Zolpidem to the rescue!

I recently decided I'd had enough restless nights in a row that I should break down and take a zolpidem (the generic name for the drug sold under the title Ambien--actually, I take a half tablet)--especially after the torture session that took place Saturday night. What a relief to be able finally to lay down and fall asleep within a half hour, and especially to not wake up until after 6 A.M.!It almost never happens that I don't wake up several times during the night, tossing and turning. The worst is on those nights when, having woken up several times and tried not to look at the clock, I finally allow myself to glance at the blasted chronometer, only to confirm that I went to bed just a couple of hours ago. So it's like a dream come true to wake up only when it's starting to get light outside.

On several days last week I'd felt as though I were in zombie mode owing to lack of sleep. And the insomnia definitely wasn't helping my workouts, either. It's that much harder to push yourself exercising when you're feeling like it's a struggle just to stay awake.

I've tried to be discerning about my mood today and I'm certain it has been negatively affected by the zolpidem (proneness to fits of anger). Zolpidem does seem to have some borderline positive effects as well: I'm pretty sure it increases my libido. It also seems to give me a better appetite. But the negative side effects outweigh the positive, except in extreme circumstances. At any rate I won't take any more zolpidem until maybe next weekend anyway, so those effects will be well worn off by then.

Power 90 master's circuit 5-6 sculpt outline

I've decided that one of the things I need to do on this blog is to offer more detail on our strength-training workouts. I've already mentioned that we do a modified P90X routine and listed the titles of the DVD's we use out of that set. I recently revised that posting, adding a table that lists all exercises on each of the DVD's. I added some informational links there too, where reviewers of those routines offer yet more detail about the exercises--see all that material here.

Continuing in that same vein I posted an outline of one of our less rigorous routines (the ones we currently do on Mondays and Fridays) as well here. I promised in that entry to list the exercises in our other less rigorous strength-training routine and now I'm actually getting around to doing that. Here's the list for the Power 90 masters series circuit 5-6 sculpt (what a mouthful, eh? Maybe an acronym is in order here: p90mc56s, perhaps?) routine we do on most Fridays:

• warm-up/stretch (6 mins. plus about 30 seconds banter)

1. side-to-side push-ups
2. one leg at a time (variation on lawnmowers)
3. 6-direction shoulder flys
4. preacher curls (crouching)
5. split-leg wide tri rises
6. one-legged hamstring press
7. plange push-ups

8. reverse-grip heavy pants
9. straight-arm shoulder flys (bent over)
10. incline (sloucher) curls - use chair
11. elevated chair dips
12. 1-legged Russian rouble squats

• 30-second water break (at 21-minute mark)

1. rami push-ups (wide for x, then diver bomber for x)
2. 2-way lawnmowers
3. scarecrow press
4. in and out hammer curls
5. flared-arm sphinx
6. prayer squat-toe raise
7. salutation push-ups (1 minute duration)
8. locomotive lawnmowers
9. upright row/Y press
10. open-arm 21's (curls, 7 low halfway, 7 high halfway, 7 full distance)
11. reverse-grip tricep extensions
12. plyo 80/20's

• stretch/cool-down (about 5.5 minutes)
  

It will again be worth rehearsing why I feel the need to list in greater detail what we're doing in the way of strength training. First, it's more informative to you, the reader: instead of appearing as though I'm trying to sell you on some product by just saying "we're doing this or that commercially-available routine" you'll be able to see just what that routine involves. Second, these lists may actually help you to develop some of your own fitness routines--that's what I plan on doing with these "raw materials" once I've gotten more experience with this type of fitness. Finally, with these sorts of lists I can get to a point where I can stop using DVD's (watching the same thing over and over and over gets kind'a old, ya' know?) and just do my routines from a list.

So, posting these outlines stands to benefit both of us. I'm thankful I discovered these routines and they have gotten me off to a good start. But you have to be prepared to strike out on your own after a certain period of dependency. I think these outlines may help all of us to do that when the time comes.

Blood pressure let-down

Just a short entry today, mainly about ongoing blood-pressure issues. I hadn't been feeling too well lately and had some indications it might be owing to elevated blood pressure: some borderline headaches and another tell-tale sign I've become familiar with--extreme redness in the face when I'm doing certain strenuous exercise (e.g., incline push-ups)--were the main indicators.

I finally decided to measure my blood pressure day before yesterday and was very disappointed to see that it's gone up again (ca. 152/90). So, unfortunately, it looks like it's back to the hydrochlorothiazide (HZ hereafter) for me--at least until major aerobic exercise can be undertaken again (spring, God willing).

I was initially pretty discouraged about this: I make serious efforts at being fit and active, my diet is good, my cholesterol levels are immaculate, and my heart rate is generally low (registered about 63 when I was measuring my blood pressure). All the most evident causes of hypertension are lacking.

But I've developed a theory that perhaps a major factor in my heightened blood pressure is chronic insomnia. I haven't blogged much about this but a health issue that's dogged me over the last decade and more is chronic intestinal discomfort--something I've been seeing various medical professionals about since 1998. No diagnosis so far.

One of the effects this intestinal distress has is to make sleep difficult and generally very fitful. So, for days, weeks, and months on end I'll not get a decent night's sleep. It can, I think, cause major stress when your body cannot, over long periods of time, get the kind of rest it needs to rejuvinate.

I think what's happening with me is that my body rarely goes into deep sleep, where you really become sort of dead to the world. Many, many nights I never get beyond the R.E.M. stage of sleep, since the discomfort in the abdominal area ensures that I have plenty of nightmares and dreams involving tension all night. Believe me, I have had many mornings when I've gotten out of bed thinking "that's the sort of night you wouldn't wish even on your worst enemy." It's not rest I'm getting on these nights, but some kind of torture session.

The point I'm making, as might be obvious, is that I suspect this restlessness and sleeplessness may be a major contributing factor to my high blood pressure. It's just a theory for now, of course, but it makes sense to me.

Furthermore, I decided some months ago to ask my doctor to prescribe a sleep aid in hopes that it might relieve the insomnia and perhaps help lower my blood pressure. At first I tried amitriptyline, which seemed not to be very effective and additionally had the undesirable side-effect of making me feel very groggy the day after I'd taken it. Next, ambien (zolpidem is the generic name and is the name of the one I was eventually prescribed) was recommended. It did definitely help me to sleep through the intestinal distress and did not seem to have lingering after-effects, so I used it with some regularity for a few weeks. With regular use, however, I found that it began to effect my moods very negatively: the day after I'd take it I would be prone to fits of anger and feelings of aggression.

Long story short, I recently decided to stop taking zolpidem except in extreme circumstances (i.e., sleeplessness lasting a few days). Which brings me to the present blog entry and the high blood-pressure readings I got the other day. Is there a connection between stopping the sleep aid, which has resulted in a return of insomnia problems, and my recent elevated blood-pressure reading? I just can't say for sure . . .

Anyway, I've resigned in the near term to the reality that I'll have to go back on HZ. In fact, I've already taken it for the third day now. And I did feel some immediate relief from some of the headachiness and other symptoms.

This time, however, I'm going to experiment with cutting down to a quarter of a tablet (ca. 6 mg.) to see how that goes. And I think I'll not take it on strength-training days (Mondays and Fridays) since those are the days, at this time of year, when I'm pushing myself pretty hard physically. And I've already blogged about how HZ and rigorous exercise do not mix well in my experience. I'll doubtless be posting on how this works out.

ADDENDUM: while researching blood pressure on the 'net I came across this article, which offers support to my idea that my insomnia could be a contributing factor in my heightened blood pressure:

Question
Sleep deprivation: A cause of high blood pressure?
Is it true that sleep deprivation can cause high blood pressure?
Answer
from Sheldon G. Sheps, M.D.

Possibly. Recent studies suggest that sleep deprivation may increase the risk of high blood pressure (hypertension).

An October 2007 study in the medical journal Hypertension suggests that women who routinely sleep fewer than seven hours a night may have an increased risk of developing high blood pressure. The study followed 10,300 adults between the ages of 35 and 55 for five years. When compared with women who typically slept seven hours each night, women who slept six hours a night were 42 percent more likely to develop high blood pressure. Women who routinely slept no more than five hours had a 31 percent higher risk. The study didn't show a relationship between sleep deprivation and high blood pressure in men.

A May 2006 report also published in Hypertension further suggests that long-term sleep deprivation increases the risk of hypertension. Researchers analyzed data for 4,810 participants, who were between the ages of 32 and 86 years old. Among participants between the ages of 32 and 59 years, those who slept less than six hours a night had more than double the risk of high blood pressure than did those who slept more than six hours a night. This association was not significant in participants older than 59 years.

According to some researchers, people who sleep for only short periods — less than six hours a night — increase their average 24-hour blood pressure and heart rate. Over time, this may lead to persistent high blood pressure. (emphasis added)

Additional studies are needed to better understand the role of sleep deprivation in high blood pressure. But these studies suggest that increasing the amount and quality of sleep may play a role in the treatment and prevention of high blood pressure.

Where I've been, where I'm at, and whither I am going

I'll dedicate this entry to Mathew, who seems to have some unrealistic notions about fitness and aging.

Maybe I should have entitled this entry "Where we've been, where we're at, and whither we're going?" After all, it's relevant to all of us--despite the fact that even those around 30 years of age might still entertain hopes of immortality. Another alternate title might be something like "The athlete's regress."

I found the following outline at http://www.coastkinetics.com/blog/?p=189. It appears to be excerpted from notes someone took in a physiology or perhaps physical therapy course.

It doesn't present a very pretty prospectus, but I'm a realist. I already have an idea of what I'm in for health-wise as I age. I hope through exercise to at least delay some of the deterioration that goes along with aging. I realize at this stage--from first-hand experience involving my own health over the last decade or so--that I can't foil father time. But I intend to do what I can to make the aging process as graceful as possible.

Without further ado, the outline:

These are lecture notes from a course I took on aging from SFU. Although the changes in the body may make you feel a bit depressed…it can also be excellent motivation to make fitness an integral part of your life.

What happens per decade as we age?

In your 30s
· Aerobic capacity will decline by approx 1% per year, and strength may decline by 0.5% per year (after the age of 30)

· metabolism may decrease (a change in diet may be in order to maintain healthy body weight)

· flexibility will start to decrease (joint problems are common from previous injuries)

· recovery from training will not be as quick as it was in 20s
In your 40s
· by maintaining a good aerobic and strength program, retention of fitness from 30s is totally achievable

· reaction time slows by approximately 5% and coordination starts to deteriorate

· loss of fast twitch muscle fibers and ability to accelerate will diminish

· metabolism will decrease (a change in diet may be in order to maintain healthy body weight)

· flexibility will continue to decline (may experience more joint problems)

· recovery from training will be slower

· increased risk of many diseases (diabetes and heart disease)
In your 50s
· retention of fitness from 40s is possible if a solid aerobic and strength training program is followed

· reaction time slows by approximately 5% and coordination continues to deteriorate

· gradual loss of fast twitch muscle fibers and ability to accelerate quickly

· Bones will become less dense and vision may start to deteriorate

· metabolism will decrease (a change in diet may be in order to maintain healthy body weight)

· flexibility will continue to decline (may experience more joint problems)

· increased risk of many diseases
In your 60s
· retention of fitness from 50s is possible if a solid aerobic and strength training program is followed

· reaction time will slow by approximately 20% from its peak and coordination will continue to deteriorate

· continued loss of fast twitch muscle fibers and ability to accelerate quickly

· bones are less dense and vision deteriorates

· metabolism has declined and total body mass will probably decrease

· flexibility has declined (may feel more joint problems and may have arthritis)

· longer recovery time from training is needed

· exercise is key to reducing risk of disease and maintaining a reasonable level of strength and mobility
In your 70s
· the effect of aging will make it difficult to retain fitness level from 60s

· daily tasks require a significant percentage of aerobic and strength capacity

· reaction time has slowed significantly and coordination deteriorated

· considerable loss of strength and aerobic capacity

· bones less dense, vision continues to deteriorate

I think this outline was probably not put together by someone in their 70's. I've definitely got the failing vision and joint problems attributed to the 6th decade (50's). I had perfect vision all my life and did not need any sort of glasses til I was in my 40's. Now, however, I'm lost--at least when it comes to reading print--without glasses. Then there's the arthritis that's cropped up in my toe over the last 3 years or so. I suspect arthritis may be developing in my right hip as well.

I don't intend to dwell on ill health and bleak outlooks, though. Off now to try and make the best I can of this 6th decade!

Power 90 circuit 3-4 sculpt outline

I want to provide a list of exercises that comprise each of the exercise videos we've incorporated into our fitness regimen. I've already begun this task by editing an older blog entry I made that described the portions of the P90X regime we were doing last winter: I added a table there that lists all the exercises contained on of the four DVD's we were using. So this entry is a continuation of that itemization project.

Why itemize the exercises from each of the video rotuines we're using? Because providing these lists will be more informative than simply saying "we're using circuit 3-4 sculpt from Power 90." Offering this sort of information will give my readers a better idea of just what sort of strength training I do twice per week. The descriptions could also be of use to the DIY'er who doesn't want to run out (or sit in front of their computer) and buy fitness videos: using the information I give here and in other entries in this blog, a person could put together their own rough approximation of many of the fitness routines I'm describing. So, in this entry I'll offer an overview of another of our current strength-training routines, the Power 90 circuit 3-4 sculpt routine.

We currently do this one on Mondays. On Fridays--our second strength-training day of the week--we do a routine I'll describe in greater detail later that's called "Power 90 master's series circuit 5-6 sculpt." Wow, that's sure a mouthful. And, as I've observed earlier, if it sounds confusing in comparison to the routine I'm describing in this entry, I think that's deliberate.

The routine I'll describe now is the shorter of the two we currently perform every Monday and Friday. This one takes about 38 minutes, and that includes the introductory stretching/warm-up session and final stretching/cool-down period.

This routine divides into four sub-sections, each of which is separated by a short stretching/water break period. The overview I'll post below is actually excerpted from another site that offers reviews of various exercise routines and that can be viewed here. I include a link to that site among the links found on the right side of the main page of this blog as well, by the way.

Below, then, is the overview I excerpted from that site. I've done a very limited amount of editing so as to make the overview more consistent, but the form is substantially that posted by Leela at that site way back in 2001. The weight-lifting exercises, by the way, like in most Tony Horton routines I've seen, are performed using dumbbells.

Segment 1:
warm up, stretch

Decline pushups: 15-20 target. Down-hold, up-hold.
Heavy Pants (8-15)
Military press (8-15, twist 90 degrees on the way up)
Bicep curls (8-15)
Back Scratches (triceps) (8-15)
2 walking lunges. Reverse direction . 2 more. (5 sets of these)

stretch
Segment 2:

Wide pushups (to 20)
back flyes (same as other tape. I really forgot the name of this exercise) (8-15)
swimmers press (8-15)
wide angle (open arm) bicep curl (8-15)
(2 arm) kickbacks with hold at top (8-15)
2 walking lunges. Squat 5 times. 2 more in other direction. Repeat this whole thing 5 times.

Stretch break
Segment 3:

wide-tri-die: 7 wide, 7 tri pushups, and max out on the standards (til you can't do anymore)
lawnmower pulls
shoulder flys (8-15--not lateral raises, as Leela wrote)
21s (bicep curls--7 halfway lower, 7 halfway upper, 7 full distance)
chair dips (up to 20)
15-15-15 squats (feet shoulder width. feet wide. plie, with hands pushing out thighs)

water break.
Segment 4:

upright rows (8-15)
calf raises, weight optional (20--Leela did not list these)
forearm blasts (work): forearm curls for 20, then wrist curls for 20
lower back extensions (hold for 5 seconds. do five of these)
max pushups
max squats (25?)

stretch

If it's unclear to what exercise each of the items in these lists refers, a google search should help clarify exactly how it's done. If your searches don't turn up helpful results, you may ask for further clarification in the comments section for this blog entry. It's worth noting that one of the virtues of using the actual exercise videos as opposed to a list like this one is that they emphasize, demonstrate, and explain well in the videos the correct form to use when performing these exercises.