Trouble sleeping? Try Sleeping in a Cooler Room

Updated on Jun 30, 2022 | Sleep, Your Health

Most everyone appreciates the comforts of a warm, cozy bed. But if you’re having trouble sleeping, one suggestion is to try throwing off some of those blankets and avoid sleeping in a way that leads to overheating.

“If you have difficulty sleeping, you should err on the side of keeping the room a little colder,” says Andrew Varga, MD, PhD, at the Mount Sinai Integrative Sleep Center. And don’t pile on the blankets. If you’re too warm in bed, that can make sleeping difficult.

In this Q&A, Dr. Varga provides more insight into what makes for a good night’s sleep.

Experts say your body temperature goes up and down throughout the day, and it tends to decline at night. As you begin to fall asleep, your body temperature can drop by as much as a degree or two. Then, as morning approaches, your temperature starts to rise a little. Keeping your room on the cool side promotes the deepest levels of sleep.

“Some people think that if it’s snowing out, I should pull out my thickest comforter,” explains Dr. Varga, a physician and neuroscientist. “They end up being even warmer than in summer. And that could be making it a little harder for your body to get its optimal night’s rest.” In fact, the importance of the proper temperature is one reason you may have seen advertisements for cooling mattress pads and even cooling mattresses.

What room temperature is best?

There is no specific temperature that’s perfect for everyone. If you have trouble sleeping, consider lowering the room temperature a bit to see how it affects you. Many people find temperatures between 60 and 70 degrees to be most suitable. You may need to play around a little to determine what temperature works best for you.

Should everyone sleep in a cool room?

Some people are lucky when it comes to getting a good night’s slumber. They sleep well in a room that’s 60 degrees and one that’s 70 degrees. They get quality sleep regardless of the sirens, honking horns, and car alarms that punctuate New York’s nights. They aren’t even bothered by streetlamps, neon signs, and other light pollution.

If you’re one of these fortunate folks, you don’t have to worry about ambient temperature. This advice is only relevant for people who think they sleep too much, find themselves craving a catnap during the day, can’t fall asleep at night, or do something weird while they snooze, such as snoring, talking, walking, or even sleep-fighting. Sleep fighting is when someone shouts, punches or kicks during sleep. If you get a good seven or eight hours’ rest a night and feel like you’re already sleeping well, you probably are.

Why is it so important to get a good night’s sleep?

The importance of sleep is increasingly recognized. But people still don’t treat sleep as something that’s as important as diet and exercise. The three of them fall into the same category. We all pay attention to what we put into our bodies and how much we move them. We need to put the same amount of thought into how well and how long we power down.

Poor sleep over time has been linked to high blood pressure, diabetes, and certain types of cancer. It can also have an immediate impact on your life. If you don’t get a good night’s rest, you could feel tired, sluggish, and irritable, and you might find your reflexes are slower than usual. You might even mistakenly think you’re just fine. One of the symptoms of not getting enough sleep is the inability to recognize our own deficits.

What makes a good night’s sleep?

A good night’s sleep takes into account two things: quantity and quality. Quantity is easy. Almost everyone needs between seven and eight hours of sleep. A lot of people think they do just fine on, say, five hours a night. That’s true for some people, but the percentage of people who fit into that category is extremely small.

Sleep quality is more subjective. Some people worry if it takes more than a half-hour to fall asleep; others are concerned if they wake up more than once during the night; still others fret if they wake up in the middle of the night and can’t fall back asleep. If you have any questions, don’t ignore it. You should probably have it checked out. You can make an appointment with a sleep specialist who will review your medical history, make a diagnosis, and prepare a treatment plan. A specialists may ask you to keep a sleep log for two weeks and bring it with you for your initial consultation. Sometimes the evaluation will include an oversight sleep study.

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Is Asthma Worse When You’re Pregnant?

Updated on Jun 30, 2022 | Asthma, OB/GYN, Your Health

 

Pregnancy can be a difficult time for many women, but especially for those with the added burden of asthma.

Asthma, a chronic disease of the airways of the lungs, is one of the most common medical problems that occurs during pregnancy. Sonali Bose, MD, a pulmonologist at the Mount Sinai – National Jewish Health Respiratory Institute, explains how asthma can affect both the mother and child, and what you can do about it.

Why is my asthma worse when I am pregnant?
Asthma control during pregnancy can be unpredictable. Asthma may get worse during pregnancy because of the effects of hormonal changes associated with pregnancy. Some experts have proposed that changes in the hormone progesterone can have effects on the mother’s airways, such as influencing airway inflammation or its sensitivity, but the exact mechanisms are still unclear.

Another major reason that asthma may get worse during pregnancy is that many pregnant women tend to stop or decrease their asthma medications because they are worried about how these medications may affect their unborn child, which in turn may cause the mothers to have worse control of their asthma.

What are the symptoms of asthma during pregnancy?
Women with asthma may have variable symptoms over the course of their pregnancy. Women with poorly controlled asthma may have more severe respiratory symptoms, such as wheeze, chest tightness, or cough. Some women may be more likely to have an asthma attack, either during the pregnancy or even after delivery.

Is asthma dangerous during pregnancy?
Asthma is a serious disease for all patients, not just pregnant women. However, asthma control can get worse with pregnancy. The detrimental effects of asthma not only affect the mother, but we are increasingly discovering their serious effects on the health and development of the unborn child.

Women with uncontrolled asthma during pregnancy have been reported to have more complications, such as preeclampsia, pregnancy-induced hypertension, and preterm labor. Uncontrolled asthma during pregnancy may lead to poor growth of the fetus and low birth weight. But we need better research studies to improve our understanding of exactly how asthma during pregnancy affects both the mother and child.

Can asthma be transferred from mother to child?
Asthma does run in families. Children of mothers with uncontrolled asthma (for example, those who have had an asthma attack during pregnancy) may have a higher risk of developing asthma and other allergic diseases and chest infections, or have lower lung function during childhood.

How is asthma treated during pregnancy?
The goal for treating asthma during pregnancy is similar to that for patients who are not pregnant: focus on improving asthma control. Inhaled corticosteroids are still the main way of helping control asthma during pregnancy and are effective in treating airway inflammation and preventing an exacerbation.  These inhalers appear to be safe in pregnancy, and any risks are thought to be outweighed by the benefits of achieving good asthma control.

However, if an exacerbation occurs, oral steroids may be needed to treat it. In addition, we advise that pregnant mothers try to avoid their known environmental triggers and follow universal precautions to avoid contracting a respiratory infection. It is important to optimize asthma control even before becoming pregnant, because it seems that women who have more severe asthma before getting pregnant may be more vulnerable to having problems during their pregnancy.

Make an appointment with Sonali Bose, MD
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How Important Is Getting the Flu Shot?

Updated on Jun 30, 2022 | Cold and Flu, Infectious Diseases, Your Health

Despite all the media attention about the novel coronavirus, now known as COVID-19, influenza is currently a much bigger risk for most people in the United States. Yet many people do not plan to get a flu shot this year. You may be busy, or perhaps you think you might get sick from the shot, or that it’s not necessary. Matthew Weissman, MD, MBA, a primary care doctor with the Mount Sinai Health System, explains why you shouldn’t put it off.

Why should I get the flu shot?

The flu shot is extremely important. It not only prevents you from getting sick from flu, but it can lessen the severity of flu even if it’s not a perfect match for the type that is going around. For instance, my own daughter got the B strain of the flu. Luckily, she had a much milder case of it because she got the shot.

People forget that the flu is a deadly disease. Each season, tens of thousands of people die from the flu, and hundreds of thousands are hospitalized, according to the Centers for Disease Control and Prevention (CDC). Most of the people who died were not vaccinated. If you’re overweight, pregnant, elderly, or a child, or you have other diseases, you’re in a high-risk category. When you add all those up, you’re talking about a wide swath of New Yorkers.

Keep in mind that the flu shot doesn’t just protect you; it protects your co-workers, your classmates, your parents, and your grandparents—including people whose immune systems may not be good enough to build up their own defenses. It’s like a ripple effect, or herd immunity. It would be a great idea to have a workplace event for people to get vaccinated. It’s a smart idea for businesses to help cut down absenteeism this way.

Some people don’t get the shot because they think they’re going to feel sick for a couple days. Is that true or a myth?

People’s responses vary. Some people do feel a little feverish, get a sniffle, or have a sore arm for a bit. That’s actually a good sign, because it means their immune system is revving up to combat the flu. I think that’s a fair price to pay for not being incapacitated for over a week or being at risk of death from a vaccine-preventable illness. And these side effects don’t happen to everybody, and it doesn’t happen every time.

People have all kinds of excuses why they can’t get the flu shot. People are sometimes worried that the shot may cause a bad reaction because they have an egg allergy. But there are lots of ways to deal with that, including some vaccines that were not created using eggs. People should ask their doctor to find out what’s right for them.

Bottom line, the benefit of the flu vaccine outweighs the risk for most people, by far.

Is it too late to get a flu shot this season?

Definitely not. Flu season doesn’t appear to have peaked yet.  The flu season is generally during fall and winter. The CDC recommends that everyone six months or older get the flu shot. You can get it any time up until spring, so don’t wait.

Matthew A. Weissman, MD, MBA, is Chair of Medicine at Mount Sinai Downtown and Associate Professor of Medicine (General Internal Medicine), and Pediatrics, at Icahn School of Medicine at Mount Sinai

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Is Oat Milk the Best Milk for You?

Updated on Jun 30, 2022 | Diet and Nutrition, Your Health

The popularity of oat milk has exploded in the last few years. From Starbucks adding an oat milk beverage to its menu to Chobani launching a line of oat yogurts, it’s clear that oat milk is more than a fad.

However, is oat milk the best milk for you?

We spoke with Carrie Morowitz, RDN, a senior clinical dietitian at Mount Sinai Health System, about the recent popularity of oat milk and whether you should consider adding it to your diet.

The popularity of oat milk has grown exponentially. What do you think sparked this?

Oat milk has been around for a while, but in the past two years it has become much more popular. I believe that stems from a move to more plant-based products. Now companies are making oat milk-based yogurts, and oat milk is widely available in restaurants and cafes, something we never used to see.

A debate is raging: oat milk vs. almond milk vs. cow’s milk. Is oat milk a healthier option?
In certain ways, oat milk is healthier than other milk options. But in some other ways, it’s lacking. For example, oat milk has more fiber than cow’s milk or nut-based milk. An average cup of oat milk has about two grams of fiber. However, oat milk has more carbohydrates. That’s especially important if you’re trying to monitor your carb intake, or if you have diabetes. A glass of oat milk has about 15-20 grams of carbs, whereas a glass of regular cow’s milk has only about 8 grams. Oat milk is also vegan and contains no soy or nuts. So for people with common allergies or lactose intolerance, it’s a safer option.

Is oat milk gluten free?

Usually, oat milk is considered gluten free. But you need to check for the additives. If it is made with certified gluten-free oats, it’s a good gluten-free option.

Can oat milk replace cow’s milk in a traditional diet?

It depends on the individual. If you have diabetes, oat milk may not be the best option since it’s the highest carbohydrate-containing milk of those other options. If you’re a diabetic who already uses almond milk, I don’t think switching from almond milk to oat milk would be very beneficial. If you are looking to move towards a more plant-based diet, oat milk may be a good option for you. However, make sure to check the label and ensure that there are no added sugars, as a product simply being plant-based can trick you into thinking it’s the healthiest option.

Carrie Morowitz, RDN, is a senior clinical dietitian at Mount Sinai Health System.

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What You Need to Know About Lyme Disease Before Taking That Hike

Updated on Jun 30, 2022 | Your Health

Lyme disease can cause swollen joints, chronic fatigue, and a host of ailments that make diagnosis difficult. Erna M. Kojic, MD, Chief of Infectious Diseases at Mount Sinai Morningside and Mount Sinai West, explains the condition and whether you should worry if you feel lethargic a few days after a trek through the woods.

Is there a typical Lyme disease patient?

Each year, 30,000 people in the United States contract Lyme disease caused when a blacklegged tick—also known as a deer tick—carrying the Borrelia burgdorferi bacterium has fed on a person for at least 48 hours. The typical patient is someone who has been hiking, biking, or otherwise been active in a grassy, woody area, like those throughout upstate New York, Long Island, and other parts of the New York metropolitan area. Within a week of contracting a tick bite, they often develop a bullseye rash and experience flu-like symptoms, joint swelling, fever, and fatigue. After visiting an urgent or primary care physician, these patients will receive antibiotic treatment that will cure the disease.  

That being said, I often tell people that Lyme disease can be anything, and anything can be Lyme disease. Depending on how long the bacteria has been untreated, it can affect almost any part of the body, including the nervous system and the heart.

According to the Centers for Disease Control and Prevention (CDC), 20 to 30 percent of those infected with Lyme do not get the bullseye rash. Are there other warning signs?

Unfortunately, there are no foolproof warning signs. But there is a blood test for Lyme disease that you can receive if you experience flu-like symptoms after being active in a tick-infested area.

People who are infected can go untreated for a long time if they don’t see a rash and therefore don’t connect their fatigue with Lyme disease. Fortunately, patients with years-long, unmanaged Lyme disease can be treated with intravenous antibiotics. 

I thought my chronic fatigue was Lyme, but test results were negative. Should I get tested again?

When we test for Lyme disease, we look for specific antibodies that the body produces in response to infection. However, these antibodies cannot be detected until the bacteria has been present in the body for weeks. If you tested negative for Lyme disease but are still concerned that you have the condition, visit an infectious disease specialist.  

I was treated for Lyme, but I still feel fatigued. What should I do?

Although Lyme disease is curable with antibiotic treatment, some people develop something called Post-Treatment Lyme Disease Syndrome, in which joint pain and fatigue linger. This condition is manageable with physical therapy. I advise patients with these lingering symptoms to listen to their body, stay active, and trust that they will get back to their baseline in time.    

There is a common misconception that antibiotic treatment does not work, or that Lyme disease patients should remain on antibiotics indefinitely. This is incorrect.

Any advice for people who are at risk of contracting Lyme disease?

I often tell hikers, bikers, or anyone at risk for tick exposure to apply tick-repelling bug spray to bare skin and to treat their clothing with permethrin, an insect repellent. Permethrin is particularly useful as it kills ticks on contact, and it can last on clothing for several washes.  

I also tell patients that having had Lyme disease once does not prevent you from getting it again, so tick prevention remains important.

Finally, do not blame everything that is bothering you on Lyme disease. Because the disease is so multi-symptomatic, I have had patients miss serious conditions, like multiple sclerosis, because they believe they have Lyme disease. If you have had symptoms for quite a long time, and you test negative for Lyme disease, you should be looking for something else.

 

Erna M. Kojic, MD, is the Chief of the Division of Infectious Diseases at Mount Sinai Morningside and Mount Sinai West. She is board certified in Internal Medicine and Infectious Disease as well as a prolific researcher in the area of Human Papillomavirus (HPV) and HIV. 

Make an appointment with Dr. Kojic
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I Feel Sick. Should I Stay Home or Go to Work?

Updated on Jun 30, 2022 | Cold and Flu, Your Health

You wake up in the morning and you know you don’t feel right, but you can’t afford to be sick. Meetings to attend, deadlines to meet, kids to get to school—it’s not going to go away because you don’t feel good. Matthew Weissman, MD, MBA, a primary care doctor with the Mount Sinai Health System, offers some common-sense advice about when to stay home, and when to keep your kids home.

As New Yorkers, we feel this drive to keep going all the time. So many of us feel compelled to go to work even when they don’t feel well. When should people stay home from work?

Lots of us feel this pressure to show up to work, be tough, and work through it. But we’re doing a disservice to our colleagues and ourselves by doing that. Helping each other as good New Yorkers means that if you have symptoms such as fever, sneezing, runny nose, muscle aches, or fatigue, you should stay home. You should give your body—and your colleagues—a break and stay home.

How long should you stay home?

If you have a fever, you should stay home at least 24 hours after the fever goes away. And when flu symptoms are present, you should probably stay home for a week from the time the symptoms start. Maybe you can find an alternative way to work, like working from home, but that’s not an option for everyone. Perhaps you can find time to work when others aren’t around, or find a space that’s a bit secluded. But pushing yourself is never a good idea. It will just take that much longer to recover.

The other thing is that people are contagious 24 hours before they start showing signs of the flu. So that’s even more reason to practice good hand hygiene all the time, get your flu shot, and don’t share drinks, food, or toothbrushes with other people. You really have to be on alert all the time—not just when someone near you is coughing or sneezing.

What about keeping my kids home from school?

I know it’s tough on kids to miss school, so perhaps checking with your pediatrician is a good idea. If it’s just the sniffles and no fever, it may be okay for them to go. Or perhaps they can find a way to video chat into some classes. You certainly want to help prevent spreading colds and flu around the class. That’s why it’s important to teach kids about good hand hygiene, and to cover their cough with their elbow instead of their hands.

Sometimes when you’re sick, you are a bit torn. You wonder if it’s in your head, and you think about all the stuff you have to do.

It’s a balancing act. But think about it as an investment in the future. If you get some rest now, you’ll be more productive at work in the future. It may not be in our nature to slow down, and it may not seem like it’s what everyone else is doing. But it’s really important to protect our ability to function down the line. Because the flu will wipe you out for a week, at least, and then you’re really playing catch up.

The flu isn’t always just a few days of being under the weather. People forget that it’s a deadly disease, and can lead to other complications like pneumonia. So if you’re going to err, it might as well be on the side of safety.

Another thing that people wrestle with is, “Is this just a cold or is it the flu?”

That’s true. Many people confuse the flu with a cold, so it’s important to know the difference and to get checked out when appropriate, since the flu can be deadly. Colds tend to come with just runny noses, sneezing, and head symptoms, while influenza tends to have more bodily symptoms like muscle aches and fever. If it is the flu, treatment like Tamiflu is most effective in the first few days of symptoms. If it’s a bacterial infection, you may need antibiotics. If it’s a cold, the best thing you can do is rest and get plenty of fluids. Many times people come to us and feel they should have antibiotics. It’s important that doctors only prescribe antibiotics when needed; otherwise, patients may experience unnecessary side effects, or the antibiotics may not be as effective when you really need them.

And of course, you have New Yorkers who don’t want to give up their workout. Is it a bad idea to work out when you don’t feel well?

If you really have the flu, you’re going to feel debilitated and not feel like working out anyway. But if you just have the sniffles, you might feel better after a little exercise. Certainly you don’t want to contaminate people. But if you have a slight cold, it might feel better to get the blood pumping and your airways opened up. And you definitely want to wipe down the treadmill with an antiseptic wipe, and wash your hands before and after your workout. The gym is one of those places where you can come into contact with all kinds of germs.

Always listen to your body and let that (and your doctor) be your guide.

Matthew A. Weissman, MD, MBA, is Chair of Medicine at Mount Sinai Downtown and Associate Professor of Medicine (General Internal Medicine), and Pediatrics, at Icahn School of Medicine at Mount Sinai

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