By: Jill Menefee, PT

Sleep plays a major role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your emotional health, physical health, quality-of-life, and even safety. The way you feel while you're awake depends in part on what happens while you are sleeping. During sleep, your body is working to support healthy brain and bodily function.

Sleep hygiene is the practice of following good habits in order to have a more restful and effective sleep. Trouble sleeping and daytime sleepiness can be signs of poor sleep hygiene. Some good sleep habits include:

Avoid napping during the day. It can disturb the normal pattern of sleep and wakefulness.
Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol.
Exercise can promote good sleep. Exercise should be done in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night's sleep.
Food can be disruptive right before sleep. Stay away from large meals close to bedtime.
Establish a regular relaxing pre-sleep routine. Avoid stressful activities and don't take your worries to bed with you.
Avoid checking the clock continually through the night. This can increase stress and make it harder to fall asleep.
Make your bedroom more sleep friendly. Keep your room dark and quiet. Use an eye mask or ear plugs if needed.
Avoid use of your television, computer or backlit device an hour before bed. These can suppress melatonin production and stimulate rather than relax.

Developing good sleep habits can help make the difference between restlessness and a refreshing sleep experience. Some habits are easier to follow than others but consistency is the key.

By Maureen Mason, MS PT

Your body mass index, or BMI, is a measure of your health based on your height and weight. BMI is being used frequently to screen for the health risks of underweight, overweight, or obese individuals, and it is important to know our own BMI to track changes in your health. Most adults in the U.S. increase their BMI as they age, due to less energy expenditure and increase calorie consumption, and an increasing BMI may correlate with increase risk for diseases. For adults, "Underweight" is a BMI less than 18.5, "Normal" is the range between 18.5 and 24.9. "Overweight" individuals are at a BMI between 25 and 29.9, and "Obese" is at a rating of 30.0 or higher. You can observe our laminated chart at Comprehensive Therapy Services (CTS), and see your BMI number, or use the resources listed below. Lowering your BMI, if in the overweight or obese category, can improve your health on many parameters.

Raising your BMI may be indicated if you are in the underweight zone. BMI is one health parameter that is useful in health screening, and due to the growing girth of our nation, the government is advising that health care providers screen for BMI, and provide education if the BMI number falls outside the normal range. BMI, along with other measures such as blood pressure, cholesterol, and blood sugar (glucose) levels can provide a measure of your relative health risks for diseases. Being overweight or obese increases the risk for osteoarthritis, heart attacks, strokes, and diabetes.

Doctors recognize that patients with a high BMI may have metabolic syndrome, which is the combination of high blood pressure, high cholesterol, and high blood sugar levels, all of which may lead to the development of diabetes over time. In fact, metabolic syndrome may occur as you approach the overweight category, so beware! Recent research identifies overweight individuals with signs of metabolic syndrome.

Your body type contributes to your BMI. Body "typing" classifies 3 genetically determined tendencies to being thin, termed ectomorph, or muscular and short stature, termed mesomorph, or fat and round, termed endomorph. Most individuals are a mixture of these body types, but consider the cartoon Popeye, with the female character Olive Oil being the ectomorph, Popeye being the mesomorph, and Wimpy, the hamburger eater, being the endomorph. (The bully Bluto is tall and muscular, a combination character). Olive Oil may be tall and thin, and have a low or healthy BMI, but she could also have osteoporosis or an eating disorder. Popeye may be stocky and muscular, and his dense body may indicate a high BMI, appearing as overweight. BMI measures tend to discriminate against shorter, stocky, muscular individuals, such as Popeye. Wimpy's probable high BMI would indicate he is obese, and he needs to develop some better nutrition habits and exercise. BMI is a number that needs to be taken into consideration along with other health measures, such as body composition.

If your BMI is not in the "normal" range, and you are underweight or overweight, how can you change your BMI? Changing BMI involves knowledge about energy expenditure with activity levels, and energy density or calories in food. An optimal BMI results from incorporating regular healthy habits into your lifestyle. Keys to success include: setting a BMI goal, and having nutrition and fitness plan and a specific results tracking program. Ask your therapist at CTS for their recommendation for you, based on your needs and interests. Ask your Doctor for guidance as well. The internet is bursting with resources and free guides and plans for improving BMI, and many individuals do well with an accountability partner or family plan to help them meet their improved health goals. Medicare now requires that health providers screen and counsel clients regarding BMI, so you will see a scale and tape measure in our clinic. Apparently many individuals "lose 10 pounds, and gain an inch of height" when reporting weight and height, so we can help you be accurate with our screening!

Resources:
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

to find out your BMI.
http://www.cdc.gov/healthyweight/physical_activity/index.html

to identify strategies that can help you improve your BMI.
Heartwire BP, Cholesterol, and Glucose Explain CHD Risk With High BMI Marlene Busko, November 29, 2013,Medscape Medical News. http://www.medscape.com/viewarticle/815211
Screen Time, Including Games, Videos, May Affect Youth BMI

http://www.medscape.com/viewarticle/814931
Current BMI Cutoffs May Miss Metabolic Disease Risk Marlene Busko, November 14, 2013
http://www.medscape.com/viewarticle/814378
http://healthyeating.sfgate.com/improve-bmi-level-8137.html
http://www.acefitness.org/acefit/fit-life/
http://www.acsm.org/access-public-information/articles/2012/01/12/measuring-and-evaluating-body-composition

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In This Issue

Sleep Hygiene

BMI and Your Health

Pilates

Exercise for Health

Group Apparatus

Class Schedule

Reach your fitness goals, then challenge yourself to new ones!

Check out our expanded class schedule and find a Pilates class for you.

Bladder Basics

Educate Yourself

Join us for our next round of educational seminars to learn all you need to know about bladder health!

Call CTS for upcoming seminars!

CoreAlign

Balance & Strengthen

Contact our office for information about this new way to activate your core and balance your body. Free 15 minute trials available.

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