Footbaths to Fight Insomnia?

Dr. Oz’s tip for curing insomnia—wearing heated rice footsies to bed (see my blog last March)—may have led to second- and third-degree burns for TV viewer Frank Dietl, but Oz is not responsible for the injuries, the New York Supreme Court ruled on Oct. 3. Moral of story? Take the advice of tele-evangelist health gurus with a grain of salt.

But let’s get back to the notion that heating the extremities might help to promote sleep. For some of us, this may be a useful strategy.

Foot-bathDr. Oz’s tip for curing insomnia—wearing heated rice footsies to bed (see my blog last March)—may have led to second- and third-degree burns for TV viewer Frank Dietl, but Oz is not responsible for the injuries, the New York Supreme Court ruled on Oct. 3. Judge Saliann Scarpulla dismissed the lawsuit against Oz, saying that there was no “duty of care between a television talk-show host and his vast home-viewing audience.”

Moral of story? Take the advice of tele-evangelist health gurus with a grain of salt. Frankly, some of Dr. Oz’s tips on insomnia sound pretty lame. Eat lots of gelatin to combat sleeplessness? Puh-lease!

But let’s get back to the notion that heating the extremities might help to promote sleep. Particularly in people who normally can’t sleep until late at night, this may be a useful strategy.

Body Temperature and Sleep

The rhythm of your core body temperature has a strong effect on when you feel sleepy; you start feeling sleepy when your temperature is going down. People who have trouble falling asleep until very late may have internal clocks that run on a 25-hour day, a recent study in the Journal of Sleep Research shows, delaying the downturn in temperature and the onset of sleep.

Light exposure in the morning and melatonin supplements in the evening may be the best remedies for people with longer-than-normal circadian temperature periods. But a warm footbath before bed may also help.

Why It May Work

Most heat loss occurs through the hands and feet, and heating the extremities hastens heat loss by dilating blood vessels. This allows for the swift release of body heat and a lowering of core body temperature, in turn helping promote sleep. So hot footbaths and warm socks may be a good idea for people who struggle to fall asleep at a reasonable hour.

But a new study from Taiwan confirms the results of an older study showing that footbaths prior to sleep do not alter sleep patterns in older adults. Heating the extremities may only help with sleep if you’re young or middle aged.

Do you bathe at night and/or wear socks to bed? Have you noticed it has any effect on your sleep?

Dr. Oz’s Sleep Tip Sparks Lawsuit

Dr. Oz is at it again, spreading careless advice about sleep. And this time somebody besides me is complaining.

Last week, Frank Dietl, 76, filed suit against Dr. Oz for a sleep tip that left him with third-degree burns on his feet and several weeks’ confinement in bed.

Dr. Oz is at it again, spreading careless advice about sleep. And this time somebody besides me is complaining.

sleeping-footsies

Last week, Frank Dietl, 76, filed suit against Dr. Oz for a sleep tip that left him with third-degree burns on his feet and several weeks’ confinement in bed.

Oz gave his tip in a show last April, telling viewers that they could sleep better by heating their feet with a “heated rice footsie.” He said to fill the toes of a pair of socks with uncooked rice, heat the socks in a microwave and then wear them about 20 minutes while lying in bed.

Dietl, who is diabetic and suffers numbness in his feet, followed Oz’s instructions. But then, instead of removing the footsies after 20 minutes, he fell asleep wearing them. He woke up in the middle of the night to discover burns on his feet that left him barely able to walk.

I am truly sorry for Mr. Dietl, but I’m happy to see tele-evangelist health gurus like Dr. Oz get challenged on some of the half-baked advice they toss our way.

This time, Dr. Oz’s facts weren’t inaccurate. His explanation for why heating the feet might help with sleep—“When your feet get hot . . . your body gets cold. Your body will automatically adjust its core temperature and, as it gets cooler, you’re going to be able to sleep better”—is basically true as far as it goes. Yet as usual, Dr. Oz was short on details. And in this case, the details just might have saved poor Frank Dietl’s feet.

Body Temperature and Trouble Sleeping

It’s easier to sleep when your core body temperature is falling, and people who have problems falling or staying asleep may be saddled with bodies that have trouble cooling down. Sleep experts say that insomnia is sometimes characterized by a failure to down-regulate core body temperature at night.

So how can you cool yourself down? Lots of heat loss occurs through the hands and feet. So one way to promote heat loss—and this may sound paradoxical—is to heat your extremities before going to bed (as you might with a foot bath). Heating the extremities dilates the blood vessels, in turn allowing for maximum release of body heat and a lowering of core body temperature. In some experiments (but not all), this heating of extremities has helped subjects fall asleep sooner and stay asleep. Hence, Dr. Oz’s brilliant idea for the heated rice footsies.

What Dr. Oz Failed to Mention

But here’s the catch. In the case of older people with insomnia, this doesn’t work. Heating the extremities has not helped elderly poor sleepers fall asleep sooner or sleep better, according to research (see below). If Dr. Oz had bothered to qualify his advice, Frank Dietl, 76, might have passed on the idea of the footsies and avoided the disabling burns.

But Dr. Oz and his ilk are not big on nuance. Which is why I don’t trust them, particularly on matters relating to sleep. People with insomnia differ one from another. The last thing we need is advice from doctors that treat us all alike.

What do you think about Dr. Oz? Speaking in sound bites is the norm on TV these days. Am I expecting too much?

Warm Footbath Before Bedtime

Skin Temperature and Falling Asleep

Hands Off My Sleep Meds, Dr. Oz!

Last week Dr. Oz hosted a show about “killer” sleeping pills. Now, there are lots of reasons to be cautious about sleep meds, including the fact that some leave you feeling groggy in the morning.

But when celebrities like Dr. Oz use information like this to whip up hysteria about sleeping pills, it makes my blood boil.

boxerLast week Dr. Oz hosted a show about “killer” sleeping pills.

Now, there are lots of reasons to be cautious about sleep meds, including the fact that some leave you feeling groggy in the morning. The FDA in January lowered the recommended dose of zolpidem (a.k.a. Ambien) from 10 mg. to 5 mg. for women, based on reports that women tend to metabolize the drug more slowly than men. The resulting morning grogginess can impair driving.

But when celebrities like Dr. Oz use information like this to whip up hysteria about sleeping pills, it makes my blood boil.

Consider the opener to the show.

“This is breaking news!,” Dr. Oz shouted. “There’s an alarming link between prescription sleep aids and an increased risk of cancer and death!”

“Women taking less than 18 pills had a 3½ times greater risk of increased mortality,” Dr. Michael Breus chimed in.

Oh really, doctors? Reports of the study you’re referring to first came out a full year ago. That study had serious limitations, including that the data did not show whether the increased mortality was in fact linked to the use of sleeping pills or rather to insomnia itself. Minor point.

There is nothing “breaking” about this news. But it’s a hell of an opener if your aim is to demonize sleeping pills.

Zolpidem’s Effect on Morning Driving

“Sleeping pills alter your state of consciousness,” said Dr. Breus, preparing us to understand the harm they do.

Well, duh. If I wanted to remain in a waking state all night, I’d play Monopoly and sip Kool-Aid.

“Alcohol moves out of your system faster than sleeping pills,” he added.

The statement is misleading, at best. Some sleeping pills have very short half-lives. (Take Sonata [zaleplon] with its half-life of one hour.) Others stick around in your body for many hours.

Like alcohol, sleeping pills can produce a “hangover” and cause traffic accidents, Breus said.

A Closer Look

Let’s look more closely at the comparison. The FDA has received about 700 reports of zolpidem-related driving incidents in all, according to The New York Times. Contrast this with the nearly 9,900 traffic fatalities attributable to alcohol in the year 2011 alone.

One sleeping pill-related driving incident is one too many, I think we’d all agree. But in withholding information about the scale of the problem, the doctors imply that the danger sleeping pills pose to driving is greater than it actually is.

Many sleep experts think sleeping pills are over-prescribed, and I do not doubt this claim. Prescriptions shouldn’t be tossed out like candy in cases where there are safer ways to get sound sleep.

But sleeping pills can be a godsend for people constitutionally predisposed to poor sleep. Dr. Oz’s show was not so much alarming as alarmist. It did nothing to promote thoughtful dialog on the safety and appropriate use of sleeping pills.