How to Boost Sleep for Mental and Physical Wellbeing

The expectations we put upon ourselves for a "perfect" holiday can wreak havoc on our stress levels, mood, and relationships. One of the things we can do to take care of ourselves is to get enough rest. Learn 5 tips to help you wind down and improve your sleep.  https://bit.ly/3DB4nhj

We also rebroadcast Season 1 Episode 40, where we discuss Fatigue. This is part 1 of a two-part examination of one of the top complaints for those living with a chronic or terminal illness. Fatigue is defined as: an overwhelming sustained sense of exhaustion and decreased capacity for physical & mental work.

In This Episode:

• 00:30 - Why Holidays Can Be Difficult for Mental and Physical Health
• 00:58 - The Importance of Sleep
• 01:31 - 5 Things You can Do to Wind Down and Get Better Sleep
• 03:44 - Intro: S1E40 Rebroadcast about Causes of Fatigue
• 06:11 - Recipe-Swedish Funeral Glögg
• 10:30 - Fatigue Part 1 - Causes of Fatigue
• 11:34 - Common Causes of Fatigue, Even for "Healthy" People
• 13:02 - Fatigue for Surgery, Chronic or Life-Limiting Illness
• 14:07 - Definition of Fatigue
• 30:44 - People Who Faked their Own Death
• 33:16 - Outro

Chapters

• 0:00 Intro
• 0:30 Why Holidays Can Be Difficult for Mental and Physical Health
• 0:58 The Importance of Sleep
• 1:31 5 Things You Can Do to Wind Down and Get Better Sleep
• 3:44 Intro: S1E40 Rebroadcast about Causes of Fatigue
• 6:11 Recipe-Swedish Funeral Glögg
• 10:30 Fatigue Part 1: Causes of Fatigue
• 11:34 Common Causes of Fatigue, Even for "Healthy" People
• 13:02 Fatigue with Surgery, Chronic or Life-Limiting Illness
• 14:07 Definition of Fatigue
• 30:44 People Who Faked their Own Death
• 33:16 Outro

Transcript

How-to-Boost-Sleep-for-Mental-and-Physical-Wellbeing

Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement. I'm Mary Ann Matzo, a nurse practitioner, and I use my experience from working as a nurse for 46 years to help answer your question about what happens at the end of life. The staff at Everyone Dies are taking a much-needed holiday break.

Today, we're republishing our podcast about fatigue with new information about how we can boost our sleep efficiency. The holidays are a particularly difficult time of year for our mental and physical health. The expectations that we put on ourselves to create the perfect home at Christmas can wreak havoc on our stress level, mood, and relationship.

This is a good time to ask yourself if the fantasy you've created in your mind about holidays and family are really worth the stress that you're creating for yourself. The holidays don't have to be crazy making. There are things that we can do to take care of ourselves and those around us.

Getting enough sleep may be hard to get in the best of time and feels like an impossibility during the holidays. Adults need between seven and nine hours of sleep per night. Insufficient or poor sleep has been found to increase negative emotional responses to stress as well as decreasing the feeling of positive emotions.

It's important to allow time in the evenings to decompress and unwind before heading to bed. Let me give you five things that you can do to help you wind down and get better sleep. Number one, music.

Rather than listening to the news or the chatter in your head or mind, when you get home, put on your favorite music. While classical music has been shown to lower blood pressure and reduce stress, any music that you enjoy will help you quiet down and lift your mood. Number two, dim the lights.

Instead of switching on a bright overhead light, think about lamps, a dimmer switch, or candles to create a more serene setting. In addition to being low-key, indirect light is less disruptive to the body's natural biorhythms. Three, limit caffeine and alcohol.

Part of the winding down process at night actually begins during the day. It includes exercising early, limiting caffeine like coffee, tea, and soda after lunch, avoiding foods that might upset your stomach, and perhaps skipping happy hours since alcohol too late in the day can diminish sleep quality. Four, expose yourself to natural light.

That means the sun. Getting enough natural sunlight during the day will also keep your body clock on a healthy sleep-wake cycle. And lastly, limit evening emails.

Try not to read or send work emails after dinner. According to a 2018 study from Virginia Tech, the expectation of checking work email after hours can cause anxiety and stress. Each new message represents another decision you have to make, keeping your mind active and taking away from social time, family time, or just plain alone time.

The study recommends practicing mindfulness to help you unwind and keep you present for social, family, or solo activities. Remember, only you can protect your mental health in this, the most joyful of seasons. And now please listen to our rebroadcast of season one, episode 40, where we talked about the causes of fatigue.

And this was part one of two podcasts about fatigue. This podcast does not provide medical advice. Please listen to the complete disclosure at the end of the recording.

Hello, everyone, and welcome to Everyone Does the Podcast. I'm Marian Matzo. And I'm waiting for the movie.

The podcast is nice, but I'm waiting for the movie. It just might happen. Yes.

Don't have doubts. Yes. So that's Charlie.

So put on your Lance nightie, your warm leggings, your fuzzy socks, grab something nummy to eat and drink, relax, and thank you for spending about the next hour with us. Now, today in the first half, Charlie's going to talk about Swedish glog. In the second half, I'm going to talk about fatigue.

And well, if I have the energy. Well, yeah, I'm already tired of this already. So go ahead.

Yeah. And in the third half, Charlie's going to talk about people who faked their own death. Okay.

So before we push on, though, okay, linguistically speaking, put on your Lance nightie. What is a Lance nightie? What's Lance? L-A-N-Z. What is that? So Lance is a nightgown company that makes the most wonderful flannel nighties, like the kind grandma would wear.

But they're still very popular because they're great flannel. So like at Christmas, if you were really lucky, you would get a Lance nightie. But I haven't had a Lance nightie since I was a child.

I always go there, don't I? Okay. Okay. But thanks for asking.

I'm always concerned about you. Okay, very good. I'm always concerned about you too, but for different reasons.

Charlie, it's used often to connect people with each other. You and I certainly have shared more food than anything. Yes.

It can be used to express sympathy and help families through difficult time. So if we were to go to Sweden, what would we be given to eat or drink at a funeral? I'm going to guess Swedish glog. Am I close? Well, you're going to tell me because this was your assignment.

Oh, yes. Glog. Yes, of course.

Glog. So around the world, mourners are fed a wide range of flavorful dishes. Unlike funeral feasts in other countries, which can get wild, in Sweden, post-funeral socializing focuses primarily on the dead.

The Swedes use funeral glog to toast the dearly departed, with everyone contributing multiple toasts to the memory of the deceased. This is sounding a little wild. Focusing on the dead? No, multiple toasts.

Well, you know, because there's, you know, you have wheat bread, you have rye, wonder bread. So it's understandable why there would be multiple toasts, because there are multiple types of bread. Okay, good.

Now that we have that, now that we have that cleared up. Yeah, and yeah, of course, to the memory of the dead. So you may be wondering, what exactly is funeral glog? I'm glad you're asked.

And I'm glad you're able to follow this too. So funeral glog is a mixture of red wine, muscatel, sweet vermouth, and a wide range of spices, including cinnamon. Now the recipe for this is on our web page.

Marianne, I've noticed recently, not that I ever read a script, but that the word cinnamon has appeared like in several recent episodes. And it's no secret to our loyal listeners, all five of you, that, you know, I have a difficulty with this word cinnamon. And I just did it again.

Cinnamon, cinnamon. So I'm wondering, is this intentionally that the cinnamon keeps reappearing? So how long have you had these feelings of persecution, Charles? I started out as a child in the Lower East Side of Detroit, along Rouge River. Oh, not that far back.

My marriage, I don't know. It's just, it just suddenly popped in my mind. But yes, so this word cinnamon, I have been practicing.

So now I can say cinnamon. And I can clearly see that you have been working on your cinnamon. My cinnamon buns.

Whatever. You want buns of cinnamon. Because we know certainly my buns are steel.

I've pretty much melted. All right, very good. So, so yeah, so this is what Funeral Glog is.

It's basically a red wine concoction. And, you know, people add different ingredients, different spices, including cinnamon. And the recipe is on our web page.

And to find that recipe, please go to EveryoneDies.org. That's EveryTheNumberOneDies.org. And send us your own recipes to share with others. Also, we appreciate your questions and anything else you want to tell us. You can email us at mail at EveryoneDies.org. And again, that's EveryTheNumberOneDies.org. Please join our Facebook group.

Everyone Dies. Here, everyone is spelled out. So the Facebook group is Everyone Dies.

And please remember to rate and review this podcast. Molly, our holiday old Santa baby Twitter correspondent, is hoping you will follow us on Twitter and repost her tweets so that we stop making up names for her. Marianne? So, Charlie, today I want to talk with you about fatigue.

And I started working on what I wanted to say. And I realized that I could do probably a whole hour alone just talking about fatigue. But that would be just exhausting.

Well, no, that would be fine. So while you're doing that, I'm going to go get some eggnog or something. I'll be right back.

Okay, go ahead. So what I thought I would do is I would break it up into two parts. So this week, it's going to be like fatigue part one, and just talk about all the causes of fatigue.

And the hopes that in listening to this, that our listeners realize that it's a really normal thing to have happen when you're sick. And there's nothing like particularly wrong. It's an expected side effect.

And then next week, in part two, I'm going to talk about all the things that you can do about it to help you to feel better. I'm sorry, but with this, you're speaking specifically if, I don't know, if someone is either maybe had some surgery, or well, is that, you know, in some phase, like at the end of their life, not just simply people who generally feel fatigue, or is that like everything? So people who generally feel fatigued, I'll do a quick 30-second Charles, and say that you need to talk with your doctor, your primary healthcare practitioner, and tell them that you're feeling really fatigued. And if you were coming to see me, one of the first things that I would want to do is I want to check your blood work and make sure that, you know, you have good red blood cells, there's iron in you, and the capacity to bind that iron.

And you see, if you were coming to see me, the first thing I would want to check is make sure your credit card is not expired. But go on, that's why you're the professional, Marianne, go ahead. That's just, you know, one of many differences.

So the second thing would probably be to, you know, take a look at how a person's sleeping. And one of the things would be a sleep study, because sleep apnea is a very common cause. Also looking at weight and activity, being overweight makes it really hard to move through space, and so that can be exhausting, as well as nutrition.

So there's a lot of aspects to think about, which when you're healthy and putting quote-unquote healthy, not having a chronic disease, can be looked into and possibly treated. And all of those do apply if you have a chronic illness, you know, on top of everything else. So looking at weakness and fatigue, that can happen from both the disease of whatever chronic illness that you have, and the treatment.

It can happen as a result of malnutrition, and we really need to pay attention to it, because it can cause dizziness and possibly lead to falls. Tiredness can be caused by both the disease and the treatment. Extreme tiredness may interfere with the person's ability to move, bathe, go to the toilet.

And fatigue is a primary complaint of people who are in the last four weeks of life. So it is a very common symptom. So if we wanted to say, well, so give me a good definition of that.

It's fatigue is an overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work. So it's that overwhelming, sustained, meaning it doesn't go away, sense of exhaustion and decreased capacity for physical and mental work. So fatigue is a subjective symptom, meaning I can't see that you're fatigued.

I mean, I can look at you and say, oh, you know, are you a little tired? And you might say, no, I'm full of energy. I mean, you can't really see that someone's fatigued. And there's a physical and there's a psychosocial aspect.

Fatigue is that feeling of weariness, tiredness, lack of energy that can vary in degrees, frequency, and duration. So it is very prevalent between like half to almost like 95% of the people with cancer will report that they're fatigued. About 50 to 70% who are having radiation treatment will report it.

Up to 75% of people who have chemotherapy. And, you know, we have to expect this. It can occur after surgery, any kind of chemotherapy, immunotherapy.

It can be associated with a sleep disorder and infection in the use of pain medicine like opioids. And there's an association between fatigue and major depression. So my brother had surgery over the summer and he was really, really tired.

And he said, how long is this fatigue going to go on? And I said, plan on like six months to a year. And he's like, oh, don't be telling me that. I can't feel this tired.

It's like, well, you'll feel better over time. But at some point about a year after a major surgery or a year after, you know, you finish chemotherapy and radiation treatment, it takes about that time for your body to say, oh, I feel better. And it's funny because what happens is, is that you suddenly kind of feel, not suddenly, but you know, about a year after you've had all these treatments, say, I'm feeling better.

And if you kind of look and say, oh my God, it's been a year since I had that, you know, open heart surgery or something like that. So I'm telling you. I'm sorry.

So, so with that, um, so, okay. So someone then is aware of that, you know, that, that fatigue. Is it enough to stop and think, oh, wait a minute.

I just had, I had this big surgery six months ago. You know, it's okay. Let me, let me lie down for a little bit and just let the fatigue go away or take a nap as you do.

No, no, no. Cause what you don't want to do is lay down and take a nap. So that's, that's a good question.

Um, fatigue isn't treated with increased sleeping. So let me tell you about what are some of the elements that go with that. And then next week when we go to part two, we'll talk a lot about activity and exercise and the role that napping doesn't play in this treatment.

So, um, the elements of fatigue are, are that feeling of weariness, exhaustion, loss of strength and endurance, because there's a change in your muscles at, um, when you're inactive, um, and a lack of energy. So it, and it can change how we feel about ourself, our self-concept or self-esteem. Uh, we might not feel very hungry, have less of a feeling of wellbeing, have trouble even taking care of ourselves and have trouble interacting in terms of social or family relationships.

I can remember after I'd spent a couple months in the hospital, coming home and, um, I couldn't turn the shower on and off. I, I didn't have the strength to turn it on and off. And I didn't have the strength to stand in the shower.

And so, um, one of my neighbors had a shower chair from, I don't know, from wherever, and she let me borrow it because the only way I could take a shower would be to sit in the shower. So when you're talking about fatigue, we're not just like, man, I could use a nap. It's like, oh my God, I can't stand up and take a shower.

Um, when you're really fatigued, you have trouble paying attention. I can remember love, you know, I love to read Charlie, but I couldn't track words in a book. I was just incapable of reading a book.

All I could do is look at really pictures in a magazine. That's all I was capable of doing. Um, people can have anxiety, feelings of discouragement, depression, feelings of hopelessness, um, and just not feeling like they have the mental or physical capacity to do what they usually do.

So fatigue is a consistent finding in people who are recovering from surgery. Um, postoperative fatigue can take six months to a year to resolve completely. Uh, people feel like they can't focus.

They're mentally tired, have a shortened tension span, can't remember where did I put this or where did I put that? Um, which if you're really tired, you don't have the energy to go all over the house looking for whatever it is. Yeah, exactly. Yeah.

So in terms of how, you know, you're the emotional dimension of having fatigue, people tend to be irritable. You know, they're tired, they're fatigued. Don't, don't give me none of your nonsense.

You know, what are you talking about? Yeah, right. You know, grew up in Detroit. You learn how to be irritable.

Yeah, that's, that's, that's right. Yeah, yeah. Um, and patience, you know, like you're trying to do a task and you're feeling so tired and your fingers aren't working right and you get very impatient.

Um, mood changes, you know, become angry when you're not an angry person or become anxious when you're not an anxious person. Um, depression. And the other thing that your clinician should really ask you about is what does the fatigue being to you? Some people think that the fatigue is there because they're getting sicker or the fatigue is there because something went wrong in the surgery and they're not as well as what the doctor or surgeon told them they were.

So we can very easily within our heads, tell us that that fatigue means a lot more than what it does. So we're here to tell you today, you know, the fatigue is a normal thing and that don't put any more meaning to it than that. That it's a result of your illness and your treatment.

So fatigue can really interfere with socializing. You know, maybe you used to go out and play cards on Saturday night and that was part of your couple's time or you were in a bowling league and you just say, I don't have the energy to do anything like that. And so it really closes up your social group and your ability to interact with people.

And that again can then lead to depression. So you can see this big cycle of one thing piling on another as a result of the disease and the treatment. It might change your roles.

Maybe you were the person who made everybody their lunches every single day. And the idea of walking into the kitchen and putting, you know, bologna between two slices of bread is just beyond imagination. Just a bologna then.

So I guess the possibility of adding, oh, I don't know, mayonnaise or mustard is just out of the question. Well, the fact of even walking into the kitchen and opening up the fridge, let alone who did the grocery shopping and how the food get in there. You don't have the energy to walk around a grocery store.

No. And it also affects physical activities. You know, like if you used to coach or you were always a runner or whatever it is that you were always to do, it's like, I can't even, I don't even want to think about getting up from the living room to go into the bathroom to go to the bathroom, let alone doing all these other things.

And fatigue can be related to other physical symptoms. Pain in particular is an exhausting experience that can result in fatigue. And fatigue can reduce your tolerance to pain and distress.

So if you're one of those people who says, I don't need my pain medicine. I'm just fine. And you have cancer or you've had their treatments, surgery, and you're saying, you know, I can really get by with just a Tylenol.

Well, if it really is reducing your pain score and the Tylenol's working fine, that's great. But if you're taking a Tylenol and your pain on your zero to 10 scale is still a nine, then what you're doing is essentially sort of shooting yourself in the foot because your body is going to have trouble healing. You're going to be extremely fatigued.

You're going to be more anxious, more depressed, more irritable, where if you just took your pain medicine, let's say it's after surgery for those first few days so that you can sleep well at night, so that your body is able to rest without the stress of the pain, that you would recover quicker. Nobody will be wanting to throw you out of the house because you're so cranky. And, you know, your recovery will be just that much better.

Now, when we're talking about chronic fatigue and treatment for chronic fatigue, that's going to be a whole separate chat. And we're going to do that in the next episode. But know that one of your best treatments is to get up and walk and walk, even if it's five minutes every day and then seven minutes every day.

Just move your body because you will find that that movement of your body will help your recovery and help with your fatigue. And there's been study after study after study looking at what are the best interventions, the best thing you can do if you're really fatigued, and looking at different medicines and looking at how much you sleep and looking at a whole variety of things. The thing that comes out in every single study that makes a difference for the management of fatigue is activity.

Balancing activity with rest. So we're not saying go do the Ironman marathon. We're not saying do any kind of marathon.

We're saying get up and move your body. Okay. Did you have a question, Charles? With this, no, but I'm sorry, but I was just thinking what you had said a little before about the, you know, people taking their, you know, just feeling fatigue and just, you know, take your pain medication.

Why wouldn't someone want to take their pain medication? Well, people, you know, hear on the news about the opioid epidemic and, you know, with good reason, we have a major problem. There's a huge problem. Yeah, yeah, yeah.

So you have people who are in late stage cancer, you know, and say, well, I don't want to, I don't want to become an addict. Well, then that, and like I said, that's a whole conversation. It's a whole podcast to talk about the difference between the opioid crisis and pain management, you know, at the end of life or in late stage disease.

But people will, and it's not just, you know, the general population, healthcare practitioners will do the same thing. They lump all kinds of pain into the same, In the same category. Bucket.

Right, okay. And don't differentiate between, oh, you know, I mean, I remember my kids had their wisdom teeth pulled 10 some years ago. They gave them this huge bottle of pain medicine, you know, of, I don't know, it was Tylenol number three or Oxy or whatever.

And it was like, I, you don't need that much to have your teeth pulled. Yeah. You know? And so it, so changing some prescribing practices, you know, how much do people really need through a surgical event of whatever kind, that kind of thing.

Yeah, as you're saying this, I mean, even like, you know, with the girls, it's, it's what you, it's pain management. So it's not one, as you were saying, it's not one size fits all. If, you know, you sit down with the, with your doctor and you figure out how much the doctor figures out how much you need.

And the doctor is not going to prescribe something that, you know, some sort of, you know, over medication. You, you will know how much it takes. So it's safe.

Well, but, but what I'm saying is that a few years ago, there'd be a standard of a week's worth of pain medicine for wisdom teeth removal. And not everybody needs that. They might need a day or two.

And so better practices look at, well, how much does it, you know, like giving somebody three days worth and then, you know, how's the pain after that? Can it go to a different over-the-counter medication or something like that? But the point being is to, you know, have the conversation about your concerns with your healthcare practitioner. I mean, bottom line comes, if somebody chooses not to take their pain medicine and, and manage their pain, and they know this means I'm going to be crankier, that I'm going to be more tired. I'm not going to be able to do a lot of things that I want to do.

And they want to make that trade-off, that's trade-off they can make. But the, but we're here, Charlie, so that people will have the facts. So they know what are they trading off by making whatever decision it is that you make, you know, don't just go on.

Well, here's what I think, or I saw it on a TV show, or, you know, I don't know, wherever else information comes from. I'm hoping, you know, Charlie, use this information when you, when you have to make your, your decisions about your, your chronic illness. Yeah.

And not, not some wild, you know, cause a lot of people will go, you know, to, you know, we'll go online and to look up, you know, it's a legitimate question. You know, this is my situation, pain management, and, but there's so much disinformation out there. So.

Well, it's also, you, you might not know which piece of information is going to best apply to you. And is it real information? So that's why with all of our podcasts, you can look at our additional resources on our webpage, everyonedies.org. It's E-V-E-R-Y, the number one dies.org. And so if you go to our webpage this week, you'll see some resources for you. Now, Charlie, I understand that you have some stories about people who faked their own death.

Now, I don't know why people would do this other, unless they're going to go to jail for the rest of their lives or something like that. But what's the scoop with that? Hello, Mr. And Mrs. America from coast to coast and all the ships at sea. Let's go to press.

Breaking news. Connie Franklin in 1929, Connie Franklin tried to fake his death. When he was eventually discovered alive and well, he found himself in the extremely odd position of testifying at his own murder trial.

The accused man on learning about Franklin's death had led the authorities to some remains, which he was then accused of creating. Since all evidence at the time pointed to them being Franklin's, his reappearance meant he was cause of the defense witness. The defense being that he was very much alive and therefore the accused could not be convicted of killing him.

As legal strategies go, that one is pretty much bulletproof. That's just in. Timothy Dexter.

Perhaps the saddest reason to fake your own death is to see how many people will show up at your funeral. That's right. The plotline employed by Ross and friends that well after the show had jumped the shark is something real people have actually attempted.

The 18th century eccentric, Timothy Dexter was a popular author when he faked his own death in order to see how sad everyone would be when he died. While more than 3000 people showed up for his wake, not all of them passed the test. They had no idea they were taking.

His wife completely failed. While sitting by the coffin, she remained stoic and did not cry. Franklin announced his survival by berating her in front of everyone for her lack of sympathy over his supposed demise.

Amir Behbovic. In 2007, a 45 year old Bosnian named Amir Behbovic had the same idea as Dexter. But while Timothy may have at least gotten to enjoy some touching eulogies before he brought the service to a halt with his displeasure, Amir was angry right from the beginning.

The whole point of faking his own death was to see how many people showed up at his funeral. So he was devastated when he got his answer. One person attended, his mother.

Incensed, he wrote a letter to all his friends saying, I paid a lot of money to get a fake death certificate and bribe undertakers to deliver an empty coffin. I really thought a lot more of my so-called friends would turn up to pay their last respects. It just goes to show you who you can really count on.

Yes, ladies and gentlemen, who would have thought that some sort of people would hang around with a guy who would fake his own death would be unreliable. Thank you for listening. Please stay tuned for future episodes of Everyone Dies.

Our thanks to our executive producer, Major General Retired, David Gillette, our producer, Sandy, John, our technical advisor, Tom Hartman, our administrative advisor, Molly, our Twitter correspondent, and our friends, family, and our loyal listeners who are supporting our work at Everyone Dies. This is Charlie Navarette. And I'm Marianne Matzo, and we look forward to talking with you soon.

Remember, every day is a gift. Thank you. This podcast does not provide medical advice.

All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast.

If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk.