When a person has ventricular tachycardia, faulty electrical signals in the ventricles of the heart cause their heart to beat too fast or irregularly, impeding proper blood flow to the body. “This is a very urgent problem,” says Dr. Fumin Guo, a postdoctoral fellow working in the cardiovascular imaging lab of Dr. Graham Wright at SRI. “Most of these events occur, without previous symptoms, at home or in a public space, not in hospital. And they can be fatal within minutes. We are trying to improve diagnosis and therapy to prevent sudden cardiac death.”

One of the current treatments for ventricular tachycardia is radiofrequency ablation, which involves guiding a device into the heart and using an electrical current to heat up and destroy a small area of tissue that may lead to the abnormal electrical signals (arrhythmia). But about 35 per cent of ablation procedures result in either initial failure or later recurrence.

Preclinical work by Dr. Guo and others in Dr. Wright’s lab is focused on improving the outlook for those with VT in three ways: identifying the underlying structural and functional issues in the hearts of individuals, pinpointing damaged tissue with greater precision, and delivering treatment with more accuracy and efficiency.

The lab has demonstrated success using 3D magnetic resonance imaging (MRI) to guide radiofrequency ablations with improved precision. “Imaging, and in particular MRI, shows great promise in helping to improve management in this patient population, and we are working at the state of the art to look at all aspects from identifying those at risk, to improving the effectiveness of procedures,” says Dr. Wright, who is a senior scientist in the Physical Sciences Platform and Schulich Heart Research Program at SRI.

Dr. Guo recently won the prestigious Polanyi Prize in Physiology and Medicine for his significant contribution to this work. With his background in biomedical engineering, he is developing, using artificial intelligence and computer vision methods, automated image analysis systems that map the heart and pinpoint the damaged tissue. He is also advancing computer algorithms to plan, guide and assess VT treatment.

“Fumin’s work means the image analysis needed to guide procedures will be more repeatable, faster, and hopefully more accessible to others,” says Dr. Wright. “The Polanyi Prize is very prestigious. Winning the prize is emblematic of the clinical relevance of the work and the excellence of Sunnybrook’s program in image-guided, personalized, precision therapy.”

Dr. Wright adds that his lab is collaborating with clinical heart programs and partnering with industry to ensure the preclinical work can be translated to patient care as quickly as possible.

For his part, Dr. Guo is enthusiastic about what lies ahead. “Our ultimate objective is to cure patients with ventricular tachycardia conditions. We want patients to live longer, healthier and happier.”

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“Curiosity drew me,” says Adrianus, who has arrhythmia, an irregular heart beat that can cause the heart to beat too fast, too slowly, or with an irregular rhythm. “There’s not really a lot in the media about arrhythmia and I was keen to see it there was new information from a trusted source: cardiologists who specialize in this area.”

He joined the International Arrhythmia School virtual event on November 21 from the comfort of his home in northern Ontario. The event featured a session for medical professionals, followed by a tailored presentation for patients and families, covering alcohol use and unrelated procedures in arrhythmia patients.

“These are two hot topics for patients,” explains Dr. Eugene Crystal, the founder of the International Arrhythmia School and a cardiologist at Sunnybrook. “From a physician’s perspective, it’s challenging when you’re seeing 20 to 30 patients a day to address questions that those living with arrhythmia may have. The session we hosted is a pragmatic and efficient way to present an overview of the latest evidence, in layperson language, and also have time for questions from patients.”

Participants were provided with practical tips on drinking alcohol with an arrhythmia, such as ensuring two full days of abstinence and avoiding heavy consumption. Procedures covered included MRI tests, radiation procedures and general tips on what could impact the functioning of patients’ pacemakers and implantable cardioverter-defibrillators (ICDs).

Suzette Turner is a nurse practitioner with the Arrhythmia Clinic at Sunnybrook’s Schulich Heart Centre and assisted with the event. “The opportunity to virtually learn – although not a new phenomenon – is one of the silver linings of this pandemic. It’s beneficial to both patients and staff and allows for a wider demographic reach, especially during the winter months,” says Suzette.

For Adrianus, the opportunity to engage with experts was a big draw. “Hearing from heart doctors who are on the leading edge of this type of heart issue was really valuable. And the topics were relevant – many of us wonder about having a glass of wine from time-to-time. At the same time, arrhythmia patients will at some point have another medical procedure, like an MRI, and are concerned our condition or heart device may be impacted.”

The International Arrhythmia School was founded when Dr. Crystal spotted a gap between arrhythmia knowledge, rising technology, medical techniques and saw an opportunity to develop an organization specializing in innovation and education. Dr. Crystal hopes that the patient engagement section will continue each year, and notes that the response from patients who attended the inaugural session was overwhelmingly positive.

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Common symptoms of a heart attack include pain in your left arm and heartburn, but being a middle-aged female and an exercise fanatic, Ines thought nothing of it when her symptoms presented.

“I thought it was muscle pain,” says Ines about the “annoying pain” that radiated throughout her left arm while she was exercising. “I took some over-the-counter pain killers and continued my workout.”

When heartburn set in, she assumed it was side-effects of the drugs. It wasn’t until three days later when she felt a strange sensation in her chest while at work that colleagues called 9-1-1.

“It was a mix of nausea, pain, and like someone punched me in my chest,” says Ines. “The paramedics said I was probably having a panic attack but took me to the emergency department anyway.”

She was in the emergency department at a local hospital for 12 hours, as doctors ran several tests and gave her morphine to manage the pain that waxed and waned. But around midnight, her symptoms worsened, and she was sent to Sunnybrook for an emergency coronary angiogram to check her heart. The angiogram confirmed that she was having a heart attack caused by spontaneous coronary artery dissection, otherwise known as SCAD.

What is SCAD?

SCAD is an uncommon emergency condition that happens when a coronary artery tears or there is bleeding within the coronary artery wall. The bleeding can block blood supply to the heart, causing a heart attack.

SCAD predominantly affects women in their 30s, 40s and 50s, although it can sometimes occur in men as well. It causes up to 35 per cent of heart attacks in women 50 years of age and younger.

“Patients who have SCAD are often given an unclear explanation of their diagnosis and uncertain prognosis,” says Dr. Mina Madan, an interventional cardiologist at Sunnybrook’s Schulich Heart Centre and the medical director of a specialized clinic for patients affected by SCAD.

Unlike traditional risk factors known to cause heart attacks, like smoking and high blood pressure, SCAD can be triggered by severe emotional distress or exertion. It can happen spontaneously in young, active, and otherwise healthy individuals.

The importance of listening

“I heard many times throughout my journey that day that I was having a panic attack,” says Ines. “The worst thing that can happen to you is the uncertainty or the fact that you feel that no one understands what is happening to you. You feel hopeless.”

“When you’re young, it can be challenging to get people to listen to your medical concerns, even when experiencing symptoms like chest pain and shortness of breath. You can be misdiagnosed as anxious or neurotic,” says Dr. Madan, who admits several of her patients from across Ontario visited emergency rooms multiple times before being taken seriously.

While knowledge of the condition among the medical community is improving, Dr. Madan encourages her patients to advocate for themselves: “If you experience chest pain and have had SCAD, go to the emergency room and say, ‘I have chest pain and I’ve had a SCAD related heart attack.’ ”

She adds, it’s equally important to listen to yourself: “It’s easy to get caught up in the craziness of life and we forget to prioritize ourselves. Don’t ignore what your body is telling you.”

“Here’s the thing: If my husband tells me that he’s having a left arm pain and heartburn, I’d take him to the hospital right away and he will be treated as a heart attack,” says Ines. “I know what the symptoms are for a man, but it was happening to me and I never, ever thought that I was having a heart attack.”

At Sunnybrook, Ines received an emergency angioplasty where a catheter (thin tube) with a guidewire was fed up an artery near her groin and into her heart. A small balloon was then inflated to open up the artery and restore blood flow to the heart. During the procedure, patients are awake but mildly sedated.

“Instantly, I felt like an elephant was lifted off my chest,” says Ines.

Now, more than one year later, Ines says she is grateful to be alive.

“I used to associate strength with being able to do whatever I want to really challenge my body – run faster, grab more weight, work longer hours. I had to learn that it is OK to be tired. It is OK to take a break. It is not because you’re weak or incapable. You have to be aware and listen to your body.”

For more information about SCAD and the SCAD Clinic at Sunnybrook, visit Sunnybrook.ca/SCAD.

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When you think about how COVID-19 has impacted the health of people living in Ontario, it’s natural that your mind goes first to the more than 500,000 who have already been infected, the tragedy in long term care, the plight of essential workers and the uneven burden this pandemic has placed on lower socioeconomic and racialized communities. How to care for those with COVID-19 and protect those most at risk has rightly been top of mind for health care practitioners and public health experts for almost fourteen months.

However, there is a side to the pandemic that has not received the attention it deserves – the impacts on people accessing other kinds of care, in particular, for time-sensitive conditions such as heart disease and stroke. These are the untold victims of the COVID-19 pandemic. Untold, because so many of these patients have disappeared from hospitals, clinics and doctors’ offices, and even emergency departments. Today we, and on behalf of our health-care colleagues, are writing to them: Ontario’s missing patients.

To you, the missing patient, we want to say this: we’re worried about you.

We are worried you might be ignoring changes to your health because you don’t want to place additional burden on a system that you keep hearing is overwhelmed. Perhaps you feel you would not receive the quality of care you normally would. Or you might be concerned about contracting COVID-19 in our hospitals and clinics.

We understand your concerns, but we want to reassure you; while our health care system is very stretched, it is not broken. We want you to know that more than a year into this, we have learned a lot and we have applied what we have learned, including how to protect and care for you when you come to see us.

If you experience signs of a medical emergency like a heart attack or stroke, you should call 9-1-1 immediately. For heart attack, these signs include chest or upper body discomfort, sweating, and nausea. In the case of stroke, watch for weakness on one side of your body, changes to speech or drooping of the face.

But even if it’s not an emergency, let us assess you and determine if it is something that can be safely postponed. Changes to your health including increased lightheadedness, shortness of breath, tightness in the chest or jaw are all reasons to reach out.

The bottom line is simple: please don’t triage yourself. Let your health care provider do that – that’s our job and we are here for you. If we can assess you virtually, we will. If we need to see you in person, we will make sure that it’s done safely. And if your symptoms change, our approach will adapt.

But we can’t help you if you stay silent. The nature of cardiovascular disease is that your symptoms may be stable for a time, but then change very suddenly. In our world, days, hours, and even minutes can make a difference. The longer you wait, the more difficult your recovery will be – if you survive. So please don’t wait.

The consequences of COVID-19 on the health of Ontario’s missing patients are not hypothetical. Delaying heart and stroke care has very real and very serious consequences. Our health care system and the people who work in it have been challenged by COVID-19, but we are still here and ready to help you. Please let us.

This article was published first on healthing.ca, operated by Postmedia.

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With atrial fibrillation, the heart may not be able to pump blood normally. This can cause blood to pool in a small pouch that sits off the left side of the heart, known as the left atrial appendage (LAA), and form a clot. If left untreated, the clot can enter the bloodstream, travel to the brain and cause a stroke.

To reduce the risk of stroke, physicians often prescribe a blood-thinning medication, or anticoagulant. These medications slow down or prevent blood cells from clumping together to form a clot. But they may not be appropriate for everyone.

“Despite their effectiveness, taking blood thinners may be difficult for some patients,” says Dr. Sheldon Singh, a cardiac electrophysiologist at Sunnybrook’s Schulich Heart Centre. “These medications are not always well-tolerated and they present a risk for bleeding complications.”

How a unique heart device can help prevent stroke

A treatment called the Watchman implant is an alternative to blood thinners. It is designed to permanently seal off the appendage in the heart where blood clots can form.

“This procedure can protect those who are at a high risk of stroke from atrial fibrillation but who either cannot take blood thinners, or cannot take them consistently for a long period of time,” says Dr. Singh. “Studies have shown that, on average, people who got the implant lived longer than those on some blood thinners, likely caused by life-threatening bleeding.”

In the minimally-invasive procedure, a specialized device is guided by a catheter through a vein in the upper leg and into the left side of the heart. Once in position, the implant is released and seals off the left atrial appendage. Over time, heart tissue grows over the device to create a permanent barrier. The procedure typically takes an hour, with only a 24-hour recovery time.

More procedures, more lives

In the five years since Sunnybrook first introduced the minimally invasive treatment, approximately 40 patients have received the device, with the help of donor support.

During that time, a new iteration of the device first used in Ontario by Sunnybrook has made it easier to implant, says Dr. Singh, “which makes the procedure quicker and safer.”

In March 2020, the Ministry of Health announced its decision to fund 20 Watchman cases annually at Sunnybrook, along with five other centres in Ontario, making the life-saving procedure more accessible for patients who need it. After completing all 20 cases within just five months, the Schulich Heart Centre will be resuming the treatment in April 2021.

“With provincial funding and growing capacity, the procedure is gradually becoming a valuable and more commonly accepted alternative,” says Dr. Singh. “This means we have more opportunities to reduce the risk of stroke in people with atrial fibrillation who previously had very few options.”

Global studies are underway

The Schulich Heart Program was recently selected as one of three Canadian centres, and the only Ontario program, to participate in a clinical trial evaluating the Watchman technology. It is also one of only two Canadian centres chosen to participate in a pivotal global trial evaluating the Watchman against blood thinners in the general population with atrial fibrillation. Set to launch in 2021, the U.S.-run trial will involve patients who have received ablation to treat atrial fibrillation. Researchers will compare the outcomes of those who take blood thinners to those who receive the Watchman device.

“If you have atrial fibrillation and you’re looking for an alternative to blood thinners, speak to your cardiologist about your options,” says Dr. Singh.

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Here’s the good news: there are some things we can do to help prevent heart disease and, if heart disease or attack is recognized and treated early, there are some great outcomes for patients.

I spoke with Dr. Mina Madan, cardiologist at Sunnybrook, to answer some FAQs about the heart and how we can keep ours healthy.

Q. A real easy one, to get us started: What is the heart? (Because it’s been awhile since we’ve sat in a Science Class)

The heart is a muscle pump in the left part of the chest that pumps blood carrying oxygen to the rest of the body. It has its own blood supply that delivers oxygen and nutrients to the heart.

Q. What is coronary artery disease?

The heart’s blood supply is kind of like a plumbing system. Coronary artery disease is build up in those pipes. When there’s a blockage – made up of cholesterol plaque – oxygen and nutrients can’t get to the heart, and so it starts starving. The build-up can happen over time or abruptly.

After about 30-40 minutes of a complete (100%) blockage, you may start to feel some or all of the classic symptoms of a heart attack.

Q. What are the symptoms of a heart attack – or what doctors would call a myocardial infarction?

The classic symptoms are: central heaviness in the chest, burning in the chest that radiates up the neck and into the jaw, pain in the back, difficulty breathing, sweating, pain in your left arm, nausea or vomiting. If you experience these symptoms, call 911.

Q. What are some of the not-so-typical symptoms?

There are other atypical symptoms that both men and women may have. Those might be just jaw pain, just back pain, or burning in the stomach area (kind of like acid reflux). This explains why sometimes the diagnosis of heart attack can be missed.

Q. I’ve heard women experience heart attack differently than men and many don’t realize they are having a heart attack at all?

It’s true. Many women have other atypical symptoms or report just feeling breathless, or really fatigued in the days leading up to a heart attack; some women experience the so-called classic symptoms, but less intense. These symptoms could be a sign of trouble in your heart. You should talk to your doctor.

It’s not really known why these differences exist – just differences in how men and women are wired.

Heart attacks are more common in men. Post-menopausal women have heart attacks more often than pre-menopausal women due to the reduced levels of estrogen associated with menopause (estrogen has a protective effect on the heart).

Q. What are heart disease risk factors?

It’s important that people know the risk factors. Diabetes, high blood pressure, high cholesterol, smoking and a family history of heart disease are all risk factors. As you approach middle age it’s important you are aware of your family history. Talk to your doctor about your risk factors and take measures to keep your heart healthy.

Q. What can we all do to stay on the heart-healthy track?

If you smoke, consider quitting.

Get your blood pressure checked – you can actually do it yourself at most pharmacies.

Have an annual appointment with your family doctor.

Maintain a healthy body weight through a healthy diet and by staying active. You should exercise three to five times per week. Obesity itself is not a risk factor – but being overweight often goes hand in hand with high blood pressure, high cholesterol and diabetes.

If you have risk factors, feel out of breath more than usual or have any of the other lead-up symptoms mentioned above, talk to your doctor about taking a stress test. If heart disease is diagnosed, there are treatments and the outcomes are usually very good.

This column was also published in 2017 the Town Crier Group of Newspapers in Toronto, Ont. It has been reviewed and updated for 2021.

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“My 86-year-old husband is in a nursing home…one long-time friend has died of the virus, and another was diagnosed and recovered,” she says. “It hits very close to home. I know I’m vulnerable and I’m taking it very seriously.”

A former nurse and clinical researcher, Mary remembers the “old days” when she was caring for a patient with tuberculosis.

“I still remember him saying, ‘If I’ve got it, you’re going to have it too,’ then he coughed right in my face,” says Mary, who is now retired. “You get some takeaway memories. I’ve become overly critical of the techniques being used to keep people safe.”

Mary admits she was worried she’d be disappointed at the hospital when she had to go to Sunnybrook Health Sciences Centre for an echocardiogram and visit with her cardiologist.

“It was a very anxious thing, and that made me even more impressed with how well they did,” she says. “You couldn’t get in without being screened – there was no way around it. It was very reassuring.”

Toronto-area hospitals have been taking extra precautions to reduce the risk of the novel coronavirus being spread from person-to-person, from entrance screening to personal protective equipment in clinical and high-traffic common areas.

Robert Kates, a seventy-seven-year-old grandfather of six (soon to be seven), says he too is “a little paranoid” about contracting COVID-19.

“At my age and with my prior history of infections, I’m overly cautious,” he says. “I wear a mask. I carry sanitizer in both my pockets. The only time I leave my house is to go out for groceries, and that’s about twice a week. I even sanitize my own car inside.”

Over the past three months, Robert has been to Sunnybrook three times to undergo tests to evaluate possible heart problems. On visiting the hospital, he says he wasn’t overly concerned: “I wondered what they were going to do. I knew they’d be taking precautions, and I was very relaxed and calm going in there.”

If you are going to hospital or out in public, infection control experts at Sunnybrook recommend you wash or sanitize your hands frequently, keep your hands away from your face, practice physical distancing, and make sure to wear your mask properly.

“Take precautions and trust in the hospital and the doctors,” advises Robert. “If you need to visit the hospital, do it. Don’t wait. It’s your life.”

Heart attacks don’t stop during a pandemic

Don’t ignore the signs of serious heart problems, especially if you have a heart condition. Call 911 if you think you are having a heart attack. Symptoms include:

• Chest pain
• Difficulty breathing
• Discomfort in your chest, arms, back, neck, shoulder or jaw

If you have questions about COVID-19 and your heart condition, or need a health visit, speak to your cardiologist or other health-care provider.

Source: Canadian Cardiovascular Society

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Being on a waitlist is never easy, especially if you’re waiting for medical treatment. If you have severe aortic stenosis and are waiting for TAVI, the amount of time you are on a waitlist will vary depending on the number of people waiting and your symptoms.

Below are six general tips to help you maintain your heart while you are waiting, and when you should seek help. Please consult your TAVI team for recommendations specific to your condition.

Limit your fluid intake

Drink less than 2 litres (8 cups) of liquid per day. If you have kidney issues, follow your nephrologist’s advice on how much liquid you can drink per day. Liquid includes water, tea, coffee, juice, shakes, smoothies, soup and Jell-O.

Take a walk

Walk every day, slowly and rest often. If you have difficulty breathing or feel tired, stop and rest.

Limit sodium (salt)

Eat foods low in salt and don’t add salt to your food. Your maximum total salt intake in one day should be 2 grams.

Do not lift, push or pull heavy objects

Lifting, pushing or pulling objects more than 5 kilograms (10 pounds) could increase your heart rate and put strain on your heart. This includes holding children, carrying groceries or a basket of laundry, shovelling snow, using a snow blower and cutting grass.

Take your medications

Take all your medications as prescribed. If you feel your medications need to be changed, please see your family doctor, cardiologist or other specialist before stopping or adjusting medications.

Do not smoke

Smoking makes your heart work harder. It increases your heart rate, narrows blood vessels, raises blood pressure, and reduces the amount of blood, oxygen and nutrients that get to your heart. Second hand smoke can cause the same effects. Ask your doctor or pharmacist for ways of helping you stop or reduce smoking. You may also visit smokershelpline.ca.

When should I seek medical care?

If you experience swelling in your legs, speak with your cardiologist or family doctor. If you experience any of the following symptoms, call 9-1-1 or seek urgent medical care:

• Fainting
• Shortness of breath that does not improve after 10 minutes of rest.

Notify the urgent care provider that you are on the waitlist for TAVI.

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Heart problems are often to blame.

Dr. Robert Myers, a cardiologist at Sunnybrook Health Sciences Centre, says sudden death in young people is rare, but there are several causes that may contribute: “an arrhythmia (irregular heartbeat) disorder; a viral illness that weakens the heart; Marphan syndrome – a connective tissue disorder that can cause the aorta to rupture; to name a few. But the most common cause is hypertrophic cardiomyopathy.”

Hypertrophic cardiomyopathy is a genetic condition where the heart muscle becomes thickened and enlarged. Myers says it is responsible for more than one-third of all sudden deaths in young people.

“A thickened heart muscle can block the flow of blood and, in rare cases, can cause a fatal arrhythmia during vigorous physical activity,” says Myers, who is also the cardiologist for all Toronto sports teams, including the Raptors, Maple Leafs, Marlies, Toronto FC, and Argonauts.

One in 500 people has hypertrophic cardiomyopathy, the majority of which go undiagnosed. Symptoms of the condition can include sudden fatigue, rapid heartbeat, dizziness, chest pain, and fainting. Although symptoms can be managed, there is no cure.

“Unexpected breathlessness, rapid heartbeat, dizziness, losing consciousness – these symptoms are red flags that need to be investigated,” says Myers. “And exercise should be restricted.”

Mandated athlete health screening varies around the world, but in Ontario, official sports league athletes are screened for the condition through family history, physicals, electrocardiograms, and sometimes ultrasounds and stress tests, explains Myers. If any abnormalities of the heart are found, the athlete is benched until their health is cleared for play. If, however, they are diagnosed with hypertrophic cardiomyopathy, they will need to manage the illness with restricted activity.

“Athletes who have this condition would not be allowed to participate in their sport,” says Myers. “Because of that, people may not come forward with their symptoms.”

Myers says anybody who wants to partake in vigorous sporting activities should look out for the symptoms, speak up if symptoms appear, and talk to their doctor about being screened.

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Adults need on average just under 8 hours of sleep per night for good brain function (although this varies from person to person, with some needing as little as 6.5 hours and some needing as many as 10).

To find out why sleep is so important, I talked to Dr. Andrew Lim, neurologist.

“Sleep plays a key role in maintaining brain health — clearing toxins, regulating the connections between neurons, maintaining healthy brain blood flow, consolidating memories — but clearly sleep also plays a role in cardiovascular health, immune health, and other organ systems.  Sleep touches pretty much every major organ system, from brain on down.”

That includes the heart, says Dr. Anu Tandon, respirologist and sleep specialist.

“Reduced sleep may put excess strain on the heart by releasing certain hormones in the body that cause your blood pressure and heart rate to increase. Over time, this can lead to development on hypertension – one of the well-known risk factors for developing heart disease.”

Sleep fragmentation can also be a problem, she says. That’s when waking up or entering into a lighter sleep phase interrupts deep REM sleep. It can be related to obstructive sleep apnea (pauses or shallow breaths for a few seconds to a minute).

“A severe degree of apnea has been linked to increase risk of heart attacks, development of hypertension and worsening heart failure if your heart is already damaged,” Dr. Tandon says.

Talk to your doctor if you still don’t feel rested after a long night’s sleep.

So, how can we be sure to get a good rest for our brains and hearts?

• Avoid caffeine in the afternoon and evening.
• Get regular exercise.
• Keep to a sleep schedule, even on weekends.
• Avoid alcohol (it disrupts REM sleep)
• Keep the bedroom dark and cool.
• Keep electronics out of the bedroom – Oh no. My phone is practically attached to me! Let’s dig into this one a little further…

Say no to electronics in the bedroom

A TV, tablet or phone (or all three) in the bedroom can affect your sleep.

“Very similar to how one stretches before exercises, the brain needs ‘down time’ before settling,” Dr. Tandon says. “These devices engage the brain preventing it from realizing it is time to rest.”

Dr. Lim says the light from electronic devices can potentially disrupt one’s internal biological clock, making it more difficult to fall asleep. As well, the activities that you do on these devices (surfing the web, playing games, checking e-mail, doing work) are often quite activating, making it even harder to fall asleep.

For people who have trouble falling asleep (sleep initiation insomnia), it’s very important to allow the brain to decompress before sleep so it’s not over-stimulated.

Some experts suggest avoid your electronics for two hours before bedtime. If that’s not possible for you, at least try to keep them out of your bedroom or on dim.

What’s your key to a good night’s sleep? For me, it’s no caffeine after noon and a few pages of a good book to wind down before bedtime.

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Tips for a good night’s sleep

It’s not just for kids: Most adults need just under 8 hours sleep for good brain function

• Stick to a schedule
• Keep bedroom cool
• Exercise daily
• No electronics in the bedroom

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