TIME Addiction

Here’s How Big America’s Painkiller Problem Is

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More Americans are taking potentially deadly doses

The rate of Americans using pain medications like codeine, morphine, oxycodone and hydrocodone long term has remained stable in the last five years, but the amount of medication they take has increased, according to a new report.

The report, called A Nation in Pain, comes from pharmacy benefit manager Express Scripts and shows that almost half of chronic painkiller users are taking short-acting combinations that increase the risk for addiction, and often these cocktails are very dangerous.

Sixty percent of Americans on pain treatments for longterm conditions were prescribed potentially dangerous mixtures. One in three patients were taking a combination of an opiate and an anti-anxiety benzodiazepine, which is the most common combo in multiple drug overdose deaths. Eight percent were taking what’s called a “Houston Cocktail”: an opioid, muscle relaxant and a benzodiazepine. And nearly 30% were taking multiple painkillers together.

Use was most rampant in small Southeastern cities, and two-thirds of patients were prescribed the drugs by two or more physicians. About 40% filled their prescriptions at multiple pharmacies.

“There could be instances when prescribing these combinations of drugs is appropriate, but not at this scale,” said Jo-Ellen Abou Nader, the senior director of Fraud, Waste and Abuse at Express Scripts in a statement.

You can read the full report here.

TIME infectious diseases

Malaria Deaths Have Almost Halved Since 2000 Says WHO Report

But eliminating the disease altogether remains an uphill task

Global deaths from malaria, as well as the number of overall malaria cases, have reduced dramatically in the last thirteen years, the World Health Organization said in a statement on Tuesday.

According to the World Malaria Report 2014, the mortality rate for the disease decreased by 47% worldwide since 2000, and the number of people infected by it went from 173 million the same year to 128 million in 2013.

“We have the right tools and our defenses are working,” said WHO Director-General Dr. Margaret Chan. “But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

The report attributed the progress combating malaria to increased access to insecticide-treated mosquito nets and enhanced diagnostics and treatment, but admitted that there is still a lot of work to be done.

The increased susceptibility to the disease in Ebola-affected countries like Guinea, Liberia and Sierra Leone is an added cause for concern.

TIME Heart Disease

The Other Reason Canned Food Is Raising Your Blood Pressure

Tinned sardines
Brad Wenner—Getty Images

Forget sodium—BPA might be the real canned food villain

If your food or drink comes out of a can, chances are it’s not the healthiest choice for your blood pressure (thanks to all that salt preserving your beans, for example.) But the latest research suggests there may be another reason to avoid canned goods. In a study published in Hypertension, researchers from South Korea found that drinking from cans, many of which have linings that contain the chemical bisphenol A (BPA), can raise blood pressure by 16 times compared to drinking from glass bottles.

The data isn’t the first to implicate BPA as a potential health hazard. Previous studies have connected the chemical, which can be found in plastics, the linings of cans and coating some cash register receipts, to disruptions in reproductive hormones such as estrogen, as well as a higher risk of asthma, obesity and disruptions in brain development in children. Exposure is almost unavoidable. Most studies show that people living in the U.S. have high exposures to BPA, and the chemical has been found in the urine of more than 95% of adults. One study found that eating canned soup for five days in a row can boost BPA levels in the urine by more than 1,000% compared to those eating soup prepared with fresh ingredients.

MORE: Why Receipts and Greasy Fingers Shouldn’t Mix

But those studies have compared different populations of people at different times. The Korean scientists decided to study the same group of 60 older people who drank the same beverages from both cans and glass bottles. Because the same people were being studied, it was unlikely that other factors that can affect BPA concentrations were influencing the results.

Senior author Yun-Chul Hong from the department of preventive medicine and the environmental health center at Seoul National University and his colleague found that the containers the drinkers used made a big difference in their BPA levels. Each was given two servings of soy milk during each of three visits. The milk was served in either two cans, two glass bottles, or one can and one glass bottle. The volunteers’ urine BPA levels were lowest after drinking from the two glass bottles, and highest after consuming milk from the two cans.

This difference translated to a change in 5 mmHg in blood pressure. Hong notes that an increase of 20 mmHg doubles the risk of heart disease, so the rise from BPA exposure is concerning.

MORE: BPA Linked with Obesity in Kids and Teens

“Because hypertension is a well-known risk factor for heart disease, our study showing the link of BPA exposure to elevation in blood pressure strongly suggests that BPA exposure may increase the risk of heart disease,” Hong writes in an email discussing the results.

When doctors evaluate patients for high blood pressure, asking them how many canned products they consume may be worthwhile, since the exposure to BPA from those containers could be pushing their blood pressure higher. “Clinicians and patients, particularly hypertension or heart disease patients, should be aware of the potential clinical problems for blood pressure elevation when consuming canned foods or using plastics containing BPA,” Hong says. And if you have a choice of getting your vegetables from the preserved aisle or the produce aisle, it might be better for your heart to kick the can.

TIME medicine

Genetic Screening Saved This Baby’s Life

Researchers say sequencing genomes can lead to quicker diagnoses and effective treatments for more than half of children affected by brain disorders

Mya Burkhart was only six months old when she went into cardiac arrest. Fortunately, she was in the hospital when it happened, brought there by her parents because she had trouble breathing. It was her eighth or ninth visit to the emergency room for her respiratory problems, but each time the doctors had sent the Burkharts home with more questions than answers.

Mya wasn’t developing at the normal rate. She couldn’t lift her head and wasn’t responding to people and things around her. Doctors thought she might have a muscle disorder, but her other symptoms did not fit with that diagnosis.

After her heart scare, Mya spent three weeks, including her first Christmas, in the ICU on a ventilator. “I couldn’t pick her up or anything,” says her mother Holly. Still unable to solve the mystery of what was ailing her, the doctors finally suggested she have her genome tested. Maybe, they hoped, her DNA would offer some clues about why she wasn’t growing normally.

MORE: The DNA Dilemma: A Test That Could Change Your Life

Holly knew the test was still in the research stages, and that there was a chance that even it might not yield any more answers about her daughter’s condition. “At that point, I just wanted to try anything to find out what was wrong with her,” she says. It boiled down to balancing a chance that their baby would live or die.

Genetic screening, especially whole-genome screening in which people can learn about their possible risk for certain diseases, remains controversial, since the information is neither definitive nor always accurate. In most cases, genes can only predict, with a limited amount of certainty, whether a disease such as breast cancer or Alzheimer’s looms in a person’s future. As the Food and Drug Administration (FDA) contemplates the merits and efficacy of such screening, some doctors and researchers are using it with great success, according to a new study published in the journal Science Translational Medicine.

Researchers at Children’s Mercy Hospital in Kansas City, where Mya was treated, say that for 100 families, including the Burkharts, with children affected by either unknown disorders or brain abnormalities, genome screening helped 45% receive a new diagnosis, and guided 55% to a different treatment for their child’s disorder. Of the 100 families, 85 had been going from doctor to doctor in search of a diagnosis for an average of six and a half years.

“I was surprised by how many cases we found where a specific intervention can make a difference,” says Sarah Soden from the Center for Pediatric Genomic Medicine at Children’s Mercy and the study’s lead author. “For me it’s compelling enough to push the envelope and get younger kids diagnosed.”

MORE: Faster DNA Testing Helps Diagnose Disease in NICU Babies

In Mya’s case, her genome revealed a mutation in a gene responsible for transporting citrate; without it, her cells could not get the energy they needed. So far, only 13 babies have been confirmed with the condition, and all died before their first birthday after having seizures and respiratory infections. Once the genetic analysis revealed the deficiency, however, Mya was started on citrate supplements. She’s now 18 months old, having already lived nearly twice as long as the other confirmed cases. She has some developmental delays but she has not had any seizures and managed to avoid getting any serious respiratory infections.

Their success at Children’s Mercy are encouraging Soden and the study’s senior author, Dr. Stephen Kingsmore, to push ahead and determine how such screening can benefit more babies. About 5% of the 4 million babies born in the U.S. each year are admitted to the neonatal intensive care unit (NICU), and between those who are born with a genetic disorder and those who may have adverse drug interactions, he and his team anticipate that about 30%, or 60,000, may benefit from the personalized screening they offer.

For now, he and his team are targeting babies like Mya who are sick almost from the minute they enter the world, with symptoms and abnormalities that doctors simply cannot explain. For them, the screening can save families from uncertainty as well as the financial burden of having many different experts perform many different tests looking for a diagnosis. The average genetic sequencing for newborns costs around $5,000, but the average cost of a night’s stay in the Neonatal Intensive Care Unit (NICU) hovers around $8,000, and most babies spend days, if not weeks, in the units awaiting a diagnosis.

Kingsmore received a $1.5 million grant from the NIH to expand the screening program to other institutes, and he has reached out to hospitals in Florida, at the University of Maryland and in Oklahoma City to test the strategy in more babies. “If we can decrease the length of stay in the NICU it could certainly lead to huge potential cost savings,” says Dr. Alan Shuldiner, associate dean of personalized medicine at the University of Maryland.

In the latest study, Soden says that on average, families spent more than $30,000 on genetic testing alone to figure out what was ailing their babies; those who had their genomes screened paid about $3,000 for an answer.

The key to Kingsmore’s success is a system that starts with a doctor punching in a newborn’s baffling symptoms and ends with a genetic readout. The “magic juice,” as he calls it, is a database of 10,000 symptoms that typically affect infants, from simple coughs and fevers and enlarged hearts to all manner of abnormal lab readings. The baby’s unique combination of these symptoms is mapped onto the 3,000 genes that experts have so far connected to about 4,000 diseases. “No physician on the planet earth could carry that database around in his head,” says Kingsmore. But that’s what desperate parents, whose babies’ lives are at stake, expect them to do. So Kingsmore’s program accomplishes the feat, spitting out, in rank order, a list of potential genetic diagnoses. That targeted tally of diseases then directs doctors to focus on a much more manageable list of 10 or, at the most, 50 genes (from a possible 20,000 or so) that could be mutated and responsible for the baby’s condition.

While there is no argument that such testing can save lives, the more challenging question is who should be tested, and when. There is also still debate among those in the genetics and medical communities about how to interpret genomic data. “Some people would argue that he is still reporting his experimental findings, and moving too soon from the research arena into the clinical arena,” says Dr. Edward McCabe, chief medical officer of the March of Dimes.

Ethicists are concerned about the coerciveness inherent in any hand extended to parents whose babies would otherwise die; no matter how carefully and comprehensively doctors word their request, parents in that situation may not fully process the risks and benefits and be unable to provide a truly informed consent. What if the baby falls into the minority for whom the testing doesn’t yield a diagnosis or treatment? When faced with inevitable death on the one hand, and a chance, however, small, of avoiding that death on the other, can there ever really be a choice?

The stakes are especially high since in some cases, the disorders won’t lead to established and approved treatments, but experimental ones without known risks and benefits. But as the value of such testing becomes more obvious, more centers may consider sequencing more newborns’ genes. “These babies, because they are brand new, are salvageable,” says Kingsmore. “Many patients we see with genetic illnesses already have ravaged organs. In contrast, with newborn babies we have the opportunity to halt a disease early in its progression,” he says.

“I think this testing is definitely something that everybody should consider,” Holly Burkhart says. “Without it, we probably never would have figured out what was wrong with Mya. We probably would be in the same place we were a few months ago.” Instead, Mya is now smiling at her mom and making progress. “The testing helped us find answers, and tell us where we need to go from here,” she says.

TIME Diet/Nutrition

Why Farmed Salmon Is Losing Its Omega-3 Edge

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Closing the fish oil gap

When Amanda West Reade was pregnant with her now two-year-old son, she started eating farmed salmon. As a vegetarian, she knew that getting enough protein, omega-3s, and folic acid to boost her growing baby’s development might be tricky.

“My doctor listed a few meal ideas and I thought I could handle the salmon,” says Reade. “She said to lean more towards farmed salmon because it was higher in omega-3s.”

Reade followed her doctor’s advice and added farmed salmon to her diet three times a week. “It became something I really craved,” she says.

Long-chain omega-3 fatty acids are good for the brain and eye development of growing babies and salmon has been a go-to meal for those looking for a reliable a low-mercury fish source. When it comes to omega-3 fatty acids, the message is the clear: All salmon is a good choice.

But that might soon change. A piece of farmed salmon today may contain as little as half the amount of omega-3s than it did a decade ago.

This is according to the International Fishmeal and Fish Oil Organization (IFFO), a trade group that represents stakeholders in the marine ingredient industry. The group is sounding the alarm over declining levels of omega-3s in farmed salmon.

A 2008 paper showed that for every 3.5 ounces of farmed salmon you ate, you would get about 2-2.5 grams of EPA [eicosapentaenoic acid] and DHA [docosahexaenoic acid], and that was down from 3 grams three years earlier. Since 2008, it has come down further,” says Andrew Jackson, technical director at IFFO. “You’re probably only going to get 1.5 grams per serving now.”

It’s a problem the industry has been aware of for several years.

“As the producers of fish oil, we thought it would be a good idea to inform everybody. Some retailers put it on the package. Some don’t,” says Jackson. “We’re pushing for informed decision making.”

Steady pressure on the farmed salmon industry from environmentalists has pushed producers to become more eco-friendly, including efforts to reduce the quantity of forage fish like anchovy, sardines or menhaden in their feed. These small wild fish are ground up and made into fish oil and fishmeal—a critical part of the farmed salmon’s diet. And while they are the very source of the omega-3s consumers seek, most consumers choose larger fish like salmon and tuna, rather than eating sardines themselves.

Worldwide, forage fish stocks continue to shoulder enormous pressure, and environmental groups have been calling for better management of these tiny but important fish. Dwindling numbers have also led the price of fishmeal to rise by more than doubled in recent years.

In October, Peru, the largest producer of fishmeal, shut down its anchovy fishery because the stocks simply weren’t there. Weeks later, traders saw prices soar as high as a dizzying $2,370 a metric ton—66 percent higher than prices at the year’s start.

It’s understandable that salmon farmers are racing to find a replacement for forage fish. Soy, algae, barley protein, insects, trimmings from seafood processing, and even mixed nut meal from California’s pistachio and almond industry are all appearing in feed.

Verlasso, a joint venture between ag-chemical giant DuPont and farmed-salmon giant AquaChile, has also developed a genetically modified yeast which carries genes from an omega-3 producing algae and has dramatically reduced the company’s reliance on forage fish as a component of the salmon’s diet.

“I’ve never seen so much development for aquaculture,” says Rick Barrows, research nutritionist at U.S. Department of Agriculture’s Agricultural Research Service. “There are a lot of ingredients being evaluated and developed. The whole question is, can they be scalable?”

So far, the alternatives are expensive, and most don’t solve the problem of how to keep the omega-3s in farmed salmon.

“There’s a lot of research on what we can do to address the fish oil gap. Unfortunately there’s not a good answer to that,” says Steven Hart, executive director, Soy Aquaculture Alliance. One solution is what’s called a “finishing feed.” Producers use vegetable oil for most of the salmon’s life, and then “switch it to fishmeal to keep the omega-3 levels up.”

The Dietary Guidelines Advisory Committee also have their eyes on declining levels of omega-3s in farmed salmon as they work on the 2015 recommendations for Americans.

J. Thomas Brenna, professor of human nutrition, chemistry and food science, Cornell University and committee member, says the committee plans to comment on in the change in its upcoming report to the secretaries of HHS and of agriculture. “While changes in feeds is certainly an issue, recent scientific studies do not appear to support the view that omega-3 in farmed salmon is lower than in wild salmon.”

That’s an important point.

Even if today’s farmed salmon carries far less omega-3 fatty acids than it once did, it’s now on par with wild salmon, and still packs more than species like tilapia, lobster or catfish.

So how is a consumer to know if their salmon dinner is indeed rich with omega-3s? Don’t bother looking at the label.

“Omega-3s are not labeled, so consumers can’t possibly have any idea how much farmed fish contain,” says Marion Nestle, author and New York University professor of nutrition, food studies, and public health. Levels can vary from farm to farm, depending on in-house feed recipes and the time of year salmon are harvested.

Gavin Gibbons, spokesperson for the National Fisheries Institute says even with lower levels of omega-3s, farmed salmon remains a “super food.”

“The fact is, despite any increase in plant oil ingredients in salmon feed, it still contains very high levels of omega-3s,” says Gibbons.

That’s true for now, but with a finite supply of forage fish, continued worldwide growth in aquaculture, and the absence of a holy-grail, keeping our farmed fish brimming with omega-3s could be a persistent problem. But that also assumes that farmed fish will continue to be our primary source of omega-3s.

“Should [farmed] fish have to carry the omega-3 burden?” Barrows asks.

It’s an important question to consider. As Nestle points out, “They can also be synthesized in the body from shorter chain fatty acids widely available in plants, but slowly,” says Nestle. “So eating vegetables is a slow but steady way to get omega-3s.”

This article originally appeared on Civil Eats.

TIME Healthcare

Illness Strikes 200 on Cruise Ship

The passenger liner Dawn Princess, operated by Carnival Corp.'s Princess Cruises, sits docked at the Overseas Passenger Terminal at Princes Wharf in Auckland, New Zealand, on March 20, 2013.
The passenger liner Dawn Princess, operated by Carnival Corp.'s Princess Cruises, sits docked at the Overseas Passenger Terminal at Princes Wharf in Auckland, New Zealand, on March 20, 2013. Brednan O'Hagan—Bloomberg/Getty Images

Sick passengers have been confined to their cabins

A norovirus outbreak aboard a cruise ship near Australia has left 200 passengers sick and confined to their cabins, health officials said.

Princess Cruises, which operates the ship, said it has taken measures to prevent the spread of the disease, the New Zealand Herald reports. Crew members aboard the Dawn Princess, which is en route to Australia from New Zealand, have taken measures to disinfect surfaces to prevent the spread of the disease. The ship has a doctor on board responsible for overseeing the situation and the health of all 1,500 passengers.

“It takes relatively few cases to be reported onboard for even more stringent sanitation levels to be implemented,” the company said in a statement. “The containment response worked effectively and the number of new cases declined significantly.”

Norovirus, a gastrointestinal virus transmitted through blood and urine, causes diarrhea and vomiting and lasts one to three days.

[New Zealand Herald]

TIME ebola

Emory’s ‘Sickest’ Ebola Patient, Now in Recovery, Reveals Identity

He weighed 220 lb. pre-Ebola, but lost 30

A doctor who contracted Ebola while treating patients in Sierra Leone and was evacuated to the U.S. for care in September revealed his identity in a report published Sunday.

Ian Crozier, who had been working with the World Health Organization in Kenema, told the New York Times that he explicitly kept his identity a secret to protect his family. Crozier, 44, is now recovering in Phoenix and working through a physical-therapy program.

One specialist admitted in the report that Crozier was the “sickest” patient that Emory University Hospital in Atlanta has seen thus far. He weighed 220 lb. pre-Ebola, but lost 30. The viral load in his blood was 100 times that of the facility’s other patients; he spent 12 days on a ventilator and was on dialysis for 24 days.

Crozier went public, he said, to thank Emory and bring awareness to the epidemic. At least 17,145 cases of Ebola have been reported in the outbreak, including 6,070 deaths.

Read more at NYT

TIME Exercise/Fitness

5 Fitness Trends to Try in 2015

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The next big thing? Body weight training

Curious about what’s going to be hot in the wellness sphere next year? Well, you’ve come to the right place. We put our sneakers to the ground to find out what fitness trends could be making their way into your gym in 2015. Happy sweating.

Body weight training

According to an American College of Sports Medicine (ACSM) survey of more than 3,000 fitness professionals worldwide, body weight training is predicted to be the next big thing. “Expect to see it continue to expand in all movement experiences including both group and personal training,” says Carol Espel, Senior Director, Group Fitness and Pilates at Equinox. “Look for the comprehensive incorporation of gymnastics, adult jungle gyms, workout spaces that are uncluttered with weight machines and open for training, greater suspension training options, primal movements, and more programming that is less focused on standard weight lifting protocols.” In other words, those tried and true exercises that don’t require equipment—like lunges, squats, push-ups, and burpees—are here to stay, so embrace them.

HEALTH.COM: 25 Exercises You Can Do Anywhere

High-intensity interval training (HIIT)

OK, HIIT (think P90X) did take a hit over the past year dropping from the number one spot on the 2013 ACSM survey to number two this year. But we assure you that this technique, which alternates intense bursts of exercise with short, sometimes active, recovery periods, isn’t going anywhere. The reason: It’s super effective. “People are exercising in shorter bursts and they are still seeing results,” notes Donna Cyrus, Senior Vice President of Programming at Crunch. This should be no surprise, though. After all, who wants to slave away at the gym for hours each day when you can blast fat in as little as 20 minutes? Exactly.

HEALTH.COM: 11 Fitness Foods to Help You Get in Shape Faster

Treadmill training

Boutique studios that specialize in one specific fitness genre—be it underwater cycling or trampoline workouts—will continue to rise in popularity. However, within this group fitness sector, indoor group running has been steadily gaining momentum. From big gym chains like Equinox and Crunch to smaller studios like Mile High Run Club, treadmill-based training is poised to become the new “it” workout. Yes, many view this piece of machinery as a torture device (I know I’ve called it a dreadmill on more than one occasion), but these classes are truly beneficial, helping to improve your running through speed, incline, and interval-based drills.

“There is a trend in fitness to return to simplicity, and running is the oldest form of exercise,” explains Andia Winslow, a fitness expert and coach at Mile High Running Club. “With indoor treadmill training, participants are in a controlled and yet challenging environment where they can, regardless of fitness level, keep up with class while running on industry elite commercial equipment. With less strain on bones, joints and tendons, runners can focus instead on form, specialized and programmed intensity and being wholly engaged with their runs.” Even better: You will never have to worry about it being too cold or raining too hard to log those miles.

HEALTH.COM: 18 Moves to Tone Your Butt, Thighs, and Legs

Recovery efforts

Don’t you just love a super intense workout? The way it pushes you to your limits, leaving behind a reminder (read: sore muscles) of all the hard work you put in. Here’s the deal, though, too much intense training can throw your body out of whack, leaving it open for potential injuries, which is why recovery is essential. “A balanced body is key, which means all of your muscles are working correctly, not just some of them,” says David Reavy, PT, owner of React Physical Therapy and creator of the Reavy Method. “Weak muscles will fatigue quickly, and you over train muscles that are already strong. The compensation and overuse of muscles and not the work brings the need for recovery.” This is why “we will continue to see the rapid expansion of group formats that include self-care protocols for self myofascial release (SMR), such as foam rolling and therapy balls, core strengthening and dynamic stretching, full recovery days and clear focus on sleep as an integral part of one’s fitness regimen,” says Espel. “And of course restorative yoga formats will continue to become a much more prevalent part of programming.”

HEALTH.COM: 10 Exercise Cheats That Blow Your Calorie Burn

Digital engagement

In our tech-obsessed world, this one seems like a no-brainer. Just take Nike, for example: I learned at their Women’s Summit last month that 9 million women have downloaded the Nike Running app and 16 million women have downloaded the Nike Training (NTC) app. And that’s just one company—think about all of the other fitness apps and cool trackers out there that put a wealth of health info at our fingertips. The reason we’re still obsessed with these modalities is because “they provide inspiration, guidance and coaching,” explained Stefan Olander, VP of Digital Sport for Nike at the summit. Not to mention the social factor. Adds Espel: “We will continue so see an even greater level of engagement of the use of multiple devices to track and log movement, nutrition, sleep and all aspects of activity,” she says. “The challenge for all will be determining what data is pertinent and then how providers and health care experts take the most relevant information and make it continually meaningful to users.”

This article originally appeared on Health.com.

TIME Sex/Relationships

10 Ways To Sleep Better With Your Partner

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Learning to share a bed with a snorer, sheet hogger, or kicker can save your sanity—and your relationship

A good night’s rest can be hard enough to get on your own. Add in the challenge of sleeping with a partner who snores, hogs the covers, or can only nod off to the sound of the nightly news—or has issues with your sleep patterns and needs—and it’s no wonder so many partners are sleep-deprived. In fact, about 25% of American couples retreat to separate sleeping quarters, according to the National Sleep Foundation. That can be an effective solution for some spouses, but it can also take a toll on your bond and intimacy, says Michael Breus, PhD, clinical psychologist and sleep specialist and author of The Sleep Doctor’s Diet Plan. If his and hers beds don’t appeal to you, you’ve still got options. Read on for easy, expert-backed ways to navigate your different sleep styles and score the snoozetime you both deserve.

Your partner’s snoring leaves you staring at the ceiling

About 37 million adults snore regularly, according to the National Sleep Foundation, resulting in poor snooze quality for their bedmates and themselves. Men are more likely to saw away, and snoring tends to worsen with age. “The sound comes from vibrations made as you breathe through narrowed airways while sleeping,” says Breus. Congestion is often a trigger; so is drinking alcohol close to bedtime. Even sleeping on your back can be to blame, which is why nonsnoring partners often roll (or push!) the snorer over to get some peace and quiet. If addressing these issues doesn’t help, have your partner check in with a sleep doctor. Snoring can be a sign of sleep apnea, a serious but treatable condition that causes breathing to stop several times per night. In the meantime, Breus suggests the snore-free partner drown out the buzz by surrounding their ears with a wall of pillows. “The sound will bounce back in the other direction, reducing the noise enough so you’re more likely to drift off,” he says.

You can’t agree on room temperature

The optimum temperature for sleep ranges from 68 to 72 degrees fahrenheit, says Breus. But that won’t persuade a partner who craves a toasty-warm bedroom to stop secretly hiking the thermostat, nor will it stop a chill-loving spouse from throwing open the window. Call a compromise: Pick a temperature between your two preferences. The person who likes it warmer has the option of putting on another blanket or thicker pajamas, while the cold-preferring partner can sleep outside the sheets or duvet, suggests Breus. Upgrading to a bigger bed might also help. “A larger bed means more room, so the person who wants it cooler isn’t as affected by the other’s body heat,” says Janet Kennedy, Ph.D., clinical psychologist and sleep specialist in New York City and author of The Essential Guide to Sleep for Your Baby and You.

HEALTH.COM: 10 Reasons You’re Not Having Sex

Your kids keep interrupting your zzz’s

When spouses don’t agree on how to handle a child who has had a bad dream or has a potty emergency, conflict can ensue—not to mention next-day exhaustion. “Sometimes only one parent ends up taking care of the child’s needs, and that can build resentment,” says Kennedy. “Or one partner is fine with the child coming into their bed for the rest of the night, while the other parent wants the bedroom off-limits.” Kennedy suggests reaching a solution outside of the bedroom, when you and your partner are rested and thinking rationally. “You need to be on the same page about how to handle this situation, so you set boundaries for your kids but also share the responsibility of a middle-of-the-night interruption,” she advises. Otherwise, not only will you both be sleep-deprived, the conflict can potentially shake up your bond.

You have different mattress preferences

Some people love a soft, sink-into-it bed; others require bedding as firm as a board before they can start counting sheep. Luckily, mattress manufacturers have caught on to this, and options that address both preferences exist. “The Sleep Number Bed is popular because you can make one side firmer and the other softer, so spouses don’t have to resort to separate beds,” says Breus. Memory foam mattresses are also couple-friendly because they mold to your weight and body size without affecting the partner lying alongside. You could also look into a split-king bed that features a king-size frame with two side-by-side separate mattresses. These beds can be pricey, but think of it as an investment in your health and relationship, not just another piece of furniture.

HEALTH.COM: Best and Worst Foods for Sleep

You go to bed or wake up at different times

This one’s tricky: we all have an internal clock that generally determines what time we turn in for the night and wake up in the morning. Yet it’s almost impossible to change your personal pattern, says Breus. Make a deal: the later-to-bed partner promises to be extra quiet and not do anything in the bedroom that can cause the other to wake, then in the morning, the early riser promises to do the same for the partner sleeping in. “If you need to rise first, offer to not hit the snooze button too often, so it goes off a bunch of times and disturbs the other person,” says Kennedy. Similarly, night owls should use headphones to listen to music or watch TV while the other spouse is snoozing, advises Breus. Schedule time in bed to be intimate or to talk at a neutral time, like early in the evening or later in the morning, so one partner isn’t wired while the other is too tired.

You like it dark; your partner needs light

Preferring a dark bedroom makes sense; darkness is a cue to your brain to ramp up production of the hormone melatonin, which helps your body wind down, says Breus. Thing is, some people are conditioned to sleep with a light on. If you and your partner are in opposing camps, compromise by agreeing to keep a very small low-wattage lamp or nightlight plugged in, or use a clip-on booklight that can be directed away from the other partner, says Breus. And eye masks look silly, but don’t discount them—they can be surprisingly good at blocking out light. Breus also recommends a new type of lightbulb for your bedside lamp. Goodnight Bulbs use a special bulb that cuts down on blue light, the kind emitted from TV screens and smartphones that has been implicated in insomnia. Without that blue light, it’s easier for the darkness-wanting spouse to doze off.

HEALTH.COM: 10 Ways to Improve Your Relationship Instantly

You’re a cuddler, but your partner craves space

Even the closest couples can have different pre-sleep intimacy preferences. “One partner might like snuggling before bed and falling asleep in the other’s arms, while the other feels crowded and can’t relax unless he or she turns away,” says Kennedy. While that might feel like rejection or a reflection that you two aren’t as connected as you thought, Kennedy cautions against viewing it that way. “It’s just a difference in sleep styles,” she says. Here’s a fair middle ground: “Agree to cuddle until the snuggler drifts off, at which point the other person can retreat to their side of the bed and sleep solo for the rest of the night,” she says. Or have a distinct 10 to 15 minute snuggle time, during which you two can touch and talk, and then officially move to opposite sides of the bed once the time has passed. You both have your intimacy needs meet and can easily drift off to dreamland.

He needs the TV to fall asleep; you like quiet

If one of you is conditioned to fall asleep to Jimmy Kimmel’s voice on late-night TV while the other needs silence, you might need to look into headphones, especially the wireless kind. A timer is also a good idea; agree to set it for 15 or 30 minutes, by which time the TV watcher will have sacked out anyway, says Breus. If the noise can’t be totally shut out, agree to keep the TV volume low, then bring a fan into the bedroom next to your side and keep it on all night. It’s a simple white-noise infusion that can drown out the voices on the tube. If you’re out of options, foam earplugs you can buy in a drugstore can be surprisingly effective.

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You’re battling a blanket hog

Ever wake up in the middle of a sleep session to find yourself shivering because the comforter you had cocooned yourself in hours ago is now encased around your partner like a burrito? Sounds like you’re sleeping with a blanket hog—though it’s not necessarily a deliberate move on your bedmate’s part. If the tug of war over covers happens regularly, it’s no surprise you’re fatigued, says Breus. The solution is to have his and hers covers: one top sheet, blanket and/or comforter for you, and another stack for him. It’s harder for one partner to steal the covers from the other if you each have your own layers.

One partner tosses, turns, and thrashes all night

Everyone changes position at least a few times as they cycle through a night of sleep. But women tend to be more sensitive to their partner’s movements, and that means they’re more likely to be woken up by the kicking, jostles, or twitchy motions of a restless sleeper, says Breus. Layering up in separate blankets can help minimize the disruption, since his or her legs and arms will be wrapped under a different comforter and sheet set. Or consider a foam mattress like a Tempur-Pedic—the lack of springs cuts down on excessive bounce and motion, says Kennedy. A larger bed also allows you to maintain an arm’s length of distance, so the other person can thrash all over the place and not make contact with you.

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This article originally appeared on Health.com.

TIME Research

How Sharing Your Health Data Could Change Medical Research

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"There is an increasing appreciation by people that they actually own their data"

In the field of health research, data have long been held closely by the researchers who collected it. The knowledge is considered proprietary information owned by whoever conducted and funded the study, even if it has the potential to lead to future health advances.

Now, a slew of new companies and organizations promise to tear down the barriers to data collection and sharing by encouraging patients to give away their data. In addition to fostering diverse research projects, data donation helps patients learn about themselves and improve their own treatment, the companies say. The change has taken root in the medical community, and if roadblocks to privacy and data ownership can be overcome, data sharing efforts may just change the nature of research.

“Increasingly people are realizing this is an ethics issues,” says Yale Professor Harlan Krumholz of the need for relevant data to be shared among researchers. “If our job is to save lives, then it doesn’t make sense that we not share data and get as many people working on the problems as possible.”

Generally, here’s how it works: Patients contribute information about their health and receive a personal benefit of some sort. At PatientsLikeMe, for instance, patients can get treatment tips from others who have the same ailment. 23andMe, another service, provides participants with genetic information that can be used to trace ancestry. There’s also the benefit of knowing you’re contributing to medical advances.

Garth Callaghan, who suffers from kidney cancer and shares his data with PatientsLikeMe, says sharing gave him a sense of control over an ailment that he felt had taken over. “Other patients help me direct my medical team instead of me just being a participant and listening to my doctors and saying yes,” he says, adding that he hopes that sharing his data means other patients won’t need to “reinvent the wheel.”

With data in hand, the companies collecting information then act as intermediaries, deciding which research projects are worthy and facilitating access. But unlike in the long-standing research model, in which a single set of data is typically used for one study, data can be used for many projects with many different goals. In most cases, participants are also notified of the results of studies in which their data was used.

Collecting data without an initial driving question also upends traditional procedures of medical research, says James Heywood, co-founder of PatientsLikeMe.

“The world is built on this old model of raise a question, design an experiment, recruit a group of people to solve it…not in this model that we’ve built,” he says, which he calls an integrative learning model.

Health data sharing companies are only a few years old, but their influence has grown quickly. Prominent academic institutions like Yale University have signed on, along with big pharmaceutical companies like Johnson & Johnson and Pfizer.

“When we started this, it was seen as amusing. People were thinking ‘Are you kidding me?’” says Stephen Friend, who runs a non-profit he co-founded that builds platforms to facilitate data sharing. Now, he says “hubris has turned into humility” as researchers have realized the potential.

Still, Friend acknowledges there’s a long way to go and that research money spent on data intended to be shared still represents the “0.1%” of research funding.

Privacy and the question of who owns medical data are some of the concerns holding back data-sharing efforts. Typically, scientific data has been owned by whoever collects it, often universities or academic institutions that fund research. Each company has its own philosophy about who owns data when it’s shared.

Emily Drabant Conley, director of business development at 23andMe, says her company’s policy is “you own your data.” PatientsLikeMe has a policy of “mutual license,” in which both patients and the organization have rights to the data. Regardless of which model prevails, the notion that study participants have any right to their data is a noteworthy change.

“There is an increasing appreciation by people that they actually own their data, and that can actually be useful to them,” says Krumholz. “All these things are coming together in a movement to empower patients and people.”

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