Fauxpologists like Jian Ghomeshi: How to Deal with Them

The Tyee

Here’s the thing. People who see a criminal court as the sole arbiter of fact are missing both the point and the truth. The legal system is not built to handle sexual assault, and consequently, only a tiny percentage of such cases ever result in a guilty verdict. The vast majority of sexual assaults are never reported at all, let alone end up in court. This isn’t because they didn’t happen. It’s because the system is set up to make it extremely hard for victims to win. From the myriad social factors that discourage reporting to wildly inconsistent policing to judges who don’t properly apply existing sexual assault laws or understand the effects of trauma, accusers are hampered at every step. The discrepancy between sexual assault statistics and court convictions tells us that the system is failing — not that sexual assaults don’t occur.

Source: ncsf

Getting Beyond “Get Over It”: Supporting the Emotional Development of Boys

Considering the idea that boys, as opposed to girls, “get over it” in terms of relationship conflicts, things not going their way, disappointment, and the associated feelings, there is a process reinforcing this myth that needs to come to light. The process both overtly and covertly points boys in the direction of “it doesn’t matter” when the emotionally challenging experiences are left disconnected in terms of skills and personal narrative.

In the important formative years of childhood, we can’t teach when boys are unavailable because of the intensity of the moment. This scaffolding has to be done proactively not reactively. In other words, we can’t teach meaning and vital skills in the heat of the moment for the emotional context of stress begs for safety and stability — not reasoning or raising awareness.

Generally, we assume that we have to talk about feelings and while this is true, context matters. To talk about emotions you have to have them rather than be immersed in or consumed by the energy of them, and these represent distinctly different situations. Early on because of innate wiring and developmental trajectory, girls are better able to cross between the feeling, global right brain and the verbal, linear left brain.

Further, for girls language is not lateralized like it is for boys. Girls possess more white matter, responsible for integrating diverse brain structures, which provides a better capacity for processing emotions in a timely manner. And, as opposed to boys, under stress more of girls’ emotions connect from limbic regions to the areas of the brain that process, regulate, seek social support, and create a narrative from the emotional content.

Not so easy for boys. The stress of conflict and strong emotions often fires the connection between the limbic system and the brainstem. Fight, flight or freeze may follow, but the areas of the brain associated with a calm, composed dialogue are not readily available in these hot button moments. And here we find the beginnings of the process of getting over it.

In these hot button moments, adults do what adults do: reason, seek resolution, and determine culpability. And when boys stare quietly ahead or down and have no reason, logic or words for the adult inquisition the process of getting over it is nearly there. Boys need time and scaffolding to process emotions and their distinct messages, and even more time to make sense of how the situation relates to their sense of self both in the present and the future. They are not ones to vent or enlist a friend. While girls tend to seek connection under stress, boys often find a space away from it all.

The last pieces in the getting over it process are time and space. When we allow time to pass and do not make the consistent space to revisit, coach, teach, and reflect in order to make meaning and sense of emotional moments, then the meaning and sense boys do make is: it must not matter. The acknowledgment of the emotional moment is replaced by the conditioned avoidance of getting over it.

So what is the “it” in getting over it?

  1. Acknowledging the emotions and their message
  2. Noticing the subtleties of feelings and the connection to meaning
  3. The process of reflecting and making sense of changes in physical state
  4. An understanding of the cycle of emotions from a primary awareness to emotional expression to resolution and its accommodation in development
  5. The impact emotions have on choices
  6. The impact emotions have on relationships
  7. The impact emotional literacy has on maturity and development
  8. The impact of the lack of depth in emotional development on a boy’s sense of self, others, and relationships

As the father of two boys and as a practitioner, I have witnessed the cultural pressure of this process over two decades. All around is the message to move on, mistaking a boy’s not knowing in the moment for not caring. Boys care, at least until they perceive the permission to discount the emotional content. But they cannot speak this caring and this is a reason why boys look away: they don’t know or have access to what they are supposed to know in the moment. They only know how the situation feels and how it feels to be expected to know more than they can express. And when we don’t give boys the structure for understanding feelings, their meanings, and what to do with them, we stunt the development of emotional intelligence (EQ) at the core.

The consequences upstream of underdeveloped EQ are many. We witness one such expense in decision-making. Adults say to be rational — think with your head and not your heart as if this is possible. All choices and beliefs emanate from values and principles. As clean and logical as we wish to believe is possible, all choices derive from subjective motivation and the underlying motion of emotion. Cut off from a deeper sense of importance, boys mature to men who struggle with the meaning aspect of choices.

This becomes a steep price to pay when we consider the responsibility to family, work (particularly if they are employers or bosses), and fathering their own sons — and daughters. Is it any wonder that uninvolved fathers and absent fathers are plenty, and emotional intelligence declines in relationship to management level in the corporate hierarchy? Strikingly, in the male-dominated positions of CEO, a study (n= 500,000) found that on average CEOs possessed the lowest level EQ in the workplace with senior executives (another male dominated role) close behind.  

Reflection and process take time and boys need the opportunity to make space between the experience and the meaning. Developmentally, making sense and making meaning are primary. To internalize and move from an external sense of doing to a psychological sense of being requires support and challenge to facilitate development. Sensitive young men feel but they do process differently. To move the experience to a coherent narrative requires the time and space afforded by the holding environment of caring adults. But when all you have heard is boys get over it and move on, the meta-message is that it doesn’t matter. Over time the developmental leap of having feelings about feelings, and thoughts about thoughts becomes secondary to the temporary relief of moving on.

Well-intentioned men become unavailable not having the experience of reflection on making meaning and making sense. Intelligence and effort are readily available, but their emotional life is stuck in either an instrumental or scripted manner of meeting needs (consider the executives mentioned above). The opportunity to self-author or have a clear emotional center is lost in the social typecast of masculinity. As a result, a boy’s sense of power and being strong may lack an emotional connection, presence, and resilience. And his steely stare may lack empathy and courage in the face of disappointment, frustration or despair.

At the core of a boy’s emotional life we might find the simple sense of not knowing any better from living the script of getting over it. How do we change this script? One relationship at a time, one connection within your own inner circle, one boy at a time. Start early and with the 8 points outlined above in mind.

References

Bradberry, T., & Greaves, J. (2009). Emotional Intelligence 2.0. TalentSmart.

Farrell, W. & Gray, J. (2018) The Boy Crisis: Why our boys are struggling and what we can do about it. BenBella Books: Dallas, TX.

Gurian, M. (2010). The Minds of Boys: Saving our sons from falling behind in school and life. John Wiley & Sons.

Kemp, T., & Director, E. (2018). Understanding Boys in the 21st Century.

Panepinto, J.C. (2017). The Arc of Primary Leadership: The Authoritative Foundations and Influences of Our Most Immediate Roles. DX Sport and Life, Inc.

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The Brains of Jazz and Classical Musicians Work Differently, New Research Shows

All of the musicians I’ve played with have been improvisers, whether they came from jazz, rock, folk, or whatever. As a loose improvisor myself, I’ve found it difficult to collaborate with trained classical players. It’s not for lack of trying, but—while we like to think of music as a universal language—the means of communication were […]

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Panel Sets First-Ever Guidelines for Perimenopausal Depression

A multi-institutional panel of scientists have developed the first-ever guidelines for the evaluation and treatment of perimenopausal depression. Their recommendations are published in the journal Menopause and the Journal of Women’s Health.

Perimenopause refers to the three- to four-year period immediately prior to menopause when periods become irregular and eventually stop, as well as the first year after the final menstrual period. It typically begins in a woman’s 40s but can start even earlier.

Women are at greater risk of depression after the birth of a child when hormone levels are changing, but the risk of depression associated with perimenopause still remains under-recognized. Clinical recommendations on how to diagnose and treat this kind of depression in women have been lacking until now.

“The reason these guidelines are needed is because depression during the perimenopausal phase can occur along with menopausal symptoms, and these two sets of symptoms are hard to tease apart, which makes it difficult for clinicians to appropriately treat these women,” said Dr. Pauline Maki, professor of psychology and psychiatry in the University of Illinois at Chicago College of Medicine and co-lead author of the new guidelines.

“Many women experience a new onset of depressive symptoms. If there is underlying low-level depression to begin with, perimenopause can increase the intensity of depressive symptoms.”

The panel was co-chaired by Maki and Dr. Susan Kornstein, professor of psychiatry and obstetrics & gynecology at Virginia Commonwealth University and executive director of the Institute for Women’s Health at Virginia Commonwealth University.

The team reviewed the scientific literature on depressive disorders and symptoms in perimenopausal women and focused on five areas: epidemiology, clinical presentation, therapeutic effects of antidepressants, effects of hormone therapy, and efficacy of other therapies such as psychotherapy, exercise and natural products.

Perimenopause symptoms such as hot flashes and sleep disturbances often begin at this time and can co-occur and overlap with symptoms of depression, the new guidelines state.

“Eighty percent of women in menopause experience hot flashes, and when they occur at night, also known as the ‘night sweats,’ sleep can be interrupted. Persistent sleep disturbances caused by hot flashes contribute to the development or exacerbation of depressive symptoms,” said Maki.

In addition, perimenopausal women often juggle multiple responsibilities and face multiple stressors. They care for their own children, experience children leaving the home, help aging parents, retain primary responsibility for the home, and face increasing job demands at a time when they may be approaching the peak of their career.

All of this can be extremely stressful, Maki explained.

“Relationships can be taxed and the realities of aging can become quite apparent,” Maki said. “Life stressors, low social support and physical health problems are strongly related to depression during perimenopause.

“When you add in hormonal changes that can affect the brain’s ability to cope with these stressors, it’s no surprise that depression is a common occurrence in midlife women. The good news is that there are effective treatments.”

The root causes of perimenopausal depression can be hard to identify, said Maki. “Are women experiencing low energy because they are having night sweats and losing sleep? If so, treating with hormones may be the best bet,” she said.

“Alternatively, is a woman with a past history of depression having another depressive episode? In that case, antidepressant therapy might be most effective. Is the issue primarily due to family and job burden? If so, cognitive behavioral therapy with or without an antidepressant might be best.”

Maki added that while it is common for women with menopausal symptoms to experience depressive symptoms, most of the time those symptoms do not meet the criteria for a depression diagnosis. However, even low-level depressive symptoms can lower quality of life and strain relationships, and hormone therapy might help.

“It is important for women and their health care providers to recognize that these symptoms are common during perimenopause and can be treated,” she said.

Some of the findings of the panel include:

  • Perimenopause is a window of vulnerability for the development of both depressive symptoms and a diagnosis of major depressive disorder;
  • The risk for depressive symptoms is elevated during perimenopause even in women with no prior history of depression;
  • Clinicians should consider treating co-occurring sleep disturbance and night sweats as part of treatment for menopause-related depression;
  • Hormonal contraceptives may improve depressive symptoms in women approaching menopause.

“Perimenopause is a window of vulnerability for the development of both depressive symptoms and major depressive episodes,” Maki said.

“The recent suicide of Kate Spade at 55 years of age shows the seriousness of mental health issues in midlife women, a group that has shown a 45 percent increase in suicide rates over the past 15 years,” said Maki.

Source: University of Illinois at Chicago

 

 

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Even Mild Physical Activity May Boost Memory

New research suggests that even light workouts can improve brain function. Indeed, modest yoga exercises or tai chi may help with memory tasks such as remembering where you left the keys.

In the study, investigators at the University of California, Irvine and Japan’s University of Tsukuba found that even very light workouts can increase the connectivity between parts of the brain responsible for memory formation and storage.

In a study of 36 healthy young adults, the researchers discovered that a single 10-minute period of mild exertion can yield considerable cognitive benefits, confirmed by high-resolution functional magnetic resonance imaging (fMRI).

Investigators used fMRI technology to examine participants’ brains shortly after exercise sessions. In doing so, they observed better connectivity between the hippocampal dentate gyrus and cortical areas linked to detailed memory processing.

Their results appear in Proceedings of the National Academy of Sciences.

“The hippocampus is critical for the creation of new memories; it’s one of the first regions of the brain to deteriorate as we get older — and much more severely in Alzheimer’s disease,” said project co-leader Dr. Michael Yassa, a UCI professor. “Improving the function of the hippocampus holds much promise for improving memory in everyday settings.”

The neuroscientists found that the level of heightened connectivity predicted the degree of recall enhancement. Yassa, director of UCI’s Center for the Neurobiology of Learning and Memory, said that the new study expands prior research that centered on the way exercise promotes the generation of new brain cells in memory regions.

Specifically, the new study demonstrates a more immediate impact: strengthened communication between memory-focused parts of the brain.

“We don’t discount the possibility that new cells are being born, but that’s a process that takes a bit longer to unfold,” he said. “What we observed is that these 10-minute periods of exercise showed results immediately afterward.”

A little bit of physical activity can go a long way, Yassa stressed.

“It’s encouraging to see more people keeping track of their exercise habits — by monitoring the number of steps they’re taking, for example,” he said. “Even short walking breaks throughout the day may have considerable effects on improving memory and cognition.”

Yassa and his colleagues at UCI and at the University of Tsukuba are extending this avenue of research by testing older adults who are at greater risk of age-related mental impairment.

For this cohort, researchers are conducting long-term interventions to see if regular, brief, light exercise done daily for several weeks or months can have a positive impact on the brain’s structure and function in these subjects.

“Clearly, there is tremendous value to understanding the exercise prescription that best works in the elderly so that we can make recommendations for staving off cognitive decline,” he said.

Source: University of California Irvine

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Best of Our Blogs: September 25, 2018

I caught this quote at a popular pizza chain and it really resonated with me. I once heard you are the sum of the people you hang out with. If you want to live with more gratitude, who you surround yourself with is imperative to your success. Every time you attempt to see life in a positive light, they’ll pull you down into their negative reality.

It can be heartbreaking to end a relationship and do the steps you need to do such as the ones discussed this week. But doing the work to heal requires it. The gold at the end of the rainbow is, however, always worth the effort.

Single Women over 50 – What’s it Like to Date
(Thriving After 50) – Here’s the 411 of what it’s really like dating in the second half of your life.

An Introduction To Boundaries and Why We Need Them
(Psychology of Self) – Read this to understand the type of boundaries you set, why you need them and how they were formed.

How To Heal From a Narcissistic Parent
(The Exhausted Woman) – Recovery from a narcissistic parent may involve these seven steps.

3 Factors That Will Keep You Stuck If You Let Them
(Childhood Emotional Neglect) – Find out what beliefs and thoughts you need to continue on your path towards change and self-growth.

Emotional Leakage
(Radical Hope) – This post reveals who is most vulnerable to emotional leakage and what they need to do to cope.

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OCD and Muscular Dystrophy

The Usefulness of Collaborative CareObsessive-compulsive disorder (OCD) is largely characterized by obsessions and compulsions which can overtake a person’s life. While previously labeled as an anxiety disorder, it is now listed in the DSM 5 under the heading of obsessive-compulsive and related disorders.

While not technically an anxiety disorder, the majority of people with OCD deal with anxiety issues and might even be diagnosed with a specific anxiety disorder, such as Generalized Anxiety Disorder (GAD) or social anxiety disorder. Indeed, comorbid conditions with OCD are not unusual, and OCD can often be seen with depression and, to a lesser extent, with Bipolar Disorder and schizophrenia.

Now researchers have found that compared to the general population there is a higher than average prevalence of obsessive-compulsive disorder in those with Duchenne Muscular Dystrophy (DMD). DMD is a genetic illness that leads to progressive deterioration of muscle fibers. It usually only affects males but females can carry the mutated gene.

The study was published in May 2018 in the Journal of Child Neurology and was conducted by researchers from the University of Iowa. They worked on characterizing the clinical signs of OCD in those with DMD as well as its impact on patients and their families. The participants’ response to treatment was also studied.

The team reviewed the medical charts of 107 male patients aged 5-34 who had been treated at the University of Iowa Hospital and Clinics between 2012 and 2017. The study focused on a final group consisting of thirty-nine patients with DMD.  These patients, on the whole, exhibited higher levels than average of anxiety, depression and OCD, with symptoms of the disorders often overlapping. A total of fifteen subjects ranging in age from 5 – 23 exhibited signs of OCD. The mean age at onset was 12.1 years, but the study reported evidence of symptoms starting as early as age five.

The researchers said:

“Common initial symptoms included difficulty with changes in routine, repetitive behaviors, and organizational compulsions. Many patients required a very specific bedtime routine.”

“Our data affirm that internalizing disorders [OCD] are prevalent in the Duchenne muscular dystrophy population, warranting clinical attention and screening, as generally early diagnosis and treatment are associated with greater symptom improvement.”

Not surprisingly, the lives of families and patients with DMD are often negatively affected by the presence of obsessive-compulsive disorder. Distress and irritability in those suffering with both DMD and OCD significantly disturbed family routines and quality of life. Symptoms also tended to worsen as patients grew older, but treatment with selective serotonin reuptake inhibitors (SSRIs) resulted in consistent improvements over time. While medication did not completely resolve OCD symptoms, patients and their families reported they helped ease anxiety and improved their quality of life.

What I find particularly interesting about this study is that while psychotherapy (I’m hoping in the form of exposure and response prevention therapy) was recommended to all fifteen participants with OCD, only five were actually getting this treatment. In contrast fourteen of the fifteen subjects were taking SSRIs. The researchers attributed these statistics to a lack of access to qualified therapists as well as financial constraints felt by the families.

Once again, we see how difficult it can be for those with obsessive-compulsive disorder to get the proper treatment. Exposure and response prevention (ERP) therapy is the recommended, evidence-based psychological therapy for the treatment of OCD, but it is often out of reach for so many people. Those with DMD and OCD are likely to face unique challenges in terms of family accommodations and dynamics, and could benefit greatly from expert care and advice.

At the very least, this study brings OCD awareness to the forefront for those with DMD and their families. If OCD is recognized early and properly treated, its effect on lives can be minimal. And for those already living with the burden of DMD, that would surely be a good thing.

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Trial, Meet Error: The Story of a Pharmacy Regular

“Why isn’t this medication working?” me in 2002.

“Why isn’t this medication working?” me in 2018.

When the university nurse first prodded me to consider medication, I hesitated before eventually relenting. My reasoning: While this little white pill may not be my salvation, it surely can’t hurt.

Or can it?

Over the past 16 years, my medication history is longer than a typical Catholic wedding. A is for Abilify, B is for Buspar, C is for Clonazepam…and, well, you get the idea.

Medication, I naively hoped, would be a cure-all — a foolproof remedy for intrusive, tormenting thoughts. And while medication has, at times, lowered the volume on my depressive radio, it has come with its own set of challenges.  

Speaking from firsthand experience — now 16 years and counting, medications have potent and, at times, debilitating side effects. From complaining about grogginess to bouts of irritability to general apathy, my panicked emails to my dedicated health care team bear this out. Pinpointing the right medication is trial and error — in my case, a 16-year trial replete with lots of errors (and lethargy and grogginess and irritability).

When I first accepted the shiny white pill, at the university nurse’s gentle insistence, I had no idea I had just signed up for a 16-year medication joyride. In my naïveté, there was an implicit assumption — “just give the medication six weeks and life will suddenly become unicorns, rainbows, and free Beyonce concerts.”

Forget unicorns and a resplendent Beyonce sashaying in her yellow dress, I will take six weeks without a panic-stricken email to my dedicated health care provider (thank you, Dr. Neumaier, for your endless patience).

More than lamenting my own trials and tribulations, though, this article is intended for “Prozac Nation” — the millions of Americans seeking magic in a pill bottle as we shuffle from one supposed elixir to another. I understand the frustration — even despair — because I have lived it: the dry mouth, the racing heartbeat, the mental grogginess.  

After 16 years wandering in the (medication) desert, I believe I am inching closer to a long(er)-term solution. Knock on proverbial wood — or that Bartell’s counter that I have visited all too frequently. While Wellbutrin is far from perfect — and, yes, my mood vacillates more than Tesla stock — it is has provided a level of clarity and creativity. After years of medications numbing my mood, feelings, and, in some respects, life enjoyment, there is a level of comfort to know that there is a medication that, you know, actually works.

An estimated 40 million Americans now take a psychiatric drug; these drugs are as much of an American institution as the 9 to 5 and Thanksgiving family feuds. Despite prescription drugs’ ubiquity, however, their effects are deeply personal, even idiosyncratic (notwithstanding your health care professional’s calming reassurances that “you will feel better in no time”). For some, Prozac Nation may be an accurate title. For others, including yours truly, Wellbutrin World is a more fitting descriptor. One unmistakable lesson (and revelation) during my 16 years of medication cat and mouse: the best prescription may be, well, another prescription.  

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Breast Milk Best for Premature Babies’ Brain Development

Premature babies show better brain development when fed breast milk rather than formula, according to a new study.

Premature birth has been linked to an increased possibility of problems with learning and thinking skills in later life, which are thought to be linked to alterations in brain development, according to researchers at the University of Edinburgh.

Previous studies have shown that pre-term birth is associated with changes in the part of the brain’s structure that helps brain cells communicate with one another, known as white matter.

For their study, researchers studied MRI brain scans from 47 babies from a study group known as the Theirworld Edinburgh Birth Cohort.

The babies were born before 33 weeks gestation. Scans took place when they reached term-equivalent age, an average of 40 weeks from conception, the researchers reported.

The researchers also collected information about how the infants had been fed while in intensive care — either formula milk or breast milk from the mother or a donor.

The study found that babies who exclusively received breast milk for at least three-quarters of the days they spent in hospital showed improved brain connectivity.

The effects were greatest in babies who were fed breast milk for a greater proportion of their time spent in intensive care, the researchers discovered.

“Our findings suggest that brain development in the weeks after preterm birth is improved in babies who receive greater amounts of breast milk,” said Professor James Boardman, director of the Jennifer Brown Research Laboratory at the University of Edinburgh.

“This study highlights the need for more research to understand the role of early life nutrition for improving long-term outcomes for pre-term babies.”

“Mothers of pre-term babies should be supported to provide breast milk while their baby is in neonatal care — if they are able to and if their baby is well enough to receive milk — because this may give their children the best chance of healthy brain development,” he concluded.

The study was published in the journal NeuroImage.

Source: University of Edinburgh

Photo: The data suggest that brain connections in preterm babies are improved with greater amounts of breast milk in the weeks after birth. Credit: Jennifer Brown Research Laboratory, the University of Edinburgh.

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Regular Bedtime Can Help Keep Older Adults Healthy

A regular bedtime is not just for kids. A new study on sleep patterns suggests that a regular bedtime and wake time are just as important for heart and metabolic health among older adults.

In a study of 1,978 older adults, researchers at Duke Health and the Duke Clinical Research Institute found people with irregular sleep patterns weighed more, had higher blood sugar, higher blood pressure, and a higher projected risk of having a heart attack or stroke within 10 years than those who slept and woke at the same times every day.

Irregular sleepers were also more likely to report depression and stress than regular sleepers, both of which are tied to heart health, according to the researchers.

African-Americans had the most irregular sleep patterns compared to participants who were white, Chinese-American or Hispanic, the study’s findings showed.

The findings show an association — but not a cause-and-effect relationship — between sleep regularity and heart and metabolic health, according to the researchers.

“From our study, we can’t conclude that sleep irregularity results in health risks, or whether health conditions affect sleep,” said Jessica Lunsford-Avery, Ph.D., an assistant professor in psychiatry and behavioral sciences and the study’s lead author. “Perhaps all of these things are impacting each other.”

The data suggest tracking sleep regularity could help identify people at risk of disease, and where health disparities may impact specific groups, such as African Americans, she noted.

“Heart disease and diabetes are extremely common in the United States, are extremely costly, and also are leading causes of death in this country,” she said. “To the extent we can predict individuals at risk for these diseases, we may be able to prevent or delay their onset.”

For the study, participants used devices that tracked sleep schedules down to the minute so researchers could learn whether even subtle changes — going to bed at 10:10 p.m. instead of the usual 10 p.m. — were linked to the health of participants.

Study participants ranged in age from 54 to 93. People with diagnosed sleep disorders, such as sleep apnea, were not included in the study, she noted.

The study also tracked the duration of participants’ sleep and whether someone turned in early or was a night owl. According to these measures, people with hypertension tended to sleep more hours, and people with obesity tended to stay up later, the study discovered.

Of all three measures, however, regularity was the best at predicting someone’s heart and metabolic disease risk, the researchers found.

As one might expect, irregular sleepers experienced more sleepiness during the day and were less active, perhaps because they were tired, Lunsford-Avery said.

The study was published in the journal Scientific Reports.

Source: Duke University Medical Center

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