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Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 03 November 2014

Insomnia Guide

What is Insomnia?

Insomnia is a condition in which a patient has serious issues falling asleep, or wakes up frequently throughout the night. Insomnia refers to a number of sleep issues, and can be diagnosed when the patient:

  • Has Trouble Getting to Sleep

  • Is Restlessness During Sleep

  • Sleeps for a Short Time and Wakes Up Unable to Fall Asleep Again

  • Wakes Up Before One is Rested

  • Is Fatigued Even After Rest

Kinds of Insomnia

There are two main categories of Insomnia, based upon the root source of the condition: Primary Insomnia and Secondary Insomnia

What is Primary Insomnia?

Primary Insomnia refers to sleep issues that are not caused by other health issues that the patient experiences.

What is Secondary Insomnia?

Secondary Insomnia refers to sleep issues that are related to other aspects of a patient's health state or lifestyle. There are a number of subcategories here:

  • Emotional issues such as depression and anxiety can lead to Insomnia

  • Health problems such as heartburn, cancer, or arthritis can lead to Insomnia

  • Lifestyle issues such as drinking or shift work can lead to Insomnia

Chronic and Acute Insomnia

Insomnia is also categorized by frequency and duration. Chronic Insomnia refers to Insomnia which has been an issue in the patient's life for an extended period of time, whereas Acute Insomnia refers to temporary, yet still significant sleep disruption. Some patients deal with Chronic Insomnia day after day, whereas others only experience the condition under certain circumstances.

From a medical perspective, Chronic Insomnia refers to sleep disruption which lasts for at least a month and manifests itself at least 3 times per week, whereas Acute Insomnia refers to Insomnia which only occurs a single time or over the course of less than a month.

What Causes Acute Insomnia?

Acute Insomnia is generally the result of factors and changes in one's life, including stress and environment. As such, usually Acute Insomnia can be treated through changing one's habits. The following are some factors which can lead to Acute Insomnia:

  • Disruption of Sleeping Habits resulting from Lifestyle Adjustments

  • Certain Medications, including those for Asthma, Hypertension, Depression, Allergies, and Cold

  • Environmental disruptions, including uncomfortable heat or cold, light, or noise

  • Uncomfortable sleeping arrangements

  • Emotional distress

  • Illness

  • Major stress, such as stress resulting from moving, divorce, mourning, or employment changes

What Causes Chronic Insomnia?

There are certain conditions in one's life which can lead to Chronic Insomnia, but in the case of Primary Insomnia, the root cause is physiological and direct. Secondary causes of Chronic Insomnia include:

  • Discomfort or pain which make it hard to fall asleep

  • Chronic stress which prevents the body and mind from successfully falling asleep

  • Anxiety and depression which make it difficult to prime the mind for restful sleep

What Are the Symptoms of Insomnia?

Sleep is incredibly important. Our bodies use the time that we are asleep to rebuild and rejuvenate our bodies. Our brains also use sleep to form long term memories and remember important information. Hormone Balance is also predicated on healthy sleep, as Testosterone and Human Growth Hormone, along with other hormones, are primarily produced while we are asleep. The following are some of the most common symptoms of Insomnia:

  • Forgetfulness

  • Trouble Concentrating

  • General Exhaustion

  • Daytime Sleepiness, or a Tendency to Fall Asleep During the Day

How is Insomnia Diagnosed?

Unlike many other conditions, it's pretty easy to recognize when one is suffering from Insomnia, although patients that wake up exhausted may be less likely to seek assistance as quickly as those that experience frequent sleepless nights. If you believe that you are experiencing Insomnia, make an appointment with a health professional.

During your appointment, you'll usually provide a medical history, and your doctor will perform a physical in order to evaluate your condition. You'll also, obviously, need to report the sleeping issues that you've been experiencing, including the severity and the duration of your issues.

Most doctors will request that you maintain a diary of your sleeping habits over the course of a couple of weeks, in which you write down when you remember falling asleep and waking up, as well as your energy levels during the day. If you have a partner, your doctor may want to discuss your sleeping habits with them in order to learn more about your sleeping habits, including any snoring or restlessness that you may not experience consciously.

If your doctor suspects sleep apnea, or another condition which inhibits sleep which can't be effectively diagnosed without actually monitoring your sleep, they may arrange for you to go to a sleep specialist.

How is Insomnia Treated?

How Insomnia is treated depends upon the severity and the duration of the Insomnia. For patients that experience short term, Acute Insomnia, no treatment may be needed at all, or the treatment may just be minor, perhaps even just a simple OTC Sleep Aid.

For patients with light Insomnia, the best form of treatment is often lifestyle adjustment—making the effort to engage in healthy and conscientious sleeping habits.

For patients that are experiencing Chronic Insomnia which is impacting their ability to perform in their Day-to-Day life, your physician may provide you with one of many prescription medications designed to help you fall asleep easier. Generally, these treatments are only prescribed short term, as the goal is to restore a normalized sleeping pattern and then train the patient to sleep better on his or her own.

For Chronic Insomnia, the ideal prescription medication for most patient activates rapidly and helps the patient fall asleep quickly before wearing off, allowing the patient to sleep restfully throughout the rest of the night. For these patients, OTC Sleep Aids aren't enough under most circumstances, and long term use of these sleep aids can lead to side-effects which can even exacerbate Insomnia in the long term.

Of course, one of the most important aspects of Chronic Insomnia diagnosis and treatment is to discover whether the patient is suffering from Primary or Secondary Insomnia. The physical and medical history will provide evidence as to any underlying conditions which may be preventing healthy sleep. By treating these conditions, and helping the patient fall asleep more easily in the meantime, it is often possible to help the patient overcome Insomnia completely.

Cognitive Behavioral Therapy is also highly effective for the treatment of Insomnia, because there are certain patterns and behaviors which can exacerbate Insomnia, or may even be the root cause of Chronic Insomnia. Some forms of therapy which have shown significant effectiveness are reconditioning, sleep restriction, and relaxation techniques.

How Can I Overcome Insomnia with Good Habits?

If you are having issues with Acute Insomnia and would like to try to fix the problem on your own before seeing a specialist, there are some smart steps you can take to improve your sleep hygiene and improve your sleeping habits. Try incorporating these tips into your life and see what happens:

  • Don't smoke or use caffeine in the early afternoon or evening—These vices have the capacity to cause or exacerbate anxiety. Both nicotine and caffeine are stimulants, and if you use them late, it can make it really hard to go to sleep if you have a sleep sensitivity. Caffeine has a half life of around 5 or 6 hours, so you should have your last cup of coffee at least six hours before bed, if not nine hours.

  • Don't drink in the evening—Alcohol can help you go to sleep, but the intoxicating effects will wear off while you are asleep, and this can cause you to wake up early and hungover.

  • Establish a stable sleeping pattern—For people with Insomnia, making the effort to create a normalized sleeping pattern can be highly beneficial. Your body prefers to run on an established 24 hour pattern, and deviating from that pattern can have consequences in the form of poor sleep and insomnia.

  • Avoid naps—Although some people function well with an afternoon nap, for people with Insomnia, a nap can lead to nighttime restlessness that prevents them from getting healthy sleep.

  • Exercise Regularly—Exercise stimulates your body and helps you establish set physiological patterns. If you don't get enough exercise, this can cause you to experience symptoms of Chronic Fatigue, which can leave you constantly tired but unable to sleep well. Of course, it's important to exercise at the right time. Exercise is a highly stimulative activity, so its best for the morning or early afternoon, when you would normally find yourself dragging. Daytime exercise can help you sleep better, but if you exercise in the 3-4 hours before bed, this can get you too stimulated to sleep.

  • Don't eat too much just before bedtime—Many people make the mistake of loading up on a big meal late in the evening before bed. Although it is true that a light, protein-based snack can provide healthy benefits while you sleep, a big meal weighs you down and puts a strain on your digestive system, which slows down when you fall asleep.

  • Create a comfortable and inviting sleep space—Often, people have trouble sleeping because they don't have their bedroom designed with a healthy night's sleep in mind. Excess light and sound can make it really hard to sleep. Also, be sure to turn your thermostat to a temperature that really puts you in a comfortable mood.

  • Establish patterns before bed to help you relax—Try to follow the same pattern every night, and your body will adopt the pattern and promote restfulness. Take a hot shower before taking a half hour to wind down with a book, for example.

  • Don't use your bed as an entertainment space—Too often, people have trouble getting to sleep, because they watch television or play games on their laptop or cell phone in bed. Anything that stimulates you in bed (besides sex) is counterproductive.

  • Don't Stay in Bed When You Can't Sleep—If you find yourself dwelling on the fact that you can't sleep, get out of bed and do something else. It can actually make it even harder to fall asleep if you don't get out of bed. Spend thirty minutes or so doing something like reading or organizing that doesn't get you too active.

  • Keep a To-Do List—For people that have trouble sleeping because of anxiety and worry, it can be helpful to write down a list of things you need to do in the near future. Create a time line or a grocery list. Write a list of your worries. Once you get your worries down on paper, push them out of your mind until the next morning.


Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 23 October 2014

The Importance and Purpose of Stress

You hear a lot about the bad things associated with stress these days. Too much stress causes a plethora of problems that are bad for both our mind and our body. It's largely a symptom of the world we live in, with all of its pressures. Of course, stress is a natural, physiological response that is important, in spite of the issues that it causes when we experience stress in abundance.

Perhaps the biggest issue with stress isn't necessarily the source of stress, but rather the way that you respond to that stress. Let's take the remainder of this article to discuss stress in more detail—why we experience it, how it benefits us, and how it can harm us.

Stress is complex. It's not only a psychological feeling, it represents the physiological way that our bodies respond to stressors. Although physical and psychological stress may seem very different on the outside, our bodies react to them in the same way.

What is Stress?

Stress is a feeling that you get when you consciously or subconsciously feel that you are unable to meet obligations and expectations. It's a feeling that you get when something inside of you tells you that you can't do something.

What Are the Different Kinds of Stress?

There are different forms of stress. Some people experience chronic stress, meaning that they are plagued by such feelings that leave them drained. Sometimes, stress is episodic, meaning that it comes and goes as a result of certain psychological, social, or physiological cues. Acute stress is also a problem that some people experience. Acute stress is when things that elicit a stress response have a larger effect on an individual than they should.

Everyone has their own stress profile, and have their own reasons why they get stressed. Stress can be categorized into two forms: Extrinsic and Intrinsic stress. Extrinsic stress is the result of factors outside of yourself, like when you have a big project or presentation due at work, or you're flirting with someone that you're attracted to. Intrinsic stress is stress that is the result of things going on inside of your own head. Perhaps you've built walls inside yourself that you have to overcome to be social, for example. Or maybe you find yourself questioning your self-worth. These are forms of intrinsic stress.

Your feelings of stress actually represent physiological changes that are going on inside your body in an attempt to help you deal with stressors. These physiological changes are associated with what is known as the fight-or-flight response. When you feel stress, your sympathetic nervous system activates. The sympathetic nervous system gets your body ready to deal with immediate issues, whether you are risking life and limb, or feel anxiety about an upcoming exam.

When you feel stressed, your body responds in a system-wide manner. When stress activates the sympathetic nervous system, your body experiences a veritable flood of Hormone and Neurological response, all designed to help you overcome that stress.

What Are the Phases of Stress Response?

Stress response can be divided into three different phases:

Stage One: Alarm

The first response to stress is alarm. Alarm represents the recognition of a perceived threat, which initially activates the sympathetic nervous system response. During this phase of stress response, the brain sends signals to systems all throughout the body to go on high-alert. This response is mediated by the Hypothalamus, which is considered the “control center” of the human brain. An important part of the alarm phase is the activation of the adrenal glands, which produce cortisol and other stress hormones.

As these signals circulate through the body, they encourage a wide variety of changes. For example, stress primes your circulatory system to send oxygen to the skeletal muscles and brain, and it speeds up the lungs and heart. At the same time, your body's baseline functions, such as digestion, slow down. This is your body's way of getting you out of a threatening situation, temporarily sacrificing your normal function to get you out of harm's way, or stir you to take action. Your body also sends energy in the form of glucose to these organs, getting you ready to put it all on the line, if necessary.

The issue with the way that the body prepares for stress, is that there isn't really a meaningful mechanism for the brain to differentiate between different forms of stress, whether that stress is menial or life threatening, minor or major. Stress developed as an evolutionary response, and it is present in all complex animals. The fact that physical and emotional stress are handled in the exact same way by the body is a hold-over from our ancestors. The body's response to psychological stress in the modern world, therefore, can be overkill, to say the least. This is why many people feel overwhelmed by stress, and we've all likely felt this way at some point or another.

Stage Two: Resistance

The second phase of stress is resistance. During this phase, your body has prepared itself for response, giving you the tools to respond to stress. Your brain has altered your physiological priorities for action. During the resistance phase, the Hypothalamus initiates another Hormone Cascade designed to amplify and enhance your response to stress further. During this period, the Hypothalamus secretes three important hormones, known as Thyrotrophic-Releasing Hormone, Growth Hormone-Releasing Hormone, and Corticotrophin-Releasing Hormone.

This phase of stress response is designed to keep your body adapted to ongoing stress. This second phase heightens the body's preparedness in a variety of ways, all designed to protect you in a high-pressure situation. For example, the body starts catabolizing proteins and fatty acids into glucose. This provides energy to your muscles, even if you don't have carbohydrate energy immediately available. Also during the resistance phase, the body increases salt and water retention to protect you in case you start bleeding or are seriously hurt.

Another aspect of stress response is that the brain suppresses sensations of pain so that one can make it through a stressful situation alive and in one piece. This is why, for example, if you get in a fight or a car crash, you will likely underestimate your pain levels until after the damage is done.

Again, these changes are designed to keep us alive and to help us win fights or run away, but we also respond with stress in myriad of situations which are far more benign.

Stage Three: Exhaustive

The third phase of stress is exhaustive. This is the body's response to long bouts of stress or chronic stress, which are different than a stressor which can be dealt with quickly. It is this form of stress which can be most detrimental to health and wellness, because the body functions optimally when it only activates sympathetic response when needed, rather than leaving stress “on” all the time.

Exhaustive Stress is the result of extended periods of excessively high pressure and alertness which inhibit health and wellness. Exhaustive Stress will eventually lead to a condition known as Adrenal Fatigue, in which the body is no longer able to produce enough stress hormones, and this also drains the body of the resources necessary to produce other hormones such as HGH and Testosterone which are associated with healthy and optimal function.

Exhaustive Stress can be divided into two categories, although the body will respond in the same manner. Some people experience this form of stress for an explicit reason. For example, military personnel can experience Exhaustive Stress as a result of long-term high-stakes situations which necessitate peak performance.

The second category belongs to ordinary people that experience exhaustive levels of stress as a result of their body's chronic over-response to everyday stressors or psychological stress. For example, people with PTSD or high levels of anxiety can be so on edge that their bodies spend an overwhelming amount of time in a stress phase, putting undue pressure on the body. Also, many people experience exhaustive stress as a result of issues such as chronic pain. Stress is not only psychological, but physical, and the body responds to physical pain with a sympathetic stress response.

Exhaustive Stress weakens the immune system, as stress response is designed to protect one against immediate threats. The catabolic processes which create energy from protein also eat away at muscle tissue, depleting strength and reducing energy levels over time. The body also loses its ability to produce hormones effectively, which can actually leave you more susceptible to pain over time. Exhaustive stress is dangerous and significantly increases mortality risk from a variety of sources if not dealt with appropriately.

Healthy Stress Associated with Enhanced Performance

Although too much stress is obviously very bad, experiencing just enough stress can be extremely beneficial, which explains why human beings still experience stress. Stress is designed to be a temporary response to “get you into the game.” It gets your body and mind ready to take action. If you don't experience any stress, you aren't ready to do what you need to do, but if you have too much stress, you lose everything beneficial about stress and only experience the negative aspects of stress.

Of course, psychological stress is more multifaceted than we've described in this article, but this provides a rough sketch of how stress “works.” There are many different types of stressors, and different people obviously get stressed about different things. For example, some people experience stress as a result of difficult tasks, where as others experience stress as a result of simpler, more repetitive tasks. Some people experience existential anxiety, whereas others experience excess stress as a result of social interactions.

Stress is Not Always Tangible

As a result of both the complexities of modern life, and the complexities of the human mind, not all stress is the result of events in our day-to-day lives. Unlike most animals, we have an internal dialog, and internal hopes and dreams, and our stress can actually be the result of things going on inside of our own head rather than our response to the world around us and our preconditions. This is one of the reasons why human beings are so susceptible to stress—our brains and our culture have evolved in a way that can potentially cause our natural, evolutionary response to stress to work against us.

How to Deal With Stress

Part of learning to deal with stress is learning about what causes it, and how our bodies and minds respond to stress as a single unit. Many patients can learn to deal with stress through cognitive behavioral therapy. Others benefit from physical activities that relieve stress such as exercise or yoga. Because the body and mind both respond to physiological stress response, taking steps to relax the body can relax the mind. The reverse is also true, which is why meditation and cognitive therapy can also relieve symptoms of physical stress.

Hormone Imbalance also both contributes to stress, and is a side effect of Adrenal Fatigue and Exhaustive Stress (which, in many ways, are one in the same). Excess physical and psychological stress cause the body to favor hormones which benefit the individual immediately, while limiting the body's ability to produce hormones associated with homeostasis and balance, such as Growth Hormone and Testosterone. Long term, extreme stress drains the body's ability to effectively produce all of these hormones, leaving the patient in an even more dire state.

Manage Stress to Improve Health and Wellness

Controlling stress is one of the key factors of living a healthy life. If you are having trouble with stress, and your personal efforts aren't enough, it would benefit you greatly to visit a life coach, psychologist, or even a fitness, nutrition, or wellness specialist. There's no reason to let yourself be eaten alive by stress, when there are things you can do and people you can talk to that can help you. Learn to master your stress for a happier and healthier life!


Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 16 October 2014

Alcohol Appears to Impact Sperm Quality Based on Consumption

It has long been known that alcohol has a significant effect upon human sexuality, especially in males. For example, there is strong evidence that the abuse of alcohol has powerful effects on erectile function and libido, and that it also suppresses Testosterone Production. New research, conducted in Denmark, suggests that Alcohol use also has a direct impact on sperm quality, and at drinking levels that are somewhat lower than you might expect.

In this study, a total of 1221 men were examined, all of which were no younger than 18 and no older than 28. In Denmark, all men are required to undergo a physical in order to assess their ability to serve in the Danish military. Men are technically conscripted to military service in Denmark, but in the end, only less than 10% of their military is drafted. These physicals do provide a host of medical data which can be used for clinical analysis, however.

Part of their physical is oral, and patients were asked about their history of alcohol use. Participants were asked the following questions regarding their alcohol use:

  • How much alcohol did you drink in the last week?

  • Is this level of alcohol consumption normal?

  • How often do you engage in binge drinking (more than five drinks in one day)

  • How many times have you been inebriated in the last month?

During their physical, the participants were also encouraged to voluntarily provide a blood sample and semen sample for analysis. These samples were diagnostically analyzed in order to provide a snapshot of both the hormone balance (via blood sample) and the sperm health (via semen sample) of the participants.

How Much Do Young Men Drink in Denmark?

The data shows that young men in Denmark drink quite a bit. Overall, participants averaged eleven drinks in the previous seven days. Out of all of the men, almost 60% were inebriated more than two times in the last month, and nearly two out of three had went out on a binge at least once in the last month.

How Does Alcohol Affect Sperm Quality?

Based on the data, there appeared to be no direct link between the amount of alcohol drunk or the amount of binge drinking performed in the prior month. This seems to suggest that alcohol itself does not have any long-term effects on sperm quality. On the other hand, men that drank in the last week did have suppressed sex-hormone levels, and the level of suppression was directly correlated with the amount of alcohol consumed.

What researchers found was that, among these drinkers, levels of Testosterone in the blood stream increased, and Sex Hormone-Binding Globulin Levels in the blood stream dropped. These changes in hormone balance were also notable among men that engaged in binge drinking or heavy drinking performed in the last month, and were correlated both with the amount of binging and the number of times that the participants got drunk in the last thirty days.

Nearly half of the participants in this study admitted that the amount that they drank in the last week was normal for them every week. Researchers looked into the sperm health of participants that steadily drank the same amount every week and found that the more that they drank per week, the weaker their sperm health, particularly in the proportion of normal and healthy sperm to malformed sperm, as well as the overall sperm production of the male. Researchers controlled for a variety of factors to increase the power of the results.

What researchers found was that men started to have issues with sperm quality when they drank five or more drinks per week. These effects were notable but not powerful at lower levels of consumption, but men that drank at least 25 drinks per week experienced readily apparent changes in sperm health and production.

Men that drank 40 drinks each week, minimum, for example, had sperm counts that were 2/3s of males that drank one to five beers per week. The heavy drinkers also had more than 50% less healthy sperm, compared to light drinkers. Fertility depends on both sperm quality and sperm count, and both are very important. Healthy sperm is also vitally important for fertilization. Sperm that have more than one tail, or have tails which function abnormally, for example, won't be able to effectively reach their destination.

Overall, Hormone Production was most significantly affected by recent alcohol consumption, although alcohol consumption over the prior month did play a notable role. Interestingly enough, light drinkers were the group most likely to have the healthiest sperm. Men that drank 1-5 drinks per week had healthier sperm than those that drank no alcohol at all.

What Can Be Learned from this Study?

It's important to note that, by the nature of this study, it is impossible to draw definite conclusions regarding how alcohol impacts reproductive health, because of the number of factors at play which are not sufficiently controlled for. For example, these differences in sexual health could be compounded by other factors of behavior and lifestyle. For example, men that are sedentary produce less Testosterone, as well as men that smoke.ffffff

Although this study does not have definitive power alone, it does corroborate with evidence collected in other, more controlled studies, particularly those conducted in animal research. There is undeniable evidence that in animal research, alcohol does have a negative influence on sperm health.

Why Is This Study Important?

There isn't a lot of data out there regarding how alcohol effects healthy men. The researchers believe that this is the first research of its kind to evaluate hormone and sperm quality as a function of alcohol consumption in healthy men. Europe, as a whole, as well as the United States, is known for its alcohol consumption, so it is vitally important to learn more about how drinking impacts health at every stage of life, and that includes reproductive health.

It's also important to gather this data so that young men understand all of the risks associated with their vices, and how alcohol can impact their health.

This information is also important for older men, or men that are having trouble conceiving a child with their partner, because it shows how alcohol can potentially be a roadblock to both hormone health and the ability to easily have children. It shows that cutting back on alcohol potentially increases the body's ability to produce both Testosterone and healthy sperm.

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