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Here's why you're probably waking up right at 3 or 4 in the morning and how to make it stop

It happens to just about everyone.

via Polina Kovaleva/Pexels

A woman with her eye mask on in bed.

Do you often wake up at 3 or 4 a.m. with an intense feeling of anxiety? Do you get stressed that you’re awake and begin making a mental laundry list of everything you need to do the next day? Do you start thinking about fights you once had with your spouse or ponder how you have let yourself down in the past?

If so, you’re not alone. It’s common for people to wake up at 3 or 4 a.m. regularly and there’s a reason why we choose this time to catastrophize and worry. The good news is that there are some steps we can take to get through that awkward phase of the night so we can wake up refreshed.

Why do I wake up at 3 or 4 a.m. every night?

Many of us reliably wake up in the middle of the night because after we’ve had a good chunk of sleep, our bodies start to slowly prepare us for the day by reducing melatonin, the hormone that puts us to sleep and increasing levels of cortisol, the stress hormone.

That biological phase of sleep is why we start to feel stressed.

sleep, nightmares, cortisole A woman wakes up in the middle of the nightvia Oscar Calstrom/Pexels

After the big hormone release at 3 or 4 in the morning, if you are dealing with stress in your life, you are more likely to wake up. If your life is calmer and you don’t already have a stress baseline, you will probably wake up, fall asleep quickly and forget that it happened.

Why do I wake up feeling stressed in the middle of the night?

If you’re already experiencing stress in your life, that extra cortisol kick is going to cause you to wake up with a feeling of anxiety. The problem is that when we’re lying in bed in the middle of the night, we are in a vulnerable position. “Around this time in the sleep cycle, we’re at our lowest ebb physically and cognitively. From nature’s viewpoint, this is meant to be a time of physical and emotional recovery, so it’s understandable that our internal resources are low,” Greg Murray, a psychology researcher with expertise in mood, sleep, and the circadian system, writes in The Conversation.

“But we also lack other resources in the middle of the night – social connections, cultural assets, all the coping skills of an adult are unavailable at this time,” Murray continues. “With none of our human skills and capital, we are left alone in the dark with our thoughts. So the mind is partly right when it concludes the problems it’s generated are unsolvable – at 3 a.m., most problems literally would be.”


At this moment, when we’re stressed and feeling vulnerable, stuck in bed with no way out, we can begin to spiral. This is when we ruminate on why we forgot to feed the dog that one day in 1994 or contemplate why things went bad with your first significant other at 21. It’s when we start recalling a disagreement with a friend and plotting out what we’ll say the next time the issue arises.

At this point, if we don’t stop spiraling, we’ll be up until 5 a.m. and will feel like garbage when it’s time to go to work.

The good news is that there are ways to get back to sleep and stop the downward anxiety spiral.

Make a list

Dr. Jade Wu says that if you wake up and feel stressed about things you need to take care of, walk out of your room (so you don’t associate it with stressors) and make a list to read in the morning. This will free you of your worries, because you know you can care for them when you are awake.

Pay attention to your breath

Murray says you should redirect your attention from your thoughts to your breath, which is a form of meditation. “I bring my attention to my senses, specifically the sound of my breath. When I notice thoughts arising, I gently bring my attention back to the sound of breathing,” Murray writes in The Conversation. This works in 2 ways: first, it takes your attention away from your spiraling thoughts and second, the breathing exercise helps you relax.

Have a bite to eat

Sometimes, we wake up in the middle of the night because we’re hungry and our blood sugar is dropping. “The first question I ask [my patients] is, ‘When was the last time you ate?’” Michael Breus, Ph.D. psychologist specializing in sleep disorders, told Sleep.com. “Often, they’ve finished their last meal at 7 p.m.; now it’s 3 in the morning — that’s eight hours later — so guess what? They’re out of fuel.” If you’ve woken up because of a drop in blood sugar, experts recommend eating a small snack that includes protein and fat, like peanut butter.

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Health

He went to the ER in Taiwan, then his "Horrors of Socialized Medicine" post went viral

His Facebook post ignited a firestorm.

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An ER trip in Taiwan is how much?


We all know that Americans pay more for healthcare than every other country in the world. But how much more?

According to an American student who shared the story of his ER visit in a Taiwanese hospital, Americans are being taken to the cleaners when we go to the doctor. We live in a country that claims to be the greatest in the world, but where an emergency trip to the hospital can easily bankrupt someone.

Kevin Bozeat, a 25-year-old student at the time, had that fact in mind when he fell ill while studying in Taiwan and needed to go to the hospital. He didn't have insurance and he had no idea how much it was going to cost him. He shared the experience in a now-viral Facebook post he called "The Horrors of Socialized Medicine: A first hand experience."

It started with a stomach ache

Bozeat's stomach began to hurt. Not thinking much of it, he went home to rest. Then, he started vomiting and couldn't stop, unable to even keep water down. "My symptoms showed no signs of abating," he wrote. "At this point I had to seek medical treatment, I knew I had to go to the hospital."

"I wanted to avoid it," he added. "I had no idea how different Taiwanese hospitals would be, whether I would be able to find an English speaking doctor, or what it would cost me (my US health insurance has lapsed and I don't qualify for Taiwanese NHI)."

Taiwan's National Health Insurance (NHI) is a single-payer system that covers all residents of Taiwan. Foreigners can take part in the system immediately upon obtaining a work permit, or after six months of living in the country. As a student, Bozeat hadn't lived there long enough to be eligible yet.

But he needn't have worried.

Bozeat's bill for his entire hospital stay was a fraction of many insured American's copays for emergency services.

And it's not like he received substandard service for what he paid.

"My Taiwanese roommate called a taxi and took me to the ER at NTU Hospital," Bozeat wrote. "I was immediately checked-in by an English speaking nurse. Within 20 minutes I was given IV fluids and anti-emetics. They took blood tests and did an ultrasound to ensure it wasn't gall stones or appendicitis. From there I was given a diagnosis: a particularly severe case of Acute Viral Gastroenteritis (aka the stomach flu). After about 3 hours on an IV, I began to feel slightly better, my nausea disappeared and my stomach began to calm down."

Bozeat was discharged with a prescription for anti-emetics and pain medication, and after a few days he was back to normal. This is when most of us would start panicking as we wait for the hospital bills to arrive. But Bozeat was pleasantly surprised:

"The bill for the ER visit?...US $80.00. Eighty. American. Dollars. Out of pocket. Full cost. No discounts. No insurance. At one of the best hospitals in Taiwan. And if I had NHI, it would have been a fraction of that. This could have easily cost me hundreds or even thousands in the US without insurance. But here in Taiwan I was able to receive speedy, quality care comparable to what I would have gotten in a US hospital for relatively small amount of money."

I did some research, and the cost of living overall in Taiwan is about half what it is here. There is not a hospital that I know of in the U.S. where you can be admitted and discharged for anything close to $160, even for something as simple as a bee sting. (Seriously, an ER visit for a bee sting can set you back $12,000 in the U.S.)

Bozeat also pointed out that the taxes that pay for Taiwan's health system are not that high.

Responding to the common complaint that we'd have to raise taxes to pay for universal healthcare, Bozeat addressed that with a listicle:

"5: Yes, taxes pay for the healthcare here. No, they are not high. Try for yourself: The formula for the NHI monthly premium contribution for a single employed adult is: [your monthly income] x 0.0469 (4.69%) x 0.3 (30%) = Your monthly out-of-pocket healthcare premium."

I did the math for a $60,000 per year income—it comes to $70.53/month. [Sigh.]

But Bozeat wasn't done:

"6: It's not perfect. Not everything is 100% covered. I had a good experience, but Im sure many people have had [non-financial] medical horror stories here.

7: This system exists because the Taiwanese government believes that healthcare is a right for all of its citizens, rather than a privilege for those who can afford it. Those aren't my words, thats what the Ministry of Health said in its English language brochure. Every Taiwanese citizen and foreign permanent resident is entitled to, and required to enroll in the National Health Insurance Program (NHI). Everyone is covered, regardless of employment status, no one is uninsured, no one ever goes bankrupt due to medical bills."

The quality of care does not appear to be compromised in this system, either.

"I have yet to meet a Taiwanese person who wasn't satisfied with, or even outright proud of their healthcare system," Bozeat wrote. "My expat friends praise it, even those from countries with universal healthcare systems of their own. "

Well, there you have it. This certainly gives us a lot to think about.


This article originally appeared on five years ago.

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Hospice nurse shares clue she uses to know if someone is dying 6 months before it happens

"Allow the body to be the guide."

via Sabinevanerp/Pixabay

An old woman holding a cane.

Death is the last great mystery that all of us face. We don’t know when we will go or can really be sure what comes next. So there’s understandably a lot of fear and uncertainty that most of us feel around death, whether we’re thinking about ourselves or a loved one. That’s why Julie McFadden's work is so important. As a palliative care nurse in the Los Angeles area, who has seen over a hundred people die, her TikTok videos shed light on the process to make us all a bit more comfortable with the inevitable.

McFadden is also the author of the bestseller, “Nothing to Fear.” The nurse’s experience helping people in their final stages has given her a unique perspective on the process. In a recent video, she shared how she can see the first symptoms that someone is going to die a natural death about 6 months before they finally do.

Interestingly, she can determine that someone only has half a year left to live when most of us have no idea they have entered the final stages of life.

@hospicenursejulie

Replying to @Mariah educating yourself about scary topics will help decrease fear. ✨Nothing to Fear ✨- my book- out june 11th #hospicenursejulie #hospicenurse #caregiversoftiktok #medicaltiktok #learnontiktok #nothingtofearbook

What are the symptoms of dying at the 6-month mark?

McFadden adds that people who are dying are usually placed in hospice care when the symptoms begin to appear around the 6-month mark.

"You will have very generalized symptoms. Those symptoms will usually be, one, you will be less social. So you'll be more introverted than extroverted," McFadden said. "Two, you will be sleeping a lot more. And three, you will be eating and drinking a lot less. Literally, everyone on hospice, I see this happen to."

heaven, clouds, ray of lightA Ray of light over a mountain. via PIxbay/Pexels



What are the symptoms of dying at the 3-month mark?

You are going to notice more debility,” McFadden continues. “They will be staying in their house most of the time. It's going to be difficult getting up and just going to the bathroom. Again, sleeping a lot more and eating and drinking a lot less.”

What are the symptoms of dying at the 1-month mark?

Something usually begins to happen in the final month of someone’s life. They start to believe they are in contact with others they have lost. It’s like they are there to make the dying person feel comfortable with their final transition.

"Usually around the one month mark is when people will start seeing 'the unseen', they have the visioning. They'll be seeing dead relatives, dead loved ones, dead pets, old friends who have died,” McFadden said. “Again, not everyone — but many, many people will start seeing these things at around one month."

heaven, death, trumpetAn angel with a trumpet.via PixaBay/Pexels

Angela Morrow, a registered nurse at Verywell Health, agrees that people in the final stage of life often hear from those who have passed before them. Morrow says we should refrain from correcting the patients when they share their stories of talking to people and pets who have died. "You might feel frustrated because you can't know for sure whether they're hallucinating, having a spiritual experience, or just getting confused. The uncertainty can be unsettling, but it's part of the process," Morrow writes.

At the end of the video, McFadden says that the most important factors palliative care nurses look at to determine the stage of death are eating, drinking and sleeping. “Most people, a few weeks out from death, will be sleeping more than they are awake. And they will be barely eating and barely drinking,” McFadden said.

i.giphy.com

In the end, hospice nurses “allow the body to be the guide” as they help their patients transition from life to death.

McFadden’s work has brought a lot of peace to her followers as they go through trying times. "My mom is in hospice right now and she’s currently, I think, hours or days from death. YourTikToks have helped me out tremendously," Deb wrote. "My grandma passed away in February, and she experienced all of this. this page brings me peace knowing everything she went through was natural," Jaida added.

"Thanks, Julie. I volunteer in a hospice end-of-life facility, and this helps educate the families. Your posts are wonderful," Grandma Nita wrote.

One of the things that makes death so scary is the number of unknowns surrounding the process. That’s why it’s so important that McFadden shares her stories of helping people to the next side. She shows that death is a natural process and that hospice nurses are here to help make the transition as peaceful as possible.

This article originally appeared in September

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Star neuroscientist Andrew Huberman breaks down two simple exercises to improve vision

The eyes are muscles like any other and need both stimulation and relaxation.

Canva

Treat the eyes like a muscle. Give them exercise and relaxation.

We spend a lot of time looking at things up close, particularly our screens. For many of us, it’s the first thing we look at in the morning, the last thing we look at before going to sleep, and the thing we look at most during all those hours in between. According to a study commissioned by Vision Direct, the average American will spend 44 years looking at a screen. You read that right. Over. Four. Decades.

Really, it’s no wonder that eyesight has worsened. Experts have declared that myopia, aka nearsightedness, has grown to an epidemic level. In addition, we suffer more headaches and migraines, get poor sleep, and tend to feel more fatigued.

Luckily, there are a few things we can do to help, whether we boast 20/20 vision or are already constantly squinting.

Neuroscientist Andrew Huberman, well known for his podcast “Huberman Lab,” breaks down all kinds of science-based life hacks for health, wellness, and fitness.

In addition to studying the brain, one of Huberman’s main research topics is vision. In a video, Huberman shares two simple exercises that can dramatically help improve eyesight.

First and foremost, we need to allow our vision to relax.

You can’t do this just by looking up from your computer screen. Instead, Huberman suggests going to a window and looking out at a point in the distance. Ideally, you would open the window because windows filter out a lot of the blue light and sunlight that you want during the daytime. Better yet, go to a balcony, relax your eyes, and look out at the horizon. This allows the eyes to relax and go into panoramic vision, relieving stress and fatigue.

According to Huberman, you should be doing some kind of relaxation of the eyes, face, and jaw for every 30 minutes of focused work—which works out to at least every 90 minutes.

Second, stimulate the eyes by focusing on motion.

Smooth pursuit is our natural ability to track individual objects moving through space. You can train or improve your vision simply by stimulating this mechanism. To do this, Huberman suggests taking a few minutes each day or every three days to visually track a ball. Or, get outside and watch objects move around. Think swooping birds, falling leaves, etc. If you couldn’t tell, Huberman is a big proponent of going outside.

Bottom line: Our eyes are muscles. Just like our biceps, they need stimulation and relaxation, and while we might not be able to get this kind of nourishment from our tiny screens, nature provides.

This article originally appeared last year.

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