Mark Twain and Alternative Medicine

BY HARRIET HALL, M.D.

What do you know about Mark Twain? That he was a famous humorist? That he wrote Tom Sawyer and Huckleberry Finn? Maybe you know he questioned many conventions like organized religion. What you may not know is that he was an enthusiastic proponent of “alternative medicine” long before the term was coined.

Mark Twain, the pen name of Samuel Clemens, was born in 1835, long before germ theory, antibiotics, randomized clinical trials, or modern vaccines. The medicine of his day was pre-scientific and unregulated, splintered into sects with allopaths, homeopaths, hydrotherapists, osteopaths, and others battling each other for primacy. Anyone could practice medicine without a license. Twain had no rational basis for choosing one sect over another.

Twain always feared death, with good reason. In his day, life was very uncertain, with 25 percent of children dying before their first birthday, and 50 percent by age 21. Twain was a premature, sickly child. As an adult, he asked his mother if she had been afraid he wouldn’t live; he claims she said no, she was afraid he would! He saw four of his siblings die. Frequent epidemics of smallpox, cholera, and scarlet fever tore through the population; mortality was high due to poor nutrition and poor public sanitation.

As a child, Twain was so afraid of measles that he decided to put an end to the fear by catching measles; he deliberately exposed himself to a patient. He found that having measles was nowhere near as bad as the fear had been. He learned there was something worse than death: worrying about it.

Twain was raised with alternative medicine. His mother, Jane Clemens, dabbled in everything from homeopathy to spiritualism to patent medicines. As a boy, Twain saw a faith healer cure his mother’s toothache with suggestion. His mother frequently dosed him with Perry Davis’ “Pain Killer” — a mixture of alcohol, camphor, and cayenne pepper. All treatments apparently worked: he survived.

As an adult, Twain experimented with everything, sampling every system of medical treatment. He thought there was no reliable way to find out why people got sick or the best way to make them well. Back then, there wasn't; but today we do have a reliable way: science. Twain thought that if enough treatments were sampled, there might be a remote chance of finding one that actually worked. […]

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Resistance Bands: The Pros & Cons of Elastic Resistance

by Tom Venuto, from the Burn the Fat, Feed the Muscle e-zine

Do resistance bands build muscle? Yes. You can build muscle with resistance band training, there's no question about that. If you stop lifting and switch to bands only, you can probably maintain most of the muscle size that you previously built with free weights as well (maybe all of it).  If you have more casual fitness goals, band training only or band training combined with bodyweight training is a perfectly valid option that can produce some nice results if you make it a point to train progressively.

Muscle is built through resistance training where tension is placed on a muscle and then the amount of tension is increased over time. This is known as progressive overload. Bands are a form of resistance just like free weights. Doing exercises with any form of resistance can build muscle, and muscle growth can continue with any type of resistance as long as you can apply progressive overload over time.

Pros And Cons Of Elastic Resistance Band Training: Maybe the biggest advantage of bands is they are light, portable and convenient. They can be tossed in a gym bag or backpack or packed in a suitcase. Even a whole set of bands is still incredibly lightweight. That makes bands fantastic for training while you are traveling. Even if training with free weights is your primary type of workout there's no question you can at least maintain your gains while you're on the road with band training.

The fact that bands are small and portable also means they're a great tool for people who want to train at home and don't want to join a gym. Whether that's to save driving time, to have solitude instead of crowds, or to save on gym membership dues, these are all valid reasons to train at home.

Versatility is another benefit of resistance bands. This is especially true if you compare bands to weight machines because many exercise machines only allow you to perform one exercise or just a few exercises. There's huge number of exercises you can do with a single set of elastic bands. There are so many, it's almost limited only by your imagination.

On a similar note, bands are unique in the way they offer resistance through various angles and planes of motion that can't be duplicated by free weights. That's because the bands don't depend on gravity to provide the resistance. With one band, you can do pushing and pulling exercises through countless different angles that would require multiple machines costing thousands of dollars each to duplicate. In addition, many of these angles can't be duplicated at all with free weights because gravity only pulls weight one way - down.

Many studies on band training were performed with elderly people as subjects. When you look at the results of this research you see that not only were they able to gain muscle and strength, but also the ease, convenience and safety of bands made them a good choice for that demographic, even people with osteoarthritis (fibromyalgia too). There are also clinical and rehabilitative applications for elastic resistance, as well as sports and athletic training uses. These are beyond the scope of this short article but chalk them up as yet more benefits for bands.

Bands are generally considered very safe, but they can break, resulting in an accident as minor (but painful) as a giant rubber band snap, or as serious as losing an eyeball. The quality of bands can vary and some may be more susceptible to breakage than others. If you overstretch a lighter band, when instead you should have moved up to a heavier band, that also increases the risk.

In addition, if a band is not properly secured to an anchor, it can snap back and strike you even though it didn't break. This can easily happen when you're standing on a band to anchor it and it slips out from underneath your foot. Bands are considered a very joint-friendly form of training, but as you can see, injuries can arrive in other forms than exercise-induced joint pain.

We also need to acknowledge the downsides of band training. One of the major drawbacks of elastic resistance is that it's more difficult to apply progressive overload with any kind of precision. You can apply progressive overload with band training, but it's harder to quantify. The more a band is stretched, the more resistance it provides. One band does not equate to one specific number of pounds of resistance. You can systematically apply overload by simply stretching the band more, but you can't quantify the resistance with an exact number.

It's much easier to track your progress and see the load increases with free weight training. You can count it right down to the pound by tracking volume load. With weight training, you can use a 100 pound barbell on workout one, and then 105 on workout two, 110 on workout three and so on, or whatever exact amount of resistance you need. Multiply the weight by the sets and reps and you have your total volume load and you can confirm if it went up or not. There are bands that provide different levels of resistance, and they are usually even advertised with a poundage number, but this still doesn't provide the precision of free weights.

Concluding Thoughts And Recommendations: If your goal is general fitness and a muscular physique, there's little doubt you can achieve your goals with bands alone, or bands combined with bodyweight and or free weight exercises. If you train at home, bands are a great tool to have. If you travel a lot, they are incredibly useful. I'd also recommend you learn how to do some bodyweight exercises as well. Bodyweight training can be almost equally useful for home and travel training.

If you're in the older age demographic and intimidated by free weights or suffering from osteoarthritis, bands can be an excellent tool. If you're working around joint pain or injuries, bands are a good choice for rehabilitation at any age. Bands can be useful to almost everyone for occasional variety or convenience. I think it's worth it for everyone, regardless of goals, to invest in some resistance bands and experiment with some band training.

Scientific References: Lopes J et al, Effects of training with elastic resistance versus conventional resistance on muscular strength: A systematic review and meta-analysis, Sage Open Medicine, 7: 20, 2019

Can Simply Listening To Nature Be Good For Your Health?

from The Optimist Daily e-zine

There are few things as relaxing as the whisper of wind through the trees or the camping sound of a mountain stream, but it turns out these sounds do more than just help you fall asleep. It turns out that the sounds of nature can actually be beneficial for your health. Listening to nature-made noise can decrease stress and pain, improve cognitive performance, enhance mood, and much more.

A group of researchers from Michigan State University, Carleton University, and Colorado State University partnered with the National Park Service to analyze 18 studies on how natural sounds can impact human health. Their results, published in Proceedings of the National Academy of Sciences, shows that listening to existing noises in nature has incredibly positive effects, including a decrease in stress and pain, an improvement in cognitive performance, an enhancement in mood, and much more. The research even goes into further detail outlining which particular sounds might bring about specific benefits.

Why we have such a positive response to certain natural sounds isn’t completely clear, but researchers have their theories. To explore the possible health benefits of natural sounds, the team studied more than 10 years' worth of studies conducted around the world. Researchers found that activity in the brain’s default mode network differed in listening to natural sounds versus man-made sounds. Natural sounds resulted in outward focus of attention, whereas man-made sounds evoked an inward focus of attention—a pattern linked to stress.

Buxton, a professor at Carleton University in Ottawa, Canada, conducted a statistical analysis with her team that synthesized results and found that bird sounds helped alleviate stress and annoyance. And water sounds enhanced positive emotions like tranquility, awareness, and relaxation. Buxton’s team encourages people to find inspiration in the Japanese practice of “forest bathing” by visiting a national park or participating in innovative programs, such as sound walks, designed to increase our appreciation of natural sounds that already exist.

The Cathedral Grove in Muir Woods, California is designed as a serene place  where visitors can appreciate nature quietly. So you can leave the Bluetooth speaker at home and let natural life provide the playlist.

But what if there is no escaping unwanted noise such as traffic? There’s good news as research suggests people can still benefit from natural sounds mixed with man-made noises. There’s evidence that natural sounds help mask the negative impacts of unwanted noise, such as cars, trains, and planes. Listening to natural sounds along with man-made noise has better outcomes for your well-being than listening to the unnatural noises on their own. That ocean sounds playlist you listen to every night to drown out the street noise might be doing wonders for your overall health—more than you may even realize!

The benefit of nature sounds to physical and mental health are well-recorded. Studies have linked experiences in nature to have a positive impact on well-being with a measurable decrease in mental stress, an improvement in cognitive performance, and high levels of creativity, as well as improved sleep.

Trans Science

In 2018 I wrote about a research study by Lisa Littman. She coined the term rapid onset gender dysphoria (ROGD) to describe reports she had been reading about gender dysphoria appearing rapidly around the time of puberty in adolescents and young adults who would not have met the criteria for gender dysphoria in childhood. Her study raised the possibility that rather than always being an innate, immutable sense of incongruence between anatomical sex and personal sense of gender, some cases of gender dysphoria might be due to social contagion from peer pressure and online influences.

I thought that was worthy of investigation. I got a lot of criticism for writing about it. I was even called transphobic, which I absolutely am not. I only want the best for each individual. If that means transitioning, I fully support that. If it means some individuals transition for the wrong reasons and later change their minds, that’s regrettable and we need to find a better way to identify those individuals and treat their dysphoria without subjecting them to irreversible interventions. I hesitated to tackle this controversial subject again, but in 2020 Abigail Shrier wrote a book that shares my and Littman’s concerns. It combines well-researched facts with horrifying stories about botched surgeries, people who later regret their choices, and therapists who are not providing therapy but just validating their patient’s self-diagnosis. The title is Irreversible Damage: The Transgender Craze Seducing Our Daughters.

Littman’s Research Methods Were Flawed but She was Unfairly Vilified

Littman’s research was widely criticized for its flaws, which I described in my article. It was not good science and didn’t set out to establish that ROGD was real; it was meant to be exploratory and hypothesis-generating. Transgender activists accused Littman of having hurt people with her research; they called it “dangerous.” Her paper drew praise from some world experts on gender dysphoria and from many parents, but she was also tarred as a bully and a bigot. She was denounced by activists to her employer, the Rhode Island Department of Health, and they fired her, even though her job had nothing to do with transgender youth or even young children. She was unfairly attacked, her reputation was tarnished, and she lost a job she loved.

The Numbers are Alarming

Historically, the conviction that one’s gender doesn’t match one’s anatomical sex typically began around age 2–4. It affected only .01 percent of children, almost exclusively boys. And in 70% of cases, they eventually outgrew it. Prior to 2012, there was no scientific literature on girls age 11–21 ever having developed gender dysphoria at all.

The picture has changed dramatically. Natal girls now constitute the majority. Clusters of adolescents are discovering transgender identities together and are clamoring for hormones and surgery. In 2018 the UK reported a 4,400% rise over the previous decade in teenage girls seeking gender treatments; similar spikes have been observed in many other countries. In the US, the prevalence of adolescent gender dysphoria has increased by over 1000% in the last decade. In 2016, natal females accounted for 46% of all sex reassignment surgeries; a year later it was 70%.

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Noise: A Flaw in Human Judgment

Imagine that two doctors in the same city give different diagnoses to identical patients. Now imagine that the same doctor making a different decision depending on whether it is morning or afternoon, or Monday rather than Wednesday. This is an example of noise: variability in judgments that should be identical.

Shermer speaks with Nobel Prize winning psychologist and economist Daniel Kahneman about the detrimental effects of noise and what we can do to reduce both noise and bias, and make better decisions in: medicine, law, economic forecasting, forensic science, bail, child protection, strategy, performance reviews, and personnel selection.

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Quercetin: How to Increase Your Intake of This Important Antioxidant

 While most of us are aware that we need to include important vitamins and minerals in our diet such as vitamin C and zinc, there is a lesser-known compound that doesn’t get the attention it deserves: quercetin.

If you aren’t familiar with quercetin, it belongs to a group of plant compounds called flavonoids, which act as an antioxidant in your body and hunts for free radicals. Quercetin has been found to provide allergy-relief and reduce inflammation, as well as boost immunity. Board-certified internist Vincent Pedre, M.D. says part of the reason quercetin supports your immune system is because it acts as a prebiotic, which feeds the good bacteria in your gut.

"It also augments the effects of vitamin C, synergistically helping to prevent over-activation of mast cells, which secrete histamine when the body is inflamed," Pedre said. "Not to mention, quercetin acts as a zinc shuttle, getting natural antiviral zinc into cells where it can help mitigate viral replication."

Although there is no magic number for how much quercetin you should be getting daily, most supplements recommend dosages between 500 and 1,000 milligrams per day. If you simply make sure to include the following 21 foods in your diet, it should be more than easy to get your daily dose of quercetin.

1. Capers (most concentrated source)
2. Red onion (highest vegetable source)
3. Shallots
4. Red apples
5. Grapes
6. Berries
7. Cherries
8. Scallions
9. Kale
10. Tomatoes (organically grown tomatoes have up to 79% more than conventional fruit)
11. Broccoli
12. Brussels sprouts
13. Cabbage
14. Citrus fruits
15. Bell peppers (green and yellow)
16. Nuts (almonds and pistachios)
17. Asparagus (cooked has slightly more)
18. Buckwheat
19. Black tea
20. Green tea
21. Elderberry tea

The average person typically gets a maximum of 40 milligrams of quercetin per day, but by including these foods in your diet, you can up your intake to at least 500 milligrams and gain the most health benefits. There are plenty of quercetin supplements, but the best plan of attack for boosting your intake is to include a variety of quercetin-rich foods.

How long it took to develop 12 other vaccines in history

With the speed at which the COVID-19 vaccination was produced, there are as many questions about it as it provides us with answers. A look at history may tell us some of what we want to know, but much more data is required.

How long it took to develop 12 other vaccines in history

Understanding the Unidentified

 BY MICHAEL SHERMER

An advantage of having worked in the skeptical business for 30 years is institutional memory that enables me to place current claims and controversies into historical context. So, when the New York Times published their article on “The Pentagon’s Mysterious U.F.O. Program” in December 2017, and CBS’s 60 Minutes reported that “UFOs Regularly Spotted in Restricted U.S. Airspace” in May 2021—the reports bracketing the latest wave of apparent sightings—I immediately recalled similar waves dating back to the 1890s groundswell of “mystery airships” (later identified as dirigibles). Historian Mike Dash’s description of the 1896–1897 reports in his book Borderlands: The Ultimate Exploration of the Unknownwill sound familiar to those energized by the latest round of UFO videos:

Not only were [the mystery airships] bigger, faster and more robust than anything then produced by the aviators of the world; they seemed to be able to fly enormous distances, and some were equipped with giant wings … The files of almost 1,500 newspapers from across the United States have been combed for reports, an astonishing feat of research. The general conclusion of investigators was that a considerable number of the simpler sightings were misidentification of planets and stars, and a large number of the more complex the result of hoaxes and practical jokes. A small residuum remains perplexing.

Residues & Distortions

The final “small residuum” qualification hints at a reality in all skeptical and scientific investigations. No hypothesis or theory in any field accounts for 100 percent of the phenomena under investigation. The “residue problem” means that no matter how comprehensive a theory is, there will always be a residue of anomalies for which it cannot account. The most famous case in the history of science is that Newton’s gravitational theory could not account for the precession of the planet Mercury’s orbit, subsequently explained by Einstein’s theory of relativity. Darwin’s theory of evolution by means of natural selection could not account for anomalies like the Peacock’s large and colorful tail (which would be a bullseye for predators), but his theory of sexual selection did, demonstrating how females select for mates based on certain traits males develop to stand out from other males and to attract females.

The residue problem in UFOlogy is instructive because it enables skeptics to find common ground with believers and allows us to live comfortably with the fact that we can’t explain everything. For example, in her bestselling 2010 book, UFOs: Generals, Pilots and Government Officials Go on the Record, UFOlogist Leslie Kean notes that “roughly 90 to 95 percent of UFO sightings can be explained” as:

… weather balloons, flares, sky lanterns, planes flying in formation, secret military aircraft, birds reflecting the sun, planes reflecting the sun, blimps, helicopters, the planets Venus or Mars, meteors or meteorites, space junk, satellites, swamp gas, spinning eddies, sundogs, ball lightning, ice crystals, reflected light off clouds, lights on the ground or lights reflected on a cockpit window, temperature inversions, hole-punch clouds, and the list goes on!

So, the entire extraterrestrial hypothesis for explaining Unidentified Flying Objects and Unidentified Aerial Phenomena (UFOs and UAPs, respectively) is based on a residue of data left over after the above list has been exhausted. What’s left? Not much, I’m afraid. […]

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The Fine Art of Calming Down

by Lisa Firestone, PhD, for the Psych Alive e-zine 

We all have those moments when we come unglued. We’ve probably had a few more of those than usual this past year. This time period has tested us in entirely new ways, and more likely than not, we can all recount a recent example of flipping our lid. For some, it was that second month of quarantine while we were stress-washing a freshly delivered jar of peanut butter. For others, it’s followed a critical comment from our partner or a stubborn fit from our kids. The point is, we all get activated, and we don’t always get a handle the flood of emotion that overcomes us. What we can control is our response to it.

Calming down is an exercise in patience and self-compassion. It is a skill we can hone by understanding what’s going on in our brains when we feel overwhelmed and by taking actions to help ourselves get our cerebral cortex and the higher functions of our brain back online. When a person flips their lid, their emotions are firing out of control; they may even feel as if they’re in a state of fight, flight, or freeze. They’ve lost connection to their prefrontal cortex, a part of the brain that typically, in essence, “hugs” their limbic (emotional) system and helps them stay attuned, flexible, balanced, and regulated emotionally.

When triggered in moments of stress, our limbic system/emotional center of our brains, perceives a threat and overrides our prefrontal cortex. When this occurs, people lose their perspective and chaos ensues.

Think of that split second when you slammed the door on your partner, snapped at your kid, burnt out in a meeting, or panicked at a parade of thoughts marching into your head as you tried to fall asleep. These can all be examples of “flipped lid” moments. Making ourselves aware of what’s going on in our brains can help us hit the brakes and calm down, rather than reacting in ways that hurt us (or others) or we later regret.

The best thing to do in these heightened moments of stress is take pause and do something rhythmical and predictable like going for a walk or breathing. When we breathe in, we are going to breathe out. When we put one foot down, we pick up the other. The breathing practice of 4-7-8 is one very simple exercise we can try. The idea is to breathe in through our nose for 4 seconds, hold the breath for 7 seconds, and breath out through our mouths for 8 seconds. Doing this five times in a row helps our brain reintegrate and our nervous system calm.

When we get activated by intense emotions in a given moment, our reactions are  sometimes out of sync with what’s actually going on in the present. We react in a big way, but later, when those prefrontal cortex functions are back in place, we regret how we reacted and often hold a more balanced perspective. We may have insight into how we took our partner’s words out of context in an argument. We may realize that our kid was feeling overwhelmed when they acted unreasonably, and our response to them arose from our own feelings of inadequacy or frustration. We may start to see how a persistent feeling of being behind or “not good enough” at work finally got to us. And we may definitely realize how our overactive minds can transform into our biggest critics the minute we have time to sit and think.

In truth, many of our heightened emotional reactions are triggered or intensified by an old familiar feeling or implicit memory and not simply the events we’re facing in the moment. A specific word our partner uses to describe us can tap into an old feeling of insecurity and set off an ocean of self-attacks. A certain tone in our child’s whine can trigger memories of painful moments in our own childhood or a feeling we struggle to handle in ourselves.

Because these momentary reactions are like rivers running into old reserves of untapped emotion, we can use what Dr. Daniel Siegel calls “Mindsight” to step back and create a barrier between what we’re experiencing and how we react. Mindsight describes our “capacity to label, analyze and clarify our internal emotional world and how it responds to the world around us.” We can cultivate this capacity by using mindfulness skills.

Mindfulness allows us to see our thoughts and feelings like ships passing on the horizon. We can watch each silhouette sail by, but we don’t need to hop aboard and get carried away. So many of our thoughts and feelings overpower us and take the wheel when it comes to our behavior. By using techniques like meditation and simple breathing exercises, we can notice these thoughts and feelings with compassion and curiosity, but we can bring our attention back to our breath, which helps us to not over-identify with these thoughts or assign them too much meaning.

Every wave of emotion rises and falls. If we can help guide ourselves through these instances of intensity, we can return to a calmer state. The trick is to give ourselves permission to pause. If we can recognize two things, first, that our brains are overwhelmed and not functioning at their strongest capacity to regulate, and second, that our reaction probably has to do with a deeper wound or vulnerability within us, we can meet our uncomfortable emotions with patience, compassion, and perspective.

Giving ourselves this time and space to calm down is a productive action. It helps us reconnect to the wonderful functions of our prefrontal cortex. It helps improve our communication with our partner and model resilience for our children. It allows us to be curious about why we feel the intense ways we do at times, unlocking memories from our history that impacted us in ways of which we might not otherwise be aware. Finally, it allows us to act with integrity and care in how we treat others and how we treat ourselves.

A Conversation with William Nordhaus on the Economics of Global Warming, Pandemics, and Corporate Malfeasance

In this conversation, based on his book The Spirit of Green: The Economics of Collisions and Contagions in a Crowded World, Nobel Prize-winning pioneer in environmental economics, Dr. Nordhaus explains how and why “green thinking” could cure many of the world’s most serious problems — from global warming to pandemics. Solving the world’s biggest problems requires, more than anything else, coming up with new ways to manage the powerful interactions that surround us. For carbon emissions and other environmental damage, this means ensuring that those responsible pay their full costs rather than continuing to pass them along to others, including future generations. Nordhaus describes a new way of green thinking that would help us overcome our biggest challenges without sacrificing economic prosperity, in large part by accounting for the spillover costs of economic collisions. In a discussion that ranges from the history of the environmental movement to the Green New Deal, Nordhaus explains how rethinking economic efficiency, sustainability, politics, profits, taxes, individual ethics, corporate social responsibility, finance, and more would improve the effectiveness and equity of our society.

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Eating Habits to Avoid for Better Sleep According to Nutrition Experts

by Amt Shiffer for “Eat This, Not That”

If you're having trouble falling or staying asleep or feel like you aren't getting restful sleep, it may be time to look at your diet.

There are so many reasons why you might struggle to get good sleep, but one which you may not have considered is your diet. In fact, what you eat and drink on a daily basis has the serious potential to ruin your sleep.

"The food we eat impacts our sleep because of the process of digestion, which spikes blood sugar and causes the secretion of insulin in response to eating," says Lauren Minchen, MPH, RDN, CDN, nutrition consultant. "If our bodies are too busy breaking down heavy foods (particularly if we eat them right before bed), we may not sleep as deeply as we would if we ate healthier, lighter foods."

In order for our sleep to be more fully restorative, our whole body, including our digestion, needs to be at rest," Minchen adds, underscoring the important role the foods you eat before bedtime can have on your sleep. To make matters even more complicated, our diet doesn't just affect our sleep by interfering with our digestive processes, it can also have a direct impact on our circadian rhythm.

"If there is an imbalance of certain essential nutrients or fluid throughout the day, our circadian rhythms may be disrupted," adds Minchen, citing the importance of maintaining a well-balanced, regular diet throughout the day for optimal sleep health.
To get better, more restful sleep, we asked dietitians for the 8 eating habits that you should avoid.

1). Avoid Eating Dinner Late: "So many of us eat dinner late and go to bed shortly after or eat food prior to going to bed, and this can disrupt our sleep as our blood and energy is still going to our GI tract to digest our food," says Amy Shapiro, MS, RD, CDN, registered dietitian and nutritionist. "We want our stomachs to be mostly empty so our energy can be spent restoring and we can get into a deeper sleep. Also, if you are too full prior to going to sleep you can be uncomfortable, experience acid reflux and that can keep you up and disrupt sleep as well."

Adds Brenda Braslow, MS, RDN, LDN, registered dietitian, "The pressure on the esophageal sphincter can cause acid to backflow into the esophagus. This can be very uncomfortable and keep you awake."

2). Avoid Greasy, High-Fat Meals Close to Bedtime: "Fat takes longer to digest and so stays in the stomach longer, stimulating more stomach acid. This can result in heartburn," says Braslow. "Lying horizontally in bed makes heartburn worse because the stomach acid can more easily backflow into the esophagus." It all gets much worse if any of these 18 Foods Making Your Heartburn Worse are on the dinner menu.

3). Avoid Eating Too Much Sugar/Carbs: "Carbohydrates can make us feel drowsy, which may make us feel like they boost our sleep," says Minchen. "However, too many carbs or too much sugar (think sweets, too many starches, etc.) throughout the day can trigger sugar and insulin spikes that ultimately disrupt our sleep hormones and contribute to more wakefulness throughout the night and lighter, less restorative sleep."

4). Avoid Trying to Meet Your Water Intake Goals Too Close to Bedtime: "So many of us forget to drink water during the day and we try to consume most of our water needs in the evening," says Shapiro. "This can lead to disrupted sleep as you may have to wake up throughout the night to use the restroom. It is important to drink water throughout the day to support your body's digestion and detoxification processes and to promote energy.”

5). Avoid Drinking Too Much Alcohol: "Like carbohydrates, alcohol can make us feel sleepy. However, too much alcohol (and for some, any alcohol at all) can actually suppress the first two stages of REM sleep (there are four total stages we cycle through a few times each night), which contributes to a disruption of the natural sleep cycle and leads to less restorative sleep," says Minchen. "Alcohol can also lead to insomnia for some since they experience a delay/suppression of the first two stages of their REM sleep."

6). & 7). Avoid Drinking Coffee or Tea After Dinner & Avoid Generally Drinking Caffeine Late in the Day: 

6). "Caffeine blocks adenosine in the brain. Adenosine is a sleep-promoting chemical we naturally produce when we need sleep (we produce more as the day progresses). When caffeine blocks this brain chemical, we feel alert and awake," says Minchen. "Caffeine also has a half-life of 4-6 hours, meaning that only 1/2 of it has been broken down in that time frame. If you drink coffee or tea after dinner, you will effectively experience the alert feelings of caffeine all night, and the caffeine will only be metabolized closer to when you wake in the morning."

7). "Caffeine is a stimulant and gives us energy, clarity and focus. However, some people do not metabolize caffeine very efficiently and it can remain in our systems long after we consume it. This can prevent us from falling to sleep," says Shapiro. "I recommend my clients do not consume caffeine (from tea, soda, coffee or even chocolate in some individuals) after 12 p.m. If you reach for a 4 p.m. coffee to get you through the rest of the day and you don't sleep well you may want to consider switching to water, decaf, or other (unsweetened) non-caffeine beverages!"

8). Avoid Going to Bed Dehydrated: "Becoming dehydrated throughout the day disrupts our sleep cycles and may lead to more wakefulness and less restorative sleep," says Minchen. "Dehydration actually contributes to there being fewer available amino acids (proteins) in our bloodstream, which means we don't produce adequate amounts of melatonin. This may mean that being chronically dehydrated will disrupt our circadian rhythm and actually leads to insomnia. Further, not getting adequate sleep can then lead to dehydration, which feeds this vicious cycle. Adequate sleep helps our bodies regulate fluid retention through the secretion of vasopressin. If we cut sleep short, we may end up more dehydrated throughout the day."