Latest news with #AASM
Los Angeles Times
5 days ago
- Health
- Los Angeles Times
Restless Legs Syndrome: What Works and What Doesn't
Restless Legs Syndrome (RLS) (also known as Willis Ekbom disease) is more than just an annoying urge to move your legs—it's a neurological condition and a sleep disorder that can seriously disrupt sleep and daily life. An irresistible urge to move, especially in the evening or when lying down, is often paired with uncomfortable sensations—such as tingling, aching, or crawling—that are a hallmark of the condition and are only relieved by movement. These symptoms of restless legs are most noticeable during periods of rest or inactivity. For many, this cycle of discomfort leads to poor sleep, irritability, and fatigue that affects their overall well-being. RLS often begins in middle age, but it can develop earlier or later. People may develop RLS due to genetic factors or underlying medical conditions. In addition, periodic limb movement disorder is a related sleep disorder that can further disrupt sleep in those with RLS. The good news? RLS is treatable. The 2025 clinical guidelines from the American Academy of Sleep Medicine (AASM) recommend a personalized treatment approach, combining medications, iron therapy, and lifestyle modifications [1]. Let's explore the latest evidence and strategies to help patients get relief and better rest. Iron plays a surprisingly central role in RLS. Low ferritin levels—an indicator of iron storage—are strongly linked to symptom severity. Iron deficiency is a common underlying cause of RLS. When ferritin levels fall below 75 ng/mL, the AASM recommends initiating oral iron therapy with ferrous sulfate [1]. Diagnosis of RLS often involves taking a thorough medical history, using a sleep diary to track symptoms and sleep patterns, and evaluating for other sleep conditions. Blood tests are used to check for iron deficiency and to rule out other causes such as kidney failure and sleep apnea. Why? Because restoring iron stores can significantly reduce or even eliminate RLS symptoms in many cases. This is especially important in children, pregnant women—who are at increased risk for RLS due to iron and folate deficiencies—and adults who don't require other medications. Think of iron as the body's fuel for dopamine production—something that RLS patients tend to lack. If the tank's empty, symptoms flare. For those with absorption issues or extremely low levels, intravenous (IV) iron may be an option under medical supervision. But in most cases, a daily iron supplement can be a simple, effective starting point. Dopaminergic medications have long been the go-to treatment for RLS. Drugs like ropinirole, pramipexole, and rotigotine are dopamine agonist medications that mimic dopamine, specifically the brain chemical dopamine, which is a chemical messenger dopamine involved in muscle movement and sensory regulation. These drugs work by increasing dopamine levels in the brain and acting on dopamine receptors to relieve symptoms. They can be very effective—especially in the early stages of treatment. Ropinirole, in particular, is FDA-approved and backed by three robust clinical trials. These studies showed notable improvements in the International RLS Rating Scale (IRLS) and Clinical Global Impressions-Improvement Scale (CGI-I) at an average dose of 2 mg/day over 12 weeks [2] [3]. But there's a catch. Over time, some patients experience 'augmentation'—a worsening of symptoms, either earlier in the day or in new body parts. Others may develop side effects like nausea, dizziness, impulse control disorder (such as compulsive gambling or shopping), daytime drowsiness, or weight gain. Symptoms occur when side effects or augmentation develop, and certain medications—including antipsychotic drugs and anti seizure medications—can interact with dopaminergic agents or worsen RLS symptoms. Some medications can worsen symptoms, worsen RLS, or make RLS symptoms worse, so monitoring is needed to prevent symptoms worse and worsening symptoms. Because of these risks, the 2025 AASM guideline recommends limiting dopaminergic agents to carefully selected patients and emphasizing routine monitoring [1]. For many, these medications still play an important role in treating RLS, especially in severe RLS cases, but with caution and close follow-up to treat RLS, relieve symptoms, and ensure that treating RLS does not lead to further complications. When dopamine agonists aren't suitable—due to side effects, contraindications, or comorbidities like end-stage renal disease (ESRD)—other medication classes come into play. These medications are also used to treat periodic limb movement disorder, a related sleep disorder. Periodic limb movement and periodic limb movements are common in RLS and can disrupt sleep, making their management important for overall sleep quality. Patients with developing RLS in middle age or those with early onset (before age 45) may particularly benefit from these alternatives. Gabapentin and gabapentin enacarbil (a longer-acting version) are particularly helpful in RLS patients with sleep disturbances or pain. These alpha-2-delta ligands work by calming nerve activity and improving sleep quality. They act on the central nervous system, nervous system, and may affect the spinal cord to help control symptoms [6]. They're a go-to choice for people who can't tolerate dopamine drugs or who are at high risk for augmentation. In rare, severe cases, extended-release oxycodone may be prescribed. But opioids are considered a last resort due to concerns around tolerance, dependence, and long-term safety [1]. There is also an increased risk of adverse effects, including dependence and other complications. That said, for patients with refractory RLS who have exhausted other options, carefully monitored opioid use can provide much-needed, though often only temporary relief. Guidelines for these medications are developed by a combined task force of experts in the field of clinical sleep medicine, ensuring recommendations are evidence-based and up to date. Medications aren't the only answer. In fact, combining drug therapy with non-pharmacological treatments often leads to the best outcomes—especially for those with mild to moderate RLS or who want to minimize medication use. Simple lifestyle changes—such as improving sleep hygiene, adjusting daily routines, and avoiding triggers—can also play a key role in managing RLS symptoms. A 2019 systematic review highlighted several low-risk interventions with emerging benefits [4] [5]: For ESRD patients, cool dialysate and intradialytic stretching have been shown to reduce RLS severity during dialysis sessions. While more large-scale studies are needed, these approaches offer accessible, often cost-effective ways to support conventional treatments. RLS is one of several sleep disorders, and consulting a sleep specialist may be helpful for complex or persistent cases. Whether you're starting iron therapy, trying ropinirole, or exploring non-drug therapies, ongoing monitoring is essential. Symptoms may wax and wane, and medications can lose effectiveness or cause side effects over time. Regular follow-up visits allow healthcare providers to: For many patients, managing RLS becomes a long-term balancing act—but one that's highly achievable with the right support and care plan. Restless Legs Syndrome may not be dangerous, but it can take a serious toll on sleep, mental health, and quality of life. Fortunately, there are more treatment options than ever—ranging from iron supplements and dopamine agonists to gabapentin, opioids, and innovative non-drug therapies. What matters most is a personalized, evidence-based approach. For patients, that means partnering with a knowledgeable provider, staying open to a combination of treatments, and committing to regular check-ins. Relief is possible—and better sleep is well within reach. [1] Winkelman, J. W., Berkowski, J. A., DelRosso, L. M., Koo, B. B., Scharf, M. T., Sharon, D., Zak, R. S., Kazmi, U., Falck-Ytter, Y., Shelgikar, A. V., Trotti, L. M., & Walters, A. S. (2025). Treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 21(1), 137–152. [2] Harrison, E. G., Keating, J. L., & Morgan, P. E. (2019). Non-pharmacological interventions for restless legs syndrome: a systematic review of randomised controlled trials. Disability and rehabilitation, 41(17), 2006–2014. [3] Bega, D., & Malkani, R. (2016). Alternative treatment of restless legs syndrome: an overview of the evidence for mind-body interventions, lifestyle interventions, and neutraceuticals. Sleep medicine, 17, 99–105. [4] Ferini-Strambi L. (2009). Treatment options for restless legs syndrome. Expert opinion on pharmacotherapy, 10(4), 545–554. [5] Chen, J. J., Lee, T. H., Tu, Y. K., Kuo, G., Yang, H. Y., Yen, C. L., Fan, P. C., & Chang, C. H. (2022). Pharmacological and non-pharmacological treatments for restless legs syndrome in end-stage kidney disease: a systematic review and component network meta-analysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 37(10), 1982–1992. [6] Anguelova, G. V., Vlak, M. H. M., Kurvers, A. G. Y., & Rijsman, R. M. (2020). Pharmacologic and Nonpharmacologic Treatment of Restless Legs Syndrome. Sleep medicine clinics, 15(2), 277–288.
Medscape
13-06-2025
- Health
- Medscape
Rapid Rx Quiz: Sleep Apnea Devices
CPAP (continuous positive airway pressure), along with other devices such as APAP (automatic positive airway pressure) and BiPAP (bilevel positive airway pressure), have been the mainstay in treating obstructive sleep apnea (OSA) for decades. Despite their proven effectiveness, patients can struggle with discomfort or intolerance of these treatments, which can lead to suboptimal adherence. As a result, alternative devices have been developed to address the needs of individuals who cannot tolerate traditional therapy, offering other approaches to maintaining airway patency and managing related health outcomes. What do you know about devices for sleep apnea? Test yourself with this brief quiz. Current clinical practice guidelines from the AASM recommend the use of either APAP or CPAP in OSA treatment in adults. No clinically meaningful differences were found in outcomes of APAP treatment vs CPAP treatment, and benefits and harm were similar between the two modalities. Patient tolerance and symptom response should guide the choice of one over the other. APAP or CPAP are recommended over BiPAP for initial treatment of OSA in adults. BiPAP might provide an expiratory pressure that is too low to prevent obstructive breathing. However, BiPAP therapy for OSA might be appropriate in certain patients, such as those who have not responded to treatment with APAP and CPAP or those who require very high pressures (> 20 cm H2O). Learn more about sleep-disordered breathing and CPAP. According to current guidelines from the AADSM, patients should be seen by their dentist for a follow-up evaluation within 30 days after appliance insertion. During the first year, patients should be re-evaluated every 6 months, and at least once annually after that to assess treatment efficacy and adherence. At these visits, the treating dentist should use the same standardized tools and questionnaires employed during the initial evaluation to monitor symptoms and treatment response. Adjustment of the oral appliance depends on several factors, including the patient's mandibular range of motion, OSA severity, comfort, and observed changes in symptoms. A collaborative protocol between the treating dentist and the patient's medical provider should be in place to support objective and coordinated assessment. Learn more about oral appliance therapy for OSA. The implantable hypoglossal nerve stimulator received US Food and Drug Administration (FDA) approval in 2014 for the treatment of moderate to severe OSA in patients who have not responded to or cannot tolerate PAP therapy. As hypoglossal nerve stimulation has been shown to be most efficacious in those with a BMI < 32, an adult with moderate OSA and a BMI of 28 probably would be a good candidate for this treatment approach. Hypoglossal nerve stimulation has not been approved in patients aged < 18 years, so a boy aged 15 years would not be a candidate. Also, the stimulator is contraindicated in patients with central sleep apnea. The safety of hypoglossal nerve stimulation has not been established in pregnant patients and should not be undertaken. Learn more about upper airway evaluation in snoring and OSA. An external tongue muscle stimulator device was cleared by the FDA in 2020. Intended for use 20 min/d for 6 weeks and then twice per week subsequently, the device requires far less patient time commitment than some other OSA therapy devices. The tongue muscle stimulator is designed to be used while awake for 20-minute increments. It is indicated for snoring and mild OSA and is not indicated to treat OSA with an apnea-hypopnea index (AHI) > 15. The device is approved only for adults aged ≥ 18 years. Learn more about macroglossia. EPAP devices are noninvasive, valve-based devices for the treatment of mild to moderate OSA. They function by creating resistance during expiration, generating back pressure that helps keep the upper airway open during sleep. Unlike CPAP therapy, which provides constant pressure during both inhalation and exhalation, EPAP devices are passive and provide pressure only during expiration. These devices do not require batteries or power sources. They resemble nasal pillows, like those used with many CPAP machines. Unlike oral appliances, EPAP devices do not require custom fitting. Monthly calibration is also not needed. Learn more about pathologic conditions associated with OSA.
Medscape
30-05-2025
- Health
- Medscape
Iron Over Dopamine? Restless Legs Syndrome Guidelines Revamp
To reduce the risk for complications, the use of dopaminergic agonists in the treatment of severe restless legs syndrome (RLS) has become less common. RLS is characterized by an irresistible urge to move the legs, often accompanied by unpleasant sensations such as itching, tingling, or electric paresthesia, which typically affect the lower limbs. It affects 8% of the French population, predominantly women. New guidelines from the American Academy of Sleep Medicine (AASM) no longer recommend the use of these drugs as first-line treatments. During the recent French Language Neurology Days in Montpellier, France, Sofiène Chenini, PhD, a researcher at the Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, reviewed the current treatment approaches for RLS and highlighted non-dopaminergic alternatives. He cautioned that dopaminergic agonists could lead to the augmentation and worsening of symptoms over time. In France, RLS is guided by the 2019 recommendations of the French Society for Sleep Research and Medicine (SFRMS), which still supports the use of dopaminergic agonists for the most severe cases of RLS. 'For now, we have not updated the guidelines, but we are considering it,' said Chenini, referring to the new American recommendations. Iron as First Line According to the new AASM guidelines, intravenous iron supplementation is the preferred first-line treatment for severe RLS. In some cases, second-line antiepileptic drugs are considered a first-line treatment option in French recommendations when the severity is low. These sensations of restlessness typically occur in the evening or at night during periods of rest or inactivity and are temporarily relieved by movement, such as walking and stretching. The condition often leads to repeated leg movements during sleep and difficulty falling asleep due to increased brain activity. RLS is not fully understood but is often linked to problems with iron regulation. MRI studies have shown iron deficiency in the brains of patients with RLS. This suggests a disruption in iron transport across the blood-brain barrier and into neurons, possibly due to a decrease in the transferrin receptor. This disruption in iron regulation, believed to have a primarily genetic origin, induces an increase in the synthesis of dopamine and glutamate, which is likely the cause of the symptoms. In RLS, changes in the dopaminergic system are linked to risk factors such as aging and the use of certain medications. Five Clinical Criteria According to a 2016 consensus from the SFRMS, RLS diagnosis is based on five clinical criteria: An intense and irresistible urge to move the lower limbs accompanied by unpleasant sensations Worsening symptoms at rest, the patient is unable to stay still Relief of symptoms through movement such as walking or stretching Increased severity of symptoms in the evening and at night The absence of other causes, such as myalgia, fibromyalgia, osteoarthritis, venous insufficiency, and obliterative arteriopathy of the lower limbs Once diagnosed, iron assessment is required to check for iron deficiency. The analysis includes measuring C-reactive protein to ensure there is no inflammation, 'which reduces iron bioavailability,' Chenini explained. Therefore, polysomnography remains optional in such cases. If ferritin levels are below 75 µg/L, iron supplementation is recommended. Treatment also involves addressing factors that worsen symptoms, such as caffeine and alcohol consumption and smoking. It is advisable to stop or switch medications that may aggravate symptoms, such as antidepressants and antihistamines. The antidepressants involved are serotonergic, particularly serotonin reuptake inhibitors, with a long half-life. 'If stopping treatment is not possible, switching to antidepressants with a short half-life, such as venlafaxine or duloxetine taken in the morning, is recommended,' he said. Lifestyle For mild RLS cases, lifestyle changes may be sufficient to ease symptoms. These include avoiding coffee, alcohol, and tobacco; maintaining regular sleep and wake times; engaging in physical activity early in the day; and performing stretching exercises before sleeping. If ferritin levels remain low after 3 months of iron supplementation, switching to intravenous treatment is recommended. Options included a single dose of ferric carboxymaltose (500-1000 mg) or multiple sessions of 200 mg ferric hydroxide-sucrose. If symptoms persist, a mild opioid is recommended as needed, starting with opium powder, codeine (such as paracetamol-codeine 500/30 mg, up to 60 mg of codeine or more), and tramadol (starting at 50 mg and increasing to 100 mg if necessary). If the improvement remains insufficient, specific treatment should be considered on the basis of the severity of RLS assessed using the International Restless Legs Syndrome Severity Scale (IRLS) score. Background treatment is recommended for very severe cases (IRLS score above 30), which are linked to the risks for depression and even suicide, as noted by Chenini. It is also advised in cases of severe insomnia or when the quality of life is significantly affected. A recent study by Chenini and colleagues found a 10-fold higher risk for depressive symptoms in patients with RLS, particularly in young women with insomnia. The study also reported a threefold increase in suicidal thoughts. Dose and Misuse According to the French guidelines, very severe cases of RLS require treatment with low-dose dopamine agonists, such as pramipexole, rotigotine, or ropinirole. These drugs may also help reduce motor inhibition in patients with depression. Dopamine agonists are the only approved treatment for this indication. 'It is essential to respect the maximum dosages,' Chenini emphasized. The recommended maximum doses are 3 mg for rotigotine, 0.54 mg for pramipexole, and 4 mg for ropinirole. Second-line treatments include alpha-2 delta ligand antiepileptics, such as gabapentin and pregabalin, especially in cases of severe insomnia. For less severe cases, these antiepileptics are preferred as first-line treatment. Gabapentin may be favored over pregabalin because it causes less sedation. The major risk associated with dopamine agonists is worsening symptoms after prolonged use, known as augmentation syndrome, which is particularly higher in patients with iron deficiency, older age, and those prescribed high doses of antagonists. Concerns about this complication led the AASM to remove dopamine agonists from the recommendations for RLS management. In 2016, American guidelines similar to the current French recommendations for dopamine agonists were the first-line treatment alongside antiepileptics in the treatment of severe forms of the disease. The new recommendations now place intravenous iron supplementation as the first-line treatment, while antiepileptics are the second line. Chenini highlighted that this change is due to the misuse of dopamine agonists in RLS. A registry of 670,000 patients with RLS in the United States showed that 60% were treated with dopamine agonists, and 20% received doses exceeding the recommended limits. The registry shows that neurologists prescribe higher doses of dopamine agonists for RLS than general practitioners. This is likely because these drugs are also used to treat Parkinson's disease, where the doses are approximately 10 times higher than those used for RLS. Chenini reported having no conflicts of interest.
Yahoo
06-05-2025
- Politics
- Yahoo
'Putin doesn't want peace, he wants Ukraine' — Pence rebukes Trump's stance on Russia
Former U.S. Vice President Mike Pence has spoken out against the White House's stance on the war in Ukraine, saying its actions have "only emboldened Russia" despite efforts to bring about a ceasefire. "If the last three years teaches us anything, it's that (Russian President) Vladimir Putin doesn't want peace; he wants Ukraine," Pence said in an interview with CNN published on May 5. "And the fact that we are now nearly two months following a ceasefire agreement that Ukraine has agreed to and Russia continues to delay and give excuses confirms that point," he added. Ukraine has already agreed to a U.S.-proposed full 30-day ceasefire, saying on March 11 that Kyiv is ready if Russia also agrees to the terms. So far, Moscow has refused. Trump has reportedly grown frustrated with the slow progression of peace negotiations, claiming on April 26 that Putin may be "tapping me along," and that he may not be interested in ending the war. While Trump has so far resisted applying any real pressure on the Kremlin, has has been willing to temporarily turn off military aid and stop intelligence sharing with Ukraine. Criticizing the approach, Pence said Putin "only understands power." "It's the reason why, in this moment, we need to make it clear that the United States is going to continue to lead the free world, to provide Ukraine with the military support they need to repel the Russian invasion and achieve a just and lasting peace," he said. "The wavering support the administration has shown over the last few months, I believe, has only emboldened Russia." Instead of agreeing to the U.S.-proposed 30-day ceasefire in March, the Kremlin has instead unilaterally declared its own partial truces. Putin on April 28 announced a so-called "humanitarian truce" from May 7-9, during Moscow's Victory Day celebrations. Despite being from what the White House had originally called for, Trump on May 5 hailed it as a significant step towards a peace settlement. "As you know, President Putin just announced a three-day ceasefire, which doesn't sound like much, but it's a lot, if you know where we started from," Trump told reporters in an Oval Office briefing. President Volodymyr Zelensky has dismissed Putin's announcement as a "theatrical performance" rather than a serious move towards peace. In his interview with CNN, Pence also warned of the long-term consequences of not achieving a just peace in Ukraine. "This is not just about Ukraine for me. I really do believe that if Vladimir Putin overruns Ukraine, it's just a matter of time before he crosses a border where our men and women in uniform are going to have to go fight him," he said. "I hold to that old Reagan doctrine that if you're willing to fight our enemies on your soil, we'll give you the means to fight them there so we don't have to fight them." Read also: France is sending Ukraine more AASM Hammer bombs — here's what they can do against Russian forces We've been working hard to bring you independent, locally-sourced news from Ukraine. Consider supporting the Kyiv Independent.
Forbes
05-05-2025
- Business
- Forbes
Sleep Like—Hatch Cofounders Ann Crady Weiss And Dave Weiss
Sleep Like is a column in which Forbes Vetted asks entrepreneurs and tastemakers to reveal the go-to sleep essentials that help them rest, recharge and ultimately conquer their busy days. Since the start of their company in 2014, Hatch cofounders Ann Crady Weiss and Dave Weiss have been in the business of sleep solutions. When their third child struggled to sleep, they launched Hatch Rest, a kid-friendly sound machine, night-light and sleep trainer to curb the nightly army crawl out of his room. Later, when Dave's chronic insomnia and Ann's work-related stress spiked along with the growth of the brand, they were inspired to create a solve for adults: the Hatch Restore, a sunrise alarm clock meets sound machine that encourages deep rest and gentle rises. The brand's smart tech devices helped the Weiss family—and countless others—set and stick to a sleep routine that's based in behavioral science. But still, like many married couples, Ann and Dave found that other interruptions (differing sleep styles, nightly tossing and turning) often led one of them to head from the bed to the couch in the hopes of snagging that coveted slumber. Eventually, they decided the benefits of sleeping in the same bed couldn't compete with the quality rest they got while sleeping apart. So the official solution, in this case, was to separate their sleeping arrangements altogether, a decision more colloquially known as a sleep divorce. According to the American Academy of Sleep Medicine (AASM), many U.S. couples have gone down a similar path. A 2023 AASM survey found that more than one-third of people occasionally or consistently sleep in another room to accommodate a partner. For Ann and Dave, it has been a mutually beneficial way to prioritize their well-being. 'It's still important for us to be able to connect as a couple, so every night, we spend time together in our main bedroom, which is actually mine,' says Ann, who also wrote an essay on the topic for Hatch's blog last year. 'And then, we go our separate ways when it's time to sleep. It's wonderful, and I actually sleep so much better now.' For Dave, sleeping separately has helped with his insomnia, too. 'We've always gone to bed at different times—I'm usually the last to fall asleep, so now Ann can go earlier in the evening without any disruption,' he says. Although they sleep apart, the couple does share a love for the same rotation of quality sleep products, including plush down pillows from Quince, crisp cotton sheets by Brooklinen and, of course, a custom wind-down routine with their Hatch Restore. Says Dave: 'Above all, we enjoy creating a sleep environment that works for us.' Read on to shop Ann and Dave's go-to picks for achieving deep, restful sleep—together or apart. Nico Zurcher 'My Hatch Restore is the number one sleep essential I can't live without,' says Ann of the sunrise alarm clock and sound machine that's available in four colors, including a new rosy hue (right). 'Right now, I'm loving the sound baths and irreverent meditations, and I transition to a rain sound during the night. Then, around 6:30 a.m., my room starts to fill with the light, and I wake up to the voice of drag queen Jaida Essence Hall telling me, 'Girl, get out of bed. You're going to slay the day.'' Quince 'I'm constantly searching for the ultimate pillow,' Dave says. 'I've had three back surgeries, and I'm also a 6-foot-7 side sleeper, so it's hard to get comfortable, period. Right now, Ann and I are both using this Quince down pillow. I use one to support my neck and another to support my free shoulder.' Adds Ann: 'I'm a side and back sleeper, and I love that it works for both. It's a nice, comfy option.' Brooklinen 'The Classic Percale sheets from Brooklinen are great,' Ann says. 'I have the window pane print, and Dave has the solid white color. I love that they have long and short label tags inside, so when you're putting on the fitted sheet, it's easy to do. It's such a small detail but completely game-changing.' The Company Store 'We both use the same cozy down comforter from The Company Store. I have allergies, so I also use a hypoallergenic cover from Amazon for my comforter and pillow,' Ann says. Leesa 'We're currently using Leesa mattresses,' Dave says. 'Now that we're out of the traditional spring mattress era, there are so many high-quality options to choose from. It's really hard to notice the difference because they're all so much better.' Target 'Ricola's lemon-flavored, sugar-free cough drops are an essential for me,' Ann says. 'I have allergies, so sometimes I get stuffed up. When I eat one of these, even in the middle of the night, I don't get a dry mouth, and I feel so much better.' Lunya 'Dave is not a pajama guy, and sometimes I just sleep in a T-shirt and undies,' Ann says. 'But I do have a pair of Lunya pajamas that I really like. This set includes a short-sleeve tee and shorts that are lightweight and breathable.' Amazon 'When I need to unwind at night, I use my Hatch Restore for meditations, or I pick up a good book. Right now, I'm reading the novel Hello Beautiful, which is incredible,' Ann says. Dave's relaxation routine involves some gaming. 'I like to play chess online,' he says. 'It was initially a pandemic hobby, but I noticed that it requires enough of my attention that the things that were on my mind kind of melt away when I play. When I return, I feel just a little more refreshed.' Amazon 'Next to my bed, I always keep some Blistex lip balm to make sure my lips aren't too dry,' Ann says. 'Blistex is not a very sexy brand, but that's what I use—and it totally works.' Hatch 'Eight years after our second child was born, we had our 'bonus baby,' and he struggled with bedtime, so Hatch was created out of a necessity to help people train their kids to sleep through sound and light,' Ann says. 'The Hatch Rest can really help you establish a good routine. I also recommend that any new parents get educated about sleep for babies, whether that's through a sleep coach or books on the topic. A great swaddle also helps. We've bought the Ollie Swaddle a bunch of times.' Papier 'As a parent, it's important to have a journal to record your own experiences,' Ann says. 'You're so exhausted, and time flies, but whether I'm feeling high or low, I like to write things down so I can remember to keep things in perspective.'
