleep.' There is another way to think about it: when your brain thinks that something might be wrong, its priority shifts to protecting you. In this heightened state of alertness, sleep takes a back seat because your brain is focused on keeping you safe, not relaxing. That's why it's better to signal to your brain that it's time to relax, with a calming bedtime routine that puts your brain into rest mode. Don't start doom scrolling; reading fiction, even on an e-reader, is a great option – one study suggests that a 30-minute bout has similar stress-reducing effects to a half-hour yoga session. Doing it on the highest brightness setting for four hours might delay your sleep by a few minutes, but that's about it. When it's time for some shuteye, do a bit more box breathing, make your bedroom as dark as you can, and let yourself drift off. Tomorrow's another day. – Guardian
Irish Times
3 days ago
- Irish Times
Looming ‘patent cliff' facing Big Pharma adds to sector's woes
Every year, thousands of patients sit in doctors' offices with needles in their arms receiving a dose of a wonder drug called Keytruda. The cancer medicine earned Merck $29.5 billion (€25.2 billion) in sales last year. But drip by drip, the US pharma company's time is running out. In 2028, Keytruda's patent ends, allowing rivals to sell the same drug at a cheaper price. Investors are spooked and Merck's shares have sunk 35 per cent over the past 12 months. While the company has been at pains to show it is prepared, Daina Graybosch, an analyst at Leerink, says the so-called patent cliff is hanging over the business. Merck has a 'massive hole' in its revenue to fill. 'They can't fill it with one drug,' she says. Merck on Wednesday appeared to take a step towards addressing the looming Keytruda patent cliff. The company is closing in on a $10 billion deal to buy London-based biotech Verona Pharma, which has an approved respiratory disease drug that analysts predict could generate peak annual sales of approaching $4 billion. READ MORE Losing the intellectual property rights for blockbuster drugs is a long-standing ritual for pharma companies. Drugmakers can earn fortunes when new discoveries are first sold to patients. Governments grant them about 20 years of patent life per drug. But up to half of that time can be used before the drug gets to market. When the patent is up, competitors are allowed to release generic rivals, potentially wiping out billions of dollars of revenue for the original proprietor. Drugs worth about $180 billion of revenue a year are going off patent in 2027 and 2028, says research firm Evaluate Pharma, representing almost 12 per cent of the global market. Bristol Myers Squibb and Pfizer are also facing 2028 patent expirations for top-selling drugs. The boom-and-bust cycle is the result of an uneasy compromise in how we fund innovation that is expensive to create but cheap to copy. Governments would rather grant limited monopolies to the private sector than fund much of this essential but risky work themselves. Stephen Haber, a professor of political science and history at Stanford University, says that without patents, medicines would not exist. Healthcare systems baulk at expensive new drugs, given to more people as populations age. Developing countries struggle to access the innovation until patents expire. To get through bust periods historically, pharma companies would go on spending sprees, buying up smaller biotechs, where many innovative drugs are discovered, to fill their pipelines in advance of the patent expiry. An uncertain political climate has resulted in the sector at large moving cautiously. First, companies feared that former US president Joe Biden's aggressive Federal Trade Commission could stop deals in their tracks. Then came his successor Donald Trump's threat of US tariffs on the sector. The industry also lacks clarity on how much they will be able to charge for drugs, as politicians pressure them to cut prices. The patent system was established in Britain during the industrial revolution and was first formalised in law in the US. Intellectual property protections were essential to the development of the pharma industry in the late 19th century and to it thriving in countries such as the United States, UK and Germany. 'It's not an accident that there's only a few countries in the world that are huge pharmaceutical developers,' Haber says. When a drug goes off patent, other companies can seek approval for their copycat versions. These are usually made based on reverse engineering and are informed by the proprietor's patent filings. The copycats are then tested to ensure they are equivalent to the branded medicine. But crucially, they do not need to go through the expensive clinical trials process again. The pharma industry suffers from patent cliffs in ways that others such as the tech industry do not. This is mainly because the key active ingredient in a drug is covered by one main patent, which is hard to invent around, and chemical formulas are relatively easy to copy. So pharma companies have to focus relentlessly on refilling their pipelines before their best-sellers lose patent protection. At present, companies actually have plenty of money to spend on deals due to the success of the drugs going off patent plus an industry-wide move to slim down operations. EY estimates that companies are sitting on $1.3 trillion in deal-making firepower. Companies are searching for the 'Goldilocks' targets, neither too big nor too small. In 2009, in advance of the last major patent cliff, there were several megamergers: Pfizer bought Wyeth for $68 billion, Merck bought Schering-Plough for $41 billion and Roche acquired Genentech for $47 billion. But there has not been a megamerger in pharma since 2019, when Bristol Myers Squibb bought Celgene for $90 billion. These huge deals have fallen out of favour with many investors, who worry about competition law scrutiny and see them as tough to integrate. Smaller targets can be relatively cheap as the biotech market is down 50 per cent since its peak in February 2021, and many early-stage companies are trading below cash. But ideally Big Pharma is looking for biotechs with drugs that could come on to the market soon – and sell in their billions. One difference since the last major set of patent cliffs is that companies are now looking for drugs to buy in China . They often buy ex-China rights to early-stage innovative medicines and then conduct the later-stage trials themselves, so they can provide global data to western regulators. So far this year, there have been licensing deals between Chinese companies and US and European partners worth up to $35 billion, data from EY shows. Daniel Parisotto, managing director in healthcare investment banking at Oppenheimer, says Big Pharma is attracted to Chinese assets – typically the rights to develop and sell the drugs outside China – because they have smaller upfront costs than western deals, where much of the price is tied to a drug reaching certain milestones, like trials, or approvals. Drugmakers pay less upfront than they would in the West. 'But ultimately the jury is still out on whether those Chinese assets have a higher failure rate or the same success rate as western assets,' he says. Pharma also deploys strategies to extend the life of its existing drugs. Robin Feldman, a law professor at the University of California San Francisco, says the record for extending a patent beyond the original expiry is more than 30 years. Before Keytruda, the world's bestselling medicine was AbbVie's Humira, a wonder drug that fights arthritis, Crohn's disease and other inflammations. In 2020, AbbVie earned $16 billion in the US alone from Humira, and it was charging $77,000 a year for the drug, a 2021 congressional report said. Humira's basic patent expired in 2016, but AbbVie obtained 132 other patents for administering and making the drug, essentially fortifying Humira's exclusivity with a 'patent thicket'. The last of these patents expires in 2034. US lawmakers baulked at the lingering high cost for Humira and sued AbbVie. The city of Baltimore alleged people were paying millions of dollars unnecessarily to AbbVie and that its patent strategy violated competition law. But in 2022, a US appeals court ruled for the company, saying there was nothing wrong with holding a lot of patents. Nevertheless the pharma industry is facing renewed political scrutiny for such tactics. Trump has railed against high drug prices. In the US, pharma companies have been able to keep rivals off the market by offering discounts to wholesalers and pharmacy benefit managers across a range of drugs in return for not carrying the cheaper rival to the now off-patent branded drug. Despite predictions of a dramatic drop in sales, the 2027-28 cliff could be more like a 'steep hill', says Frank Lichtenberg, professor of healthcare management at Columbia Business School. The blockbuster drugs going off patent are almost all biologics – infusions derived from biological, not chemical, processes – and they are harder to replicate than pills. Lichtenberg thinks it could take five years for sales to slump as much as 75 per cent, far longer than the months it took for some bestselling tablets to be replaced by generics last time. Biosimilars – generic versions of biologics – are harder to reverse engineer and are subject to different laws, which mean branded drugmakers only share broad information about the manufacturing process. When biosimilars get to market, US pharmacists cannot by law automatically swap them in as cheaper alternatives as they can with generics. And when they do, the price drops are not as steep. Lichtenberg estimates they sell for about half the price of the branded drug, rather than 10 or 20 per cent of the price for a generic. The US has been far slower than Europe in adopting biosimilars, but that may soon change. The US Food and Drug Administration (FDA) was already speeding up its process of approving biosimilars and a recent Trump executive order directed the regulator to find ways to accelerate approvals further. The Trump administration is also working on policies that would make it easier for pharmacists to substitute biosimilars for a branded drug as is already done in Europe. For companies such as Merck, all these potential policy changes only add to the uncertainty around how severe their patent cliff will be. It is going to be hard to find another drug that can treat so many patients – or generate so many billions. – Financial Times
