During the holidays, you should feel festive, not frenzied! Hectic schedules, lack of sleep, and overall holiday anxiety can easily dampen your spirit. Springfield Clinic’s panel of experts discuss how to keep your blood pressure in check, get a restful night’s sleep, recognize your emotional triggers and manage the holidays with ease!

3. “Happy” Holidays?: Holiday Stressors
• What do Americans stress about most during the
holidays?
5. Seeing certain relatives (24%)
4. Travel (25%)
3. Gift shopping (28%)
T2. Debt (37%)
T2. Gaining weight (37%)
1. Crowds and long lines (68%)

4. Holiday Stress: Planning Ahead
• Identify Your Triggers
• Plan for the “big” days
• Set aside “me time”

5. Holiday Stress: The Soda Bottle
“Calming the Fizz”
• Deep Breathing
• Relaxing Activities
• Scheduled Stress Time
“Managing the Explosion”
• 3 Rules of Safety
– Self
– Others
– Property
• Exercise
• “Controlled Explosions”

6. Holiday Stress: Asking for Help
• Signs you should seek more help:
– Consistently sad, anxious, or angry
– Difficulty enjoying activities
– Significant changes in sleeping or eating habits
– Thoughts about harm
– Significant mood changes lasting past the holidays

7. LCSW Resources
• Jeanne Armour – Main Campus, Wabash,
Jacksonville, and Carlinville
• Brian Gazdziak – Lincoln and Taylorville
• Mercedes Kent – Main Campus, Wabash, and
Decatur
• Barb Mackey-Bruzetti – SPAC
• Thomas Moll – Effingham and Hillsboro

11. FACTS
 Do you know what your blood pressure reading is?
 Have you had your blood pressure checked in the last year?
 If you are a man over age 45 or a woman over age 55, especially
if you are African-American, high blood pressure is a condition
you can't ignore.
 According to the U.S. Centers for Disease Control and
Prevention, more than half of all men and women will
develop high blood pressure after age 55.

12. }
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STAGE I
STAGE 2

13. WHY DO WE CARE ABOUT HIGH
BLOOD PRESSURE
(HYPERTENSION)

14.  No 1 cause of-
heart attack and stroke, two of the three leading causes
of death for Americans.
 You can have high blood pressure without experiencing any
symptoms –
 That is why-
even if you know that you have a normal blood
pressure reading today….
you want to do everything you can to keep it normal

15. Reason for high BP
Getting older,
being African-American,
having diabetes
having a family history of diabetes

16. How to keep your BP under control
 Exercise
 Lose excess weight
 Eat healthy
 Shake the salt habit Put the brakes on smoking
and drinking

17. Exercise.
1) Stimulates your body to release a substance called
nitric acid.
2) Nitric acid causes blood vessels to open up, which
reduces blood pressure.
3) Exercise also helps to strengthen your heart muscle,
reduce stress, and aid weight loss.

19. Lose excess weight.
1) There's no getting around the fact that blood pressure
goes up as the pounds pile on.
2) Being overweight increases your risk for heart disease
and diabetes, too.
3) Losing even 10 pounds can start to make your blood
pressure go back down.

21. Eat healthy
1) Eating the right type of diet can lower your risk for high
blood pressure or help you return to normal blood
pressure.
2) Clinical studies show that a diet high in fruits,
vegetables, low-fat dairy, whole grains, poultry, fish, and
nuts really works.
3) You also need to avoid fats, red meat, and excess sugar.

22. Excerpt from the AHA website
(www.heart.org)
1) Visit our Simple Cooking with Heart website, and learn to use nutritious
ingredients and follow a healthy preparation routine.
2) Use our Healthy Diet Goal guidelines to make smart choices to benefit
your heart and your overall health.
3) Get tips on staying heart-smart and making healthy choices at the store.
4) Learn to eat healthy when you dine out.
5) Learning how to read and understand food labels can help you make
healthier choices.

23. Shake the salt habit.
1) Your body only needs about 500 milligrams of salt a day, but…….
2) For optimal heart-health, the American Heart Association
recommends people aim to eat no more than 1,500 milligrams of
sodium per day
3) if you are like the average American you may be consuming up to
9,000 mg a day.
4) Studies show that high salt leads to high blood pressure.
5) Due to such a high intake, BP advantages are seen even
with cutting salt intake to < 2,400 mg per day.

24. • 1/4 teaspoon salt = 575 mg sodium
• 1/2 teaspoon salt = 1,150 mg sodium
• 3/4 teaspoon salt = 1,725 mg sodium
• 1 teaspoon salt = 2,300 mg sodium

25. Top six sodium sources in the U.S. diet.
breads and rolls
cold cuts and cured meats
pizza
soup
sandwiches
poultry

26. Put the brakes on smoking and drinking.
1) Alcohol raises blood pressure and adds empty calories.
2) A safe amount of alcohol is only one drink a day for
women and two for men.
3) Smoking is not safe in any amount. Nicotine causes
blood vessels to constrict and that raises blood
pressure. Quitting will also lower your risk of cancer and
heart disease

28. Function of Sleep
• Memory restoration
• Body reparation
• Immune system function
• Sleep Deprivation leads to poor concentration, poor
mood and decreased performance
• Complete lack of sleep leads to death within a few
days

29. Sleep is Active

30. Sleep Stages

31. Cycles Of Sleep Stages In a Night

33. Sleep Changes with Age
• Increased awakenings and arousals
• Decreased REM sleep
• (Probably) Decreased SWS
• Fewer “cycles”
• Reduced sleep efficiency
• Phase advancment

34. Sleep Disorders
• Multitude Sleep disorder diagnosis, at this time over
200 described conditions
• At some point in time most people will suffer from
some sleep problem
• Over 20% of the general population will suffer from a
chronic sleep problem
• Development of Sleep medicine and Professionals to
treat Sleep Disorders

35. Sleep Disorders
• Two main symptoms:
1) Always Sleepy
2) Cannot Sleep
• Sleepiness can present in many ways fatigue, poor
memory, agitated, grumpy, and even hyperactive.

36. What is sleep deprivation ?
• A reduction in sleep required to fulfill an individuals
physiological needs
1) Quantity of sleep
2) Quality of sleep
• Different mechanisms with possible similar
consequences socially, psychologically
and medically.

37. Sleep Deprivation
Consequences of sleep deprivation
• Poor mood and depression
• Decreased work performance
• Motor vehicle accidents
• Cardiovascular problems
• Decreased immunity
• Decreased fertility
• Acid Reflux

38. Sleep Deprivation
• How much sleep?
• On average most individuals need 8 hours of sleep,
but most are only getting 6.5 hours
• Every individual needs are variable
• The right amount is that which allows a person fully
alert and energetic throughout the day

39. How much sleep do we need ?
• NEWBORNS (0–2 months) 12–18 hours
• INFANTS (3–11 months) 14–15 hours
• TODDLERS (1–3 years) 12–14 hours
• PRESCHOOLERS (3–5 years) 11–13 hours
• SCHOOL-AGE CHILDREN (5–10 years) 10–11 hours
• TEENS (10–17) 8.5–9.25 hours
• ADULTS 7–9 hours
(Taken from the National Sleep
Foundation Web site.)

40. How much are we sleeping
• On average the general population is sleeping 7 hours
• 39.3% of adults are sleeping 5-6 hours
• 62% of adults reporting less than 7 hours of sleep
during weekdays

41. Effects of Sleep Deprivation
• Medical /Physiologic
• Social
• Psychological

42. Medical effects
• Decreased Alertness greatest effect of sleep
deprivation with greatest impact on individual and
public.

43. Alertness

44. Alertness

45. Medical effects

46. Immunity and Sleep Deprivation
• One whole night of sleep deprivation before
vaccination suppresses antibody response to hepatitis
A vaccine about 50%
• Chronic sleep loss in shift workers is associated with
increased infections
• Severe chronic sleep loss in rats results in breakdown
on intestinal defenses and systemic invasion by
intestinal flora

47. Sleep and hormonal regulation
• Sleep restriction increases daytime growth hormone,
ghrelin and evening cortisol levels
• Increase in cortisol and growth hormone lead to insulin
resistance
• Increase ghrelin and decrease leptin contribute to
increase in appetite

49. Sleep ,appetite and weight
• Those who reported sleeping < 5h/night gained more weight than those
sleeping 7h/night (Patel et al 2006)
• Women who slept <5h/night at 6months post partum had greater odds of
substantial weight gain by 1 year post partum compared to 7h/night
(Gunderson et al 2008)
• Mean sleep at ages 3-5 years was 30min less for those who became
overweight compared to those who did not, most of which was daytime
sleep. (Agras et al 2004)
• Increasing sleep problems at 2-4 years of age was associated with
increasing BMI and overweight/obesity at age 21 (Al Mamun et al 2007)

50. Medical effects

51. Sleep and Diabetes
• Odds of incident diabetes were higher for those reporting sleeping
6h/night and 7h/night (Yaggi et al 2006)
• Odds of incident impaired glucose tolerance/type 2 diabetes were
higher for those reporting sleeping <6h or >9h compared to those
sleeping 7h (Chaput et al )
• Odds of incident diabetes was higher in those reporting sleeping
<5h/night compared to 7-8h/night. Longer day napping was also
associated with increased odds of incident diabetes. (Xu et al 2010)

52. Sleep and cardiovascular disease
• Shorter sleep duration sleep and lower sleep maintenance were both associated
cross sectionally with higher blood pressure ( CARDIA study)
• Several prospective epidemiologic studies in the US found that those reporting
<5h sleep compared to those 7h had increased odds of incident hypertension.
(NHANES and CARDIA study)
• CARDIA study also examined incidence of coronary artery calcification. Longer
sleep duration was associated decreased odds of calcification
• Subjective insomnia or insomnia symptoms associated with increased
cardiovascular events or mortality
• Laboratory studies sleep restriction associated with elevated cardiac symphatho-
vagal balance estimated from heart rate variability

53. Medical effects

54. Psychological effects

55. Effects of Sleep Deprivation

56. Social implications
• Work absenteeism
• Industrial and motor vehicle accidents (chernobyl,3 mile
island,exxon valdez)
• Impaired cognitive and executive functions to perform
duties (libby zion)
• Impaired physical performance (athletic training)
• Marital discord

57. Drowsy driving and motor vehicle accidents
• 250,000 US driver fall asleep at the wheel daily
• Drowsy driving causes
– A crash every 25 seconds
• 1.2 million drowsy driving crashes/year
– Debilitating injury every 10 minutes
• 55,000 debilitating injuries/year
– A fatality every 70 minutes
• approx. 7,500 deaths/year

58. Psychological effects
• Some patient develop acute paranoid schizophrenia
• Acute confusional state
• Dependent on
a) Age
b) Personality
c) underlying psychopathology

59. Social Causes
• Light bulb
• 24/7/365 culture /shift work/ entertainment
• Family pressure more working mothers
• Poor sleep hygiene/ Distracters/Social media
• Increased stress levels/insomnia
• Drugs/alcohol use
• School start times

60. Gender Differences in Sleep
• Complaints of sleep disturbance are more prevalent for
women than men across the lifespan
• Compared to men and younger women, post
menopausal women are more likely to take hypnotics
for sleep

66. Better Sleep Habits
Better sleep habits:
• Regular sleep routine with minimum of 7 hours but need to find
individual need
• Reduce caffeine use
• No food or exercise within 2 hours of sleep
• Bedroom only for sleep , no TV/internet/social media
• Dark bedroom
• Good temperature/humidity
• School/work start time
• Bed partner snorer, leg kicker

67. “Early to bed, early to rise makes a person
healthy, wealthy and wise.”
Benjamin Franklin