You swear you sleep better when you drift off in your partner’s arms, while your sweetheart says spooning is more stress than it’s worth. The heat. The accidental kicks. That you’re-smothering-me feeling. So who’s right? Does cuddling help or harm your sleep?
There is not a lot of scientific research on the subject. But the data that do exist come out in support of snuggles. “The perception is that it is a form of bonding, and there’s actually good empirical support for the idea that cuddling could be good for sleep,” says Wendy Troxel, a senior behavioral scientist at the RAND Corporation and author of Sharing the Covers: Every Couple’s Guide to Better Sleep.
Here’s how cuddling might help you get better sleep.
It may make you calmer
Research has shown that forms of body-to-body contact like hugging can be stress-relieving, and the same applies to bedtime snuggling. “It can produce a feeling of calm and even have physiological effects, including lowering blood pressure and essentially lowering that ‘fight or flight’ or sympathetic nervous-system response,” says Troxel.
She says that such a calming response before bedtime—“particularly with somebody with whom you have a good quality relationship”—can promote feelings of safety, security, and relaxation, which could be beneficial for sleep.
Dr. Simran Malhotra, an internal medicine and lifestyle medicine physician in Bethesda, Md., says that for married couples, snuggling has been shown to boost relationship satisfaction more than just spending time together does. “It also enhances sleep quality by promoting feelings of safety and security, especially for women,” she adds.
The oxytocin effect
Another reason that snuggling may be a boon for sleep relates to what scientists know about oxytocin, sometimes aptly called the “cuddle hormone” or “love hormone.”
Research shows that snuggling increases feelings of comfort, relaxation, and intimacy, while boosting positive emotions. All of these benefit sleep quality and overall well-being. These feelings come from oxytocin, which is released through various forms of touch, says Malhotra, and is known to reduce anxiety, depression, and stress by lowering cortisol levels, which can have a negative impact on sleep quality.
Different types of touch that don’t just involve sex—cuddling, hugging, or even holding hands—can generate this hormone and an “anti-stress response” along with it, says Troxel.
Snuggling can enhance your sleep routine
“Routines in general are good for sleep,” says Troxel—and that includes the five or 10 minutes you spend spooning each night. Historically, sleep has always been a communal behavior, so a tilt toward solo sleep is only relatively recent. Historian A. Roger Ekirch wrote in his book At Day’s Close: Night in Times Past that nighttime was “man’s first necessary evil” and caused a lot of fear, particularly in pre-industrial societies before artificial light was invented. Ekrich posited that sharing a bed offered a sense of security and physical warmth that was critical to ward off real and imagined threats at night. Even now, sleep remains a vulnerable state, Troxel says, and we as humans tend to derive a sense of security via our connections with others. “That’s why it is important to take a close look at how our nighttime routines have changed—in many cases, they are absent all together, and often they are solitary instead of social,” says Troxel. Saying no to snuggling is a missed opportunity for social connection in an increasingly socially isolated world.
Everyone is aware that using technology before bed is detrimental for sleep, but one little-known reason why is that it’s a solitary activity, says Troxel. In the distant past, the options for pre-sleep activities were limited and often social in nature, such as gathering around the fire. Now, smartphones and tablets rule the night.
“There is even a term for this called ‘technoference,’ which refers to the increasingly common phenomenon where the use of technological devices interferes with face-to-face (or skin-to-skin) interactions, including cuddling,” she says.
Having some physical contact and an opportunity to enhance your relational bond prior to sleep, by contrast, “can be very beneficial to cue the brain, ‘OK, now it’s time for settling and unwinding,’” says Troxel.
Take the example of Saša Malek, a technical documentation specialist based in Munich. She wears an Oura Ring, a smart ring that tracks fitness and sleep. “I realized what really helps me before bed is certain types of body closeness, like cuddling—emotional embodied closeness between me and my partner,” says Malek. When she cuddles, she falls asleep more quickly and gets more REM sleep. “It’s really about allowing your body to relax.”
“When I’m not having sufficient REM sleep, I have trouble. I’m cranky, and my psychology doesn’t adapt well,” she says, so when she figured out this pattern with her Oura data, she started to prioritize cuddling.
Pets can be good snuggle partners, too. The fitness-tracker brand WHOOP found in 2022 that sharing a bed with their dog or cat helped people feel more rested and recovered the next day, and helped them sleep a few extra minutes. Despite these potential perks of tucking in with a four-legged friend, research is mixed on whether cuddling with pets in your bed helps or hurts sleep quality; more is needed.
When is the best time to snuggle?
Studies suggest that many couples cuddle before bedtime, and then when it’s time for sleep, they go their separate ways, says Troxel.
Dr. Dylan Petkus, founder of Optimal Circadian Health in Tallahassee, Fla., says that some research shows that touching, hugging, massaging, and being intimate with a partner during sleep onset generally has a positive impact on sleep quality. But cuddling can also negatively affect sleep if it goes on for too long, he points out.
That same study indicates that there’s a specific threshold of nighttime physical contact for people which can deteriorate sleep quality. “This was highly individual,” says Petkus. “Everybody has a certain snuggle requirement that can improve sleep. If you go over that, it can lead to sleep disruptions.”
Whether cuddling negatively or positively impacts your sleep depends on the person and also how sleep is measured. “Many people may feel like they sleep better after cuddling, but that doesn’t necessarily manifest in objective measures of sleep,” says Troxel. What’s soothing and enjoyable for one person can be a sleep disruptor for someone else—particularly for those with a history of trauma.
Being too close can cause discomfort, overheating, or limited movement, which can wake someone up when they are trying to sleep, says Shelby Harris, director of sleep health at Sleepopolis, an independent sleep and mattress review website. Plus, if one partner moves a lot, it can disturb the other, leading to poor sleep. Those sensitive to temperature or movement may have an especially tough time with falling asleep snuggling, she says.
“It’s not going to be a one-size-fits-all approach,” echoes Troxel.
Cheryl Groskopf, a therapist in Los Angeles, says that cuddling comes up a lot in couples’ sessions, and she often coaches clients through such a wide spectrum of cuddling preference differences. “One partner sees not cuddling as rejection, while the other finds it suffocating,” she says. What’s important in this scenario is to explore each person’s needs and come up with a compromise.
For one couple that Groskopf counseled, this meant implementing a set snuggle time before sleep, then transitioning to separate sleeping positions. She also says using separate comforters or sheets can help regulate temperature, making sleep and even snuggling more comfortable for everyone. “The goal is to find a balance that makes both partners feel valued and comfortable without compromising intimacy,” she says.
What’s the best snuggling position?
A lack of research means it’s hard to single out an ideal position prescription for snuggling. But Harris and Malhotra both mention “spooning” as the most common choice. (This position involves one person lying on their side, and the other person curling up behind them on their side as well). “It allows for close contact while still giving room to move and breathe,” says Harris.
If spooning isn’t for you, you can still get the health and relationship benefits through various forms of touch like hugs, hand-holding, gentle stroking and massage, says Malhotra. It’s true from birth: “During the newborn period, skin-to-skin contact, a form of snuggling, has been shown to significantly improve infants’ sleep quality,” she says.
Since the limited research doesn’t help to provide any guidelines on how to snuggle to reap the most benefits, experts agree you should do what feels best for you and your partner. That could be, say, cuddling in the nook of your spouse’s shoulder or squeezing hands for a few seconds to feel some closeness.
Perhaps most relevant for couples in this modern age is how solitary we’re making the experience of sharing a bed when it doesn’t have to be, and wasn’t for our ancestors, says Troxel. “It’s a sacrifice that couples are inadvertently making, and they’re not even realizing it,” she says. If we ignore that chance to connect “by independently scrolling through our phones or iPads or watching Netflix, we’re really neglecting that very rare opportunity which could be a sacred ritual,” she says.
Some lucky sleepers climb into bed, close their eyes, and are out cold within five minutes. Others stare at the ceiling for an hour, check the clock, try to find a fresh angle of the ceiling to observe, and then toss, turn, and repeat, every night, week after week.
Insomnia affects 10% to 15% of the U.S. population, and it’s usually caused by a variety of biological and behavioral factors, says Dr. Sairam Parthasarathy, director of the University of Arizona Health Sciences Center for Sleep, Circadian and Neuroscience Research. Women, people who work nights, and seniors are among those most at risk. It often runs in families, and recently, experts concluded that COVID-19can trigger new insomnia.
While everyone will experience the occasional sleepless night, usually brought on by stress or lifestyle changes, chronic insomnia occurs three or more nights a week, lasts more than three months, and can’t be fully explained by a health problem. “For those who are in the ‘very severe’ category, it can be debilitating and incapacitating,” Parthasarathy says. “We see people where it’s crippling, and then there are some where it’s been annoying them for years”—and when they retire or otherwise have more free time, they finally decide to do something about it.
There’s good reason to work on putting your insomnia to sleep: The sleep disorder is associated with an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. And it can make you miserable.
Fortunately, resetting your sleep schedule can help the majority of people recover from insomnia—and cognitive behavioral therapy for insomnia, or CBT-I, is a proven way of doing it. But it takes time, and it’s not always an easy process.
A new sleep schedule
CBT-I is like “a brain retraining program,” says Dr. Jing Wang, clinical director of the Mount Sinai Integrative Sleep Center and an associate professor at the Icahn School of Medicine at Mount Sinai. Over the course of weekly sessions for around four to eight weeks, you’ll work with a sleep doctor or psychiatrist to target the behaviors and habits perpetuating your insomnia.
One of the cornerstones of treatment is sleep restriction therapy, which helps reset and create new habits around what happens when you’re in bed. Patients generally keep a sleep diary tracking what time they get into bed, when they wake up, and how many hours they actually sleep, Parthasarathy says. Then, doctors use that information to create a temporary schedule. Imagine, for example, that someone goes to bed at 8 p.m. and gets up at 6 a.m., but they’re only actually asleep for six of those hours. The rest of the time? They’re lying there in agony, stressed over the fact that they’re still awake—or they’re rummaging through the fridge, and then turning their laptop on to at least make that sleepless time productive.
With sleep restriction therapy, Parthasarathy would work backward from that hypothetical patient’s wake time (6 a.m.), since it’s probably non-negotiable due to work. Then he would instruct the person to get into bed at midnight—with the idea that they’d fall right asleep and get the same six hours of sleep before getting up at 6 a.m. Other patients will have different get-into-bed times, based on how many hours they’re currently sleeping per night, and what time they need to get up. (Doctors never set a schedule that drops someone below 5.5 hours of sleep per night, however.)
No matter how tired a person feels leading up to midnight—or whatever other sleep time they’ve been assigned—they’re not allowed to climb into bed. “We’re trying to consolidate the sleep period, and take off the time where sleep is not actually happening in the person’s bed,” he says. “By making them go longer without sleep, their brain becomes thirsty for it. So when they go to bed at 12, they’re not tossing and turning for an hour. They fall asleep in 5 or 10 minutes.”
After one week, Parthasarathy assesses how well his patients are sleeping. While sleep diaries aren’t always 100% accurate, he’s found that patients generally do a good job estimating how long it took them to fall asleep, and how much they were awake during the night, especially given that many watch the clock. If someone’s sleep efficiency was greater than 90% every night—meaning they slept for more than 90% of the time they were in bed—he’ll relax their sleeping window by 15 minutes, so they get to go to bed slightly earlier. He’ll continue adjusting the sleep window by 15-minute increments weekly until the person’s sleep efficacy drops to 85% to 90%. “If it falls below 85%, that means there’s a lot of them lying around in bed, and we don’t want that,” he says. With time, patients’ sleep schedules are adjusted to their ideal bedtime—and by then, their body has learned that as soon as they get into bed, it’s time to fall asleep. “There’s subliminal programming that happens in our brain,” Parthasarathy says.
Though CBT-I is considered safe and effective for most people, sleep restriction can be exhausting; as Parthasarathy acknowledges, things often get worse before they get better for people with insomnia. That’s why he advises people with conditions like a seizure disorder or bipolar disorder to avoid CBT-I—lack of sleep can be triggering. It’s not always the right choice for people in jobs that require vigilance, either, like public-transportation drivers.
In general, even if you proceed with CBT-I, it’s important to be safe in those hours before you’re allowed to get into bed. “The first week or two after starting sleep restriction, people will feel sleepier,” Parthasarathy says. “Some of them are like, ‘Why am I doing this to myself?’” In addition to avoiding risky behaviors like driving, experts recommend filling the hours before you’re allowed to get into bed with relaxing activities: maybe journaling, taking a bath, or meditating.
Setting yourself up for success
Improving sleep hygiene is an essential part of CBT-I, Wang says. That includes adopting new habits around screens: Wang recommends turning off phones, computers, and even the TV at least one to two hours before going to bed. Part of the problem with screens, she says, is the light they produce: It suppresses melatonin, the hormone that helps prepare you for sleep.
The content on your screens can also be problematic. People have heightened reactions to, for example, watching the news, Wang points out—while some stay up late to catch whatever’s going on in politics or around the world, the scenes they see playing out can upset them to the point that they’re unable to sleep. Watching a horror film before bed can have a similar effect.
In addition to keeping your bedroom as dark as possible, consider ditching your alarm clock. “Cover it, or take it out of the bedroom,” Wang advises. “That act of looking at the time is activating. You’re taking a mental check: ‘OK, it’s midnight, I need to be up in five hours.’” That kind of stress certainly does not encourage sleep.
Wang also urges patients to ditch the sleep trackers—or at least look at them less frequently. Some people get fixated on combing through data, she’s found, obsessing over every slight change in their sleep patterns. “There’s always night-to-night variability,” she says. “So for somebody for whom looking at that data is causing a lot of anxiety, and that’s getting them more worked up, I really encourage them not to check it.”
Adjusting lifestyle habits
What you eat and drink before going to bed can play a role in how soundly you sleep. Doctors generally recommend not eating right before bed—late meals are linked with more frequent wake-ups during the night. And it’s a good idea to cut off caffeine intake by 12 p.m., says Dr. Emerson Wickwire, section head of sleep medicine at the University of Maryland Medical Center.
Proceed carefully, too, with alcohol intake. “Alcohol makes everything about sleep worse,” Wickwire says, “with one exception—you’ll fall asleep faster.” After that, things take a turn. Alcohol is a muscle relaxant, which means it relaxes the muscles in the upper airway, potentially causing symptoms of obstructive sleep apnea, even in people who aren’t diagnosed with the condition. “The second reason that alcohol can impair sleep is that it changes the distribution of sleep stages across the evening, or what’s called sleep architecture, and that can negatively impact brain function,” he says. You might find that you experience more fragmented sleep after drinking, waking up frequently and having trouble falling back asleep.
People with a napping habit also need to make adjustments while undergoing CBT-I. The sleep drive is influenced by how long you’ve been awake and how active you’ve been, Wickwire says. While napping is OK for people who don’t have insomnia, it can thwart progress during CBT-I, because it means someone won’t be as tired when it’s time to go to bed. For example, if you get up at 7 a.m., you’ve been awake for 16 hours by 11 p.m.—which means your body should be craving sleep. “But if you take a nap at 6 p.m., by 11 p.m. you’ve only been awake for four or five hours,” he says, which could sentence you to a night of tossing and turning.
A role for medication
Clinical practice guidelines from the American Academy of Sleep Medicine consistently recommend CBT-I as the first-line treatment for chronic insomnia. “There are multiple studies that have compared outcomes between behavioral treatments and medication treatments,” Wickwire says. “And in general, CBT is equally effective in the short term, with gains better maintained over time.” Research suggests that CBT-I leads to fewer side effects than medication, a lower chance of relapse, and a tendency for sleep to continue improving long into the future.
“No pill can teach your body how to sleep,” Wickwire says. “At the same time, that’s not to say that all sleep medications are bad.” Patients should talk to their provider; sometimes, like in especially severe cases, it makes sense to combine CBT-I with a prescription sleep medication.
Over-the-counter sleep supplements are a different story. It’s important not to rely on products like ZzzQuil, Benadryl, melatonin gummies, or Advil PM, Wang says. “If you’re sick and need to take one, that’s fine.” But with melatonin especially, “There’s a lot of variability and potential for misuses, or inadvertently causing the reverse effect. We really discourage self-medicating for insomnia.”
Light at the end of the tunnel
People with insomnia often start to see improvement in how much sleep they’re getting within a couple weeks. Exactly how quickly people respond varies, Wang says; some might need six to 12 weeks before noticing a meaningful difference.
Wang likes to remind patients—who are often stressed and exhausted—that change is possible. “Oftentimes it’s very slow. We don’t expect that tomorrow, these issues will all go away,” she says. “It’s the little steps and consistency—and encouraging people who feel like this is too hard that, yes, it may get worse before it gets better.” But if you keep at it, she adds, long, peaceful nights of slumber will be more than a sweet dream.
Parvovirus B19, a respiratory virus that causes a telltale “slapped-cheek” rash, is on the rise in the U.S., according to an Aug. 13 alert from the U.S. Centers for Disease Control and Prevention (CDC).
There’s no routine surveillance for parvovirus in the U.S., but several indicators suggest the virus is spreading widely right now, the CDC says. Doctors have reported unusual numbers of parvovirus-related complications among two high-risk populations: pregnant people and patients with blood diseases. And as of June, laboratory data hinted that about 10% of the U.S. population—and 40% of kids ages 5 to 9—had antibodies in their blood suggesting they were recently infected, the CDC’s alert says.
Here’s what to know about parvovirus B19 as the virus circulates.
What is parvovirus B19?
Parvovirus is a common respiratory illness, with “mini-outbreaks” occurring roughly every three to four years, according to the National Library of Medicine (NLM). In developed countries like the U.S., the vast majority of people get it at some point during their lives, often during childhood. Up to 10% of kids get parvovirus by the time they’re 5, the NLM says, and about half of people have had it by age 20.
Parvovirus B19 is a virus that solely affects humans; it’s different from the parvovirus that affects pets. Like other respiratory diseases, it spreads person-to-person, commonly through the respiratory droplets expelled when a sick person sneezes or coughs, the CDC says.
Most of the time, the CDC says, cases are mild or even asymptomatic. When people do develop symptoms, they commonly start with fever, headache, cough, and a sore throat. As the illness progresses, people may develop additional symptoms. The most distinctive later-phase symptom is a red facial rash—also known as a “slapped-cheek” rash—that more commonly affects children than adults. Some may also develop a rash covering the torso, limbs, and buttocks.
Patients with parvovirus may also develop joint pain as their illness progress. Sometimes, according to the CDC, joint pain is the only symptom adults experience, and it may last for weeks or even months following infection.
Is parvovirus B19 serious?
People who are otherwise healthy usually recover from parvovirus on their own and require no treatment. But complications are possible for certain groups.
People with blood disorders or compromised immune systems may experience potentially serious anemia—a drop in red blood cells—if they catch parvovirus, according to the Mayo Clinic. And pregnant people who catch the virus may pass it to their fetus, potentially causing anemia in the fetus and raising the risk of miscarriage or stillbirth. People who fit into these categories should see a doctor if they think they have parvovirus.
What should I do during the parvovirus B19 outbreak?
There is no vaccine that can prevent parvovirus’ spread, so the best way to avoid infection is to wash your hands frequently, clean communal surfaces like doorknobs regularly, and avoid direct contact with someone who is sick with the virus. People are most contagious during the early phases of the illness, the CDC says. Someone is unlikely to be contagious by the time they develop a rash or joint pain.
During the current outbreak, the CDC says, people who work in high-risk settings—such as schools and daycares—or who are at high risk of complications may consider wearing a mask for additional protection.
Online health influencers have plenty to say lately about oils. We should cook with certain oils, banish others from our pantries, swish them around our mouths for flawless gumlines, and lather our bodies and hair with them for everlasting beauty. About the only purposes not suggested for oils are finding lost socks and doing our taxes.
The focus on oils isn’t exactly new; they’ve been praised and debated for eons. The difference today is that scientific research can help separate fact from fiction. But studies are often misunderstood or rejected in favor of personal anecdotes that may be unreliable.
Here are the biggest oil myths going around the internet, according to scientists.
Myth #1: It’s bad to cook with olive oil
The unrefined version of olive oil—extra virgin, or EVOO—provides significant health benefits, especially in preventing heart disease. However, some online gurus say cooking with EVOO is problematic because of its low smoke point, meaning that, when heated, it may start smoking sooner than other oils. The smoke is viewed as a signal of chemicals developing in food that may eventually cause cancer and heart disease.
But scientific research doesn’t support this “where there’s smoke, there’s fire” theory. In fact, cooking with EVOO can make both the oil and the food it’s covering healthier, compared to the same food eaten raw, according to recentresearch.
Smoke “doesn’t correlate very well with the actual breakdown of the oil,” says Selina Wang, associate professor of food science and technology at University of California, Davis. EVOO is packed with phenols, compounds that support health partly by reducing inflammation. Phenols also protect the oil from deteriorating—regardless of whether it’s smoking. Unlike other oils, “EVOO has the ability to protect itself,” Wang says.
Oils produce the most smoke during high-temperature cooking processes like frying, which aren’t healthy to begin with. “Smoke point is irrelevant because we shouldn’t cook at those temperatures,” says Mary Flynn, associate professor of medicine at Brown University who studies olive oil.
Wang advises cooking food like vegetables in EVOO at lower temperatures, below 400°F, for just long enough to heat up the veggies—and for their health-giving properties to seep into the oil’s healthy fat. (On a stovetop, this advice may translate to medium heat, though stoves vary in their cooking strengths.) Once transferred to the oil, the beneficial components, such as vitamins and substances called antioxidants that protect the cells from unstable molecules, are absorbed better by our bodies. Antioxidants called carotenoids, for example, help protect against cancer.
The synergy goes the other way, too: the healthy olive oil components “get sucked into the vegetables,” Flynn says. “In the U.S., we don’t consume our vegetables with fat.” That’s a mistake, because when it comes to getting these micronutrients, “if you’re not cooking vegetables with fat, they’re not getting into your body.”
Reducing cooking times with EVOO will also ensure a high level of phenols. If cooked longer, their levels decline. Diets rich in phenols are linked to lower risk of heart disease, cancer, and neurodegenerative diseases.
Myth #2: More expensive oil is healthier
The prices of cooking oils are sometimes inflated to suggest they’re superior to their shelf neighbors. In reality, the cost of EVOO reveals little about its quality. Often, bottles between $45 and $90 are “no better” than more reasonably-priced brands.
Instead of cost, judge EVOO by whether the bottle was produced in California. Large producers in California must pass the state’s tests requiring purity and authenticity. Olive oil is often fraudulent and mixed with other cheaper oils.
Freshness matters, too. Look for bottles with “harvest dates” showing they’re relatively new to shelves. After opening a bottle, try to use it within four to six weeks. Secure the cap tightly between uses. “Oxygen will destroy the health components,” explains Flynn, who is also an independent science advisor to the Olive Wellness Institute.
Most important may be an old-fashioned taste test. “One of the best tools we can give consumers is to know the flavor of good olive oil,” Wang says. A teaspoon of EVOO should taste slightly bitter at first, she says, followed by a pungent, spicy tingle at the back of your throat—a sign of its phenols—perhaps causing a couple of coughs.
Myth #3: Non-olive oils are unhealthy
Seed oils such as canola are the scourge of several online influencers, who cite studies on the harms of consuming these oils. But such studies are often misinterpreted. Scientists think seed and vegetable oils can be healthy, with some important caveats.
Unlike EVOO, most oils are refined, meaning they’re heat-treated. This process strips some of their healthful properties—reducing their phenols, for example. However, refined oils like canola are still high in monounsaturated fats—though not as high as EVOO—that buoy heart health.
“I don’t want to stigmatize other oils,” Wang says, because they’re generally more affordable than EVOO. She has friends who understand EVOO’s benefits but buy less expensive seed and vegetable oils to save money.
These oils are healthyenough for home cooking, but the problem is what happens in restaurant kitchens, Wang says. Trying to keep their costs low, many restaurants cook with cheap oils like canola and reuse the same oil puddle. Over several hours, the fats in these recycled oils become oxidized, producing harmful compounds that can lead to serioushealth issues for those who dine out often. The same concern applies to many cooked items in the prepared food sections of supermarkets.
Like technology, Wang says, it’s not seed or vegetable oils themselves that are bad, but how they’re made and used.
Coconut oil, on the other hand, is inherently unhealthy, says Qi Sun, an associate professor of nutrition at Harvard, despite influencers touting the benefits of consuming it, such as curing back pain and boosting energy and cognition. Scant research supports these claims, and coconut oil is high in unhealthy saturated fats; one tablespoon-sized serving has about 90% of the daily allowance recommended by the American Heart Association. Because it raises fats in the blood linked to heart disease—LDL cholesterol and triglycerides—“you can conclude it wouldn’t provide any cardiovascular benefits,” Sun says. “It’s not too different from butter or lard.”
By comparison, the same amount of olive oil has 15% of daily recommended saturated fat. Even this lower saturated fat content is potentially harmful, so limit EVOO to 2-4 tablespoons per day, Wang says.
Myth #4: Oil pulling beats brushing and flossing
Another coconut oil myth is that swishing it around the mouth is better for oral health than standard dental practices. Advocates of “oil pulling” claim that the lauric acid in coconut oil helps fight harmful bacteria and plaque that would otherwise build up in the mouth. But credible research hasn’t suggested benefits, whereas brushing and flossing are backed by far more evidence.
“Has oil pulling ever reversed periodontitis or gingivitis? The answer is no,” says Mark Wolff, professor of restorative dentistry at the University of Pennsylvania.
Not that oil pulling will necessarily hurt you. “There’s no real reason it would cause harm,” Wolff says, unless it’s substituted for the gold-standard approaches to oral health. “If you want to oil pull, it’s okay, but still brush and floss,” and use doctor-prescribed antibiotics, not oils, to treat oral infections, says Matthew Messina, assistant professor of dentistry at Ohio State University.
The swishing action of oil pulling may remove debris from between teeth, which could help with preventing dental problems. But flossing, oral irrigation devices like water flossers, and common mouthwashes with specific antimicrobial ingredients are research-supported options for dislodging these food particles. Sesame and sunflower oils are sometimes recommended for oil pulling, based on Ayurvedic medicine practices. However, like coconut oil, they’re lacking in evidence.
Myth #5: Coconut oil transforms hair
Several oils, including coconut oil, contain fatty acid ingredients that hydrate the hair, softening and smoothing it. But claims about the wonders of suffusing hair with coconut oil are exaggerated. These oils may cause more harm than benefit, depending on the person.
Coconut oil could help some who regularly color their hair, heat it, or use potentially harmful products, says Dr. Joshua Zeichner, associate professor of dermatology at Mt. Sinai Hospital in New York City. “You want to make sure you’re hydrating the hair shaft, strengthening and protecting it, especially when caring for chemically treated hair,” he says. Coconut oil could serve this purpose by forming a protective barrier. Zeichner compares it to spackling your walls. “It’s kind of filling in the cracks.”
But use it in moderation, says Dr. Michele Green, a New York City dermatologist—not every night.
For dandruff relief, coconut oil is a “double-edged sword,” Zeichner says. “If it creates a greasy environment, it encourages yeast to grow,” worsening dandruff in some cases, he explains.
Don’t reach for EVOO as an alternative, Green says. “There’s no evidence that olive oil improves hair health.” Rosemary oil is a hot trend currently for hair growth, she adds; people massage it into the scalp twice daily, in the morning and evening, leaving it in their hair overnight. “There’s a small research literature showing it could work,” although it can irritate the scalp if it’s not mixed with another oil, like argan or coconut, Green adds.
Myth #6: Oils cure acne
Applying oil to the skin, like the hair, may benefit some people while causing trouble for others.
The lauric acid in coconut oil has antimicrobial properties, “so it’s thought to decrease levels of acne-causing bacteria and even yeast on the skin,” Zeichner says. However, coconut oil is comedogenic, meaning it can clog the pores and increase acne. Also comedogenic are olive, marula, flaxseed, and carrot seed oils. “I would stick with refined, non-comedogenic moisturizers proven not to block the pores,” Zeichner says. “The perception is that natural is better, but that’s not always the case.”
Green sees value in natural oils for overall skin health for some patients, but they should be used in moderation and combined with moisturizers. “The additional moisture is retained by the barrier the oils offer,” she says.
EVOO, in particular, may enhance the skin’s natural moisture barrier, due to its healthy fat, antioxidants, and vitamins A, D, K, and E, according to Green. Jojoba, argan, and almond oils could be beneficial, too. Almond oil is a common allergen, though. Test it on one spot to check for irritation, Green suggests.
“Some data from lab studies support the use of individual natural oils on the hair and skin,” Zeichner says. “But we’re lacking studies on the real-world use of products.”
LONDON — The World Health Organization has declared the mpox outbreaks in Congo and elsewhere in Africa a global emergency, with cases confirmed among children and adults in more than a dozen countries and a new form of the virus spreading. Few vaccine doses are available on the continent.
Earlier this week, the Africa Centers for Disease Control and Prevention announced that the mpox outbreaks were a public health emergency, with more than 500 deaths, and called for international help to stop the virus’ spread.
“This is something that should concern us all … The potential for further spread beyond Africa and beyond is very worrying,” said WHO director-general Tedros Adhanom Ghebreyesus.
The Africa CDC previously said that mpox, also known as monkeypox, has been detected in 13 countries this year, and that more than 96% of all cases and deaths are in Congo. Cases are up 160% and deaths are up 19% compared with the same period last year. So far, there have been more than 14,000 cases and 524 people have died.
“We are now in a situation where (mpox) poses a risk to many more neighbors in and around central Africa,” said Salim Abdool Karim, a South African infectious diseases expert who chairs the Africa CDC emergency group. He noted that the new version of mpox spreading from Congo appears to have a death rate of about 3-4%.
During the global 2022 mpox outbreak that affected more than 70 countries, fewer than 1% of people died.
Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, said declaring the mpox outbreaks in Africa an emergency is warranted if that might lead to more support to contain them.
“It’s a failure of the global community that things had to get this bad to release the resources needed,” he said.
Officials at the Africa CDC said nearly 70% of cases in Congo are in children younger than 15, who also accounted for 85% of deaths.
Jacques Alonda, an epidemiologist working in Congo with international charities, said he and other experts were particularly worried about the spread of mpox in camps for refugees in the country’s conflict-ridden east.
“The worst case I’ve seen is that of a six-week-old baby who was just two weeks old when he contracted mpox,” Alonda said, adding the baby has been in their care for a month. “He got infected because hospital overcrowding meant he and his mother were forced to share a room with someone else who had the virus, which was undiagnosed.”
Save the Children said Congo’s health system already had been “collapsing” under the strain of malnutrition, measles and cholera.
WHO Director-General Tedros Adhanom Ghebreyesus said officials were facing several outbreaks of mpox outbreaks in various countries with “different modes of transmission and different levels of risk.”
The U.N. health agency said mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda, and Uganda. All of those outbreaks are linked to the one in Congo. In the Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread worldwide in 2022.
Earlier this year, scientists reported the emergence of a new form of the deadlier form of mpox, which can kill up to 10% of people, in a Congolese mining town that they feared might spread more easily. Mpox mostly spreads via close contact with infected people, including through sex.
Unlike in previous mpox outbreaks, where lesions were mostly seen on the chest, hands, and feet, the new form causes milder symptoms and lesions on the genitals. That makes it harder to spot, meaning people might also sicken others without knowing they’re infected.
In 2022, WHO declared mpox to be a global emergency after it spread to more than 70 countries that had not previously reported mpox, mostly affecting gay and bisexual men. Before that outbreak, the disease had mostly been seen in sporadic outbreaks in central and West Africa when people came into close contact with infected wild animals.
Western countries mostly shut down the spread of mpox with the help of vaccines and treatments, but very few of those have been available in Africa.
Marks of the London School of Hygiene and Tropical Medicine said that in the absence of mpox vaccines licensed in the West, officials could consider inoculating people against smallpox, a related disease. “We need a large supply of vaccine so that we can vaccinate populations most at risk,” he said, adding that would mean sex workers, children and adults living in outbreak regions.
Congolese authorities said they have asked for 4 million doses of mpox vaccine, Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee, told The Associated Press. Osako said those would mostly be used for children under 18.
“The United States and Japan are the two countries that positioned themselves to give vaccines to our country,” Osako said.
Although WHO’s emergency declaration is meant to spur donor agencies and countries into action, the global response to previous emergency designations has been mixed.
Dr. Boghuma Titanji, an infectious diseases expert at Emory University, said the last WHO emergency declaration for mpox “did very little to move the needle” on getting things like diagnostic tests, medicines and vaccines to Africa.
“The world has a real opportunity here to act in a decisive manner and not repeat past mistakes, (but) that will take more than an (emergency) declaration,” Titanji said.
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Associated Press writers Gerald Imray in Cape Town, South Africa, Christina Malkia in Kinshasa, Congo and Mark Banchereau in Dakar, Senegal contributed to this report.
In your 20s and 30s, heart disease can seem like a far-off concern. It’s more common among people 75 or older than in any other age group.
But there’s good reason to think about your heart health decades earlier: “While young adults often associate heart disease with people in their parents’ and grandparents’ ages, it’s never too early to start prevention,” says Dr. Nieca Goldberg, a cardiologist, author, and clinical associate professor at NYU Grossman School of Medicine. “In fact, 80% of heart disease is preventable.”
If there’s just one thing you do for your heart when you’re young, it should be increasing your physical activity, experts agree. “Exercise is the foundation of heart-disease prevention, and combining aerobic exercise with resistance training has been shown to have the greatest impact on preventing and managing heart disease,” Goldberg says. That’s because physical activity taxes your heart and lungs, helping them to adapt to the stress and grow stronger over time.
Getting regular exercise is also a step in the American Heart Association’s (AHA) Life’s Essential 8, a list of eight crucial health behaviors for maintaining optimal cardiovascular health. Aside from staying active, the list also includes eating a nutritious diet; managing your blood pressure, cholesterol, and blood sugar; maintaining a healthy weight; quitting tobacco; and getting plenty of sleep.
Starting with physical activity will likely trickle down to these other arenas, says Dr. Keith Churchwell, president of the AHA. “If you stay active, it probably will help your sleep, it’ll probably help you in terms of thinking about your diet appropriately. It’ll help in terms of reducing your blood pressure, controlling your lipid status, your weight…and hopefully keep you away from other issues, like tobacco use.”
How to get (even just a little) more exercise
You don’t have to suddenly become a runner or join a gym if that’s not your style. You can focus on simply moving more throughout the day to start, Churchwell says. Take an extra stroll with your dog, meet a friend for a walk instead of a drink, finally give pickleball a try, or sign up for a dance class. Even just 20 more minutes of activity a day is a great benchmark to aim for, he says.
It’s important not to go too hard, too fast. “The idea here is you want to establish lifestyle changes that are truly going to last you a lifetime,” says Dr. Nishant Shah, a preventive cardiologist and assistant professor at Duke University School of Medicine and the Duke Cardiometabolic Prevention Clinic. “Whatever you decide to do now, don’t do it with the intention of stopping it six months later.”
Establishing a lifelong fitness plan means identifying forms of exercise you actually like; it’s fine if CrossFit isn’t your thing. “Spend time to find activities that you enjoy so it doesn’t feel like a chore,” Goldberg says.
Gradually build up to at least 150 minutes of moderate or 75 minutes of vigorous cardio activity, plus two strength-training sessions a week. That’s the general AHA recommendation for overall health and wellbeing.
You can modify and tailor your exercise program to your specific needs, abilities, interests, and fitness level, Goldberg says. If you’re not sure how to get started, speak with your doctor or a certified fitness professional who can guide you. “Start small and build from there: Consistency is key, so it’s important to ensure your routine is manageable based on your current lifestyle and commitments,” she says.
It can get harder to start a physical activity routine as you get older, so it may be easier to maintain for your entire life if you make it a habit in your 20s or 30s. “When you maintain a habit of exercising at an earlier age, it’s just normal for you,” Shah says.
Finding the time can be tough, though, he admits. Try blocking off 30 to 60 minutes of your day for exercise just like you would for any other commitment or meeting, and then stick to it, he says.
Shah offers one caveat to the exercise-first mentality: If you use tobacco, the most important heart-health habit for you, no matter your age, is to stop. While only about 5 to 12% of Americans in their 20s and 30s smoke now, according to a 2023 report in JAMA Health Forum, it’s still the most important habit to quit for your heart and overall health, he says, even before picking up an exercise routine. Smoking is linked to about one-third of heart disease-related deaths.
And whether or not you’re ready to make some heart-healthy changes, talk with your relatives about any heart-health concerns in your family tree—especially your first-degree relatives. “Oftentimes when I see patients in this age range, they are unaware of any conditions that run in the family,” says Dr. Maxim Olivier, a cardiologist at Orlando Health Heart and Vascular Institute. “A good family history is very important to determine if they are at an increased risk for premature coronary artery disease, heart disease, or even sudden cardiac death. Though the ramifications may seem far off, there are patients who can present with heart disease as early as 20s to 30s, and even younger, which is often a reflection of their genetic predisposition and/or lifestyle.”
If you’re asked to share a few fun facts about yourself, you’re probably not going to rattle off your blood pressure or cholesterol levels (even if your “good” cholesterol is, well, really good). But you should have a solid sense of what those numbers are, experts say. Why? “That old adage that an ounce of prevention is worth a pound of cure is absolutely correct,” says Dr. Josh Septimus, an internal medicine physician with Houston Methodist Hospital. A small number of conditions, including heart disease and metabolic disorders, cause an enormous amount of suffering. “If we can identify a few things that help us prevent those morbidities, it’s very much worth your time.”
That said, you don’t have to know everything. Experts widely pan full-body health scans, for example, that claim to catch early signs of problems like cancer. And while it’s certainly possible to track and analyze your health data via smartwatches and other gadgets, you’re not necessarily going to gain much by doing so. Septimus’ patients sometimes “get lost in some random number,” he says—and when that happens, he refocuses them “on the basics.”
Here’s a look at the seven metrics everyone should know about their own health.
Your waist circumference
Septimus always tells medical students that if he had only one measurement to use to predict how greatly they’d suffer from medical problems, it would be waist circumference, which reveals the amount of fat around your middle section. If you have a waist size greater than 35 inches for women or 40 inches for men, your risk for heart disease, Type 2 diabetes, and other metabolic problems increases.
This is a much more useful measure than BMI, he says—a notion supported by research. It provides a more accurate estimate of abdominal fat, which predicts disease risk. Plus, BMI—which is calculated based on height and weight—doesn’t account for factors like muscle mass.
To figure out your waist circumference, wrap a tape measure around your middle section, right at your belly button. Make sure you’re standing up, and take the measurement after you exhale. “Know your number, and if it’s too big, try to make it smaller,” Septimus says. He regularly tells patients he doesn’t care what the scale says—that number can be influenced by, for example, new muscle mass—but he does like to challenge them to lose 1 to 2 inches off their waist in six months. “If you’re going to the gym and your waist size is dropping, it’s working,” he says. “If your waist size is not changing, it’s not working,” in which case it’s time to reevaluate your strategy, ideally with the help of a doctor.
Your cholesterol profile
You should always have a sense of your total cholesterol, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol. That’s why Dr. Sam Setareh, a staff cardiologist at Cedars-Sinai Medical Center and senior clinical researcher at the National Heart Institute, runs lipid panels on his patients at least annually. He repeats the tests every three to six months if someone has elevated levels they’re working on lowering. LDL, he adds, is the most important value: “That’s going to tell me about the patient’s risk of developing coronary disease or atherosclerosis,” also known as plaque-clogged arteries. (Not every doctor does this automatically, so you may need to ask for a panel if it’s been a while.)
Many people with high LDL will be prescribed medication like a statin, but that depends on factors like your personal risk level. As the U.S. Centers for Disease Control and Prevention points out, you might be prescribed medicine if your LDL is 190 mg/dL or higher, or if you’re age 40-75, have diabetes or a high risk of heart disease or stroke, and have an LDL level of 70 mg/dL or higher.
Your blood pressure
If you have high blood pressure, your heart has to work harder to pump blood—which, over time, can damage the walls of the blood vessels, leading to atherosclerosis. As Septimus points out, hypertension can trigger complications like heart attack and stroke, while hurting organs including your brain and kidneys. That’s why it’s so important to check your blood pressure at least once a year, and more often if you’re at higher risk based on factors like age, family history, and obesity.
According to the American Heart Association, normal blood pressure is less than 120/80 mmHg. Exactly how your doctor proceeds if yours is high depends on your individual circumstances. If you’re a 35-year-old with mildly elevated numbers, Septimus says, you’ll probably be instructed to make lifestyle changes. But if you’re 60 and your father died of a heart attack, it’s much more likely you’ll start medication. “We have dozens of blood pressure medications, many of which are cheap as dirt,” he says. “We can use them safely to reduce heart attack and stroke.”
Your blood sugar
There are a few basic ways doctors can measure blood sugar, but most rely on a hemoglobin A1C (HbA1C) test. “It’s a little bit of a crude tool, and it doesn’t tell the whole story, but it’s usually the best number to go with,” Septimus says. The test averages blood sugar over the past two to three months, and it’s used to diagnose Type 2 diabetes and prediabetes. If your A1C level is between 5.7% and 6.4%, you’ll meet the criteria for prediabetes. If you have an A1C of 6.5% or above, you’ll be diagnosed with Type 2 diabetes, in which case your doctor might encourage lifestyle changes or prescribe medication like metformin.
You should get your A1C tested annually if you’re over 45, or if you’re younger but are overweight or have risk factors like a sedentary lifestyle or a parent or sibling with diabetes. People with diagnosed diabetes, meanwhile, usually test at least twice a year, depending where they are in their treatment regimen.
Your basal metabolic rate
It’s easy to confuse basal metabolic rate, or BMR, with that other three-letter acronym that starts with a B: BMI. But the two measures are markedly different. Your BMR measures the minimum amount of energy your body needs to function at rest. “It’s the fuel your body burns just to stay alive each day,” says Dr. Farhan Malik, medical director at Atlanta Innovative Medicine. Knowing your BMR, he explains, allows you to determine if you’re eating enough to support your body’s basic needs. That way, you can ensure changes to your diet and exercise routine are safe and sustainable.
Lots of onlinecalculators can determine your BMR if you plug in your age, height, weight, and gender. For example, a 30-year-old woman who’s 5’5″ and 130 pounds would have a BMR of around 1,300 calories per day. “If she’s exercising a few times a week, she’d want to consume more than that to avoid fatigue and maintain muscle,” Malik says. “But without knowing her BMR, she wouldn’t have that frame of reference to set a proper calorie target.” This insight, he adds, helps you know what your body really requires to thrive every day.
Starting in your mid-30s: your grip strength
Grip strength—or how much hand and forearm power you have—is important. “It’s a good indicator of the future functionality a person will have as they age,” Setareh says. If you have strong hands, you’ll be able to open jars, swing a pickleball racket, lift heavy objects, and catch yourself when you fall. Research suggests that weak grip strength, on the other hand, is linked with diabetes, heart disease, and cognitive decline, as well as a higher risk of mortality and worse quality of life.
Setareh recommends asking your doctor or physical therapist to measure yours at your annual physical starting in your mid- to late-30s. Usually, the test involves squeezing a dynamometer, which is a device that measures power. If your grip strength could use improvement, your doctor will suggest a plan for special exercises you can do at home—like squeezing a tennis ball for 10 minutes twice a day—in addition to weight training and resistance training, Setareh says.
If you’re over 60: your vitamin D level
As you age, your body’s ability to convert sunlight into vitamin D decreases—which is why Dr. Meghan Garcia-Webb, an internist based in Wellesley Hills, Mass., checks patients’ levels annually after they turn 60. She does the same for adults who have darker skin (melanin can interfere with vitamin D synthesis) or live in areas that don’t get lots of sunlight (like the Northeast during gloomy winters). It’s also important to be tested regularly if you have a high body weight, “because vitamin D is a fat-soluble vitamin,” she says. “It’s going to get kind of sequestered into that fatty tissue.”
Why the focus on D? For starters, it plays an essential role in keeping bones strong and helping prevent osteoporosis, and it can bolster the immune system. While Garcia-Webb usually treats mildly to moderately low levels with an over-the-counter supplement, people with particularly low levels require a high-dose prescription tablet.
A fast-spreading mpox outbreak in Africa was declared a continent-wide public health emergency, as the region’s main health advisory body invoked this power for the first time as it moved to marshal resources.
The declaration will prompt countries in the region to share timely information on mpox’s spread with the Africa Centres for Disease Control and Prevention, helping it to better tap financial aid, Jean Kaseya, director general of the Addis Ababa-based agency, said on Tuesday.
“Today I commit to you that African citizens will lead this fight with every resource at our disposal,” he told a virtual press briefing. “We’ll work with government, international partners and local communities to ensure that every African, from the bustling cities to the remote area, is protected.”
A mutated mpox strain has spread to at least six African countries, infecting about 15,000 people and killing more than 500 in the Democratic Republic of the Congo this year alone. The variant was first reported in the DRC less than 12 months ago.
While mpox vaccines are available, few have made their way to Africa—the only continent where the disease is endemic. At about $100 per dose, the vaccines are currently very expensive, Kaseya has previously said. Africa will need about $4 billion to fight mpox, money that “we are confident that we can leverage,” he said.
About 200,000 doses will begin to be distributed in countries that are the most severely affected in the next two weeks, and work is under way to secure more than 10 million shots that it is expected the continent will ultimately need, according to Kaseya.
The move by the Africa CDC came a day before a panel of advisers convened by the World Health Organization is due to meet to help determine whether the deadly outbreak constitutes an international emergency.
The WHO last declared mpox a public health emergency of international concern in May 2022 when cases of a milder strain erupted globally, “but Africa didn’t get appropriate support,” Kaseya said. When the agency lowered its alert level a year later, “cases in Africa continued to increase and today we are facing the consequence of no assistance,” he said.
Africa CDC was only given the mandate to call regional public health emergencies in 2023, even as WHO warned it could also trigger travel and trade restrictions that would isolate the continent. Still, there is no reason to close borders or stop trading, Kaseya said.
“What we were doing before didn’t work,” he said. “We call upon our international partners to take this mpox as an opportunity to act differently and to work closely with African CDC and African countries to provide appropriate support to affected people.”
Face it: sometimes, you’re just too busy to pay attention to your skin. What’s a harried person to do, when skin-care routines touted online often have 10+ steps?
We went straight to the source—five dermatologists—for their desert-island tip: the one thing you absolutely must do every day for your skin. The answer was unanimous.
1. Always apply sunscreen
Everyone agreed: The No. 1 thing you can do to take care of your skin is apply sunscreen daily.
“Applying sunscreen every day is the most important thing you can do to keep your skin looking healthy and prevent skin cancer,” says Dr. Sara Perkins, assistant professor of dermatology at the Yale School of Medicine. “Ultraviolet radiation can lead to hyperpigmentation, fine lines, and wrinkles, not to mention basal and squamous cell skin cancer and melanoma.”
Sunscreen is a no-brainer if you work outdoors or live in a warm, sunny city. But even if you spend most of your time indoors or live somewhere that’s often overcast, it’s still important. “I think most people underestimate the amount of sun exposure they get each day through [things like] windows, running errands, walking the dog, and playing tennis,” she says. “We’re also still getting exposure on cloudy days and in colder temperatures.”
Apply sunscreen of at least 30 SPF to your face, neck, and any area of your skin that’s exposed to the sun, including places you wouldn’t normally consider, like your ears and the backs of your hands, says Dr. Rosanne Paul, assistant professor of dermatology at Case Western Reserve University in Cleveland. She adds that most people underestimate the amount of sunscreen they need—in general, the amount you’d fit on your fingertip is the amount you should use to cover the surface area of your palm. (Your face is probably the size of two to three palms, so you’d need two to three fingertip’s worth of sunscreen.) Another way of looking at it, she says, is that a shot glass full of sunscreen would typically be the right amount if you’re outside in a bathing suit.
There are both mineral and chemical sunscreens. Mineral sunscreens (which contain ingredients like zinc and titanium) create a barrier between the skin and the sun, bouncing UV light off of the skin. Chemical sunscreens (which include ingredients like avobenzone) absorb it like a sponge, says Dr. Heather Goff, director of cosmetic dermatology and associate professor of dermatology at UT Southwestern Medical Center in Dallas. Both are effective, but most experts recommend mineral-based sunscreens since they’re gentler on the skin, especially for people with conditions like rosacea and eczema. (Plus, chemical sunscreens can be harmful to the ocean’s coral reefs.) Goff adds that you should select a sunscreen that says broad-spectrum, as this means it protects against both UVA and UVB rays.
Some research suggests the blue light that’s emitted from our screens can cause hyperpigmentation of the skin. If you have a lot of dark spots or you spend a lot of time in front of screens, consider using a tinted sunscreen, Paul says, as the ferric oxide in tinted sunscreen is protective against hyperpigmentation, as well as the visible light emitted from our screens.
Though sunscreen took the top spot, the dermatologists also offered four more skin-care priorities.
2. Use a retinoid or retinol
The next-most popular piece of advice was to use a topical retinoid. Retinoids, which are a derivative of vitamin A, can promote skin cell turnover; improve pigmentation; minimize the clogging of pores; and stimulate the production of collagen and elastin, which can help reduce the appearance of fine lines and wrinkles, Perkins says. “Their efficacy is well-supported by decades of research, so if you’re looking for something that will deliver real results, this is it,” she says.
Topical retinoids (like tretinoin) are prescription medications, whereas retinol is a type of retinoid that’s available over the counter. Prescription retinoids are already in their active form, whereas retinol has to be converted by the body into the active form, says Dr. Alexis Livingston Young, a dermatologist at Hackensack University Medical Center. While all retinoids are effective, prescription retinoids are generally thought to be more effective than retinol since they’re stronger, Young says. She adds that this area is a bit murky since over-the-counter retinol products aren’t regulated by the U.S. Food and Drug Administration (FDA).
Young recommends people begin using a retinoid after age 25 or 30. Retinoids can have side effects like redness, dryness, irritation, and peeling, so she suggests people with sensitive skin start with retinol. And, of course, people using retinoids should always wear sunscreen since these drugs make the skin more sensitive.
3. Add a topical antioxidant to your routine
One great way people can take care of their skin is by using a topical antioxidant every day, Paul says.
Topical antioxidants can help protect against the damage caused by free radicals, which are harmful molecules that are generated by the sun’s UV rays. Free radicals can damage DNA, which can lead to skin cancer and other skin conditions, as well as fine lines and wrinkles. Retinol is a type of antioxidant, but there are several others with notable benefits.
Topical antioxidants are available over the counter, and most come in serum form. Paul recommends using a vitamin C serum, especially if you’re looking to manage fine lines, wrinkles, or pigmented spots.
She notes that while there are some very costly vitamin C serums on the market, “you don’t have to buy an extremely expensive one in order for it to be effective.”
Paul recommends people add antioxidants to their skin care routine in their late 20s or early 30s. Be sure to use an antioxidant product consistently for two to three months before giving up, she says, as it can take this long to see results.
4. The lifestyle things: Hydrate, get enough sleep, and eat a balanced diet
By focusing on your gut health, you can improve your skin health, says Dr. Deeptej Singh, assistant professor of dermatology at the University of New Mexico and founder of Sandia Dermatology.
Many skin care products include antioxidants like niacinamide, vitamin A, vitamin C, vitamin B, and potassium. Including these in your diet—as opposed to just using them topically—can be an effective way to take care of your skin health, Singh says. He recommends a diet that focuses on whole plant foods like fruits, vegetables, nuts, seeds, legumes, beans, and intact grains.
And don’t forget to drink enough H20. “Water is a phenomenally healthful beverage, and so are tea and coffee,” he says. People often worry about drinking too much caffeine, but caffeine can actually be good for the skin, he says, noting that many skin care products are purposefully formulated with caffeine in them.
Just make sure you aren’t using caffeine to make up for lost sleep: “Sleep is integral for skin health,” he says. “Sleep is the time when we detoxify and repair our body, and if you’re trying to use caffeine as a crutch to make up for lack of sleep, you’re not going to get the benefit of it, and you’re going to notice the imbalance in your skin.”
Try to stay away from that nightly glass of wine, too, as alcohol can have a negative effect on the skin. “The fermentation of alcohol causes a reaction in the gut, which can kind of overwhelm our detoxifying capacity and lead to inflammation in the skin,” Singh says.
5. Consider using a red-light therapy mask
Red-light therapy masks, which have become increasingly popular in recent years, can be a great addition to someone’s daily skin care routine, Singh says. They can stimulate collagen production and protect against fine lines and wrinkles, he says. (They’re also quite expensive, with most costing several hundred dollars.)
But how exactly do they work? Sunlight is composed of near-infrared light (which is invisible and accounts for 50% of sunlight); visible light (which includes red light); and ultraviolet light. Both red light and near infrared light “directly communicate with our cellular mitochondria, or the energy powerhouses of the cells, and it activates them,” Singh says. “It keeps them young.”
Red-light therapy masks can mimic this naturally occurring process. Although red light therapy masks are a new trend, Singh notes that different forms of light therapy have been used to treat and prevent skin diseases for over a century.
Singh recommends using a red light therapy mask at least three times a week to see results, though it’s safe to use daily. As long as you—you guessed it—always wear sunscreen.
WASHINGTON — Federal health regulators on Friday declined to approve the psychedelic drug MDMA as a therapy for PTSD, a major setback for groups seeking a breakthrough decision in favor of using mind-altering substances to treat serious mental health conditions.
Drugmaker Lykos Therapeutics said the FDA notified the company that its drug “could not be approved based on data submitted to date,” and requested an additional late-stage study. Such studies generally takes several years and millions of dollars to conduct. The company said it plans to ask the agency to reconsider.
Lykos and other psychedelic companies had hoped that MDMA would be approved and pave the way for other hallucinogenic drugs to enter the medical mainstream. If the FDA had granted the request, MDMA, also known as ecstasy or molly, would have become the first illegal psychedelic to become a federally approved medicine.
The FDA’s decision was expected after a panel of government advisors voted overwhelmingly against the drug’s use for post-traumatic stress disorder in June. The negative vote came after an all-day meeting in which experts scrutinized Lykos’ study data, research methods and possible risks of the drug, including heart problems, injury, and abuse.
FDA said Friday the MDMA application had “significant limitations” that “prevent the agency from concluding that the drug is safe and effective for the proposed indication.” The agency said it will continue encouraging “innovation for psychedelic treatments and other therapies to address these medical needs.”
Lykos said the issues FDA raised in what’s called a complete response letter echoed the concerns during the June meeting.
“The FDA request for another study is deeply disappointing,” Lykos CEO Amy Emerson said Friday in a statement. “Our heart breaks for the millions of military veterans, first responders, victims of sexual and domestic abuse, and countless others suffering from PTSD who may now face more years without access to new treatment options.”
Lykos is essentially a corporate spinoff of the nation’s leading psychedelic advocacy group, the Multidisciplinary Association for Psychedelic Studies, or MAPS, which funded the initial studies of MDMA by raising millions of dollars from wealthy backers.
The group has been a pioneer in researching the medical use of psychedelics, which major pharmaceutical companies have been unwilling to fund. Two small studies submitted to the FDA suggested combining MDMA with talk therapy led to significant easing of PTSD symptoms.
Antidepressants are now the only FDA-approved drugs for PTSD, which is closely linked to depression, anxiety, and suicidal thinking and is more prevalent among women and veterans.
In recent years, MDMA research has been widely publicized by combat veterans, who say the lack of treatments options for the condition has contributed to higher rates of suicide among military personnel. Last month, veterans supporting psychedelic therapy rallied on Capitol Hill in support of the drug. And more than 80 House and Senate lawmakers have signed letters to the FDA in recent weeks urging MDMA’s approval.
But FDA’s review brought new scrutiny to the research. The vast majority of patients in Lykos’ studies correctly guessed whether they had received MDMA or a dummy pill, making it “nearly impossible” to maintain the “blinding” which is considered essential for medical research, according to FDA internal staffers.
In recent months, separate allegations of misconduct have emerged, including that some researchers involved in the studies coached patients to suppress negative results or inflate positive ones.
Despite the setback, many experts say other psychedelics may fare better before the agency.
MDMA is the first in a series of psychedelics that are expected to be reviewed by the FDA in coming years as part of a resurgence of interesting into their therapeutic potential.
The idea of using psychedelics to enhance psychotherapy is not new. A handful of therapists in California used MDMA during the 1970s and 1980s—when it was still legal—to facilitate couples therapy sessions. MAPS was founded in 1986 to oppose a federal decision placing MDMA in the same ultra-restrictive drug category as heroin, LSD, and other illegal psychedelics.
MAPS’ studies of MDMA began more than a decade ago. Since then, dozens of small, startup drugmakers have entered the field, studying other substances like psilocybin and LSD for conditions including depression, addiction, and anxiety. Those studies are generally larger and more rigorous than the MDMA studies submitted to the FDA.
Two drug developers, Compass Pathways and Usona Institute, are conducting late-stage studies of psilocybin—the active ingredient in magic mushrooms—for severe depression.
Seventy years ago, two scientists working for the American Cancer Society, E. Cuyler Hammond and Daniel Horn, published one of the first studies definitively linking cigarette smoking to lung cancer, adding to a growing scientific consensus that cigarettes were behind a worldwide spike in the disease. This might have been the moment when Americans realized the risks of smoking and gave up their cigarettes for good. But of course, it wasn’t.
Faced with mounting evidence that their highly profitable product was harming its users’ health, the tobacco industry pushed back. That same year, it formed the Tobacco Industry Research Committee with an aim of sowing doubt about the science. And it worked. Pseudoscience created by industry had more influence on public beliefs about smoking than rigorously sifted data. People kept puffing away, and through the 1950s even many doctors remained unconvinced that cigarettes cause cancer. Only in the mid-1960s did U.S. cigarette sales begin to decline—a decade-long lag in public awareness that cost many smokers their lives.
Tobacco’s stubborn resistance to public-health common sense is an all-too-predictable story. Companies that profit from harmful or unhealthy products—from ultra-processed foods to prescription opioids to social media—often follow a familiar playbook of misdirection and denial to extend their sales for as long as they can. Their strategies can be so effective that public perception takes decades to catch up, fueling public-health crises that seem almost impossible to control. Companies often manufacture doubt just as effectively as they manufacture unhealthy products.
As public-health scholars, we recently introduced the concept of “market-driven epidemics” to describe the dynamics of such harmful consumer products. We estimate that these market-driven epidemics contribute to the deaths of 850,000 people in the U.S. and 23 million worldwide each year. They underlie some of the most urgent health crises on the planet, including heart disease, obesity, diabetes, drug addiction and overdose, and certain cancers, and cost health systems trillions of dollars to combat.
But these staggering social and economic costs are not inevitable. We could save countless lives if we did a better job of recognizing market-driven epidemic patterns sooner, and work more assertively to counteract predictable corporate resistance.
We recently studied three of the largest scale market-driven epidemics in modern history—cigarettes, prescription opioids, and sugary foods and beverages—to understand how this might be possible. In each of these cases, companies aggressively marketed products despite proven harms and actively resisted public-health efforts to control them. The tobacco industry, for example, funded research aimed at blaming cancer on other causes, like certain foods or hormones, rather than cigarettes. The sugar industry took a page from the tobacco script by funding research that dubiously shifted the blame for America’s obesity crisis toward saturated fats, launching a wave of low-fat foods that conveniently boosted their sugar content to preserve flavor.
In the late 1990s, Purdue Pharma relied on many of the same tactics to ramp up demand for its prescription opioid, OxyContin. They continued to falsely claim OxyContin had a misuse rate of less than 1%, even while the opioid crisis was starting to build in rural communities. Many doctors accepted these specious claims of low misuse rate, and it was not until 2011 that the U.S. Centers for Disease Control and Prevention acknowledged the overdose crisis in the U.S.
Eventually, the overwhelming evidence of these products’ harmful effects and the persistent messaging of public-health authorities was enough to overcome corporate resistance. From the peak of consumption, U.S. cigarette sales have fallen by 82%, and use of prescription opioids has dropped by 62%. Even consumption of sugar has declined by 15% from its peak as consumers shift away from soft drinks and sugar-laden foods.
This evolution, however, was painfully slow. In the three scenarios we studied, the gap between the first suspicion of harm and a decline in consumption ranged from one to five decades. Even when overconsumption or misuse abates, companies are often adept at shifting focus to less-regulated markets abroad or encouraging consumers to switch to alternative products that still cause harm.
It’s not always obvious when a market-driven epidemic starts. Many of the products we now know to be harmful were seen as innocuous or even beneficial when consumers first began adopting them. But there are clear steps public-health authorities can take to recognize and interrupt market-driven epidemics before they inflict widespread harm. Emerging market-driven epidemics that warrant close attention include ultra-processed foods, since there is mounting evidence of harm but the evidence has not yet persuaded policymakers to act, along with nutraceuticals and dietary supplements. The U.S. remains the only high-income country that does not require companies to provide any efficacy or safety evidence for the long-term use of nutraceuticals and dietary supplements, yet these very widely used products are known to cause health harms.
First, researchers must act more quickly to investigate the earliest evidence of emerging health threats, ensuring credible science moves faster than corporate efforts to debunk it. Governments also need to strengthen the requirements on companies to study and report the impacts of their products on health and hold them accountable when they hide evidence of harm.
Second, public-health leaders need to recognize the important role they have in bending the consumption curve. When the U.S. Surgeon General finally issued its first official warning about smoking in 1964, the bombshell report blanketed newspapers and television, becoming the authoritative voice the public could no longer ignore. It’s no surprise, then, that cigarette consumption in the U.S. began falling from around 1964 onwards.
Third, the voices of professional organizations, journalists, and even pop culture figures can have outsized influence in beginning to change the direction of a market-driven epidemic. In the case of sugar, for example, a 1999 report by the Center for Science in the Public Interest called “America is Drowning in Sugar” stands out as one of the watershed moments that began to turn the tide on America’s sugar habit.
Appealing and often addictive products such as cigarettes, sugar, and prescription opioids will, of course, continue to be marketed by companies seeking to capitalize on human needs and desires. But understanding the life cycle of these three market-driven epidemics shows us that it is possible to see dramatic changes in the consumption of such products over time, and that these shifts, while slower than we might like, save lives. Our research has shown that there are ways to intervene to accelerate the shifts, so that the consumption tipping point comes sooner, averting illness and death.
The bigger question is how we will react the next time that astute observers begin to point out adverse health effects that appear connected to the use of a popular consumer product. Will we listen? Or will we let the cynical machinations of companies seeking to preserve their profits succeed yet again? If we get better at recognizing the early warning signs—and calling out the inevitable attempts to distract us from them—perhaps the next market-driven epidemic won’t be so costly.
All sorts of nasties—lead, mercury, radium, nitrates, norovirus, agricultural runoff, PFAS, and more—can lurk in your water. No surprise, then, that about 40% of U.S. homes filter theirs.
But the options are endless, from simple $20 charcoal-filter pitchers to reverse osmosis, point-of-entry, or ultraviolet filters. Depending on what you choose, a water filter can cost you tens of dollars, or thousands.
Here’s what to know if you’re considering a water filter—and how to tell if you need one.
How do you know if you need a water filter?
Plenty of public systems produce impressively pristine water. New York City, for example, puts out a billion clean gallons of water a day, says environmental health scientist David Nadler of the New York Institute of Technology. But the water that leaves the reservoir and treatment plant is not necessarily the same water that comes out of your tap.
In cities, water is typically pumped up to rooftop tanks, which feed the flow down to spigots via gravity. If the tank is not kept clean, the water will suffer too. Older buildings may still have lead pipes or asbestos in the walls, which can contaminate water as well.
“Your supply company could send you the purest water in the world. But if your pipes are old and have lead in them, there’s really no protecting you,” says Nadler. “You’re at the mercy of your plumbing.”
In cities, suburbs, and rural areas, periodic flooding can contaminate otherwise-clean water with industrial or agricultural runoff or sewer overflow. Algae and fungi, which bloom in the spring and summer, can pose a danger too. “There can be differences caused by the seasons and by weather, in addition to those caused by plumbing,” says registered dietitian Mindy Haar, assistant dean at the New York Institute of Technology’s School of Health Professions. The Safe Water Drinking Act, signed into law in 1974, provides certain nationwide minimum standards for water cleanliness, but, says Haar, “there can be variety from place to place.”
Everybody is susceptible to contaminants in water, but older people and those with compromised immune systems are especially at risk. Knowing how clean your water supply is can take some doing. A provision of the Safe Water Drinking Act requires water suppliers to release an annual water quality report to the community. This is typically mailed to households, but can also be accessed online, says Nadler. People who live off the water grid—such as those with their own wells—do not have the benefit of an annual report and must test their water on their own. And again, even when an annual report is released, it only reveals the state of the water when it left the supplier, not when you consume it or bathe in it.
“As a homeowner or a renter, the only way to know unequivocally [the state of your water] is to have it tested by a professional,” says Haar. That, in turn, is the only way to know what kind of filter—with what level of protection—you should buy.
What kind of water filters are out there?
Water filters come in all makes and models. Pitcher versions (like a Brita) filter water by running it through a block of charcoal, a piece of mesh, or both as you fill the reservoir. Most pitchers use physical barriers like these and are effective at screening out chemicals like benzene and chlorine, metals like lead and mercury, and particulates, including asbestos. They do not, however, filter out viruses and bacteria.
Other filters need a plumber or a home handyperson to install. They sit either on the countertop or under the sink, at just a single faucet (so-called “point-of-use” systems), or outside the home, filtering all water as it enters the house (“point-of-entry” systems). These provide much higher quality—and more expensive—filtration, and they typically use one of several technologies, according to the U.S. Centers for Disease Control and Prevention (CDC). Depending on the type of filter, the barrier provides either microfiltration, ultrafiltration, or nanofiltration. Microfiltration has an average pore size of 0.1 microns—or millionths of a meter. (The period at the end of this sentence measures about 500 microns.) Ultrafiltration has a pore size of about 0.01 microns. Nanofiltration weighs in at just 0.001 microns.
The smaller the filter pores, the smaller the pathogens and toxins that can be strained out of your water. Microfiltration (found in some higher-end pitchers), is highly effective at eliminating protozoa, moderately effective at screening out smaller bacteria, and not effective against viruses or chemicals, according to the U.S. Centers for Disease Control and Prevention (CDC). Nanofiltration—also found in some pricier pitchers, as well as in reverse osmosis and distillation systems—is highly effective against protozoa, bacteria, and viruses and moderately effective against chemicals.
Reverse osmosis filters, which are installed under the sink or on the countertop, use a different technology from that of pitchers, forcing water across a membrane that strains out impurities. Distillation systems, which are also both countertop and undersink devices, work by yet another technology, heating water to the boiling point and collecting and condensing the vapor, leaving contaminants behind. Reverse osmosis and distillation systems are more effective and costly than charcoal and mesh filters.
Finally, there are ultraviolet systems, which kill pathogens using UV light. They are highly effective against microorganisms, but not against chemicals, and are available in both point-of-use and point-of-entry configurations.
Consumer Reportsrecommends a handful of under-sink models that use a range of different types of filters and are certified to remove PFAS, but advises checking the brand you’re considering with the National Sanitation Foundation (NSF), the Water Quality Association (WQA), or the International Association of Plumbing & Mechanical Officials (IAPMO). The system you buy should depend on just which impurities are in your water.
“You can buy a filter and include a lot of different add-ons,” says Nadler. “But there is no magic box that does everything.”
Like Consumer Reports, the CDC recommends turning to the NSF to check the make and model of any filter you’re considering buying to determine its effectiveness against various contaminants.
How often should you change your filter?
A dirty filter does not do you a fraction of the good a clean filter does. The CDC recommends checking the manufacturer’s recommendation for changing filters and following that guidance. Brita calls for changing pitcher and faucet charcoal filters every two to six months, depending on make and model and how much water is used. Culligan recommends changing its charcoal filters every two to six months; reverse osmosis filters every three to five years; and whole-home systems every several years.
When it comes to ultraviolet systems, Nadler recommends changing the lights every year or so. “If they’re running 24/7, you get maybe 9,000 to 10,000 hours out of them, “ he says. For any filter, Nadler urges consumers to know the manufacturer’s guidelines and comply with them. “If you don’t change the filters, eventually they’re going to fail,” he adds.
Apart from the danger posed by contaminants, Haar recommends using filtration systems if only to make water taste better and smell better—and to wean people away from sodas and other sugar-sweetened beverages which, as a dietitian, she sees as a scourge.
“If somebody’s got a Brita pitcher on the table,” she says, “and it’s perceived that the water might taste better and be more pure, people would likely drink more. That’s going to be a good idea.”
If you get enough back aches, someone will eventually tell you that’s where your body stores stress. If your stomach hurts, you’ll hear the same thing: Your emotions are trapped in your belly.
But what does that mean? Is your anxiety about work or money really coursing through your body and nestling into your organs and limbs?
In short, no. “We can and do manifest stress physically. There’s no question about it,” says Steven Tovian, a clinical professor of psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University. “But it’s not like there’s a stress reservoir to the left of our kidneys—and when it bubbles over or overflows, we’ve got problems. It’s not that kind of boiling-cauldron analogy.”
Unfortunately, the truth is that stress lives everywhere inside your body. Here’s what really happens in your body when you’re stressed.
How stress affects the body
The idea that stress is stored in specific parts of the body likely comes from Sigmund Freud’s work more than 100 years ago. “There was this idea that when people repress or deny their emotions, those emotions would appear as physical symptoms instead,” says Camelia Hostinar, an associate professor in the psychology department at the University of California, Davis. “And if you acknowledge those emotions, that would treat the symptoms, and the symptoms would disappear.” As scientists have learned more about stress, however, it’s become clear that such thinking is too simplistic, she says. Rather than causing us to store anger in our back, or fear in our stomach, stress triggers a dynamic whole-body response—and it happens not just when people repress their emotions, but even if they’re fully aware of them.
When you encounter a stressor, your hypothalamus (the control center in your brain) starts to orchestrate a hormonal stress response. It triggers a cascade of hormones that are released from the pituitary gland that, in turn, let the adrenal glands know it’s time to release the stress hormone cortisol into the blood supply, says Alicia Walf, a neuroscientist and assistant professor of cognitive science at Rensselaer Polytechnic Institute in N.Y. Meanwhile, the hypothalamus also orchestrates the release of adrenaline and noradrenaline from the adrenal glands. “These adrenal hormones have temporary physiological effects in the body, such as quickening of the heart rate, but they also have effects in the brain that alter cognition,” Walf says.
Hostinar likes to think of this response as a “stress symphony,” a metaphor coined by neuroscience researchers. “There are multiple stress systems that respond differentially—like musical instruments—to various stressors, some with more or less intensity than others, leading to potentially unique combinations of symptoms in different people,” she says. For example, one person might experience an increase in appetite and cravings for comfort foods, while another reports muscle tension and pain. “There are effects that happen within seconds, minutes, and even days,” Hostinar says. In the first few seconds, for example, you might experience an increase in heart rate or cold, clammy hands. Days later, your high stress load might dampen your immune system. “You could see both immediate and delayed effects from all these different musical instruments that are working at different time scales and different intensities to orchestrate this response,” she says.
Type of stress matters—and so does who you are
The type of stress you’re dealing with—and its frequency, duration, and intensity—plays a role in determining how it might manifest in your body. There are a number of different types: acute (sitting in a traffic jam), episodic (work projects that pop up occasionally), chronic (losing a job, getting divorced, or dealing with a long-term illness), and traumatic (childhood abuse). “Stress is not one entity,” Tovian says. While acute stress, for example, is typically fleeting and can be resolved by calming regimens like deep breathing, leaving no lingering effects in its wake, other types of stress require more vigilance.
Your overall health status, age, genetic profile, and past experiences also influence how your body reacts to stress. As you get older, you might feel the effects of stress more harshly—or in a mitigated way, thanks to learned experience, Tovian says. And if you have a history of lower back pain because of a slipped disc, you’ll have a greater-than-average chance of stress-related symptoms appearing in your lower back. Likewise, if digestive problems run in your family, that might be how your stress shows up. “Like any adversary, the effects of the stress are going to attack the weakest parts of your system,” Tovian says.
Our bodies are equipped to deal with a certain amount of stress based on all these factors, he adds. When stress exceeds our personal threshold—usually over a period of months or years—it’s more likely that it will cause physical harm.
What are the symptoms of stress?
Research suggests that stress can lead to problems with the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and reproductive systems. It’s called somatization—the medical term for expressing stress as physical symptoms.
Some of the most common stress-related symptoms include headaches, nausea, fatigue, dizziness, heart palpitations, and chest, back, or abdominal pain, says Dr. Ashwini Nadkarni, associate medical director of Brigham Psychiatric Specialties at Brigham and Women’s Hospital in Boston. Stress can contribute to inflammation in the circulatory system, including the coronary arteries; trigger migraines; throw off menstrual cycles; lead to stomach ulcers; and more.
Somatization affects plenty of people, Nadkarni says. “One-third of symptoms people report in a primary care visit are medically unexplained,” she says. “There’s no objective evidence to support a biological explanation. Or somebody might have a medical condition, but they’re reporting a set of symptoms that are out of proportion to that condition.”
Still, doctors treat stress as a diagnosis of exclusion. That means conducting a thorough physical exam and running tests to rule out medical conditions. That helps them ultimately determine if stress is the root cause of whatever’s going on. As Tovian puts it, “I can get a headache from too much stress, but I can also get a headache from a brain tumor.” It’s essential, he adds, not to diagnose yourself as suffering from stress and decide not to seek medical care for symptoms you’re experiencing.
Recovery is crucial
If your doctor determines your symptoms are stress-related, they’ll likely recommend mindfulness-based stress reduction, Nadkarni says. It’s a meditation therapy that helps people feel centered in the present moment—and it can encourage those experiencing somatization to adopt a non-judgmental acceptance of their physical pain or psychological distress. “You’re reducing that tendency to have hypervigilance about the symptoms or catastrophize about the symptoms,” she says. “It’s thought to reduce pain, reduce symptom severity, reduce any depression or anxiety that might be associated with somatization, and also improve people’s quality of life.”
It’s also important to find healthy ways to recover after a high-stress event; doing so can prevent symptoms from flaring up. One of Hostinar’s favorite ways to bounce back from stress is tapping into social support. “It can lower stress in real time and over the years,” she says. “People recover more easily and have a more muted stress response if they have someone to talk to or a hand to hold.” Plus, it’s universally beneficial across all ages, cultures, and backgrounds.
Given that stress is inevitable, it’s also important to boost resilience, Tovian says. Sound easier said than done? Focus on understanding yourself and your body, getting enough sleep, exercising, and eating well. The key, he says, “is being able to manage stress, so it doesn’t manage you.”
On a cold night in November 2001, I locked the bathroom door of a residential women’s trauma center. As I climbed into the bathtub and began to choke down a large bottle of pills, my phone rang. It was my mother calling to say she was worried about me. “I’m fine, Mama, don’t worry,” I said. “I love you.” I set down the phone and picked up the razor blades.
My suicide attempt was the culmination of a two-year journey spent mostly in institutionalized psychiatric care for symptoms of complex post-traumatic stress disorder (PTSD) due to childhood sexual abuse and terrorization. I went into hospital care willingly and stayed hopeful, but after a litany of psychiatric drugs and months of abuse by a medical professional, I became despondent. There was no treatment that worked for me, no escape or safe place to turn to for care. Suicide seemed like the only option.
Fortunately, the paramedics were able to resuscitate me, and my journey of recovery began. Coming so close to death made me choose life and gave me the motivation to spend 20 years trying every clinical and alternative therapy I could find to learn to cope with the symptoms.
I promised myself back then that I would find a way to help some of the 13 million Americans who suffer from PTSD, a chronic disorder that can strike after a traumatic situation and disproportionately affects women and veterans. Untreated PTSD can make you feel like you have no other option but suicide or living in a medicated stupor of depression, night-terrors, anxiety, and addiction.
Help is harder to find than it should be. There have been practically no innovations in PTSD treatment for more than two decades. But that, I hope, is about to change. The U.S. Food and Drug Administration (FDA) will soon determine whether to approve MDMA to treat PTSD. It is our best hope to help people who are currently struggling.
MDMA-assisted therapy would be an entirely new model of care. Over the course of 12 weeks, this treatment uses outpatient psychotherapy plus three day-long therapy sessions during which patients take MDMA. Neuroscientists say the drug elicits pleasurable feelings of energy and openness, which clears the way for processing trauma. Though its use would be novel in modern times, MDMA has been around for more than a century and was used in psychotherapy for years before it was made illegal.
There’s been a resurgence in scientific interest in psychedelic drugs for mental-health conditions, and the results of recent clinical trials of MDMA-assisted therapy are nothing short of astounding. In a 2023 study published in Nature Medicine, 71% of people in the treatment group had such marked improvement that they no longer qualified for a PTSD diagnosis, and 86% experienced clinically significant reductions in their symptoms. The results show that using MDMA in sessions is almost twice as effective as therapy sessions without the drug.
As the leader of a philanthropic fund that supports PTSD research, I am a frontline witness to the urgent need for effective treatments. One in six women experience sexual abuse, which can lead to PTSD. I receive desperate pleas for help from women all the time, and have nowhere to send those in need. That’s why this could be so game changing.
Although I am not an investor in Lykos Therapeutics, the company that is trying to bring this treatment to market, I philanthropically support several research centers that conduct MDMA-assisted therapy. I have witnessed the transformational impacts on participants. “Sexual trauma frequently keeps women locked in the cycles of shame and silence with no real hope of change,” says Kim Roddy, COO at Sunstone Therapies and a recipient of one of our grants. “The participants we have treated have found greater agency, reduced their PTSD symptoms which allowed them to make different choices, and changed the course of their lives by breaking the cycles that kept them trapped.”
Despite its promise, MDMA’s path toward approval has been rocky. In June, an FDA advisory committee made the surprising decision not to recommend approval of MDMA-assisted therapy, citing concerns about the design of some of the studies, among other things. The committee was not accustomed to including psychotherapy as a variable in assessing the effectiveness and risks of a medicine. In a statement on July 7 respectfully disagreeing with the committee, scientists and clinicians who have expertise with drug-assisted psychotherapy argued that the concerns about study design aren’t large enough to “call the main clinical trial findings into question,” that “serious adverse events are rare,” and that “MDMA is now approvable for use with therapy in the treatment of PTSD.”
I couldn’t agree more: We are on the threshold of a breakthrough treatment for trauma.
Since the advisory committee’s recommendation isn’t binding, the FDA will consider their recommendation, the voices of experts, and the profound unmet needs of the PTSD patient populations when they decide in August whether to approve MDMA-assisted therapy. Now is the time for survivors of trauma and their families to demonstrate support for this new approach.
Cristina Pearse, a clinical trial participant who testified before the FDA advisory committee, was only five years old when she was sexually assaulted. “PTSD is no longer my life sentence,” she said. “How many more people need to die before we approve an effective therapy?”
The push for approval has bipartisan support. Members of Congress from both parties—along with veterans groups, some of MDMA-assisted therapy’s strongest advocates—called on the FDA to “follow the science” when they gathered July 10 at the Capitol. There, they unveiled a tombstone displaying nearly 150,000 dog tags to bring awareness to the fact that more soldiers died by suicide than were killed in war since 9/11.
I feel lucky that that cold night in November more than 20 years ago was not my last. Since then, I have built a meaningful career and raised a beautiful family. But every day the scars on my wrists remind me to seize the gift of this second chance and to dedicate my life to helping other victims become survivors who can truly thrive. MDMA-assisted therapy can offer a new path forward, if we are brave enough to open our minds to it.
The person who abused me threatened to torture and kill me if I ever spoke about it. The fact that I am writing this speaks to how much I believe in this treatment. I even plan to try it myself. Based on what I have seen from the outcomes of both these clinical trials and several investigative studies, I hope to do a full protocol of MDMA-assisted therapy when it is legal.
Sometimes I wonder what would have happened if I had had access to this breakthrough treatment two decades ago. I wish my younger self and my fellow inpatients had been able to receive it. But it’s not too late to save those who are suffering now.
If you or someone you know may be experiencing a mental-health crisis or contemplating suicide, call or text 988. In emergencies, call 911, or seek care from a local hospital or mental health provider.
In February, a horrified Elizabeth Carr scrolled through headline after headline about a pause on in vitro fertilization (IVF) procedures in Alabama. The Alabama Supreme Court had ruled that frozen embryos have the legal rights of children, a decision that meant fertility providers could feasibly face prosecution if they destroyed one. Rather than take that risk, some fertility clinics halted IVF services entirely.
Carr, who in 1981 became the first baby in the U.S. born using IVF, felt like “an endangered species.” When Carr was born, IVF—a process of fertilizing eggs outside a woman’s body, then implanting a resulting embryo in her uterus—was new and largely unknown. Carr’s parents, who desperately wanted children but struggled to have them naturally, were willing to face public scrutiny and repeatedly travel from their home in Massachusetts to a pioneering clinic in Virginia to try the cutting-edge procedure. IVF’s success for the Carrs led not only to their daughter’s historic birth, but also compelled Elizabeth to become an advocate for reproductive rights when she grew up. Over those recent days in February, when patients in Alabama were shut out of fertility clinics, Carr acutely felt the importance of her work. Moments like those, she says, are “why we advocate so loudly.”
Elizabeth Carr, pictured with her parents Judith and Roger Carr, in 1981 became the first U.S. baby born using IVF. Bettmann Archive/Getty Images
Despite the backlash, judges in Alabama declined to reconsider their controversial ruling. And more than a dozen other U.S. states have laws in place that could be interpreted as bestowing personhood rights on an embryo, even if it has not yet resulted in a pregnancy. Courts in other states haven’t yet applied these laws in ways that directly threaten IVF—although Louisiana law forces fertility providers to ship embryos out of state for destruction—but the possibility is there if the wrong case comes before the wrong judge, says Rebecca Reingold, an associate director at the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center.
Right now, it is politically unpopular to attack IVF, a technology that has given life to millions of people and hope to some of the one in six adults worldwide with infertility. Only 8% of U.S. adults actively oppose access to IVF, according to recent polling, and even lawmakers from states that have cracked down on abortion, like Texas, have introduced bills to protect IVF.
And yet, in June, Republican senators—including former President Donald Trump’s current running mate, J.D. Vance—voted against a bill that would have established a federal right to IVF care. The same month, members of the Southern Baptist church voted to oppose the use of IVF, a decision that has no legal ramifications but signals a growing willingness among religious conservatives to embrace prenatal personhood concepts that effectively place IVF in the same category as abortion.
How did we get here? And where are we going?
Doctors from the Alabama Fertility Clinic look on and takes photos as lawmakers vote on SB159, a bill providing protections for IVF providers, in the House Chambers in Montgomery, Ala., on March 6, 2024.Butch Dill—AP
Growing anti-IVF sentiment
The concept of prenatal personhood isn’t new, but it has historically been unpopular. In a 2013 legal journal article, reproductive-rights expert Maya Manian argued that’s because “public concern over the ‘side effects’ of personhood laws”—such as infringing on fertility care, contraception access, and women’s health care more broadly—“seems to have persuaded even those opposed to abortion to reject personhood legislation.” It was, in other words, a step too far for most people.
In a relatively short span of time, however, the idea has gone from “radical or fringe” to one that is gaining ground, Reingold says. It has even transcended the anti-abortion movement, with ex-spouses in some cases using the concept to argue that frozen embryos should be treated by the courts as children, not marital property, during divorce proceedings. As such ideas snowball, IVF may become the next frontier in the battle over reproductive rights, advocates and scholars say.
“It’s clear to us—it always has been—that the anti-abortion movement has not, and will not, stop their efforts at limiting or banning abortion,” says Karla Torres, who leads the nonprofit Center for Reproductive Rights’ work on assisted reproductive technology. They are “squarely targeting reproductive freedom more broadly,” drawing everything from IVF to contraception into the fray.
If IVF becomes harder to access, it’s hard to overstate the effect for American families and culture at large. About 2% of babies born in the U.S. in recent years—nearly 100,000 annually—arrived with the help of IVF. But the technology’s impact transcends statistics. In about a half century of use, it has reshaped what it means to be a parent, who gets to be one, and how—progress that’s now under threat.
A collection of needles, injections, syringes, and old pill bottles used during a patient’s IVF journey in Lemoyne, Penn., on March 9, 2024.Hannah Yoon—The Washington Post/Getty Images
A confusing position
In some ways, IVF is an unlikely target. The technology enables people to have badly wanted biological children, a sentiment that could be seen as having a “conservative traditional family aspect to it,” says Amanda Roth, an associate professor of philosophy and women’s and gender studies at the State University of New York at Geneseo. The importance of having children is a regular conservative talking point—see: Vance recently calling child-free women “cat ladies” without a “direct stake” in the future of America—and IVF makes it possible for more people to do that.
But many in the anti-abortion movement argue that life begins at the moment of conception—that is, the moment sperm fertilizes an egg to create an embryo, either the old-fashioned way or in a laboratory. (A fertilized egg is considered an embryo until the end of the 10th week of pregnancy, when it becomes a fetus.)
To that effect, about a third of U.S. states currently have laws that establish prenatal personhood rights at some stage of pregnancy, usually as a means of curtailing access to abortion by establishing that terminating a pregnancy is tantamount to killing a child. Nine of these laws, such as those in Arkansas, Kansas, and Tennessee, are either sweeping enough or vaguely worded enough that they could put IVF services at risk, according to analysis from the nonprofit Pregnancy Justice provided to TIME. Six additional states, including the Dakotas, Michigan, and Oklahoma, have either feticide or wrongful death laws broad enough to potentially apply to embryos. And there’s always the possibility of new laws: already in 2024, more than a dozen bills focused on prenatal personhood have been introduced across the U.S.
Greer Donley, an associate professor at the University of Pittsburgh School of Law who studies abortion law, doesn’t think curtailing access to IVF is a “priority” for the anti-abortion movement, but rather an “unfortunate side effect that [anti-abortion advocates] haven’t been able to account for.” It’s a narrative problem: to argue an embryo in a mother’s womb is a person, but one sitting in a fertility clinic freezer isn’t, would weaken the movement’s argument. So, despite the cognitive dissonance, IVF has become “collateral damage” in the abortion wars, Donley believes.
Graphic for TIME by Lon Tweeten and Jamie Ducharme; Getty Images
Whether the situation was intentional or not, threats to IVF are real. The Alabama Supreme Court demonstrated as much in February, when it ruled that the state’s Wrongful Death of a Minor Act applies to not-yet-implanted embryos, prompting fertility clinics to pause IVF services for fear that patients or providers could be legally liable if embryos were destroyed in the course of care. That’s not an irrational fear: embryos are destroyed all the time in the fertility world, either purposely (perhaps because a patient no longer wishes to pay for storage, or because the embryo is unlikely to result in a healthy pregnancy) or because of human error.
Accidents happen, says Dr. Gerard Letterie, a reproductive endocrinologist at Seattle Reproductive Medicine who has written about the potential impact of fetal personhood laws on clinicians. An embryo could be destroyed through an innocent mistake, like someone tripping while carrying a petri dish. “If that were to be made a felony charge, that’s a big deal,” Letterie says.
In that scenario, clinics might stop services entirely to avoid putting providers in legal jeopardy, as happened in Alabama. Or, even if services proceeded, providers might stop practicing in states with punitive laws, Letterie says, making access to fertility care as scattershot as access to abortion care. Already, fertility clinics tend to be clustered in wealthier urban areas.
Even short of criminal charges for providers, prenatal personhood laws could affect fertility practices, Letterie says. He can imagine policies that limit the number of eggs that may be fertilized per cycle to avoid creating extra embryos that ultimately end up discarded. Such policies—the likes of which have already been implemented elsewhere in the world, such as in Malta—could reduce the odds of patients getting pregnant, since not all embryos are viable, and force people to go through more rounds of treatment, making IVF more expensive and inaccessible than it already is. IVF can already cost upward of $10,000 per cycle without insurance, and coverage varies by state and insurance provider. If costs go up even more, Letterie says, IVF would be inaccessible to virtually everyone who isn’t mega-wealthy or lucky to have excellent health insurance.
Even taking finances out of the picture, threats to IVF have particularly high stakes for certain people. Those who stand to lose the most are those for whom IVF has been revolutionary over its half century of use: namely same-sex couples, people with medical infertility, and those who have decided to have children without a partner or later in life. “The existence of reproductive technologies has opened up new horizons for family life,” says Marcia Inhorn, a medical anthropologist at Yale University and author of Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs. In a future without reliable access to IVF, the possibilities of what families can look like might shrink.
An embryologist works in the IVF lab at Brigham and Women’s Hospital in Boston on March 15, 2024.David L. Ryan—The Boston Globe/Getty Images
A crossroads for U.S. culture
IVF and other fertility services helped break open the narrow definition of family that dominated for so long—a married man and woman and their naturally conceived children—to reveal a whole world of options. A mother can be 45 and single, even if she’s survived cancer or had her fallopian tubes removed or needs to use a donor egg to get pregnant. Same-sex couples can use “reciprocal” IVF to incorporate both of their genetic material. A child can even have three biological parents, a controversial technique that is not currently legal in the U.S. but is in several other countries.
“We’ve seen a significant diversification in how people understand kinship, relatedness, and parenting,” says Sarah Franklin, who directs the Reproductive Sociology Research Group at the University of Cambridge in the U.K.
This progress has not been equally felt around the world. Compared to the U.S., Europe and Asia have historically employed stricter regulations on the use of reproductive technologies like IVF. Although some of those policies have loosened in recent years, single and older women, trans and non-binary people, and/or same-sex couples are still barred from using reproductive technologies in countries including China, Poland, Turkey, and Italy. And in many poorer countries, including most of the ones in Africa, there is next to no access to IVF at all.
Even in the U.S., where IVF is much more broadly used, reproductive medicine has not wiped out persistent stereotypes and social norms, says Arthur Greil, a professor emeritus at Alfred University in New York and author of Not Yet Pregnant: Infertile Couples in Contemporary America. People are willing to pay IVF’s exorbitant fees, at least in part, because society still emphasizes the importance of a genetic relationship between parent and child, Greil says. And, he says, the knee-jerk assumption is still that a child has both a mother and father. “If you are a single woman with a child, people just assume that you must have been divorced,” Greil says. “It’s become impolite to ask questions like, ‘Where is the baby’s father?’ But people still have the questions.”
Still, IVF has made what was once impossible—or, at the very least, difficult or done outside the scope of mainstream medicine—possible for many people. Sex, age, and medical diagnoses don’t necessarily close the road to biological parenthood anymore; they are just speed bumps. Reproductive technologies are expensive and imperfect, working only about half the time in the best circumstances and becoming even less of a sure bet among patients who are older or relying on donated embryos. But it has made the possibility of biological parenthood real for swaths of the population that, a century ago, would have had zero or few options. “Fertility medicine has made all of us parents-in-waiting,” says Laura Mamo, a professor of public health at San Francisco State University who studies the intersection of sexuality and medicine.
IVF is not solely responsible for those shifts—Franklin sees it more as a “mirror” reflecting major societal changes and conditions—but it plays a part. Making the technology harder or impossible to access, then, would have profound effects on countless people, particularly those from marginalized groups. And that, Mamo says, may be exactly the point for some people pushing forward the prenatal personhood movement.
“It’s not really about personhood,” Mamo says. “It’s really about this expansion of gender and family and sexuality and autonomy over people’s bodies.”
Elizabeth Carr speaks with Sen. Tim Kaine in Washington, D.C., on March 7, 2024, the day before attending the State of the Union as Kaine’s guest.Josh Morgan—USA TODAY/Reuters
Fighting back
Already, legislators and reproductive-rights advocates are preparing for battle. In his first speech as Kamala Harris’ vice presidential running mate, Minnesota Gov. Tim Walz reaffirmed his commitment to protecting reproductive health care including IVF, a technology that he and his wife used to have their daughter, Hope. “When Vice President [Harris] and I talk about freedom, we talk about the freedom to make your own health care decisions,” Walz said.
Elsewhere, the Center for Reproductive Rights has for years been working with partner advocacy groups and legislators to expand access to IVF by implementing new state policies around fertility coverage and broadening those that already exist, which are often written in ways that exclude same-sex couples or people who aren’t cisgender. That work is continuing in earnest, Torres says. And in the aftermath of the Alabama decision, lawmakers in at least a dozen states introduced bills meant to either protect IVF providers from liability or specify that embryos outside the human body do not legally qualify as people, according to the Guttmacher Institute, a reproductive-rights nonprofit. A broader package of pro-IVF bills moved forward at the federal level before being blocked by Republican senators in June.
Along with legislative solutions, the reproductive-rights movement is also trying to develop legal defenses that can be used to stop prenatal personhood arguments in court, says Donley, the Pittsburgh law professor. Judges may hold long-term appointments and don’t necessarily need to win elections—which means some can stray from public opinion with fewer consequences than elected officials. “I feel confident right now that the politics of reproductive rights are such that Republican legislatures aren’t going to pass anti-IVF bills,” Donley says. “Republican judges are another story. They get to do whatever they want.”
That means people who want to protect IVF access will need compelling legal arguments, says Georgetown’s Reingold. One, she says, could be pointing out the slippery slope of prenatal personhood. If an embryo is considered a person in one legal context, it could be considered one in many: a pregnant person could arguably claim their embryo as a tax dependent, a beneficiary for public assistance, or (in a lower-stakes scenario) another person for the purposes of driving in a carpool lane. Pointing out “consequences for other areas of the law that haven’t necessarily been completely thought through” could be an effective strategy for limiting the influence of fetal personhood arguments, Reingold says.
Another possible consequence: if an embryo is legally considered a person, a pregnant person could feasibly be criminalized for a miscarriage or pregnancy complication, says Kulsoom Ijaz, a senior staff attorney at Pregnancy Justice. Ijaz says she’s “cautiously optimistic” that pointing out such dystopian ripple effects would sway some judges and lawmakers. “It’s a matter of summoning defiant hope so that we…make sure there is no more rollback on people’s most basic civil and human rights,” she says.
There is some precedent to back Ijaz’ optimism. Even in the 2022 U.S. Supreme Court decision that overturned Roe v. Wade, the justices did not take a position on “if and when prenatal life is entitled to any of the rights enjoyed after birth,” which could foreshadow a broader hesitation for judges throughout the U.S. court system to consider questions of legal personhood.
That reluctance may not last forever. But in the meantime, IVF advocates like Carr, the first U.S. person born using the technology, are leaning on some of the “best tools” they have: their own stories, which underscore how life-changing IVF can be for individuals, couples, and families. “I always knew there were people who didn’t agree with how I was born. Around age 10, I realized I can potentially educate people,” Carr says. “I feel very strongly, and I always have, that people fear things they don’t understand.”
The stakes of that education campaign are high. Carr’s birth was a historic first for the U.S. “I do not want to think about who could potentially be the last,” she says.
We’ve all been there: You’re snug in bed, moments away from drifting off, only to be jolted back into a state of annoyed wakefulness by a loud, persistent sound coming from the other side of the bed.
Snoring is a pervasive problem, with around 40% of men and 30% of women sawing logs at least some nights of the week, according to the Sleep Health Foundation. And while it can be linked to a variety of health risks in those who are affected, snoring also takes a toll on bed partners who struggle to get some shuteye in the midst of a cacophony of snorts and rumbles.
When chronic snorers seek a doctor’s help, it is usually at the urging of their partner, says Dr. Megan Durr, associate professor in the department of otolaryngology, head and neck surgery at the University of California, San Francisco. “I see so many patients that are ending up in different bedrooms than their partners, which is impacting their relationship and just their quality of life,” Durr says.
The good news is that she and other experts say that people can take a number of steps to help reduce or even eliminate snoring from their—and their partners’—nighttime routine, ranging from lifestyle changes to surgical interventions in more extreme cases.
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Watch the scale, hold the wine
When we sleep, the muscles at the back of the throat relax. Some people, such as those who are older or overweight, are more likely to have tissue that relaxes too much, or to have excess tissue in their throat, which can cause their airway to narrow too much during sleep. When the person breathes, the loosened throat muscles and smaller airway lead to vibrations that cause the unmistakable snoring sound. While it can be harmless, snoring can also be a sign of a more serious condition called sleep apnea, which is why many physicians urge people to visit a sleep medicine specialist if they’re worried about snoring.
While it can happen to anyone, snoring is more common as people age. If people are carrying extra weight or have consumed alcohol, the effects of snoring tend to get worse, says Dr. Michael Howell, division director of sleep medicine at the University of Minnesota Medical School.
People who are overweight or obese can experience more compression on their airway due to the extra pounds they are carrying, which is why it can cause snoring or make an existing problem worse. Losing weight is one of the first interventions physicians turn to when a patient seeks help with snoring because it can be highly effective at getting the problem under control, Howell says. “Even five or 10 pounds can make a difference,” he says.
Cutting out alcohol is also another potential solution. Alcohol can make the muscles at the back of the throat even more relaxed, so it “tends to worsen sleep apnea and snoring,” says Dr. Virginia Skiba, a sleep medicine physician at Henry Ford Health in Detroit.
Change your sleep position
If your partner snores, a simple yet effective solution could be finding a way to help them sleep on their front or their side. Back sleeping, especially if a person is lying flat, is known to worsen the effects of snoring, Skiba says, so some people find success with foam wedges or similar products to prevent rolling onto their backs. Being proposed up with pillows can also help, she says.
While there are sleep vests and other similar products on the market designed to keep people from rolling onto their backs during sleep, Durr has developed a DIY solution for her patients. She advises them to find or buy a T-shirt with a front pocket and place a tennis ball inside, securing it with a safety pin. The person who snores puts the T-shirt on backwards when they go to sleep, and it automatically keeps them from rolling onto their back during sleep.
“The ball kind of pokes you into your back, and then it will shift you to your side,” she says. “So it’s not waking your bed partner up, hopefully.”
Durr says there are other things people can try before they go the more drastic route of sleeping in a separate room from their noisy partner, such as using a white noise machine or wearing ear plugs.
“But a lot of this ends up being on the snorer,” she says. “They end up bearing the brunt of trying to fix this for their bed partner.”
CPAP and surgery
In some cases, snoring is a sign of a more serious condition called sleep apnea, which occurs when people momentarily stop breathing when they are asleep. This can lead to fatigue, irritability, and grogginess the next day and, over time, increase a person’s risk of cardiovascular disease and other health problems.
For a person to figure out if they have sleep apnea, they must undergo a sleep study, during which they are monitored overnight to identify changes in breathing, heart rate, oxygen levels and other health measures. Sleep studies are typically done in a clinic, but can be performed at home. Howell says a diagnosis isn’t necessary for a person to start using a CPAP machine or other therapies, but it is important for doctors and patients to know if snoring is caused by sleep apnea.“Sleep apnea is hugely underdiagnosed,” he says.
There are several available treatments for sleep apnea. One of the first treatments doctors will often recommend is an orthodontic device called a mandibular advancement device that can help prop open a person’s airway when they are sleeping, according to Howell.
A continuous positive airway pressure (CPAP) machine is another tried-and-true sleep apnea aid that essentially cures snoring by ensuring a person’s airway is fully open, says Durr. But it can be a lot for some people and their partners to adjust to, and many people simply find it too difficult to tolerate, she says. CPAP machines are notoriously noisy, which can be disruptive to those wearing it as well as their bed partners, and many people find the mask too uncomfortable or wake up with a very dry mouth.
Although it is fairly rare, some patients with severe snoring problems who have had little success with lifestyle changes or other treatments may require surgery to deal with their snoring, such as a minor procedure to remove some of the elongated tissue from the back of their throat, Durr says. But she says in most instances, it doesn’t take such extreme measures for people to enjoy a relatively quiet night in bed.
“The vast majority of people will get the snoring volume to a level that’s acceptable to them and their bed partner by doing some of the lifestyle things,” she says.
Happiness is a worthy pursuit. But fixating too much on achieving it often leads to bad feelings when you fall short—which ultimately makes you less happy.
That’s the finding of a new study published in the journal Emotion. “Imagine someone going to a birthday party, and midway through the event they realize they are not as happy as they were expecting to be,” says lead author and social psychologist Felicia Zerwas, who was a doctoral student at the University of California-Berkeley when the research was conducted and is now a postdoctoral researcher at New York University. “One might just acknowledge that it is a fact of life and birthday parties. Or, one might judge it, thinking how sad and disappointing it is.”
This second way of thinking, the research shows, is the problematic type. “Over time, infusing potentially positive moments with negativity can accumulate to undermine well-being—similar to the way plaque might build up in arteries and undermine heart health.”
Sabotaging your own happiness is surprisingly common, Zerwas and her colleagues found. Something interesting emerged when they analyzed mood, personality, well-being, and depression surveys, as well as diary entries, of about 1,800 people for 11 years.
They found that striving for and valuing happiness wasn’t a problem. How people pursued it was. “Someone can value happiness and struggle to identify effective strategies to reach their happiness goals,” Zerwas says, “and someone else can value happiness and successfully identify effective strategies to achieve their happiness goals.”
Worrying and stressing over not being happy, it turns out, is not one of those effective strategies. It gives rise to what are known as meta-emotions—feelings about what we’re feeling—and they can be destructive.
“Consider someone on a first date,” Zerwas says. “They had hoped to feel happy, but the date started off a bit awkward. They may start to judge their feelings by thinking they should enjoy the experience more; however, this very act works against their goal of feeling happy. Accepting that social interactions often have ups and downs can keep them from obsessing over the differences between what they want to feel and what they are feeling.”
In the study, people who said they were worried about achieving and maintaining happiness tended to have more depressive symptoms, worse well-being, and less life satisfaction than those who simply held happiness as a goal—and didn’t fret about whether they were meeting it.
What’s the secret, then? Take the pressure off and stop taking your own happiness temperature so often, Zerwas says. Embrace all of your feelings—both happy and sad ones—since all emotions can be informative, providing us insights into our psychic makeup. And practice cognitive-behavioral strategies such as mindfulness—being present in one’s emotions and aware of what those feelings are—to truly tune in. This can “decrease the pressure of setting emotion goals,” Zerwas says. “Damaging emotional experiences [can occur] during the pursuit of happiness.”
Burnout is steadily rising worldwide—and people are coping in very different ways. Some deal with their stress and exhaustion by binge-watching Netflix shows, hitting the gym, meditating, or crafting. As for others? They try bed rotting.
The Tiktok trend is (usually) less repulsive than it sounds; it simply involves spending the entire day in bed relaxing, or “rotting away,” as a way to decompress from life’s stressors.
“In our society, there’s an emphasis on being productive,” says Laurence Chan, instructor of medical psychology at Columbia University. “And bed rotting might be one socially acceptable way to say that you need a time-out and you’re looking to recharge.”
Resting regularly is good for you, but bed rotting for too long or too often can indicate a deeper mental-health issue. “It can be difficult to disentangle what is a self-care day from what is a low or major depression, and when should you seek help?” says Stephanie Preston, a professor of psychology at the University of Michigan.
Moderation is key
If you’re only bed rotting once or twice a month to cope with stress, it’s likely an acceptable form of self-care that isn’t damaging your mental health, Preston says.
But if you find yourself lying in bed multiple days a week, she says, there could be a deeper mental-health issue at play, like anxiety or depression.
Notice whether the activity is impacting your ability to keep up with work, family, or school obligations, as well as whether you’re struggling with basic hygiene. “You’re not showering, you’re not brushing your teeth, you’re not putting on clean clothes—that’s when you might suspect depression,” Preston says.
Bed rotting could also be a coping mechanism for an anxiety disorder, Chan says. Someone with problematic anxiety could be using the self-care trend as a way to avoid certain things in their life. This could “reinforce that it’s safer to avoid the things that we’re avoiding, and then we might believe that we’re not able or capable of handling them,” he says.
That’s the tricky thing about bed rotting: While it might seem like an effective way to decompress, doing it too often or for too long will only worsen depression or anxiety. “While avoiding stress may feel good in the moment, prolonged avoidance is actually linked with long-term distress and greater dysfunction,” Chan says. This is partially because we’re sedentary when we bed rot, and moving our bodies is essential for both our physical and mental health.
The anxious generation
Many of the bed-rotting TikTok videos are from users in Gen Z, a group that was born between 1997 and 2012. Research has shown that Gen Z is, generally speaking, more anxious than other generations. Countless factors contribute to this increased anxiety, from the years-long COVID-19 pandemic to increasing worry about cost of living and climate change.
“I think that in today’s world, what Gen Z and later generations are facing is very different from their grandparents and parents,” says Dr. Justin Kei, a psychiatrist and medical director for the outpatient behavioral health clinic at Hackensack University Medical Center. “So we should be mindful that there’s probably a reason for [bed rotting].”
The sleep connection
Spending an entire day resting can be restorative. But even if you feel relaxed during a lazy day, you could be setting yourself up for sleep issues that night—and for many nights to come.
“Our nighttime sleep is heavily influenced by our daytime behaviors,” says Joe Dzierzewski, vice president of research and scientific affairs at the National Sleep Foundation. If we spend too much time in bed during the day—even if we’re not strictly sleeping—we’re likely not getting enough bright light, exercise, and nutritious meals at the appropriate time. All of these are “important daytime contributors to healthy sleep,” he says.
Bed rotting can also have a long-term effect on sleep. When you spend time in bed not sleeping, “the brain makes an association that bed is a place where you stress and worry and watch TV and study and do everything else except sleep,” Kei says. This behavior over extended periods of time, he says, can lead to insomnia.
Some TikTokers who engage in bed rotting record themselves napping throughout the day. Dzierzewski notes that research has shown weekend “catch-up” sleep can actually help us recover from a sleep deficit from the previous week. But it’s important “to limit the extra sleep to one or two hours on non-workdays,” he says.
How to bed rot the right way
Some TikTokers tout the benefits of bed rotting, mentioning how refreshed and recharged they feel afterward. Others say they feel guilty or gross after spending a day or weekend cooped up under the covers. To be clear, there are far healthier ways to spend a day than curled up in bed. But if you’re headed under the covers anyway, consider these tips.
Get up and stretch every few hours. Sitting still for extended periods of time can impact mood, slow digestion, and strain the muscles. Chan recommends setting timers to get up and stretch throughout the day.
Opt for the couch instead. Spending the day in bed can confuse your brain and interfere with nighttime sleep. Because of this, Chan recommends bed rotting on the couch, on a comfy chair, or in a hammock instead.
Call or text a friend. Many bed rotting videos on TikTok show people surfing their phones all day. While social media has its place in our lives, Kei says, “real human connection in day-to-day life is extremely important for maintaining a sense of wellness.” Chat with a friend, or even consider bed rotting with them: Some TikTokers document themselves bed rotting together.
Set limits for yourself. Chan recommends people limit their bed rotting to one or two days in a row while also taking breaks and, if possible, engaging in physical activity throughout the day.
Be mindful of your social-media use. Countless research studies have shown a correlation between social-media use and mental-health issues, Chan says. If social media tends to stress you out, avoid it. But in some cases, surfing Instagram or Reddit could be OK. “While it sounds terrible to stare at your phone for nine hours, I think if your brain is fried, it’s a mindless activity that doesn’t challenge your brain and keeps you entertained,” Preston says. “So it’s not necessarily problematic.”
My nine-year-old skips, jumps, flails his arms, jumps some more, kicks, skip-jumps, stops by to punch me in the leg, and continues. He drifts through the house to the energetic pop rock of his favorite band, Imagine Dragons.
He’s mouthing the words, but his “dancing” takes no cues from the music’s rhythm. He prefers to romp spontaneously.
Many people enjoy life with some dashes of spontaneity, and this freedom is often associated with being young. Meanwhile, rigid thinking is linked to worse mental health (and humans tend to get more mentally inflexible after childhood). You’re not doomed to a grown-up life of no surprises, though. Researchers have recently identified ways to increase spontaneity for well-being—and perhaps even longevity.
Here’s what they’ve learned about spontaneity and how to cultivate it.
What is spontaneity?
Spontaneity is about loosening your mind and actions. It’s voluntary and off-task, serving no particular purpose—like an out-of-the-blue road trip this summer.
We’re spontaneous when thoughts are free to move about, flexibly shifting across ideas and topics, often wandering to external matters that go beyond self-directed, personal concerns. This type of unconstrained thought is linked to specific neural action at the front of the brain, found Julia Kam, a psychology professor at the University of Calgary in Canada. “It’s a marker of letting your mind go,” Kam says.
Thoughts that are automatic and stuck, like repetitive worries, compete with spontaneity, says Jessica Andrews-Hanna, a neuroscientist at the University of Arizona. “Habitual thoughts are ingrained in our psyches,” she explains, when brain regions related to emotion and self-focus interact repeatedly. If these constraints can be relaxed, “spontaneity is free to emerge” for a wide range of thoughts and behaviors.
Creativity is related but different. It’s the ability to choose among many spontaneously generated options for some useful purpose, whereas spontaneity “doesn’t need an end-game,” says Tali Marron, a clinical psychologist at Israel’s Shalvata Mental Health Center. It can be its own reward, like an amateur artist throwing paint at a canvas for fun, regardless of what’s produced.
Why are kids little spontaneity machines?
Young people enjoy these intrinsic pursuits naturally. As Picasso said, we are all born artists. The problem is, we grow up.
“Kids are little spontaneity machines,” says Edward Slingerland, a philosophy professor at the University of British Columbia in Canada and author of Trying Not to Try: The Art and Science of Spontaneity. He recalls his daughter at an age when she couldn’t walk a line from points A to B without zig-zagging jumps and somersaults. Kids are also known for experimenting with new personality traits, outfits, and passions that arise seemingly out of nowhere.
Few adults seek a return to this behavior. Walking in a straight line is mostly very useful. So is a stable identity that doesn’t change with the weather. But adults can benefit from understanding why and how the young are so spontaneous.
One factor is dopamine, a chemical in the brain related to motivation and reward. Sandeep Robert Datta, a neurobiologist at Harvard, monitors the brains of mice while they explore unfamiliar territory. He’s found that dopamine inspires their spontaneous movement just like more predictable movement rewarded by food, and this random behavior is far more common in younger mice. “They generate lots of spontaneous exploratory movements that peak just before adulthood, when mice begin to settle down and act their age,” Datta says.
Dopamine drives human movement, too. “Your behavior any moment is the sum of actions that make you feel good” and more unusual ones that help you “better understand and interact with the world around you,” Datta says. The more we explore an environment, like a city, the better we grasp what’s possible, increasing resourcefulness. In humans as in mice, though, dopamine levels drop as we age—10% each decade.
Another explanation for youthful spontaneity is neuroplasticity. The period of “juvenile exuberance” coincides with the brain being “massively flexible and engaged in ongoing learning,” Datta says. Like dopamine, neuroplasticity declines after a certain point in life. “With the juvenile-to-adult transition, neural circuits get locked to some extent into adult configurations,” says Datta. “Spontaneity can be viewed as a measure of biological aging.”
These changes affect more than movement. Spontaneous thoughts also seem to peak when we’re younger. Studies show that college students and young adults engage in mind wandering up to 50% of the day, Kam says. In older age, it typically declines to about 30%.
That is, unless adults actively strengthen their spontaneity muscles. “Things that keep your brain plastic are probably very important to maintaining spontaneous behavior,” Datta says. The connection between spontaneity and longevity still needs to be tested. But Kam and Andrews-Hanna have found links between freely-moving spontaneous thoughts and having more life satisfaction. And a positive mindset is associated withslower aging.
Follow these steps to enhance spontaneity regardless of age.
Take free-moving, free-thinking breaks
Make time to roam freely. Fantasize and daydream while strolling, losing track of where you’re going. Use GPS to find your way back.
Andrews-Hanna takes such walks, letting her thoughts flow. Kam exercises while avoiding mental to-do lists, television, or anything else productive or distracting. “You can’t focus your mind 24/7,” she says. “I carve out time to let my thoughts wander wherever they want.”
Peter Felsman, assistant professor of social work at Oakland University in Rochester, Mich., introduces people to “sense and savor” walks, guiding them to spontaneously engage in whatever provides pleasure, like watching a bee go from flower to flower. For these walks, psychologists recommend giving “yourself over to the experience as if it were the only thing that existed in the world. When you lose interest…discover something else that is attractive.”
Put yourself in a surprising situation
“You can force neuroplasticity and spontaneity to remain part of your life by getting yourself to do new things,” Slingerland says. “Embrace surprise,” Felsman adds. “Pleasant breaking of routine wakes people up to life.”
Recently, Felsman joined a friend for a sailing outing. He thought it’d be relaxing but, once on the water, they were invited to compete in several hours of competitive racing. The idea made Felsman nervous because this was his first time sailing. But he embraced the novelty of getting to learn how to participate in a sailing crew. “It just sort of happened,” he says. “It was extraordinary.”
Datta, too, values spontaneous, new experiences. His father has Parkinson’s disease, which is associated with low dopamine levels. “The one thing that makes him better is novelty,” he says. “If I surprise him with a trip to the mall, the beach, or anywhere else, he perks up in a way that I’m not used to.”
Free associate
If you feel stuck with an unsatisfying routine, it may help to try a certain form of free association, in which you describe your inner train of thought out loud, one word at a time, each word associating with the previous one. You might go from cloud to mother to kitchen, depending on your associations. This aids creativity and, just as importantly, it practices silencing our internal critics while boosting spontaneity, says Marron, the Israeli psychologist.
When people’s thoughts move freely, the executive parts of their brain—controlling functions like planning and decision-making, also known as convergent thinking—aren’t as activated, Marron has found. “Their associations are more flexible with less inhibition.” They improve at watching their thoughts diverge, like zigzagging children, without “feeling like half their ideas are spam,” she says.
Asking people to read positive, creative stories could make these associations moreoriginal and lively. Free-writing is another activity that encourages “free, flowing forms of thinking,” Andrews-Hanna says.
Some people enjoy being alone with their divergent thoughts more than others. Andrews-Hanna has developed an app called MindWindow that lets users gain insight into their own thinking patterns, including spontaneity.
Take an improv class
Studies in adults show that taking improv classes, another free-association activity, reduces symptoms of depression and anxiety. It also boosts creativity, which is linked to well-being. Felsman’s research in Detroit schools found that kids who participated in an improv class became better at tolerating uncertainty—key to mental health—and less socially anxious.
The executive parts of the brain are important. Without their control functions, associations would loosen too much, Marron says. But free association can help ensure that top-down, executive forces don’t dominate one’s mental landscape. “The ideal is to find a balance between divergent and convergent thinking, so you can flexibly act in line with your values,” Felsman adds.
Reduce stress
Anxiety is linked to narrower, more ritualized thoughts and behavior. Practicing mindfulness can “break your attachment” to repetitive, negative thinking, Andrews-Hanna says, freeing up mental bandwidth for spontaneity. New research shows that psilocybin can weaken psychological constraints, perhaps by reducing stress and shifting the brain temporarily to a childlike state of neuroplasticity. Ignoring the stressful, digital constraints of smartphones can help, too.
Try not to try
Spontaneity as a virtue has ancient roots. It was seen as essential to enjoying life in 5th century BCE China through the concept of wu-wei, which translates as “no trying,” Slingerman writes in his book. People with wu-wei are successful without striving; they know when to trust their unconscious mind and do what comes naturally. Cultivate it by engaging in something awe-inspiring that syncs you up with the larger, natural order, Slingerman says—in his case, it’s ocean kayaking.
Play without structure
Part of Andrews-Hanna’s regimen for spontaneity involves playing with her kids. “I try to get into their mode of thinking, rather than directing their play,” she says. “It’s very difficult, more natural for a four-year-old. But it helps me connect with them and become more flexible in my thinking.”
Recently, I started joining my son’s dancing. I imitate him with my own jumping and flailing. When he’s really feeling the music, he shakes his head vigorously, appearing to have, as Wordsworth said of poetry, “a spontaneous overflow of powerful feelings.” I shake my head, too, thinking about him sharing his gift of spontaneity.
At first, we collided a few times, but now we expertly dodge each other. Maybe it’s reopening my neural connections—or maybe not. But it’s certainly a welcome divergence from my sedentary routine. The rinse-repeat of daily life is like “hitting the same gumball machine all day,” Datta says. “If that’s all you do, when the machine runs out, you’re screwed.” There’s a fundamental need to continuously try random things. “These movements might seem meaningless, but who knows in the future whether a move you made while dancing will be useful to you.” Even if there’s no point, though, the true benefit may be simply enjoying the spontaneity for its own sake.
More than 10 million people around the world develop dementia each year. And many people assume there’s nothing they can do to avoid that fate—that dementia is “one of these things that just happens,” says Gill Livingston, a professor in the department of brain sciences at University College London.
But a new report published in The Lancet says otherwise. Nearly half of dementia cases could, in fact, be prevented or delayed if people adopted certain habits, according to the report, which was written by a group of almost 30 experts convened by the Lancet and based on an analysis of hundreds of studies.
Some risk factors for dementia can be best addressed through policy solutions—for example, by passing climate policies that reduce the public’s exposure to air pollution, a risk factor for cognitive decline. But there’s also plenty that individuals can do. Even people with genetic risk factors for dementia may be able to extend their cognitively healthy lifespans if they take certain actions, says Livingston, lead author of the report.
Here’s where to start, according to the latest research.
Keep your brain busy
Research suggests people who get a strong early-life education, as well as those who work mentally stimulating jobs during midlife, are at decreased risk of developing dementia later on. But even if neither of those are the case for you, there’s still plenty you can do to keep your mind sharp.
Aim to have plenty of new and varied experiences that get the brain working in different ways, Livingston suggests—things like learning a new skill, reading a book (especially one outside your usual genre), or traveling somewhere you’ve never been. Variety is key, Livingston emphasizes. “If you just do Sudoku, you become good at Sudoku, but that doesn’t generalize to the rest of your brain,” she says. “Your brain has lots of different functions, so the idea is to keep them all engaged.”
Socialize
One of the best ways to keep your brain busy, Livingston says, is by “talk[ing] to a variety of different people, because you don’t know what they’re going to say.” Doing so is a win-win: you’re keeping your brain sharp by coming up with responses and conversation topics, and getting plenty of social interaction at the same time.
Social contact is good for nearly all aspects of health, studies show—and that goes for cognitive health, too. People with active social calendars from midlife onward may be up to 50% less likely to experience cognitive decline as they age, relative to people who are more isolated, according to one research review from 2023. And there seems to be something special about friendship. Research suggests that people who socialize not just with family, but also with non-relatives, tend to have better cognitive performance as they get older.
Stay physically active
Being sedentary isn’t good for your physical, mental, or cognitive health. A 2023 study found a strong link between having 10 or more hours of sedentary time per day and being diagnosed with dementia. Conversely, studies suggest that regular exercise may slash the risk of developing Alzheimer’s by nearly half, and any kind of dementia by almost 30%.
The U.S. government recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous exercise each week to maintain good health and ward off chronic disease. But even if you can’t reach those benchmarks, doing anything is better than nothing. Virtually any amount of physical activity “really begins to shift the dial,” Livingston says. “You don’t have to be an ultramarathon runner”—just spend a little time each day moving in whatever way is enjoyable and sustainable for you.
And if you can, get moving outside. A 2022 study suggests spending time in green space may keep the mind healthy.
Wear a helmet
If your preferred form of exercise is a contact sport or an activity that comes with the risk of falling—like riding a bicycle—it’s crucial to wear a helmet when you do it. Suffering even one head injury over the course of your life may put you in danger of developing dementia, according to 2021 research.
But, of course, exercise alone may not be enough to protect mental health. Psychotherapy and medication are considered the gold-standard treatments for depression, and a 2022 study found that people with depression who were treated using such methods had a significantly lower dementia risk than people with untreated depression.
Follow doctor’s orders
Many of the health metrics that come up doing a routine physical—including your levels of “bad” cholesterol, blood pressure, diabetes risk, and weight—also have ties to dementia risk, studies suggest. Controlling these factors by exercising regularly; eating a diet rich in fruits, vegetables, whole grains, nuts, and other nutritious foods; and taking medication, if recommended by your physician, may help preserve your cognitive health, too.
Don’t drink too much or smoke
If you needed yet another reason to quit smoking, here’s one: current smokers may be up to 40% more likely to develop Alzheimer’s than people who have never used cigarettes, according to a 2015 research review—but that increased risk seems to mostly disappear among former smokers. Quitting, in other words, seems to be beneficial for your health in numerous ways.
Excessive alcohol consumption can also harm the brain, studies suggest. Current U.S. dietary guidelines recommend that men have no more than two alcoholic beverages per day and women no more than one. And having even fewer than that is likely a good idea, according to a flurry of recent research. Increasingly, science suggests that the less you drink, the better for your brain and body.
Protect your senses
Hearing and vision loss are both associated with dementia, perhaps in part because these conditions decrease the brain’s exposure to external stimuli and in part because they make it harder to stay cognitively, physically, and socially active. While there are some things you can do proactively—such as keeping volume low when listening to music—both conditions can be somewhat unavoidable parts of aging.
If they happen to you, don’t delay getting treatment. Studies show that using hearing aids or correcting vision problems, such as by having cataracts removed, can slow one’s rate of cognitive decline.
