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  • Paige Barnard

As humans, we spend approximately 1/3 of our life sleeping. Ideally, this time refreshes us and restores our bodies and minds so that during the other 2/3 of the time, we have optimal mental and physical health. If you’re like me, often your sleep is less than optimal. What are potential consequences of poor sleep? What do we unknowingly do that sabotages our own sleep quality? How can we improve our own habits and get better quality sleep?


Did you know poor sleep can increase pain, lower your ability to fight infection, and increase inflammation. Restful sleep can help decrease chronic pain and improve your mood, which helps you feel more energized, active and social. Good sleep can also reduce your cravings for unhealthy foods.1


So, can the opposite be true? Can quality sleep decrease pain, improve your ability to fight infection, decrease inflammation, and improve your mood? You bet! According to multiple studies2 quality sleep boosts your immune system and makes your vaccines more effective, helps with sustaining a healthy weight (sleep deprivation actually causes weight gain), strengthens your heart by lowering blood pressure and heart rate, improves mood and energy thus daily productivity, and helps improve your memory. With all those benefits, why do so many of us get such poor sleep?


What is quality sleep? Is there a difference between quality and quantity?


Quality is how well you sleep, while quantity is the number of consistent hours you slept. Both can be important. If you sleep 8 hours (quantity) but only 4 quality hours, what then? You’re probably going to have residual symptoms from 4 hours you slept that WERE NOT quality sleep. Darn! That seems like wasted time, right? Quality sleep can be identified by specific characteristics:

  • You fall asleep quickly, within 30 minutes (without a sleep aid)

  • You typically sleep all night, waking no more than once

  • You’re able to sleep the recommended amount for your age

  • You fall back asleep easily (within 20 minutes) if you do wake during the night

  • You feel rested, restored, and energized upon waking (this is the most important!)3

If that doesn’t sound like you, then what is the solution? Most likely, an improvement in sleep hygiene will help.


What is sleep hygiene?

Sleep hygiene is the behaviors that we can individually do to help ourselves promote quality sleep using behavioral interventions. Examples include: maintain a bedtime schedule, avoid daytime naps, get up after 10 minutes in bed if you can’t fall asleep, use the bed for what it was made for (no screentime), avoid caffeine after noon and any other substance that interferes with sleep, don’t exercise close to bedtime, regulate the temperature in your bedroom, and regulate the “sensory” things in your room (light, sound, interruptions).4


To summarize, we spend a lot of time sleeping. That time can either improve your overall health and wellness or do the opposite. Quality sleep doesn’t just happen for everyone. For some of us, it takes discipline and changing some lifestyle choices. However, the benefits of feeling better and (potentially) looking better are worth it in the long run.


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  • Paige Barnard

For adults with ADHD, staying on top of things in all areas of your life can be stressful! Developing daily habits can help you work more efficiently and stay organized. These strategies require practice and patience but will give you more control over your life and improve feelings of self-worth.


  1. Set reminders and allow yourself more time than you think you need.

  2. PRIORITIZE. Start with the most important task, followed by other priorities after that.

  3. Adjust your work schedule Start earlier or later in the day when it is quieter and there are less distractions.

  4. Set up bill reminders or automatic payments.

  5. Set aside 5-10 minutes each day for organization. Find storage or an organizing system that eliminates clutter.

  6. When random thoughts or good ideas pop into your head, write them down on paper or put them into the notes app on your phone to revisit later in

the day.

  1. Get moving. To prevent restlessness and fidgeting, move around when you can. Taking a walk during breaks can help with attention later on.




7 Simple tips to reduce stress


Stress is the body’s response to demanding or harmful situations or events – real or perceived. It can be a positive response, such as when in danger or working to meet a deadline but prolonged exposure to stress can have a negative effect on a person’s thoughts, feelings, behavior, and body. Here are some tips to help reduce stress.


  1. Exercise regularly. Studies have shown physical activity reduces stress and improves mood.

  2. Practice self-care. Some examples include taking a bath, reading a book, practicing yoga, or going for a walk outside.

  3. Limit caffeine intake. Consuming too much caffeine can lead to increased feelings of anxiety, stress and may impact your sleep.

  4. Spend quality time with friends and family.

  5. Learn to say “No”. Taking on too much can increase stress and limit time that you can spend on self-care.

  6. Practice mindfulness. Meditating consistently, even for short periods of time, may decrease stress and anxiety and boost mood.

  7. Get outdoors! Spending time in nature may improve mental well-being and decrease stress.

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  • Paige Barnard

Patients regularly ask for information and recommendations for nutritional supplements. While recommendations can vary greatly based on a person’s health status and individual needs, there are some supplements that we believe everyone should take for optimal health.

1. Multivitamin

A good quality multivitamin is one of the most important supplements. According to the CDC, the vast majority of Americans are not able to meet their nutrient needs by diet alone. A 2013 CDC study showed that only 13.1% of the US population met sufficient fruit intake and only 8.9% met sufficient vegetable intake. Other studies have demonstrated that the produce we eat today contains lower levels of essential vitamins and minerals than the produce we consumed decades ago, likely due to soil depletion.

2. Vitamin B12

It has been estimated that 30 million Americans are deficient in vitamin B12, Vitamin B-12 (cobalamin) plays an essential role in red blood cell formation, cell metabolism, nerve function and the production of DNA, the molecules inside cells that carry genetic information. B12 is found in poultry, beef, fish, and dairy products. People who eat a vegan or vegetarian diet are more prone to deficiencies. Also, people who use medications for acid reflux or heartburn usually have lower levels due to the medication suppressing stomach acid and blocking stomach acid can also block B12 absorption. So uses of acid blockers are advise to use an oral B12 supplement that goes under their tongue thus the absorption is oral rather than in the stomach. People who have had gastric bypass also should use an oral b12 or B12 shots due to less surface area for absorption. Lastly, as you age your body makes less stomach acid and so this affects absorption of B12 as well.

If you have your labs drawn to check B12 you will see a range from 350-1400, We have found the optimal range is closer to 1200. This is where we see the greatest benefit in terms of energy and feeling well.

Untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances.

Food sources of vitamin B-12 include poultry, meat, fish and dairy products.

3. Fish Oil

Fish oil supplements provide the body with essential omega-3 fatty acids, which are important for regulating inflammation. Omega-3 fatty acids are crucial to our health for countless reasons, and they can only be obtained through diet and supplementation. Adequate omega-3 levels are necessary for proper cardiovascular, respiratory, immune, and musculoskeletal health. They have been shown to regulate blood pressure, maintain healthy body weight, regulate immune function, support a positive mood, and promote muscle and joint health. A 2006 study found that fish oil supplementation was as effective as most over the counter medications in reducing neck and low back pain. Typically, individuals need to supplement with 2000-3000 mg of omega-3 fatty acids to meet optimal levels. Additionally, it’s recommended that individuals consume 3 servings of oily fish (like salmon, anchovies, sardines, and mackerel) per week.

4. Magnesium

Magnesium is another one of the most important supplements for optimal health because it is required for more than 600 enzyme reactions in the body. According to the World Health Organization, an estimated 75% of American adults don’t meet the FDA’s Recommended Daily Intake. Individuals who are most at risk of magnesium deficiency include those who consume diets high in processed foods, have blood sugar abnormalities or diabetes, drink large amounts of alcohol, take diuretics or proton pump inhibitors, have gastrointestinal conditions, have been on long-term antibiotics, or suffer from vitamin D deficiency. Low magnesium levels can lead to issues with vitamin D metabolism, weakening of the bones, heartbeat irregularities and irregular blood pressure, blood sugar issues, irritability and anxiety, muscle cramps and twitches, and fatigue.

There are several different forms of Magnesium but the best form for overall health is Magnesium Glycinate it won’t cause the GI effects of some other forms of Magnesium. It will cross the blood brain barrier and if taken at night can help reduce anxiety and aid in sleep. Suggested dose is 400-800 mg for adults.

5. Vitamin D

A CDC report estimated that 90 million Americans are deficient in vitamin D, In Cache Valley, I would bet it higher especially in the winter. It is estimated that 88% of the population receives less than optimal levels of vitamin D. Although the body naturally produces vitamin D through sun exposure, the sun is often not strong enough to meet the body’s needs. Vitamin D plays a key role in more than 3,000 chemical processes in the body. There are many factors that limit the body’s ability to convert sunlight to vitamin D, including limited sun exposure during winter months, older age, darker skin pigmentation, and use of sunscreen and clothes that shade the skin from the sun. Vitamin D is necessary for maintaining proper bone integrity, proper neuromuscular function, normal inflammatory response, muscle strength, proper calcium absorption, healthy immune response, and normal blood pressure. Studies have shown that adequate vitamin D levels are linked to decreased stress fractures, decreased injuries in athletes, improved bone healing and decreased rates of upper respiratory tract infections. Supplementing with vitamin D has also been shown to improve headache and migraine symptoms. The laboratory range is 30-100 but the optimal range for best function is 80-100.

6. Probiotics

Probiotics are important for maintaining gut health, which makes them important supplements for optimal health because we digest and absorb nutrients through the gut. Probiotics are beneficial bacteria that help the gut function properly. The gut also contains bad bacteria and pathogens that can decrease gut function and cause illness and disease. Maintaining a good balance between the “good” and the “bad” bacteria in the gut is important for overall health. Bacterial imbalances in the gut can lead to nutrient deficiencies even if we are consuming a balanced diet and supplementing with vitamins and other nutrients. Research shows that supplementation with probiotics supports healthy immune function, inflammation regulation, proper brain health, and weight management. It also helps to counteract some of the harmful side effects of taking common medications, like NSAIDs and antibiotics.

Because nutritional supplements are not regulated, quality can be an issue with certain brands, we recommend high quality brands found on Wellevate. We offer our patients high quality supplements at a discounted rate. It is important to keep in mind that supplements should be taken at specific doses that vary from individual to individual. In addition, certain supplements can interact with medications. Please speak to your mental health provider or primary care doctor for more information before starting a new supplement. Please contact our office with any questions.

References

  1. Ward E. Addressing nutrition gaps with multivitamin and mineral supplements. Nutr J 2014;13:72.

  2. Moore LV, Thompson FE. Adults meeting fruit and vegetable Intake recommendations – United States, 2013. MMWR Morb Mortal Wkly Rep 2015 Jul 10;64(26):709-713.

  3. Haeusler S, Parry-Strong A, Krebs JD. The prevalence of low vitamin B12 status in people with type 2 diabetes receiving metformin therapy in New Zealand – a clinical audit. N Z Med J 2014;127(1404):8-16.

  4. Sebastian RS, Cleveland LE, Goldman JD, Moshfegh AJ. Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes. J Am Diet Assoc 2007;107(8):1322-1332.

  5. Long SJ, Benton D. Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Psychosom Med 2013 Feb;75(2):144-153.

  6. Maroon, J. C., & Bost, J. W. (2006). ω-3 Fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical neurology, 65(4), 326-331.

  7. World Health Organization. Calcium and Magnesium in Drinking Water: Public health significance. Geneva: World Health Organization Press; 2009.

  8. Grober U. Magnesium and drugs. Int J Mol Sci 2019;20(9):2094.

  9. Magnesium fact sheet for health professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h6. [Accessed Oct. 31, 2019]

  10. Uwitonze A, Razzaque M. The role of magnesium in vitamin D activation and function. J Am Osteopath Assoc 2018;118(3):181-189.

  11. Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J 2012;5(Suppl):i3-i14.

  12. Bendik I, Friedel A, Roos F, et al. Vitamin D: a critical and essential micronutrient for human health. Front Physiol 2014;5:248. doi: 10.3389/fphys.2014.00248

  13. National Institutes of Health – Office of Dietary Supplements – Vitamin D – Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ [accessed May 20, 2018]

  14. Larson-Meyer D, Willis K. Vitamin D and athletes.Curr Sports Med Rep 2010;9(4):220-226.

  15. Holick M. Vitamin D deficiency. N Engl J Med 2007;357(3):266-281.

  16. Halliday T, Peterson N, Thomas J, et al. Vitamin D status relative to diet, lifestyle, injury, and illness in college athletes. Med Sci Sports Exerc 2011;43(2):335-343.

  17. Backx E, Tieland M, Maase K, et al. The impact of 1-year vitamin D supplementation on vitamin D status in athletes: a dose-response study. Eur J Clin Nutr 2016;70(9):1009-1014.

  18. Close G, Russell J, Cobley J, et al. Assessment of vitamin D concentration in non-supplemented professional athletes and healthy adults during the winter months in the UK: implications for skeletal muscle function. J Sports Sci 2013;31(4):344-353.

  19. Barker T, Schneider E, Dixon B, et al. Supplemental vitamin D enhances the recovery in peak isometric force shortly after intense exercise. Nutr Metab2013;10:69.

  20. Ruohola J, Laaksi I, Ylikomi T, et al. Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. J Bone Miner Res 2006;21(9):1483-1488.

  21. Lappe J, Cullen D, Haynatzki G, et al. Calcium and vitamin D supplementation decreases incidence of stress fractures in female Navy recruits.J Bone Miner Res 2008;23(5):741-749.

  22. Maroon J, Mathyssek C, Bost J, et al. Vitamin D profile in National Football League players. Am J Sports Med 2015;43(5):1241-1245.

  23. He C, Handzlik M, Fraser W, et al. Influence of vitamin D status on respiratory infection incidence and immune function during four months of winter training in endurance sport athletes. Exerc Immunol Rev2013;19:86-101.

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