not enough timeIf you’ve read Tim Ferris’ 4-Hour Workweek, you can just jump to the end of this post. For everyone else, I invite you to take a closer look at your relationship with time. Especially those of you who are too busy to spend, oh, I don’t know, 5 or so minutes reading this.

Somehow, “I’m busy” has become the new “I’m fine” in response to being asked how you are. I get it thought — I know you actually ARE busy, but stay with me here.

Whenever I’m working with new clients, they’ll typically tell me they don’t have time to sit down for a satiating, nutrient-dense breakfast, so they just grab a “quick toast and coffee.” Or they have too much going on and can’t get to bed on time. It’s not just a once-in-a-while-thing either. It’s day after day after day.

Sound like your life? If so, let me ask you this: why do some people seem to effortlessly crush their to-do lists and others find theirs growing out of control?

Seriously, There’s Not Enough Time

I never like to say “We all have the same 24 hours in the day,” because that logic is fundamentally flawed, and can come off sounding privileged. In truth, all of us are filling our 24 hours in different ways depending on our jobs, lives, families, hobbies, obligations, and unique life goings-on.

Sometimes I choose to be busy during my 24 hours because I have lots of things that are important to me — family, friends, my clients, my home life, my role at the Primal Health Coach Institute. And *usually* I like that because I enjoy my work and I like being productive.

I’m choosing to be busy because it leaves me feeling fulfilled. The problem arises when it leaves you feeling like a victim, like you can’t keep up, or like you just want to bury your head in the sand.

Lack of Time = Lack of Priorities

It all comes down to priorities. If better health or a leaner waistline was really important to you, you’d make it a priority. Unfortunately, if you’re like most people, you unknowingly put other, less important priorities in their place (everything from stewing over a mean comment on social media to worrying how you’re going to get it all done).1

Whenever you catch yourself having an I-don’t-have-enough-time moment, remember that what you’re spending your time on is a choice — and you always have options. This is the perfect time to take a step back and ask yourself these four questions:

  • What’s important here?
  • What’s not important?
  • Am I wasting time on things that aren’t important?
  • What else could I be doing with my time?

Go ahead and do this exercise with me for a sec. Get out a piece of paper (or the notes section on your phone) and jot down your daily schedule. What time do you typically get up? When do you go to bed? How much time do you spend at work? On social media? With your family? Daydreaming? Running errands? Working on your health?

Looking at your list, what are the three things you spend the most time on?

Like it or not, those three things are your priorities. How you spend your day reflects what you believe to be the most important. If that’s not sitting well with you — or you feel like you have an equal amount of priorities (even though that’s not actually possible), you’re in a good place to start making change.

Because when you learn to eliminate your non-priorities, you free up time to focus on what does matter to you.

How Do You Eliminate Non-Priorities?

It starts by taking things off the table that aren’t important or urgent. Research shows that having too many options can lead you to waste time attending to details that don’t matter or avoid a task altogether. In this experiment, a Columbia University professor set up a booth selling jams at a local farmers market. Every few hours she alternated between offering 24 jams and 6 jams. She found that 60% of the customers visited the booth when there was the larger assortment, however more people actually made purchases when there were fewer options.https://academic.oup.com/jcr/article-abstract/45/3/673/4847790‘>3 Researchers found that the effect was even more prominent in people who describe themselves as busy, adding that they were more likely to select an urgent task with a lower reward because they were fixated on the clock and “getting it done”.

But how do you determine what’s urgent and important? Enter the Eisenhower Matrix, named for the 34th U.S. President, Dwight D. Eisenhower. It’s a prioritization framework (used by everyone from athletes to CEOs) that helps you eliminate time wasters in your life.

And in case you need proof that Eisenhower knew what he was talking about, during his two terms in office, he signed into law the first major piece of civil rights legislation since the end of the Civil War, he ended the Korean War, oh and he created NASA.

Eisenhower recognized that having a solid grasp of time management means you’ve got to do things that are important andurgent — and eliminate all the rest.

  • Important tasks get you closer to your goal, whether it’s wearing a smaller pant size or not feeling ravenous all day.
  • Urgent tasks are ones that demand your immediate attention, like a deadline or showing up on time for an appointment.

Once you’ve got that straight, you can overcome the tendency to focus on the unimportant tasks and instead, do what’s essential to your success, whatever that looks like for you.

Let’s Put the Matrix into Action

Using the questions below, you’ll be able to get a good handle on your priorities, evaluating which are urgent, which are important, and which can be delegated to someone else — or ditched altogether.

1. Does it have consequences for not taking immediate action and does it align with your goals?

ACTION STEP: DO IT. This is a task that’s both urgent and important, which means it’s a priority. And getting it done first will take a lot of pressure off your plate. Examples are:

  • Completing a project for work
  • Deep breathing when you’re stressed
  • Responding to certain emails

2. Does it bring you closer to your goals, but doesn’t have a clear deadline?

ACTION STEP: SCHEDULE IT. This is a task that’s important, but not urgent. Since it’s easy to procrastinate here, scheduling time to attend to it is your best bet. Examples are:

  • Working out
  • General self-care
  • Spending time with your family

3. Does it need to get done within a certain timeframe, but doesn’t require your specific skill set?

ACTION STEP: DELEGATE IT. This is a task that’s urgent, but not important — at least not important for you to do, specifically. Sure, it needs to get done, but you could probably pass off this task off to someone else, which frees up your time. Examples are:

  • Making sure the kids are ready for school
  • Shopping for groceries for the week
  • Meal prepping

4. Does it not have a deadline or get you closer to your goals?

ACTION STEP: DELETE IT. This is a task that’s not important or urgent. And it’s a huge time suck! It’s the kind of “task” that makes you wonder where all your time went. Using a browser blocker like Freedom can help a ton. Examples are:

  • Scrolling your social media feed
  • Playing online games
  • Worrying, obsessing, and stressing out about things that don’t matter

Bonus Tip: Figure out what time of day you’re the most focused. When do you tend to get a lot accomplished? Are you a morning person? A night owl? Knowing when you’re the most productive can help you get stuff done with less effort.

Now tell me what you think. Have you tried these strategies? What’s worked for you?

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morning routineStarting your day with a deliberate movement routine that you repeat every single day can be life changing, because it creates the leverage and the power to become a more focused and disciplined person in all other areas of daily life. Contrast this with the disturbing stat from IDC Research that 80 percent of Americans reach for their phones as the first act upon awakening.https://www.psychologytoday.com/us/blog/brain-wise/201209/why-were-all-addicted-texts-twitter-and-google‘>2 Julie Morgenstern, renowned productivity consultant and author of Never Check Email In The Morning, explains that when you reach for your phone first thing, “You’ll never recover. Those requests and those interruptions and those unexpected surprises and those reminders and problems are endless… there is very little that cannot wait a minimum of 59 minutes.”

The Dope On Dopamine

The reason you’ll never recover is because your morning foray into hyperconnectivity is creating a dopamine addiction.https://markmanson.net/self-discipline‘>4 Alas, when you hijack the dopamine pathways too often with the aforementioned folly, you down-regulate the serotonin pathways in your brain so you become wired for quick-hit pleasure at the expense of long-term happiness.

The Magic Of Morning Movement

Extricating from this mess starts first thing in the morning! Since most of us have tons of sedentary influences during the day (commute, office work, evening screen entertainment), I’m going to suggest a mindful routine of exercises, poses, and dynamic stretches that build flexibility, mobility, core and muscle strength. Your morning routine will help you naturally awaken and energize (especially if you can do it outdoors), improve the fitness base from which you launch formal workouts, help prevent injuries, and boost your daily movement quota especially if things get hectic and you don’t have time for formal workout.

I’m not a big routine or consistency guy and never have been, so amassing a four-year streak of doing a template routine every single day may be more of a revelation to me than to big-time creatures of habit. If you’re already good at self-discipline and consistency, applying your skills to a morning movement routine will pay big dividends; you’ll likely increase your level of sophistication and degree of difficulty over time. If you are a “go with the flow” type of person, the morning routine will serve as a much- needed anchor for a focused, disciplined day—especially against the formidable foes of distraction and instant gratification.

The original impetus for designing a short morning movement routine was my frustration with recurrent and lingering soreness and stiffness after every sprint workout. I realized that I wasn’t adequately acclimating my body to doing all-out blasts once a week, because nothing else I did approximated what happened on sprint day. Perhaps many weekend warriors can relate: If you never approximate your most difficult workouts or do preparatory drills and exercises consistently, your big efforts are going to beat you up and require extended recovery time. I figured if I could raise the baseline from which I launched these tough workouts, via better core strength, hamstring and hip flexor mobility, and so forth—the workouts would be easier to recover from. I noticed these benefits right away and excitedly shot a video back in 2017 of my original routine. That’s when I learned the sequences actually took 12 minutes instead of five! I also did lots of the moves in bed (to make sure I’d do them right away) until I later discovered that the core stimulation is much more intense on the floor than on a soft mattress.

As I accumulated an impressive streak one day at a time, I started to realize some amazing physical and psychological benefits. My first few steps out of bed in the morning (that is, before starting the routine) were light and graceful—no more limping, creaking and cracking my way to the bathroom. My post-exercise soreness pretty much vanished—something I’d struggled with after every sprint workout for over a decade. Since I typically pair my morning routine with an ensuing chest freezer cold exposure session, the one-two combo gave me a sense of stability, focus and self-discipline that was missing, since I’m not part of rituals like rush hour commuting or an 8-to-5 office workday.

My routine has evolved quite a bit over the past four years. Buoyed by the confidence that I can carve out the time to execute every day no matter what, I continue to add more custom-designed moves to my template, increasing both the duration and degree of difficulty. Currently, the session lasts for a minimum of 32 minutes. Often, I will transition right into a proper strength training session since I’m so warmed up and fitness focused. This video shows the exercises and repetitions comprising my current routine, with an explanation of each.

Yeah, it’s time consuming and some of these moves—especially the grand finale Bulgarian Split Squats—are not easy! It’s important to note that I’ve progressed naturally and gradually from a modest starting point four years ago. If you are ready to take action, here are the important parameters to honor:

Start Small

Design a routine that is simple and do-able every day. Don’t make it too strenuous or too long in duration out of the gate. You must strive for consistency, convenience, and low stress. If five minutes is all you can spare right now, start with that. Over time, when the routine has become integrated into habit, you may choose to increase the duration and degree of difficulty in a manner that feels natural and fun.

Daily Commitment

Place extreme importance on doing your routine as soon as possible upon awakening every single day no matter what. The goal is to establish a streak that will become as natural as current streak of brushing your teeth every day. If you typically have to visit the bathroom, brew coffee, tend to children or pets, or check the stock ticker as your first acts upon awakening, insert the movement routine into a recurring slot in your morning pattern: bathroom, coffee, hit the deck sounds great! If a particularly hectic morning prevents you from doing your routine, perform a makeup session later in the day to honor your commitment to the project.

Repeatable

Perform the same exact sequence of movements and repetitions every time. You don’t want to have to apply any creative energy or waste precious cognitive resources deciding what exercises to do or how many reps to complete. Repeating the same sequence will make it easier to program your routine into habit. Over time, feel free to modify your template by adding or subtracting exercises, but always have a working template in place. Don’t listen to the folklore that you need to confuse your muscles with ever-changing exercises. Let’s check back in 20 years and see how not confused your body is from completing a great routine every day.

Mindful

Doing the same thing every day adds a meditative aspect to the experience. I focus entirely on proceeding through the rep count for each exercise, which is synchronized with my breathing on many of the moves. I’ve made the mistake a few times of trying to listen to a podcast or take a phone call during my routine, and it invariably causes me to lose count during one of the sequences. That’s when I established a penalty of having to start the reps of that particular exercise over if my mind wanders. That will keep you focused! Now my morning routine is a time to enjoy the view of the trees, the sound of birds, and the mind- body connection that comes from sequential movement—as you might enjoy in a guided yoga class.

Outdoors (Sunlight, Fresh Air, And Maybe Even Cold!)

Research suggests that exposing your eyeballs to direct sunlight as soon as you awaken can have a powerful effect to entrain your circadian rhythm. The sunlight hits your retina, travels down the optic nerve to the all-important suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN is considered the master clock of your circadian rhythm, and directs all manner of light-driven hormonal processes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2290997/‘>6 In the winter months, my routine doubles as cold exposure as I’ll wear only shorts in temperatures freezing or below.

Customized

Design exercises that support your fitness goals, address any muscular weaknesses or imbalances, and counter sedentary lifestyle patterns like being hunched over at the car and computer. My leg swings and hamstring extensions are contemplated with sprinting and high jumping in mind, since these muscles take a lot of impact trauma when sprinting. The difficult yoga wheel pose is directly applicable to bending over the high jump bar!

Enjoyable

There are all kinds of expert-recommended exercises that I’ve tried and discarded since I didn’t enjoy them or they don’t work for me. I did the familiar “pigeon” stretch from yoga for a while but I believe I sustained a knee injury from it, so it’s out. I have a few other cool exercises not shown on the video, such as monster walks and shuffles with Mini Bands. I’m tempted to officially add them to the routine, but I prefer to keep them as optional add-ons. With my current routine at 32 minutes, I occasionally experience a bit of time stress to get it done if I have a busy morning planned. I don’t want that feeling to happen more than occasionally, so I’m hesitant to add anything else at this time.

At first, it will be very helpful to write down each of the exercises and number of repetitions as you strive to lock in an ideal template. In particular, you want to discover a rep count that’s a bit of a challenge, but not too strenuous to have you fretting and sweating over it. As I mention on the video, when I first integrated the challenging Bulgarian split squats, I took each leg to the point of mild muscle burn that occurred at 20 reps. Today, I experience that same mild burn after 45 reps. So the degree of difficulty and mental strain have not changed, but I am validating my fitness progress over time. All of your progress with increasing reps and increasing the overall duration and degree of difficulty of your routine should happen gradually and naturally. Today is a good day to start your streak, so try stringing together a few of your favorite moves and get on the books! Good luck, and let us know some great suggestions in the comments section.

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pandemic's toll on mental health relationshipsWhen Mark asked me to write a post about the toll the pandemic is taking on mental health and relationships, I didn’t want simply to detail the ways it’s hard to live through a pandemic. Nor did I want to throw a bunch of statistics at you about how many people are having a difficult time. You know that it’s like living in the world’s least entertaining Groundhog-Day-meets-dystopian-thriller film.

If you’re like me, you’re sick of kvetching about 2020. The fact is, though, that I don’t know anyone, myself included, who isn’t struggling in one way or another right now.

After a lot of reflection, I’ve concluded that a big reason why 2020 is so draining is that our usual coping strategies don’t work like we want or expect. Most are aimed at reducing the source of our distress or dealing with the emotional aftermath. This pandemic is ongoing. We’re stuck in the middle of it, with no end in sight, and no way to speed the process along.

That doesn’t mean we’re helpless, though. Personally, I’m a huge believer in practicing self-compassion as a means of coping, almost no matter the situation. I’m talking a formal practice of self-compassion, as outlined by Dr. Kristin Neff and others.https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770146‘>2 https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/‘>4 https://richarddehoop.nl/upload/file/self-determination.pdf‘>6

It seems to me that most common coping strategies address competence (developing mastery) or relatedness (connecting to others). However, loss of autonomy—the freedom to control our own actions—is undoubtedly a primary reason we’re struggling.

The problem is, there’s not much we can do about that. The best option is to focus on controlling the things we can control and accepting those we can’t (major serenity prayer vibes, here). I’m not suggesting that we should be reasserting our autonomy by flouting the rules and doing whatever we want, virus be damned. No, the point is to understand why things still feel hard even when we’re trying our best to practice self-care so that we might give ourselves grace.

Questions I’m asking myself:

  • Am I meeting myself where I’m at, or am I using generic coping strategies that, while well-meaning, aren’t really what I need?
  • Am I blaming myself or feeling guilty for struggling, instead of accepting that the pandemic is hard in ways that are hard to cope with directly?

What Can We Learn from People Who are Doing Well?

I’m fascinated by people who are actually doing better now than before. Some kids are thriving at home, free from the social and academic pressures of traditional schooling. Lots of adults are realizing that they are happier and more productive working from home.

Getting back to the topic of this post, when I started to dig into the data on how the pandemic is affecting relationships, I expected to find dire news. I didn’t. While it’s logistically harder to see friends or travel to visit distant relatives, many people have seen their close relationships improve.

FThe Behavioural Science and Health Research Department at University College London is conducting weekly surveys looking at the psychological response to the pandemic, along with other socioemotional and behavioral variables. More than 90,000 people have responded. As of writing, data are available for the first 23 weeks here.

In July, week 16, the researchers asked about relationships. The majority of respondents said the pandemic had not changed their relationships with spouses, friends, family members, or coworkers. More people felt that their friendships had suffered since the beginning of the pandemic, compared to the number whose friendships improved—22 versus 15 percent of respondents, respectively. The data were similar for coworkers. However, relationships with some family members and neighbors were more likely to have improved:

  • 27 percent said their romantic relationship got better, while 18 percent felt it was worse
  • 35 percent reported their relationship with children living at home had improved, versus 17 percent who said it had suffered
  • 26 percent had better relationships with neighbors, versus 8 percent worse

I really wish there was more attention to being paid to those people. Why are they doing better? What’s their secret? It must have something to do with the time we have to invest differently in relationships now, but is there more to it than that? Academics are going to be writing about this for decades, I’m sure.

Shaping a “New Normal”

Since we have no choice about living through a pandemic, I hope we can at least learn from it.

When we go back to “normal,” it won’t be—and shouldn’t be—the normal we knew before. The ways people are suffering and thriving both offer important lessons about human nature, our ability to cope, and the ways we do and do not support one another effectively. That some people are doing better during an arguably terrible time is telling. It says a lot about the challenges and shortcomings of our pre-pandemic way of life.

The question is, will we heed the lessons?

What about you—how are you doing, really? Will you go back to “business as usual,” or have you gained any insights from the past six months that will change how you approach things in the future?

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why am i waking up in the middle of the nightWhenever I write about sleep, I hear from a chorus of people who struggle to sleep through the night. Anecdotally, it seems a far more common complaint than difficulty falling asleep in the first place.

These complaints are one of three types:

  1. People who have trouble falling asleep
  2. People who sleep fitfully, waking multiple times throughout the night
  3. Those who reliably wake once, around the same time most nights

Understandably, this is a hugely vexing problem. Poor quality sleep is a serious health concern. Not to mention, sleeping badly feels simply awful. When the alarm goes off after a night of tossing and turning, the next day is sure to be a slog. String several days like that together, and it’s hard to function at all.

I’m going to go out on a limb, though, and assert that waking up in the middle of the night isn’t always the problem we make it out to be. For some people, nighttime wakings are actually something to embrace. As always, context is everything.


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What Causes You to Wake Up In the Middle of the Night?

One of the most frustrating things about nighttime waking is that there are so many possible causes. Sometimes the solution is as simple as practicing good sleep hygiene. Other times, medical help is in order. Still other times, the solution is something different entirely.

Transitioning to Lighter Sleep Stages

Sleep isn’t a uniform state of unconsciousness you slip into when it becomes dark and, theoretically, ride until morning. It’s a dynamic process that goes in waves—or more precisely, cyclesthroughout the night.

There are four (or five, depending on how you slice it) stages of sleep:

  • Stage 1: light sleep, occurs right after falling asleep
  • Stage 2: deeper sleep
  • Slow-wave sleep (SWS): deepest sleep, a.k.a. Stage 3 and Stage 4 sleep
  • REM: lighter sleep where our more interesting dreams occur (although we can also dream in non-REM phaseshttps://academic.oup.com/advances/article/7/5/938/4616727‘>2 Still, you might be able to look at your diet and identify a likely culprit. For example, if your sleep problems started after going carnivore or adding intermittent fasting, that’s an obvious place to start.

    A food log can help you spot patterns, such as whether eating certain foods at dinner tends to correlate with poorer sleep. Alcohol and caffeine are big sleep disruptors as well, though you surely know that.

    If you’re frequently waking up to pee, you might be overhydrating, especially in the evening. More seriously, it can be a symptom of diabetes or bladder, prostate, kidney, adrenal, or heart problems. Getting up once or twice to pee probably isn’t cause for alarm. It’s worth seeing a doctor if you’re getting several times or urinating much more at night than during the day.


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    What to Do About Nighttime Waking

    First things first, pick the low-hanging fruit

    I’m talking good sleep hygiene practices. Things like:

    • Sleep in a cool, dark, quiet room.
    • Minimize exposure to artificial lights after the sun sets. Use blue-light blocking glasses, and turn on night mode on your devices.
    • Watch your alcohol and caffeine consumption, especially later in the day.
    • Go to bed around the same time each night.

    If applicable, experiment with your diet and food timing

    Depending on your current diet, some experiments you might try include:

    1. If you’re ultra-low-carb, try increasing your carb intake for a few weeks.
    2. Try loading more of your carbs into your evening meal.
    3. Make sure your protein intake isn’t too low.https://academic.oup.com/advances/article/7/5/938/4616727‘>4 That calls the “starving brain” hypothesis into question, but I suspect there’s an important nuance here. Individuals who can comfortably do longer fasts are almost certainly also fat-adapted and, at least during the fast, producing ketones to fuel their brains. Metabolically, they’re in a very different place from a carb-dependent person who struggles to make it through the night.

      Consider napping

      If you’re unable to get enough high-quality sleep at night, you might prefer to adjust your sleep schedule entirely. Instead, aim for a shorter nighttime sleep period, say five or six hours, paired with an afternoon nap. This is another variant of biphasic sleeping.

      Years ago, I wrote a post on how to conduct just this type of experiment. Check it out and see if it might work for you. It’s unconventional in this day and age, but I know people who thrive on this schedule.

      Finally, don’t hesitate to seek medical help

      Sleep issues are a symptom of many diverse health issues, including hyperthyroidism, anxiety, depression, and, as previously mentioned, diabetes, heart disease, and others. Your doctor may want to test you for sleep apnea.

      The Case of Hot Flashes

      Hot flashes are a common cause of nighttime waking for women of a certain age. If you endure nighttime flashes, you’re probably familiar with the standard advice:

      Unfortunately, as I’ve learned from my wife Carrie’s and many friends’ experiences, there is no one-size-fits-all solution. I do think acupuncture is a potentially helpful, underutilized tool. Mostly, though, it’s just a combo of trial-and-error plus time that seems to get most women through this phase.

      Getting Back to Sleep

      In the meantime, while you get to the root of the issue, here are some tips for getting back to sleep:

      • Take care of pressing needs. Get up and pee, get a drink of water, or adjust the thermostat. There’s no point in trying to power through the discomfort that woke you up in the first place. Just fix it.
      • Keep artificial lights and screens off. Use small nightlights to light your path to the bathroom if necessary, and wear your orange-tinted glasses.
      • Do a calm activity such as reading by candlelight, deep breathing exercises, or sketching or writing in your journal.
      • Most of all, don’t stress! Fretting is likely to keep you awake for much longer than simply accepting the fact that you are awake and lying peacefully in bed.

      Are You Fighting Something You Should Be Embracing?

      I’ve long believed that humans naturally tend to be biphasic sleepers. The idea that we should be passed out for a solid eight hours per night is a social construct not firmly rooted in our sleep biology.

      Historian Roger Ekirch argues, rather convincingly I think, that before the advent of artificial light, humans across geographical locations and social strata slept in two chunks during the night. The first, usually just called “first sleep,” or sometimes “dead sleep,” comprised the first four or so hours. “Second sleep” went until dawn. In between, people would enjoy an hour, or perhaps two or three hours, of mid-night activities such as praying and meditating, reading and writing, having sex, and even visiting neighbors. This was seen as completely normal, even welcome.https://academic.oup.com/sleep/article/39/3/715/2454050‘>6 Also, in one small experiment, seven adults lived in a controlled environment with 14 hours of darkness per night. Over the course of four weeks, their sleep and hormone secretions slowly and naturally became biphasic.https://royalsocietypublishing.org/doi/pdf/10.1098/rspb.2017.0967‘>8 If some individuals fall asleep earlier and some later, and most people are awake for an hour or two in the middle of the night, someone in the group is always up. That person can tend the fire and watch for danger. In fact, the waking hour was sometimes called the “sentinel” hour. According to Ekirch, it was often referred to as simply the “watch.”

      Are You a Biphasic Sleeper, or Do You Have a Sleep Problem?

      Waking up multiple times per night, such that you rarely feel truly rested, is a problem. However, we shouldn’t rush to pathologize a single nighttime waking. That might just be your natural sleep pattern. It doesn’t necessarily mean you’d be better off aiming for biphasic sleep either. Even if you wake reliably at the same time each night, sometimes a full bladder is just a full bladder.

      The litmus test is how you feel. With a biphasic schedule, the intervening waking period should be pleasant. Your mind should feel calm and alert, if perhaps a bit dreamy. Anecdotally, many famous writers, artists, and sculptors have adhered to a biphasic schedule, believing that creativity and flow are enhanced during the mid-night hours.

      Of course, you can’t tap into how you feel if waking is causing you a ton of angst. Remind yourself that waking can be normal, not dysfunctional. I know this can be easier said than done, especially if you’re sleep deprived. The thing about biphasic sleeping is that you’re still supposed to get the eight hours of nightly sleep you need, give or take. That means you have to spend nine or ten hours in bed. How many people do that nowadays?

      See if you can commit to at least a couple weeks of sufficient time in bed. Push away your previous (mis)conceptions about what a “good” night of sleep is “supposed” to look like. Try to welcome rather than fight the mid-night waking. Be open to what comes next.

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at home yoga

You’re doing the best you can.

You’re trying to stay at home. You’re homeschooling the kids. You’re trying to keep working at your job, or you’re navigating the waters of having lost employment. You’re trying to remain upbeat and optimistic.

There’s a lot of juggling going on, and if there’s one thing I’ve learned in my 25+ years in the health and fitness industry, it’s that the first ball we let drop is our own – our self-care.

Inertia is a Powerful Force

You may start each day with grand plans for a healthy dose of movement. You may have visions of a long, brisk walk. You may decide that today’s going to be the day you dust off the Bowflex or your dad’s ancient dumbbels in the basement. Whether it’s because you’ve run out of time, energy, or steam, or because your sense of overwhelm is holding you down like lead, perhaps you’re not taking as much care to get your body moving these days.

This has implications for your energy. Energy moves through the body freely when the body is open and unblocked. More energy begets more energy: once you’ve got it flowing, you’ll find yourself coming back
online; fully charged.

Yoga to Unlock Energy and Relieve Pressure

I’ve created the following yoga sequence precisely to help unlock energy and relieve the pressure you’re feeling in your head and heart, and that’s locked up inside your body. This sequence is simple, slow, and low-stress; designed to feel like an exhilarating and relaxing deep sigh.

And we could all use a deep sigh right about now.

So get down on the floor (you don’t even need a yoga mat) and do as many of these easy, feel-good postures as you can, for as long as it feels good.

Your Hips Hold Your Tension

Many yogis affirm that our hips are the spot in our body where we hold much of our emotional and spiritual tension. Whether that sounds plausible or far-fetched to you, there is simply no denying that hip opening yoga postures feel darn good.

So in this series, we’ll focus predominantly through the big hip joints, while also flowing through some spinal rolling. Let’s get your energy flowing again. You can complete the whole sequence in less than 30 minutes; a perfectly affordable amount of time to spend on yourself.

I’ve created short instructional videos for each couplet. I encourage you to linger in each pose of each sequence as long as you like (I move through them more quickly in the videos, in the interest of brevity). This
isn’t meant to be a heart-pumping workout. It’s an exercise in self-kindness; slow and gentle is the name of the game.

I hope it helps you feel better!
——-

Warm-Up Yoga Sequence

  • Spinal roll down
  • Forward fold with dead hang
  • Garland pose (or child’s pose)
  • Spinal roll up

Repeat this sequence as many times as you like until your back and hips feel warm and juicy. Observe how the first round feels. Observe how this improves in the second round, the third, and so on.

On the spinal curls, imagine each of your spinal vertebrae rolling up, one at a time, like a string of pearls. Concentrate on moving each one independently of its neighbors.

In the forward fold, allow your head, shoulders, and arms to hang very heavily, as dead weight, enabling a sensation of traction within the spine.

In garland pose, press your knees out with your elbows, drop your tailbone toward the floor, and try to lift the crown of your head toward the ceiling. If garland pose is eluding you today, take child’s pose and settle right down into the floor. Be sure to emphasize the length of your spine by reaching the arms very far forward, and sending the hips very far back.

Lunge Sequence (front of hip)

  • Upright reaching lunge
  • Low lunge

In the upright version of the lunge, reach the same arm as the downward leg as high as you can. You may choose to lean away, to add more length to the stretch in the front hip.

In the low lunge, bring your arms to the inside of the forward leg. You can remain up on your hands with straight arms, or play around with bending your arms a bit to drop even lower. You may even be able to take your elbows to the floor. Don’t feel the need to push it. This is meant to be gentle.

Linger as long as you like in each lunge, repeating the sequence on the other side.

Frog Sequence (inside of hip)

  • Frog pose
  • Wide child’s pose

To get into frog pose, put your elbows on the floor, then take your knees wide, your ankles wide, and your toes wide (you may wish to double up the mat under your knees or put a pillow under each knee for comfort on a hard floor). Lightly press into your elbows to send your hips and tailbone slightly backward. It doesn’t take long for frog pose to feel intense. Come out of it when you’re ready for a break.

Then move into this very wide-legged version of child’s pose by shifting your weight slightly forward from frog pose, and bringing the tips of your toes together behind you. Keep the knees wide. Reach your arms as far out in front of you as you can. Settle your body into the floor in between your knees.

Repeat this sequence as many times as you like.

Pigeon sequence (side of hips)

  • Half lotus
  • Pigeon/Extended pigeon

Don’t worry if your half lotus or pigeon look a little rougher than what you see on Pinterest. You’re working with what your body is giving you today and that is perfectly enough. Concentrate on how it feels, on letting go of any “hold” though the hips, and in the breath.

Half lotus can be done with the ankle stacked up on the opposite knee, or for a little easier option (depending on how your hips and knees feel) take the ankle to the opposite calf. Can’t manage half lotus? Simply sit cross-legged with one leg folded in front of the other.

In pigeon pose, try your best to extend your leg as far back behind you as you can, allowing your kneecap and all five toenails to anchor to the floor. You can remain upright, fold down to your elbows, or bring your forehead to the floor.

Take your time allowing gravity to sink your pigeon ever-closer to the floor, then repeat on the other side.

Seated bends sequence (lower back, side of trunk)

  • Head to knee forward bend
  • Seated side bend

“Head to knee” is merely a suggestion. A directional aspiration, if you will. Your head does not need to make contact with your knee, but behave as if that’s your desired outcome.

You may find the seated side bend a little “sticky;” I do too. Don’t worry if you can’t get over very far. Rather than leaning to the side, imagine curling your trunk over in a C shape. Observe how your body is suspended by the muscles and connective tissue in your side trunk and see if, with each subsequent round, you can’t bend a little more.

Feel free to cycle back and forth between these two postures, and don’t forget to switch sides. Observe how one side feels compared to the other.

Spinal twist sequence

  • Spinal curls
  • Supine twist

Your spine has 33 individual vertebrae, 17 of which make up the mobile and bendy part of a healthy back. This final sequence is designed to deliver on the spinal suppleness that is your birthright.

As you curl your spine in and out, can you imagine all 5 of your lumbar (lower back) vertebrae and all 12 of your thoracic (middle and upper back) vertebrae moving, one at a time? Observe where you get stuck. On each subsequent curl, observe whether that stickiness begins to loosen up. Complete several rounds of these curls before moving to the twist.

Hug your knees into your chest and then simply allow your bent legs to fall to one side, while keeping your shoulders anchored square to the floor. The weight of your legs will help deepen into this very gentle spinal twist. Switch sides when it feels good.


————
One you’ve finished your sequences, lay quietly or come to seated, and simply observe how different your body feels, and how different you feel in your body. Then go about the business of managing the challenges of the current day, with renewed, flowing energy.

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The post Easy At-home Yoga Sequence to Relieve Pressure appeared first on Mark’s Daily Apple.

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why do I feel tired all the time“I’m tired all the time.”
“I have no energy.”
“I’m too tired to go to the gym.”
“I need a nap.”

Walking around in a fog seems like standard operating procedure nowadays. No matter how common it is, though, feeling exhausted, low energy, or sleepy all the time is not normal. It’s always a sign that something else is going on.

Tiredness, Sleepiness, Fatigue: What’s the Difference?

What does it mean when someone says, “I’m tired all the time?” Are they falling asleep at their desk? Do they need to take an afternoon nap in order to function in the evening? Perhaps they feel too wiped out to exercise or even get off the couch?

Colloquially, we use the word “tired” to describe the subjective experiences of both sleepiness and fatigue. “Sleepiness” is the familiar experience of needing sleep due to sleep debt. We all know what this feels like.

“Fatigue” can mean a few things. There is the tiredness you experience after overwork or exertion, which is usually temporary. Then there are the chronic feeling of exhaustion, low motivation, physical weakness, or inability to function.

From a medical perspective, sleepiness and fatigue are different. The boundaries are fuzzy, though, and there is a lack of agreement about the best ways to assess and differentiate the two.https://www.sleepfoundation.org/sleep-disorders/excessive-sleepiness‘>2

Obviously, the first question you should ask yourself is, “Am I getting at least seven hours of sleep per night?” Really, I’d say at least eight for most people. That doesn’t mean seven hours in bed. It takes a while to fall asleep, and most people wake up at least a couple times per night. An analysis of over 10 million users’ Fitbit data revealed that the average person is awake or restless for 25.5 minutes per night.https://pubmed.ncbi.nlm.nih.gov/8843535/‘>4 If you are maintaining one sleep schedule during the week and a completely different one on the weekends, stop. Make a concerted effort to maintain the same sleep and wake times for a few weeks and see if that helps.

Sleepiness is also a sign of circadian rhythm misalignment.https://pubmed.ncbi.nlm.nih.gov/25367475/‘>6

Consider keeping a sleep-wake diary or using a sleep tracker such as an Oura Ring or Fitbit. This can provide some initial insight into what’s going on.

Can Your Diet Cause You to Feel Tired All the Time?

Possibly. There are certainly links between certain vitamin and mineral deficiencies and fatigue. Low iron (even without anemia),https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/‘>8 B vitamins (especially B12https://pubmed.ncbi.nlm.nih.gov/10767667/‘>10 Vitamin D in particular seems to be associated with sleep disorders.https://pubmed.ncbi.nlm.nih.gov/12741468/‘>12 and non-celiac gluten sensitivityhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3280075/‘>14,https://pubmed.ncbi.nlm.nih.gov/16549311/‘>16 Of course, it’s entirely possible that sleepiness leads people to consume more caffeine, not the other way around. Experimental tests on the effects of caffeine consumption are mixed, suggesting individual differences in the degree to which caffeine affects sleep.https://www.sciencedirect.com/science/article/abs/pii/S1087079201901625‘>18 It’s counter-intuitive, because a lot of people like to have a glass of wine or other beverage to help them sleep. While it may help you fall asleep, alcohol has a tendency to disrupt sleep phases in a way that renders your sleep incomplete.

On the other hand, maybe it’s what you’re not drinking—enough water. Dehydration, perhaps even mild dehydration, can cause fatigue.https://pubmed.ncbi.nlm.nih.gov/26290294/‘>20 You don’t have to force yourself to drink a certain amount each day, but consider adding a glass of water or two, perhaps with a pinch of sea salt, if you’re feeling somewhat fatigued.

Lifestyle Factors That Affect Tiredness

Leading a sedentary, indoor lifestyle

Being sedentary is associated with experiencing greater fatigue.https://pubmed.ncbi.nlm.nih.gov/18277063/‘>22,https://pubmed.ncbi.nlm.nih.gov/27995604/‘>24 Exercise can also improve sleep.https://bjsm.bmj.com/content/32/2/107‘>26 I don’t think I need to tell you how I feel about chronic cardio, do I?

Taken as a whole, the evidence suggests that low-level aerobic activity is particularly effective for helping to relieve tiredness. If you’re feeling tired all the time, try going for a daily walk. Walking is by far my favorite low-intensity activity. Plus, you get the added bonus of sun exposure, weather permitting. Get that vitamin D boost! One study found that three-quarters of patients who complained of fatigue were deficient in vitamin Dhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207540/‘>28

Stress

Experiencing extreme and/or chronic stress can also lead to fatigue and sleep problems. Mindfulness Based Stress Reduction interventions have been shown in many studies to reduce symptoms of fatigue in individuals with a wide range of chronic health problems.https://pubmed.ncbi.nlm.nih.gov/26519614/‘>30,https://www.sciencedirect.com/science/article/abs/pii/S0093775401902076‘>32

  • Type 2 diabeteshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064586/‘>34
  • Hypothyroidhttps://www.aafp.org/afp/1998/0215/p776.html‘>36
  • Heart diseasehttps://pubmed.ncbi.nlm.nih.gov/3169045/’>38
  • Perimenopause and menopausehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225130/’>40
  • These are just some of the many issues that are associated with otherwise unexplained sleepiness or fatigue. There are others, namely chronic fatigue syndrome and fibromyalgia, for which fatigue is a defining characteristic, not just a symptom.

    When you talk to your doctor, try to be as specific as possible about what you are experiencing. Is it fatigue that manifests as physical exhaustion, weakness, or lack of desire or ability to do daily activities? Persistent sleepiness despite apparently good sleep habits? Make a note of frequency and patterns, such as if you experience fatigue more at certain times of day, after meals, or, if applicable, at specific times of your menstrual cycle. Track your sleep for a few nights at least. Your doctor will ask.

    Tell your doctor about any other symptoms you are also experiencing, even if they seem unrelated. Your doctor might spot a pattern that leads to a diagnosis. Finally, make sure you tell your doctor about any medications you are taking, as fatigue might be a side effect.

    Getting to the Root of Your Issues

    As you see, there are lots of possible causes for tiredness. If your sleepiness or fatigue is significantly affecting your quality of life—you have trouble completing your daily tasks, your memory is impaired, your mood is affected or you feel depressed—a doctor’s visit is absolutely in order.

    If you want to try to self-experiment at home first, start with the obvious and easy steps:

    • Optimizing sleep hygiene
    • Staying in bed for eight to nine hours every night at the same time
    • Eliminating gluten if you haven’t already
    • Removing caffeine in the afternoon
    • Making sure you’re hydrated
    • Avoiding long periods of being sedentary
    • Getting outside and getting plenty of sunlight
    • Taking steps to alleviate stress

    You can also try tracking your food for a week using Cronometer to see if you are consistently low on any vitamins or minerals. Up your intake of foods rich in the vitamins or minerals you need. If you’re not already eating a serving of liver each week (for iron and other nutrients) and small, oily fish (for essential fatty acids) on the regular, do that. If you think you’re clinically deficient in one or more areas, get tested before supplementing willy nilly.

    Is Inflammation the Key?

    What do poor sleep, chronic illness, sedentary lifestyles, poor gut health, chronic stress, and nutrient-poor diets all have in common? Inflammation.

    It’s perhaps no surprise, then, that some scientists believe that inflammation is a key feature in fatigue of various etiologies.

    As we covered in Parts I and II of this series, during perimenopause and menopause women can experience a complex web of physical, psychological, and social symptoms.

    The treatment usually prescribed by doctors, hormone therapy (HT), is controversial and not appropriate for some women. I won’t get into the HT debate here—Mark did a great job covering the pros and cons recently. Suffice it to say that HT isn’t the answer for everyone, and it’s not a panacea by any means.

    Whether or not they choose to go the HT route, many women desire additional support during perimenopause and beyond. For the sake of keeping this post from becoming a novella, I’m going to focus on mind-body therapies today.

    This is not meant to be an exhaustive list of nonhormonal options, nor is it meant to try to dissuade you from trying HT. That’s a decision you have to make for yourself with your doctor. The approaches below can be used alone or in combination with other modalities, including HT.

    As with any medical-adjacent tools, if you are considering any of the options here, take the time to educate yourself, talk to your doctor, and find qualified practitioners to help you implement these practices.

    A Note Regarding Research Evidence…

    Because so many women are interested in complementary or alternative approaches, there’s a fair amount of research into nonhormonal treatments. There are also important limitations.

    A lot of the randomized control trials—experiments that are best for establishing causal effects—are small. There is considerable variability in research design, so it’s difficult to generalize across studies.

    Participants in these studies tend to be white and well-educated. Since there are cross-cultural differences in the experience of menopause, we shouldn’t assume that the findings apply to all women. Likewise, a lot of the research focuses on women with a history of breast cancer because HT is generally contraindicated in this population. While the results of these studies probably generalize to other women, it would be great to have more data.

    Finally, vasomotor symptoms—hot flushes and night sweats—are studied more than other types of symptoms. Though they are the most common complaint, many women do not experience debilitating vasomotor symptoms. They might, however, experience mood fluctuations, depression, sexual issues, memory problems, and more. We know less about how these approaches might help those women.

    Nevertheless, I’ll highlight some of the potentially fruitful avenues you might explore. When possible, I’ll focus on systematic reviews and meta-analyses. They pool the results of multiple smaller studies to help a more reliable picture emerge.

    Cognitive Behavioral Therapy (CBT)

    In CBT, individuals are encouraged to explore how their thoughts (cognitions) affect feelings, behaviors, and physical symptoms. With help, they change their thoughts or beliefs about a situation to help manage their responses and improve coping skills.

    Although there isn’t a ton of research on CBT for menopause, available studies are very promising. Whether or not CBT reduces the actual number of hot flushes—and the data here are mixed—CBT should work by changing women’s perceptions of their hot flushes. Multiple studies do find that after CBT women view their hot flushes as interfering less with daily life. As expected, they are also less bothered by them.

    Women who see themselves as having less control over their hot flushes also tend to experience more distress. Changing their perceived control could be an effective intervention for improving quality of life. Indeed, in one study, 95 women received either group-based or self-help CBT. After therapy they reported feeling greater control over hot flushes and having better coping skills compared to women in a no-CBT control condition. Further analyses showed that women’s beliefs about control and coping predicted how problematic they found their hot flushes to be. (Having more positive beliefs about how hot flushes affect sleep also helped.)

    Women who participated in CBT also experienced fewer sleep issues and insomnia as well as fewer depressive symptoms and sexual concerns.  They also noticed less impairment at work. Positive results were found with in-person therapy, self-help programs, and telephone-based therapy. When studies included a follow-up assessment, the beneficial effects of CBT persisted for at least six months.

    Mindfulness, Meditation and Relaxation Training

    A cross-sectional study of 1744 women found that women with higher scores on a mindfulness assessment tended to report less severe menopausal symptoms. For women with higher life stress, this association was especially strong. The idea here is that when women are able to be present-focused and observe their symptoms without judgment, they are protected against some of the distress, and possibly the physical symptoms, associated with menopause.

    Although some of the women in that survey are probably mindful by nature—lucky them—mindfulness is also a skill that can be learned and cultivated. Among the many reasons to do so, mindfulness and meditation training can apparently lessen menopausal symptoms.

    For example, researchers assigned 110 women to either an intensive eight-week mindfulness-based stress reduction program or a control group. The women who received mindfulness training reported having less bothersome hot flushes, better sleep quality, less anxiety and stress, and greater overall quality of life compared to the control group. When the researchers followed participants over the next 11 weeks, these results persisted or became even stronger.

    A few other studies found that women who receive mindfulness or meditation training report fewer and less bothersome hot flushes, improved sleep, and better psychological functioning, though the results have not consistently endured over time. However, when looking at more general relaxation training and paced breathing techniques, effects are minimal, at least for hot flushes.

    Yoga

    An ethnographic study of nine female yogi masters concluded that they tend to skate fairly easily through menopause. The authors concluded that menopausal women should be encouraged to practice yoga. Of course, in addition to yoga, these yogi masters’ lifestyles included “healthy food habits, adequate sleep, and the use of nature cure techniques (i.e., fasting, detoxification, selection of suitable food products, and living in well-ventilated houses) that facilitated the art of living in tune with nature.” This sounds pretty great, but can we give really yoga all the credit here?

    Probably not. However, two recent meta-analyses did conclude that yoga offers small but significant relief from symptoms of all types: vasomotor, psychological (including depression), somatic (including fatigue and sleep disturbances), and urogenital. Women also report better overall well-being and quality of life after receiving yoga training.

    In one study, a group of breast cancer survivors received twelve weeks of yoga and meditation instruction, and they were encouraged to practice daily at home. Compared to women in a control group (no instruction), they reported fewer symptoms and improved quality of life at the end of the twelve weeks and again when asked three months later. A later analysis found that many of the effects were mediated by improved self-esteem in the yoga group.

    Note that most of the individual studies are small, and they employ different types of yoga practices. This might be considered a strength insofar as different practices have been shown to work, or a weakness in that it’s not clear if one approach is particularly effective.

    Exercise

    Cross-cultural surveys find that women who are more active tend to have an easier time with menopause. For example, two large surveys of Swedish women found that women who exercised at least once per week reported less intrusive symptoms than women who never exercised, and women who exercised more than three hours per week were significantly less likely to experience severe symptoms than their less active counterparts. Sedentary women in this Finnish study experienced more vasomotor, psychological, and somatic/pain symptoms than women who were at least somewhat active.

    While promising, experimental studies have not yielded such favorable results. When women were assigned to “physical activity” conditions (often walking), some studies report improvements, but others find no improvements or even worsening symptoms (perhaps depending on women’s baseline fitness). Multiple reviews have concluded that there is no systematic effect of exercise, particularly not for vasomotor symptoms.

    Does that mean menopausal women shouldn’t exercise? Obviously no. It’s clear that being active—or at least not being sedentary—is important for overall health, and it probably helps menopausal women through the transition. However, there isn’t enough research to know what types of exercise are most effective and when. Do the types of movement you enjoy and that make your body feel good.

    Acupuncture

    A recent review concluded that acupuncture is effective for reducing vasomotor symptoms, both frequency and severity, as well as for improving quality of life. However, the reviewers also found that acupuncture was not reliably better than sham acupuncture where needles are inserted at points other than the prescribed pressure points and at a shallower depth—a placebo condition.

    Hypnosis

    A handful of studies have shown that clinical hypnosis can reduce hot flush frequency and distress among breast cancer patients. Another study of 187 women without breast cancer found that women who received hypnotherapy had fewer, less severe, and less bothersome hot flashes, as well as improved sleep. These results were evident at the end of the five-week treatment protocol, and they remained or got stronger in the six-week follow-up period.

    The Experts Weigh In…

    In 2015, the North American Menopause Society released a position statement on nonhormonal management of vasomotor symptoms. Of the approaches discussed here, the only ones NAMS recommended based on the strength of the available evidence were CBT and hypnosis. Mindfulness-based stress reduction earned a “recommend with caution,” which means, “We think it might work, but the evidence isn’t conclusive.”

    The others—yoga, exercise, relaxation and paced breathing techniques, and acupuncture—were not recommended. This does not mean they are not worth trying! It simply means that based on their standards, the evidence was not strong enough for the committee to conclude that they are likely to be effective treatments for vasomotor symptoms specifically. This says nothing about other types of symptoms, nor about general well-being or quality of life.

    Mind-Body Therapy Pros and Cons

    So where does this leave us? Each of these therapies shows promise for alleviating at least some symptoms of menopause. Moreover, all these therapies have the potential to improve overall quality of life, sleep, stress, and general health. While reading these studies, I did wonder whether some of the women felt better simply because they were investing time and energy in taking care of themselves. If so, is that a problem? I don’t think so. They are low-risk interventions with a lot of potential upside.

    That said, these aren’t quick solutions. The effective mindfulness/mediation trainings included six to eight weeks of classes and multiple hours per week. Women practiced yoga for two to four months during the study periods. Hypnotherapy was five weeks or longer. It’s not clear what the minimum time frame is for each of these therapies to be useful, but they’ll certainly involve a time commitment that might not be practical for all women. However, yoga, mindfulness/meditation, exercise, and even CBT can all be practiced at home once you know the proper technique.

    As I said at the beginning, this is not an exhaustive list of nonhormonal therapies. There are also various supplements that might help, as well as lifestyle modifications that most of you Primal-savvy readers are probably already implementing: eating a variety of nutrient-dense foods, getting plenty of sunlight, practicing good sleep hygiene, and nurturing social connections.

    Whatever you choose, be patient. Don’t just focus on one symptom; focus on the big picture. Pay attention to how you’re feeling more globally. Consider that while an intervention might not hit its desired mark, it might help you in ways you didn’t expect.

    Have you used mind-body techniques (these or others)? What’s been your experience? Share your insights and questions below, and have a great week, everyone.

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    References:

    Atapattu PM. Vasomotor symptoms: What is the impact of physical exercise? J SAFOMS. 2105 Jan-Jun;3(1):15-19.

    Goldstein KM, et al. Use of mindfulness, meditation and relaxation to treat vasomotor symptoms. Climacteric. 2017 Apr;20(2):178-182.

    McMillan TL, Mark S. Complementary and alternative medicine and physical activity for menopausal symptoms. J Am Med Womens Assoc (1972). 2004 Fall;59(4):270-7.

    Molefi-Youri W. Is there a role for mindfulness-based interventions (here defined as MBCT and MBSR) in facilitating optimal psychological adjustment in the menopause? Post Reprod Health. 2019 Sep;25(3):143-149

    Moore TR, Franks RB, Fox C. Review of Efficacy of Complementary and Alternative Medicine Treatments for Menopausal Symptoms. J Midwifery Womens Health. 2017 May;62(3):286-297.

    Sliwinski JR, Johnson AK, Elkins GR. Memory Decline in Peri- and Post-menopausal Women: The Potential of Mind-Body Medicine to Improve Cognitive Performance. Integr Med Insights. 2014;9:17–23.

    van Driel CM, Stuursma A, Schroevers MJ, Mourits MJ, de Bock GH. Mindfulness, cognitive behavioural and behaviour-based therapy for natural and treatment-induced menopausal symptoms: a systematic review and meta-analysis. BJOG. 2019;126(3):330–339.

    The post 6 Mind-Body Approaches for Menopause appeared first on Mark’s Daily Apple.

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