Low Back Pain, Balance, and Foot Orthotics

Low back pain (LBP) can result from many causes, and sometimes it just occurs for reasons that are not clear, such as the accumulation of stresses that occur over time. Many causes of low back pain have been described such as bending over “wrong,” combined bending and twisting, lifting, over reaching, climbing, sitting too long, repetitious activities at home or work, sports injuries, being out of shape, and so on. But what about balance? Because poor balance leads to falling, which is the #1 cause of injuries in the elderly, ANYTHING that we can do to improve our balance should help prevent falls and hence low back injuries. Let’s look at strategies to improve our balance…

First, let’s measure our ability to balance by using a simple test you can do yourself. Stand on one leg in the corner of a room or in a doorway where you can easily grab onto something if you feel like you’re going to fall. Try to do this without holding on to anything, first with your eyes open and a second time with your eyes closed. If you have a stopwatch, click it when you start and stop (when you put your foot down). Otherwise, count, “…1001, 1002, 1003, etc.” Studies have shown that for those under 60 years old, you’re “normal” if you can balance on one leg with your eyes open for 30 seconds and 25 seconds with your eyes closed. Between ages 60-69, normal is 23 sec. (eyes open) and 10 sec. (eyes closed) is normal. If you’re 70-79 years old, normal is 14 seconds (eyes open) and 4 seconds (eyes closed). Give it a try! Notice how “normal” drops as we age. From 25 sec. to 4 sec. between age 59 and 70 is pretty dramatic! No wonder falling is so common among the elderly!

So, now that you’ve tested yourself, I’m guessing you aren’t too impressed with your balance skills. The question now is, how can we improve our balance? Performing balance exercises with a rocker, wobble board or cushion is VERY EFFECTIVE! You’ll be surprised that if you use this for 10 minutes a day, the improvement in balance is significant in just 2 weeks. Another method takes no effort at all on your part, and that is the use of  made foot orthotics. Simply known as arch supports, foot orthotics (the good “prescription” kind) correct the rolling in or out of the heel bone, referred to as pronation (rolling in = most common) or supination (rolling out) by wedging the heel of the orthotic/arch support. This stabilizes the ankle joint, reduces the inward or outward shift at the knee and hip joints, and as a result, improves our balance.

Results of a recent study proved this to be the case. Researchers studied 13 subjects over 65 years of age who reported at least 1 unexpected fall in the past 12 months and measured their balance skills using a similar test as the one you just tried as well as 3 other tests (tandem stance, tandem gait, and alternating step tests) twice before and twice after starting use of  foot orthotic intervention (immediately after and 2 weeks later). In each of the 4 balance tests, improvement was statistically significant in the post-tests and 2-week later follow-up tests PROVING that balance is effectively improved when wearing foot orthotics. We recommend doing BOTH the exercises and the use of  foot orthotics to obtain even better results. Since falling is such a common occurrence at any age, especially in those over 60-65 years old, these simple strategies seem like a “no-brainer” to implement into a treatment program, especially for people with poor bone density at high risk for fractures.

At Denver Chiropractic Center we offer the-semi-custom Aline Foot Suspension system. In our opinion these are better than rigid orthotics because they allow your foot’s natural arches to function while providing a moderate amount of support. This allows your foot to naturally strengthen its intrinsic muscles. Call us for your more info 303.300.0424.

What happened in Vegas, Dr. Stripling’s Self-Help video for Neck Pain, and this week’s 1-Page Health News, from Denver Chiropractic Center

This weekend Meredith and I (Glenn) jetted off to Las Vegas so I could teach at the Active Release Techniques seminar there, and so we could hang out at night. Meredith saw (or almost saw, I never did get the story straight) the Victoria Secret models and Magic Johnson (not together). I did not. Anyway, as always Vegas was fun for a couple of days and then got really old really quickly.

Dr. Stripling and Keri held down the fort here at the office, and shot a video on a great neck stretch for those of you who work at a desk all day. The link is below.

Next week is the last week of the year for us, and we’ll be closed from December 22 through January 1, opening back up on January 2. Dr. Hyman will be on call in case of emergency. His cell phone # will be on our voicemail.

Mental Attitude: Reaction To Stress. How people react to stress determines how that stress will affect their health. Study volunteers were separated in two groups: 1) those who let their troubles affect their emotional state and 2) those who didn’t let stress bother them at all. At a 10-year follow up, those who let stress affect them (group 1) were more likely to suffer from chronic health problems. Penn State, November 2012

Health Alert: Hip Replacement and Stroke Risk. Hemorrhagic stroke and ischemic stroke risk is ~4% higher within 2 weeks of total hip replacement surgery. A hemorrhagic stroke is brought on by bleeding in the brain, while an ischemic stroke is brought on by arterial blockage. Total hip replacement is extremely common in the United States. Around 1 million hip replacement surgeries are done around the world every year, 300,000 in the United States alone. Stroke, November 2012

Diet: Vitamin D Levels Decreasing? Women with health issues such as arthritis, hypothyroidism, cancer, high blood pressure, and osteoporosis are much more likely to have inadequate levels of vitamin D during seasons with decreased daylight. 28% of women had deficient levels and 33% had insufficient levels of vitamin D. Women taking supplements were able to significantly elevate their vitamin D levels.
American Society for Clinical Pathology, November 2012

Exercise: Exercise When You’re Sick? The choice to exercise or not sometimes depends on the sickness or disease. Our bodies work harder and use more energy when we are fighting an illness. If symptoms are above the neck (sore throat, runny nose), it is probably okay to exercise. If you’re sick but still want to exercise, simply reduce your intensity and duration. You should not exercise if you have body aches, fever, diarrhea or vomiting, shortness of breath or chest congestion, dizziness or light-headedness. When resuming your regular exercise routine, try starting with 50% effort and 50% duration. Loyola University Health System, November 2012

Active Release Techniques: Sliding Nerves? Nerves need to slide past muscles and other structures in your body. As tight muscles put pressure or pinch nerves, they interrupt the blood’s circulation to the nerve. This can cause symptoms like carpal tunnel in the wrist sciatica in the hip and thigh, and many more problems. Active Release Techniques is the only system that specifically includes treatment protocols for releasing nerve entrapments. Note: Dr. Glenn Hyman is still the only Active Release Techniques instructor practicing in Denver.

Wellness/Prevention: Staying Healthy! “Check out Dr. Stripling’s Self-Help video for Neck Pain:
http://www.denverback.com/?p=966

Quote: “So many people spend their health gaining wealth, and then have to spend their wealth to regain their

Dr. Stripling’s Self-Help Video for Neck Pain, from Denver Chiropractic Center

My weekend at the Olympics, Dr. Stripling’s self-help video and this week’s 1-page health news!

Dr. Hyman spent this weekend learning all about Olympic Lifting at the Crossfit Olympic Lifting Coaches’ certification. Two full days of barbell snatches, cleans, and jerks. These lifts have a powerful application to most sports, even triathlon. Stay tuned for more info as we’re working on creating a relationship with a crossfit gym that’s close to the office. Dr. Hyman will be in the office Monday through Wednesday this week, and then he’ll be out of the office teaching for Active Release Techniques this coming weekend.

Dr. Stripling has started his weekly Denver Chiropractic Center TV segment on You Tube. In this week’s installment, Dr. S shows you how to help yourself when you feel that nagging pain between the shoulder blades. You can find these videos on our blog. The link is at the bottom of this email.

Health Alert: Children, Cars and Second-Hand Smoke. Just ten minutes in the back seat of a car with a smoker in the front seat increased a child’s exposure to harmful pollutants by 30%, even with the front windows completely rolled down. British Medical Journal, November 2012

Diet: Cholesterol and Probiotics. Two daily doses (200mg) of a probiotics lowered “bad” (LDL) and total cholesterol in study participants. Probiotics are live microorganisms (naturally occurring bacteria in the gut) thought to have beneficial effects. Common sources are yogurt or dietary supplements. Those taking the probiotics had LDL levels 11.6% lower than those on placebo after nine weeks. American Heart Association, November 2012

Exercise: Belly Fat and Sleep Quality? Losing weight can directly aid in improving sleep quality among obese or overweight people. Sleep quality was meaningfully associated with weight loss, either from changes in diet or a healthy diet combined with exercise. Sleep quality improvement was also observed with a loss in belly fat. With an average loss of 15 pounds and 15% belly fat, sleep scores improved by 20%. Chronic sleep disruptions can elevate the risk of heart attack, high blood pressure, irregular heartbeats, and stroke. American Heart Association, November 2012

Active Release / Chiropractic: Spinal Degenerative Joint Disease. Spinal DJD (degenerative joint disease) occurs in most people as early as 40 years of age. The degeneration is due to gravity, major traumas, and repetitive micro-traumas (activities of daily living). Once the spine degenerates, simple mechanical compression (moving) can change nerve impulses, and the central nervous system may interpret that as pain. Pain, 1977 (Maintain that spinal mobility by getting ART and chiropractic treatment!)

Wellness/Prevention: Sleep and The Immune System. Sleep deprivation increases the risk for developing inflammation related illnesses such as cardiovascular disease, arthritis, and diabetes. Biological Psychiatry, September 2008

Quote: “Never confuse motion with action.” ~ Ben Franklin

Video Link: Dr. Stripling’s self help for mid and upper back pain (click)

Dr. Jeff Stripling, chiropractor at Denver Chiropractic Center demonstrates some self-help trigger point work for upper back and mid-back pain.

Common Car Accident (Whiplash) Myths

Last month, we began discussing common myths about whiplash injuries, and this month, we will continue on that course. Remember, the amount of injury that occurs in an acceleration/deceleration injury is dependant on many factors, some of which include gender (females>males), body type (tall slender = worse), the amount of vehicular damage (less is sometimes worse as the energy of the strike was not absorbed by crushing metal), head position at the time of impact (rotation is worse than looking straight ahead), and more. Therefore, each case MUST be looked at on its own merits, not just analyzed based on a formula or accident reconstruction.

MYTH #5: THERE MUST BE DIRECT CONTACT WITH THE NECK FOR INJURY TO OCCUR. Injury to the neck most commonly occurs due to the rapid, uncontrolled whipping action of the head, forcing the neck to move well beyond its normal range of motion in a forwards/backwards direction (if it’s a front or rear-end collision) or, at an angle if the head is rotated or when the strike occurs at an angle.

When this occurs, the strong ligaments that hold the bones together stretch and tear in a mild, moderate, or severe degree, depending on the amount of force. Once stretched, increased motion between the affected vertebra results as ligaments, when stretched, don’t repair back to their original length and, just like a severe ankle sprain, future problems can result. This excess motion between vertebra can result in an accelerated type of arthritis and is often seen within five years following a cervical sprain or whiplash injury.

MYTH #6:  SEAT BELTS PREVENT WHIPLASH INJURIES. It’s safe to say that wearing seat belts saves lives and, it’s the law! So, WEAR YOUR SEAT BELTS! They protect us from hitting the windshield or worse, being ejected from the vehicle. But, as far as preventing whiplash, in some cases (low speed impacts where most of the force is transferred to the car’s occupants), the opposite may actually be true. (This is not an excuse to not wear a seatbelt!)

The reason seat belts can add to the injury mechanism is because when the chest or trunk is held tightly against the car seat, the head moves through a greater arc of motion than it would if the trunk were not pinned against the seat, forcing the chin further to the chest and/or the back of the head further back. The best way to minimize the whiplash injury is to have a well-designed seat belt system where the height of the chest harness can be adjusted to the height of the driver so that the chest restraint doesn’t come across the upper chest or neck.

Move the side adjustment so the chest belt crosses between the breasts (this also reduces injury risk to the breasts) and attaches at or near the height of the shoulder (not too high). Another preventer of whiplash is positioning the head restraint high enough (above the ears typically) and close to the head (no more than ½ to 1 inch) so the head rest stops the backwards-whipping action. Also, keep the seat back more vertical than reclined so the body doesn’t “ramp” up the seat back forcing the head over the top of the head restraint.

If you’ve been in a car accident, Denver Chiropractic Center can help you with Active Release Techniques, chiropractic care, and physical therapy. We accept Med Pay and will work with any auto insurance carrier. 303.300.0424. Call us today.

Dr. Glenn gets beaten up (for real) & this week’s 1-page health news

My wife Meredith and I spent this past Saturday in a “Be Your Own Bodyguard” class taught by personal defense guru Tony Blauer at Crossfit Verve. This class is going to be re-branded as CrossFit Defense, and I can’t recommend it enough, especially for women.  If you don’t mind foul language, google Tony Blauer and the SPEAR system for more info.

Meredith got a lot of hands-on practice, and after 10 years of marriage finally got a chance to give the 8-hour beating I probably deserve.

Next week is Thanksgiving week, as you know. We’ll be closing at noon on Wednesday the 21st and re-opening on Monday the 26th. This week is already nearly full, so if you need to get in and see us, call sooner rather than later.

Mental Attitude: Chew On This! People who maintain the ability to chew are less likely to develop dementia. This study shows a link between having no teeth and losing cognitive function more rapidly. The action of chewing makes more blood flow to the brain. People with few or no teeth will chew less, resulting in less blood flow to the brain. Journal of the American Geriatrics Society, October 2012

Health Alert: Younger Adults and Strokes? Stroke is becoming more common in younger adults. The reason may be an increase in risk factors like diabetes, obesity, and high cholesterol. Strokes among those under age 55 grew from around 13% in 1994 to 19% in 2005. Neurology, October 2012

Diet: Omega-3 Intake & Young Adults. For the first time, scientists have studied the effects of Omega-3 supplementation on young adults (ages 18-25). After 6 months of supplementation, subjects were able to improve their working memory (used for reason and comprehension) despite the belief that, at their age, they were operating at their cognitive best. PLoS One, October 2012

Exercise: Take A Hike For Your Heart! Going for a hike, a jog, or taking a brisk walk every day could reduce your risk of a heart attack or stroke by 50%. Researchers found that people who jog or who walk briskly have a lower risk of cardiovascular disease than those who lead more sedentary lives, or who walk at slower speeds. British Heart Foundation, October 2012

Chiropractic: Pregnancy and Back Pain. Approximately 60% of pregnant women suffer from back pain; however, only about 30% report symptoms to their prenatal provider and only 25% of providers recommend treatment. A review of 17 pregnant women who sought chiropractic care for back pain found 16 of 17 women demonstrated clinically important pain improvement within 4.5 days of seeking care, with no adverse side effects. Journal of Midwifery & Women’s Health, January-February 2006

Wellness/Prevention: What Can I Do? According to Leon Chaitow, ND, DO, “Even if conventional medicine tells you that your condition is incurable or that your only option is to live a life dependent on drugs with troublesome side effects, there is hope for improving or reversing your condition.” There are many things we can do to stay healthy and overcome illness once we become ill. The benefits of an excellent diet, a strong exercise program, getting proper rest, and a strong mental attitude (which includes stress reduction) have been studied endlessly with positive results. Being healthy almost always improves your overall body function and decreases your risk of becoming ill.

Quote: “I have chosen to be happy because it is good for my health.” ~ Voltaire

Carpal Tunnel Syndrome – Natural Treatment Options

Carpal Tunnel Syndrome (CTS) is a condition characterized by pain, numbness and/or tingling in the hand. This includes the palm and the 2nd, 3rd, and half of the 4th finger, usually sparing the thumb. Another indication of CTS is weakness in grip strength such as difficulty opening a jar to even holding a coffee cup. CTS can occur from many different causes, the most common being repetitive motion injuries such as assembly line or typing/computing work.

Here is a PARTIAL list of potential causes of CTS: heredity (a small sized tunnel), aging (>50 years old), rheumatoid arthritis, pregnancy, hypothyroid, birth control pill use, trauma to the wrist (especially colles fractures), diabetes mellitus, acromegaly, the use of corticosteroids, tumors (benign or malignant), obesity (BMI>29 are 2.5 more likely), double crush (pinching of the nerve in more than 1 place such as the neck and the carpal tunnel), heterozygous mutations in a gene (associated with Charcot-Marie-Tooth), Parvovirus b19, and others. Again, repetitive trauma is still the most common cause. Once the cause(s) of CTS has been nailed down, then treatment options can be considered.

From a treatment perspective, we’ve previously discussed what chiropractors typically do for CTS (spinal and extremity joint manipulation, muscle/soft tissue mobilization, physical therapy modalities such as laser, the use of a wrist splint – especially at night, work task modifications, wrist/hand/arm/neck exercises, vitamin B6, and more). But, what about using other “alternative” or non-medical approaches, especially those that can be done with chiropractic treatment? Here is a list of four alternative or complementary treatment options:

  1. Anti-inflammatory Goals: Reducing systemic inflammation reduces overall pressure on the median nerve that travels through the limited space within the carpal tunnel at the wrist. An “anti-inflammatory diet” such a Mediterranean diet, gluten-free diet, paleo-diet (also referred to as the caveman diet) can also help. Herbs that can helps include arnica, bromelain, white willow bark, curcumen, ginger, turmeric, boswellia, and vitamins such as bioflavinoids, Vitamin B6 (and other B vitamins such as B1 and B12), vitamin C, and also omega 3 fatty acids.
  2. Acupuncture: Inserting very thin needles into specific acupuncture points both near the wrist and further away can unblock energy channels (called meridians), improve energy flow, release natural pain reducing chemicals (endorphins and enkephlins), promote circulation and balance the nervous system. For CTS, the acupuncture points are located on the wrist, arm, thumb, hand, neck, upper back and leg. The number of sessions varies, dependant on how long the CTS has been present, the person’s overall health, and the severity of CTS.
  3. Laser acupuncture: The use of a low level (or “cold” laser) or a class IV pulsed laser over the same acupuncture points as mentioned above can have very similar beneficial effects (without needles)! One particular study of 36 subjects with CTS for an average of 24 months included 14 patients who had 1-2 prior surgeries for CTS with poor post-surgical results. Even in that group, improvement was reported after 3 laser treatments per week for 4-5 weeks! In total, 33 of the 36 subjects reported 50-100% relief. These benefits were reportedly long-term as follow-up at 1-2 years later showed only 2 out of 23 subjects had pain that returned and subsequent laser treatment was again successful within several weeks.
  4. Active Release Techniques (ART): ART releases scar tissue in the muscles that surround the median nerve. This release takes the pressure off of the nerve, and often resolves CTS. We’ve been treating Carpal Tunnel with ART successfully since 2000, and Dr. Hyman is the only ART provider in Denver who is also an ART instructor. Call us today to schedule your CTS evaluation. 303.300.0424

A spicy election day & this week’s 1-page health news

Giving your spice rack a work-out is just as brilliant as eating fruit and veggies. Take oregano. Prized in Italian and Greek cuisine, these tasty little leaves boast 30 times more polyphenols than potatoes, 12 times more than oranges, and 4 times more than blueberries. You’d never munch a bunch of oregano that’s as big as a potato, but even a pinch packs a wallop. A tablespoon of fresh oregano’s got as much antioxidant power as a medium-sized apple!

Here’s the lowdown on herbs and spices that punch up the flavor of popular ethnic cuisine, along with ways you can use them to get healthier as you spice up whatever you’re cooking tonight.

Turmeric: The compound curcumin, found in yellow mustard (not so much in brown mustard, as that has real mustard seed.. but there’s true value in its less expensive yellow imitation). Turmeric and curry powder have anti-inflammatory, antiviral, antibacterial, and antifungal properties, and may offer protection from cancer, diabetes, arthritis and Alzheimer’s disease. It is a premiere flavor in Indian cuisine and you can use it on veggies, sautéed chicken, or salad dressing.

Garlic: Munching a clove a day could help lower your cholesterol by as much as 9%. Garlic contains tons of tangy compounds that may help protect against cancers of the breast, stomach, colon, esophagus, and pancreas — and soothe high blood pressure a bit, too. Garlic’s a favorite from Scandinavia to Spain and China. Use it to spice up veggies, fish, and your next pan of brown rice. It seems to make everything taste better (you could even try it on fruit and all veggies).

Rosemary: A top seasoning in Mediterranean cooking (the French roast it with almonds, the Italians add it to herb mixes), rosemary’s antioxidant capabilities make it a must for 21st-century grill masters. Adding this herb to meat, fish, and veggie marinades before grilling reduces cancer-causing compounds, called heterocyclic amines, by up to 80%

Cinnamon: A compound in this tasty spice called hydroxychalcone makes receptors on cells work better, so your body absorbs blood sugar more easily. Getting ½ to 1 teaspoon a day, sprinkled on food, could lower blood sugar 10 points. It’s a favorite in German baked goods and Greek main dishes like hearty moussaka. Cinnamon is also delicious on oatmeal, in hot cocoa, and sprinkled on fresh fruit, like apples and bananas.

Ginger: This popular flavor in Thai cuisine may also cut your odds for inflammatory diseases like arthritis, as well as cancer and migraine headaches. You can also eat some if you’re prone to motion sickness or are nauseous, too. Try grated fresh ginger in salad dressings and shake powdered ginger into whole-grain muffins.

Here is this week’s 1-Page Health News:

Mental Attitude: What Is Dementia? Dementia is not a specific disease. It’s a term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60-80% of cases. Vascular dementia, which occurs after a stroke, is the 2nd most common type of dementia. At least two of the following core mental functions must be significantly impaired to be considered dementia: memory, communication and language, ability to focus and pay attention, reasoning and judgment, and visual perception. Alzheimer’s Association

Diet: Tomatoes! Men who eat lots of tomatoes and tomato-based products may have a lower risk for stroke. Tomatoes are rich in the antioxidant lycopene. Men who had the highest levels of lycopene in their blood (compared to their peers with the lowest levels) were 55% less likely to have a stroke and 59% less likely to have an ischemic stroke. Neurology, October 2012

Exercise: Move It! Even 30 minutes of physical activity 5 days a week (20 minutes 3 times a week for vigorous exercise, such as jogging) can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol. You don’t have to exercise for 30 minutes straight; you can break it up into 10-minute increments. (Note- check out crossfit.com and crossfitendurance.com for daily workouts that are almost always under 30 minutes) American Council on Exercise, October 2012

Active Release Technique: How Important Is Motion? After soft tissue injuries to the muscles, ligaments, tendons, and fascia that result in motion restriction, a high incidence of osteoarthritis (degeneration) can be seen on x-ray within 5 years. (Note-This is why it’s so important to get ART work to improve joint mobility. Stiff backs become arthritic) American Journal of Medicine, 2001

Wellness/Prevention: Safety For Your Children. 37% of all children under 16 years old are incorrectly restrained in the car. 23% are so poorly restrained that a collision would have very serious consequences. With the correct use of safety equipment, fewer children will be injured and killed in traffic accidents. Safety errors are highest in children aged 4-7 years. The 5 most common mistakes are misplaced seat belts, twisted belts, loose straps, belt under the arm instead of over the shoulder, and young children (<135 cm or <4.5 feet) sitting in a seat without side support. (Note- While you’re at it, consider restraining your dog, too. We’ve seen many car accidents that cause a dog to go flying through the car, injuring both the dog and people in the car) Norwegian Institute of Public Health, October 2012

Quote: “The Constitution only gives people the right to pursue happiness. You have to catch it yourself.” ~ Ben Franklin

Low Back Pain and Sleep – Part 2

Last month, we discussed the relationship between sleep deprivation and low back pain (LBP) and found that LBP can cause sleep loss AND sleep loss can cause LBP. It’s a 2-way street! This month, we will look at ways to improve your sleep quality, which in return, will reduce your LBP. There are many ways we can improve our sleep quality. Here are some of them:

  1. Turn off the lights: Complete darkness (or as close to it as possible) is best. Even the tiniest bit of light in the room can disrupt your internal clock and your pineal gland’s production of melatonin and serotonin. Cover your windows with blackout shades or drapes.
  2. Stay cool! The bedroom’s temperature should be ≤70 degrees F (21 degrees C). At about four hours after you fall asleep, your body’s internal temperature drops to its lowest level. Scientists report a cooler bedroom mimics your body’s natural temperature drop.
  3. Move the alarm clock. Keeping it out of reach (at least 3 feet) forces you to get out of bed and get moving in the AM. Also, you won’t be inclined to stare at it during the night!
  4. Avoid loud alarm clocks. It is very stressful on your body to be suddenly jolted awake. If you are regularly getting enough sleep, an alarm may even be unnecessary.
  5. Reserve your bed for sleeping. Avoid watching TV or doing work in bed, you may find it harder to relax and drift off to sleep.
  6. Get to bed before 11pm. Your adrenal system does a majority of its recharging between the hours of 11 p.m. and 1 a.m. and adrenal “burn-out” results in fatigue and other problems.
  7. Be consistent about your bed time. Try to go to bed and wake up at the same times each day, including weekends. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning.
  8. Establish a bedtime routine. Consider meditation, deep breathing, using aromatherapy, or essential oils, or massage from your partner. Relax and reduce your tension from the day.
  9. Eat a high-protein snack several hours before bed to provide the L-tryptophan needed for your melatonin and serotonin production.