Put sleep procrastination to bed for good

Q: I can’t bring myself to go to bed at a reasonable time, even though my work day starts at 8 a.m. Help!

Jessica R., St. Louis

A: It’s not just toddlers and teenagers who rebel against falling asleep at a healthy hour. According to a new study conducted at the Florida Social Cognition and Emotion Lab at the University of Florida’s Department of Psychology, people ages 18-25 are the most likely to ignore their scheduled bedtime, and it’s a common behavior of people of all ages, who feel they need more “my time.” With the demands of family, work, and friends, many people are simply trying to earn a few hours late at night for themselves.

The problem is that it backfires and, instead of doing something positive for themselves, they are getting too little and poor quality sleep. Health effects include decreased immune strength, weight gain, mood swings, and poor decision-making – and, as we now know, an increase in Alzheimer’s-associated amyloid clumps in the brain.

A study in JAMA Neurology looked at 4,417 older adults and found that six hours or fewer hours of sleep per night were associated with higher amyloid loads. And sleeping either less than six or more than nine hours a night has been linked to decreased cognitive performance, depression, weight gain, and nap.

If you want to change your bedtime and have real “time for me”, psychologists recommend taking a hard break from work – no emails, text messages or tasks after, say, 8 p.m. every day. When in bed, avoid playing games or watching shows on your phone or tablet. You want to relax, not up. Adopt a meditation routine that you do 15 minutes before the light goes out.

You give yourself the best possible “me-time” by ensuring that you get seven to eight hours of restful sleep per night.

Q: I’ve been diagnosed with benign prostatic hyperplasia – but the doctor says there isn’t much to do now. What is this exactly and how concerned should I be?

Gary F., Bozeman, Mont.

A: An enlarged prostate – officially known as benign prostatic hyperplasia or BPH – is a common and often easy-to-treat condition that affects half of men between 50 and 90 percent by the time they are 80 years old. It’s mild to begin with and can be watched – with follow-up visits every six to 12 months – until it causes problems with urination such as urine leakage or urine retention. This happens because your prostate surrounds the urethra, the tube through which urine flows out of your body. It also produces some of the fluid that carries sperm during ejaculation, and BPH can negatively affect your sex life.

Follow-up tests may include a digital rectal exam, a bladder exam, a urine flow test, blood tests to check how well your kidneys are working, and a urine sample to check for infections. You may also need to switch medications – some antihistamines and decongestants make symptoms worse.

Self-care for mild BPH includes: avoiding alcohol and caffeine, especially after dinner; Put urination on a schedule even when you don’t feel like it and make sure to leave whenever you first get the urge; do not drink a lot of fluids at once; and do not drink anything within two hours of bedtime. It’s also important to reduce your stress response through meditation and regular exercise, and to stay warm – cold can make symptoms worse.

There are drugs available to treat BPH. Some, like finasteride and dutasteride, can cause erectile dysfunction and decreased libido. Alpha-1 blockers (antihypertensive drugs) relax the muscles of the bladder neck and prostate, reducing urinary symptoms in three to seven days. Laser surgery to open the prostate and transurethral resection of the prostate to remove the prostate is also possible. Therefore, discuss your best options with your doctor at each stage.

Contact Dr. Oz and Roizen on sharecare.com.

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