In The Know: Trouble
Sleeping
A Column By Karen Morrissette
January 3 is Festival of Sleep Day. Wouldn’t we all like a little bit more of that? It was supposedly created to help people recover from the end of year festivities by promoting a bit of self-care. A good night’s sleep can increase energy levels, improve memory and cognition, and rekindle interest in activities long ignored. There is such a thing as too much sleep and it can leave your stiff, sore, and stuporous. Balance is the key but that balance is different for each individual. On average, adults function best on 7-8 hours a night. Age, medical conditions, and activity level, as well as mental and emotional well-being can all affect sleep.
One of the most common types of sleep disruption is insomnia, a sleep disorder which makes it hard to fall asleep or stay asleep. For some, this is a temporary problem and may be related to things like worry, stress, or changes in schedule such as working shifts or travel. Eating or drinking caffeine too close to bedtime, or trying to sleep in an environment with too much stimulation (Hello cell phone!) can also lead to insomnia. It is considered a chronic condition if it lasts a month or more. Medical illnesses such as anxiety, thyroid disease, chronic pain, allergies, and others can interfere with sleep long term. Some medications can be stimulating.
For temporary insomnia, practice good sleep hygiene – sleep in a dark, quiet area with a cool but comfortable temperature. Practice relaxation techniques or meditation to help prepare your body for sleep. If your insomnia is chronic, work with your medical provider to identify possible causes and treat them. Medication is never the first line of therapy, but may be helpful for some people in certain situations.
Restless leg syndrome (RLS) is another common sleep disruption that causes an uncontrollable urge to move the legs due to discomfort. The sensation usually begins once the individual has been lying down, or sometimes sitting, for a period of time and occurs mainly at night. Involuntary limb motion, such as twitching or kicking can also occur. This can be part of RLS or may indicate a rarer but superficially similar condition known as periodic limb movement disorder (PLMD). Sensations in the legs and feet can be described differently, but crawling, pulling, throbbing, itching, or electric are common descriptors. At times, the individual many even feel the need to get up and walk around. RLS can run in families and the cause is unknown, although it may be related to Dopamine levels in the brain. A medical evaluation, including neurological testing and blood work, is usually helpful in making the diagnosis, although there is no one specific test for RLS. Treatment for underlying medical conditions is the first step, but there are medications that can help relieve symptoms.
It can be annoying, frustrating, and a bit scary to sleep near someone who snores or even stops breathing at night, but it can also be a sign of a serious medical condition called obstructive sleep apnea (OSA). This disorder is characterized by repetitive episodes of breathing cessation, referred to as apnea, during sleep. This is often due to upper airway collapse and affects about 4% of the population. Symptoms may include snoring, restless sleep, waking up choking or gagging at night, foggy thinking in the mornings, morning headache, dry mouth or sore throat upon awakening, and sleepiness during the day. People with chronic OSA are at increased risk for heart attack, stroke, and high blood pressure. Risk factors for OSA include obesity, being male and middle-aged, menopause in women, and a variety of structural features involving the head and neck. Diagnosis is made through a sleep study. During this test, various pulmonary and cardiac events are monitored while a person is asleep. This can determine not only if the individual has apneic events during the night, but also how low the oxygen level in the blood gets during sleep, as well as if the heart is showing any abnormal rhythm patterns during the night.
There are several avenues for treatment, although the most common is use of a positive pressure breathing device. When an individual with OSA is required to breath against a low level pressure gradient, the airway is more likely to remain open. CPAP (continuous positive airway pressure) is the gold standard and can be provided by either full face mask or a nasal cushion. Mandibular advancement devices, similar to a mouth guard, can be used to help keep the airway open at night, but are only successful in some individuals. These must be fitted in conjunction with an experienced dentist. Surgical treatment to open the airway is a well-established treatment, but most medical providers prefer a less invasive approach when possible. A relatively new form of treatment has shown success in treating OSA in individuals who can not use positive airway pressure devices. This is an upper airway stimulator, which is an implantable device about the size of a pacemaker. Turned on and off by a handheld remote, it can deliver a mild stimulation to key muscles which help keep the airway open during sleep.
Reflections: Architects of Preservation – Past & Present
A Column By Tony Smith
“A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise.”
– Aldo Leopold, “A Sand County Almanac”
From the Transcendentalists, Thoreau and Emerson, to the most luminous 19th century conservationists, John Muir, John Burroughs, George Bird Grinnell, and Aldo Leopold; to the early to mid-1960’s, producing such visionaries as Howard Zahniser, Bob Marshall, Rachel Carson, Rosalie Edge, Winola LaDuke, and Olaus and Mardy Muri; to contemporary Yaak preservation “giants” Robyn King, Rick Bass, Scott Daily and countless others, passing the torch to a generation of youthful voices including Matt Bowser, Pete Leusch, Ben Palmer, Shawna Kelsey, Anthony and Ashley South, all of them visionary, courageous and resilient caretakers of our remaining wild sanctuaries. It matters that we celebrate them while revisiting the accomplishments and perspectives of significant forbearers in American conservation history. (120)
Although much has been written about the Transcendentalist “spirituality in nature” philosophy espoused by Emerson and Thoreau (it was Thoreau who once remarked that “every oak tree started out as couple of nuts who stood their ground”), it is George Perkins Marsh (1801-1882) who is, in his seminal work, “Man and Nature” (1864), considered by many to be the first preservationist for describing the adverse effects of deforestation on water, soil stability, vegetation, and climate. Some consider “Man and Nature” the most influential text of its time, next to Darwin’s “Origin of Species.” Marsh offered a keener scientific understanding of nature than either Emerson or Thoreau.
Scottish-born naturalist John Muir (“John of the Mountains”), fleeing to the East Lothian hills as a child to escape his strict, religious, intolerant father, and who was nearly blinded in an industrial accident, spent most of his life reveling in the Sierra Nevada Mountains (“Climb the mountains and get their good tidings. Nature’s peace will flow into you as sunshine into trees.”), eventually co-founding the Sierra Club, was largely responsible for the establishment of Yosemite and Sequoia National Parks. Conservationist historians can readily recall the now-infamous battle with forester Gifford Pinchot over the Hetch Hetchy Valley, one that Muir considered as beautiful as Yosemite, but a battle lost with the damming of the Tuolumne River, providing water for residents of San Francisco. Muir never again spoke to Pinchot, whose conservation values were utilitarian, commodity-oriented (“For the greater good for the greatest length”). On the other hand, Muir’s conservation philosophy was “institutionalized” by the Wilderness Act of 1964, written by Howard Zahniser and influenced by Bob Marshall, co-founder of the Wilderness Society. Muir today is regarded as the “patron saint of the American Wilderness.”
More in line with Muir, Aldo Leopold, author of the highly acclaimed “A Sand County Almanac,” provides perhaps the most viable conservationist philosophy in the 21st century by suggesting that man needs to live “symbiotically” with the natural world in the various eco-systems we inhabit, managing those eco-systems primarily for habitat integrity and not for commodity production. Leopold noted that “the impulse to save wild remnants is always, I think, the forerunner of the more important and complex task of mixing a degree of wildness with utility.” He struggled, as many in the field of conservation do today, with the effort to provide both beauty and utility. But by and large, Leopold envisioned ecosystem management as opposed to resource management.
Accordingly, those in the conservation community have significant challenges ahead. Will the Black Ram Project be the Yaak’s Hetch Hetchy? Will wild places once again be sacrificed on the altar of commodity-driven, excessive consumerism? Does “sustainable development” in fact mean “maximum sustainable yield?” Will the conservation community produce another John Muir, Aldo Leopold, Rachel Carson, Bob Marshall, or for that matter, another Robyn King or Rick Bass with their courage and tenacity? These are questions that matter significantly for those who cherish a wild Yaak!
“Whenever you find yourself on the side of the majority, it is time to pause and reflect”
– Mark Twain, American author and commentator