How Much Sleep Is "Enough"?

By Dr. Mercola

If you’re like most people, you’re probably not sleeping enough, and the consequences go far beyond just feeling tired and sluggish the next day.

According to a 2013 Gallup poll,1 40 percent of American adults get six hours or less per night. Even children are becoming sleep deprived. According to the 2014 Sleep in America Poll,2 58 percent of teens average only seven hours of sleep or less.

Even the Centers for Disease Control and Prevention (CDC) has stated thatlack of sleep is a public health epidemic, noting that insufficient sleep has been linked to a wide variety of health problems.

For example, getting less than five hours of sleep per night may your double risk of heart disease, heart attack, and/or stroke. Research has also found a persistent link between lack of sleep and weight gain, insulin resistance, and diabetes.3,4

But while the risks of insufficient sleep are well-documented, there have been lingering questions about how much sleep is “enough,” and recommendations have shifted upward and downward over the years. On February 2, the National Sleep Foundation released updated guidelines5,6,7 to help clarify this question.

Updated Sleep Guidelines

Led by Harvard professor Charles Czeisler, the panel of experts reviewed more than 300 studies published between 2004 and 2014 to ascertain how many hours of sleep most people need in order to maintain their health. The recommendations they came up with are as follows:

Age Group	Recommended # of hours of sleep needed
Newborns (0-3 months)	14-17 hours
Infants (4-11 months)	12-15 hours
Toddlers (1-2 years)	11-14 hours
Preschoolers (3-5)	10-13 hours
School-age children (6-13)	9-11 hours
Teenagers (14-17)	8-10 hours
Young adults (18-25)	7-9 hours
Adults (26-64)	7-9 hours
Seniors (65 and older)	7-8 hours

As you can see, the general consensus is that from the time you enter your teenage years, you probably need right around eight hours of sleep on the average. According to the panel:

“Sleep durations outside the recommended range may be appropriate, but deviating far from the normal range is rare. Individuals who habitually sleep outside the normal range may be exhibiting signs or symptoms of serious health problems or, if done volitionally, may be compromising their health and well-being.”

Modern Technology Can Affect Your Sleep in Several Ways

Modern technology is in large part to blame for many peoples’ sleep problems, for several reasons, including the following:

1. For starters, the exposure to excessive amounts of light from light bulbs and electronic gadgets at night hinders your brain from winding down for sleep by preventing the release of melatonin. (Melatonin levels naturally rise in response to darkness, which makes you feel sleepy.)
2. Electromagnetic radiation can also have an adverse effect on your sleep even if it doesn’t involve visible light.
According to the 2014 Sleep in America Poll,8 53 percent of respondents who keep personal electronics turned off while sleeping rate their sleep as excellent, compared to just 27 percent of those who leave their devices on.
3. Maintaining a natural rhythm of exposure to daylight during the day, and darkness at night, is an essential component of sleeping well. But not only are most people exposed to too much light after dark, they’re also getting insufficient amounts of natural daylight during the day.
Daytime exposure to bright sunlight is important because it serves as the major synchronizer of something called your master clock, which in turn influences other biological clocks throughout your body.

Even Daytime Use of Technology Can Significantly Prevent Sleep, Especially Among Teens

People now get one to two hours less sleep each night, on average, compared to 60 years ago.9 A primary reason for this is the proliferation of electronics, which also allows us to work (and play) later than ever before. 

According to recent research, teens in particular may have difficulty falling asleep if they spend too much time using electronic devices—even if their use of technology is restricted to daytime hours! As reported by the Huffington Post:10

“The cumulative amount of screen time a teen gets throughout the day -- not just before bedtime -- affects how long they sleep, according to the study11...

‘One of the surprising aspects was the very clear dose-response associations,’ said the study's lead researcher Mari Hysing... ‘The longer their screen time, the shorter their sleep duration.’"

Boys spent more time using game consoles, while girls favored smartphones and MP3 music players, but regardless of the type of device, the effect on sleep was the same. The researchers found that:

• Using an electronic device within one hour of bedtime resulted in spending more than an hour tossing and turning before falling asleep
• Using electronics for four hours during the day resulted in a 49 percent increased risk of needing more than one hour to fall asleep, compared to those who used electronics for less than four hours total
• Those who used any device for more than two hours per day were 20 percent more likely to need more than an hour to fall asleep, compared to those whose usage was less than two hours
• Those who spent  more than two hours online were more than three times as likely to sleep less than five hours compared to their peers who spent less time online

Good Sleep in Middle Age May Benefit You in Your Senior Years

Another study12,13--which looked at sleep habits and mental functioning in later years—reviewed 50 years’ worth of sleep research, concluding that sleeping well in your middle-age years is an “investment” that pays dividends later. According to Michael Scullin, director of the Sleep Neuroscience and Cognition Laboratory at Baylor University in Texas: "We came across studies that showed that sleeping well in middle age predicted better mental functioning 28 years later.”

This seems like a reasonable conclusion when you consider the more immediate benefits of getting enough sleep. Accumulated over time, both hazards and benefits are likely to pay dividends or exact a toll... For example, recent research14,15,16 shows that lack of sleep can shrink your brain, which, of course, can have adverse long-term ramifications. Other research published in the journal Neurobiology of Aging17 suggests that people with chronic sleep problems may develop Alzheimer’s disease sooner than those who sleep well.

Researchers have also found18 that adding just one hour of sleep a night can boost your health rather drastically. Here, they set out to determine the health effects of sleeping 6.5 hours versus 7.5 hours a night. During the study, groups of volunteers slept either 6.5 hours or 7.5 hours a night for one week. They then swapped sleeping durations for another week, yielding quite significant results. For starters, the mental agility tasks became much more difficult for the participants when they got less sleep. Other studies have also linked sleep deprivation to decreased memory recall, difficulty processing information, and dampened decision-making skills.

Even a single night of poor sleep—meaning sleeping only four to six hours—can impact your ability to think clearly the next day. It's also known to decrease your problem solving ability. The researchers also noted that about 500 genes were impacted. When the participants cut their sleep from 7.5 to 6.5 hours, there were increases in activity in genes associated with inflammation, immune excitability, diabetes, cancer risk and stress. From the results of this study, it appears as though sleeping for an extra hour, if you’re regularly getting less than seven hours of sleep a night, may be a simple way to boost your health. It may even help protect and preserve brain function in the decades to come.

A Fitness Tracker Can Be a Helpful Tool to Get More Sleep

To optimize sleep, you need to make sure you’re going to bed early enough, because if you have to get up at 6:30am, you’re just not going to get enough sleep if you go to bed after midnight. Many fitness trackers can now track both daytime body movement and sleep, allowing you to get a better picture of how much sleep you’re actually getting. Chances are, you’re getting at least 30 minutes less shut-eye than you think, as most people do not fall asleep as soon as their head hits the pillow.

I recently detailed some of the benefits of fitness trackers in my article “The Year in Sleep.” Newer devices, like Jawbone’s UP3 that should be released sometime this year, can even tell you which activities led to your best sleep and what factors resulted in poor sleep. When I first started using a fitness tracker, I was striving to get eight hours of sleep, but my Jawbone UP typically recorded me at 7.5 to 7.75. I have since increased my sleep time, not just time in bed, but total sleep time to over eight hours per night. The fitness tracker helped me realize that unless I am asleep, not just in bed, but asleep by 10 pm, I simply won’t get my eight hours. Gradually I have been able to get myself to sleep by 9:30 pm.

How to Support Your Circadian Rhythm and Sleep Better for Optimal Health

Making small adjustments to your daily routine and sleeping area can go a long way to ensure uninterrupted, restful sleep and, thereby, better health. I suggest you read through my full set of 33 healthy sleep guidelines for all of the details, but to start, consider implementing the following key changes:

• Make sure you regularly get BRIGHT sun exposure during the day. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. If you are in darkness all day long, it can't appreciate the difference and will not optimize your melatonin production. To help your circadian system to reset itself, make sure to get at least 10-15 minutes of morning sunlight. This will send a strong message to your internal clock that day has arrived, making it less likely to be confused by weaker light signals later on.
Also aim for 30-60 minutes of outdoor light exposure in the middle of the day, in order to “anchor” your master clock rhythm. The ideal time to go outdoors is right around solar noon but any time during daylight hours is useful. A gadget that can be helpful in instances when you, for some reason, cannot get outside during the day is a blue-light emitter. Philips makes one called goLITE BLU.19 It’s a small light therapy device you can keep on your desk. Use it twice a day for about 15 minutes to help you anchor your circadian rhythm if you cannot get outdoors.
• Avoid watching TV or using your computer in the evening, at least an hour or so before going to bed. Once sun has set, avoid light as much as possible, to promote natural melatonin secretion, which helps you feel sleepy. Devices such as smartphones, TVs, and computers emit blue light, which tricks your brain into thinking it's still daytime. Normally, your brain starts secreting melatonin between 9 and 10 pm, and these devices emit light that may stifle that process and keep you from falling asleep.
Even the American Medical Association now states:20 “…nighttime electric light can disrupt circadian rhythms in humans and documents the rapidly advancing understanding from basic science of how disruption of circadian rhythmicity affects aspects of physiology with direct links to human health, such as cell cycle regulation, DNA damage response, and metabolism.”
• Be mindful of electromagnetic fields (EMFs) in your bedroom. EMFs can disrupt your pineal gland and its melatonin production, and may have other negative biological effects as well. A gauss meter is required if you want to measure EMF levels in various areas of your home. At minimum, move all electrical devices at least three feet away from your bed. Ideally, turn all devices off while you’re sleeping. You may also want to consider turning off your wireless router at night. You don’t need the Internet on when you are asleep.
• Sleep in darkness. Even a small amount of light in your bedroom can disrupt your body’s internal clock and your pineal gland's melatonin production. Even the glow from your clock radio could be interfering with your sleep, so cover your radio up at night or get rid of it altogether. You may want to cover your windows with drapes or blackout shades. A less expensive alternative is to use a sleep mask.
• Install a low-wattage yellow, orange, or red light bulb if you need a source of light for navigation at night. Light in these bandwidths does not shut down melatonin production in the way that white and blue bandwidth light does. Salt lamps are handy for this purpose. You can also download a free application called f.lux21 that automatically dims your monitor or screens.
• Keep the temperature in your bedroom below 70° Fahrenheit. Many people keep their homes too warm (particularly their upstairs bedrooms). Studies show that the optimal room temperature for sleep is between 60 to 68° F.

Why Snoring Shouldn't Be Ignored

Posted: 01/14/2015 8:32 am EST Updated: 01/14/2015 8:59 am EST

By Amanda MacMillan for Life by DailyBurn

People who snore may think that their partners or roommates are the ones most affected by their nightly symphonies -- after all, they're the ones who are kept awake while the noise-maker remains, for the most part, blissfully unaware.

But snoring can be more than just an annoyance to anyone else in the room; it can also be a symptom of a serious health condition, and has been linked to dangers like heart disease and falling asleep behind the wheel.

Of course, there are many reasons why people snore and not all of them are chronic or hazardous to your health. If you sleep alone, you may not even be aware that you're "sawing logs" on a regular basis. Here's how to know if you or a loved one is at risk for snoring-related health problems and what you can do about it.

Why We Snore
Middle-of-the-night wheezing, snorting and snuffling can happen for a variety of reasons, but they all have to do with obstruction of a person's airways. Most often, muscles in the roof of the mouth (known as the soft palate) or the back of the throat relax and partially block the flow of air.

"If you blow air through a floppy tube, it's going to vibrate and make noise," explains Michael Grandner, Ph.D., professor of psychiatry and a member of the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania's Perelman School of Medicine. "And at night, for a lot of people, your airways become a floppy tube."

This can occur when people sleep on their backs instead of their sides, when they've had a few drinks before bed (because alcohol relaxes muscles) or when they have nasal congestion due to allergies or a cold. In fact, about half of adults snore at least some of the time, says Grandner, and it's usually not dangerous. "Most of the time, we can still get enough air to keep things functioning normally."

But other snoring triggers can be harder to fix. For example, having an enlarged uvula (that ball of tissue hanging in the back of your mouth), a large tongue, or being overweight -- especially for men, since they tend to gain weight around their necks -- all raise your risk for obstructive sleep apnea, a condition in which the heart isn't able to get enough oxygen to function properly.

Spotting The Sleep Apnea Symptoms
Between 5 and 15 percent of middle-aged adults probably suffer from sleep apnea, Grandner says, although it often goes undiagnosed and untreated. And that's bad news, since studies have shown strong associations between sleep apnea and high blood pressure, high cholesterol, heart attacks and other cardiovascular conditions.

For people with sleep apnea, airway obstruction is so severe that breathing slows to a trickle. It may even stop for seconds at a time. These episodes are called apneas, at which point the brain sends alert signals to the body, forcing a gasp, a gag or an extra powerful snore.

"A lot of people think sleep apnea will cause them to suffocate, but it won't," says Grandner. "You're still getting enough air to breathe -- and if not, your brain will wake you up." (Note though that according to the Mayo Clinic, for those with underlying heart disease, sleep apnea can lead to sudden death due to cardiac arrest.) The bigger risk, he says, is the long-term damage it can do.

Fluctuating oxygen levels throughout the night causes stress and oxidative damage to cells within your body. They also force the brain to be on high-alert all night and to deliver a shot of adrenaline to the heart every time an apnea occurs, when the body and brain are ideally supposed to be resting and recovering.

"It's much more of a cardiovascular problem than a respiratory one," he says. "People with untreated sleep apnea tend to develop these conditions years before they normally would."

When to Take Snoring Seriously
So how do you know whether you have run-of-the-mill snoring or a more serious problem? If someone hears you sleep on a regular basis and notices that you periodically stop breathing for several seconds at a time, that's a red flag.

So is the volume of your snoring. "If you can hear it pretty clearly through a closed door, that's a sign that your body is probably working too hard to get sufficient oxygen," says Grandner.

If you don't have a live-in partner or roommate, you can still watch out for daytime symptoms. Because the condition doesn't allow people to get the deep sleep they need, about two thirds of people with sleep apnea experience excessive daytime sleepiness. "If you can stop whatever you doing, just about any place and any time of day, and sit down and immediately fall asleep, that's a problem," says Grandner.

Waking up feeling exhausted is also a sign, especially if that feeling doesn't go away within 10 to 15 minutes of getting out of bed. People with untreated sleep apnea may also have trouble getting high blood pressure under control, even with the help of medication.

How To Treat Sleep Apnea
The good news is that sleep apnea is very treatable and easily diagnosed through an overnight sleep study done either in your own home or at a sleep clinic.

Lifestyle changes, like losing weight or not sleeping on your back, may help some people. And if not, almost all cases can be treated by using a device called a continuous positive-air pressure, or CPAP, machine. The device sends air through a tube and a mask, into a patient's nose and mouth while they sleep, keeping the airway open.

"It may take a few weeks of getting used to, but once they get over that hurdle most patients say it literally changes their life," says Grandner. "It gives them more energy during the day, so a lot of them are finally able to exercise, eat better, and really get healthier overall."

How to make sleeping with your partner a better experience

December 31, 2014

Rachel Clun

Here are some of the most common problems with sleeping with a partner, and how to deal with them.

Sleeping with your partner doesn't have to be a chore. Photo: Getty Images

Sleeping with your significant other is not always the wonderful thing it's portrayed  in the movies.

Different habits, snoring, sleep talking and moving are just a few of the things that could disturb your sleep with a partner in bed.

If you're not well rested, you're also liable to be tired and cranky – and potentially cranky at your partner.

To avoid unnecessary arguments and get a better night's sleep, here are some of the most common problems with sleeping with a partner, and how to deal with them.

You sleep with a snorer

It can be extremely hard to sleep next to someone who snores like a chainsaw all night. It can also be bad for their health, although your partner may not be aware that their nightly noise is causing a problem.

There are many factors that contribute to snoring: your partner's age and weight, whether they drink, and sleep apnea are just a few of the possible causes.

If the snoring is bad and chronic, it's best for your partner to see a doctor for a possible referral to a sleep specialist. They can come up with a plan to reduce the contributing factors, or treat them for conditions like sleep apnoea.

You sleep with a blanket hog

There are few more frustrating things than waking up freezing cold in the night, only to realise your partner has stolen most of the blanket from you.

Try using an oversized blanket or doona – a king-sized spread on a double bed, for instance – to give you both a little extra coverage.

If it's a regular and persistent problem, however, it might be worth having two sets of blankets and doonas. That way no one has their blanket stolen.

You prefer different temperatures

If you don't want to go the separate blanket route above, figure out a good temperature that's somewhere in the middle which you can both agree on.

That way one person can use an extra blanket if they like, or the other person can stick a leg out and still be happy with the temperature.

You have different bedtimes

It can be hard if you both keep different work hours, and one of you has to get up extra early for work and the other likes to stay up late.

In order to minimize sleep disturbance try to keep your screens out of bed, so the early-riser can sleep, and if you're the first to get up try to be mindful of hitting snooze too many times.

You hate being snuggled while you sleep

A cuddle is nice before bed, but many people find it difficult to go to sleep tangled up with another person.

If an evening snuggle really will prevent you drifting off, let your partner know so you can agree to sleep in your own space.

It doesn't mean forgoing a snuggle altogether, but if you bring it up your partner shouldn't be offended when you move over to your own side of the bed.

Undiagnosed Sleep Apnea among women on rise: Study

Yahoo!7 Pty Ltd October 21, 2014, 7:38 pm

Sleep Apnea is now being detected in nearly as many Australian women as men. Emily Angwin reports.

https://au.news.yahoo.com/video/watch/25314697/undiagnosed-sleep-apnea-among-women-on-rise-study/

The Best Sleep-Tracking Devices to Mind Your Z’s

Notes from Dr. Norman Blumenstock

How good are the personal tracking devices for sleep? The Wall Street Journal did a comparison of the available devices.

“The sleep-cycle data you get from these are at best approximations,” said Lawrence J. Epstein, an instructor at the division of sleep medicine at the Harvard Medical School. “The information you get is most accurate in telling you how long you’ve slept and if you are following a good sleep pattern.” 

Can Collecting Data About How You Sleep Lead to a More Restful Night?

By JOANNA STERN \ Updated Oct. 7, 2014 7:12 p.m. ET

The best night of sleep I had in the past two weeks was last Saturday night.

Maybe it was the soft new Gap pajamas or the fact that I didn’t have any wine or coffee before bed. Or maybe I had finally gotten used to sleeping with a heart-rate monitor strapped to my chest, a sensor-equipped mat underneath me, a chunky band on my wrist and a variety of other gizmos in and around my once-comfy bed.

All I know is, during that eight hours and 45 minutes of shut-eye, I must have done something really superb because my smartphone told me I scored a 90% in overall sleep quality. A pie chart showed my work, too, color coding the various stages of dormancy: REM sleep, light sleep and deep sleep.

Say good morning to connected sleep, a tech boom that is attempting to turn our movements, heart rate and respiratory information into data we can review on our smartphones when the sun rises. While an overabundance of sleep data sounds amazing, figuring out what it all means is not. The information for now just isn’t as helpful as the developers of these products want you to think.

 “The sleep-cycle data you get from these are at best approximations,” said Lawrence J. Epstein, an instructor at the division of sleep medicine at the Harvard Medical School. “The information you get is most accurate in telling you how long you’ve slept and if you are following a good sleep pattern.”

For us busy adults, the recommended goal is a consistent 7½ to 8½ hours a night. “We don’t try and make you get a certain type of sleep,” Dr. Epstein said. “We try to improve sleep by lengthening it.”

After sleeping with more than 10 sleep-tracking systems over the past few weeks, five very different products—positioned in various locations on my body, bed or nightstand—stood out. While many could help me become more aware of overall sleep patterns, the best products go further, suggesting how I could improve my sleep. And my favorites didn’t get in the way of a good night’s rest—kind of important, don’t you think?

On the Wrist

Basis Carbon Steel Edition watch ($150)

The Basis Carbon Steel’s heart rate and motion sensors collect sleep data superior to other popular fitness trackers from Fitbit, Jawbone and Misfit, which rely on only motion sensors.

After you’ve synced it to your iPhone or Android phone, the Basis app displays your overall sleep score, how long you slept and time spent in each stage of sleep. While the sleep-cycle data wasn’t always in line with the more sophisticated tracking systems I tested, the total sleep time was. It also let me set an 11:30 p.m. in-bed goal and track my progress in the app, which I found useful.

The Basis addresses Dr. Epstein’s biggest concern with these gadgets: pre-bed screen time. He said the “blue and white light” from a phone or tablet you look at moments before you close your eyes can suppress the body’s production of melatonin and alter our circadian rhythm. The Basis and the Withings Aura are the only products among my picks that didn’t need to be told (with some taps on a smartphone) that I was going to sleep.

That said, sleeping with a thick watch-like gadget—referred to by one friend as a house-arrest bracelet—isn’t ideal. A new Basis Peak, coming out next month, will provide the same sleep features in a thinner, more stylish package.

On the Chest

SleepRate app with Polar H7 heart-rate monitor ($100)

Chunky as it is, the Basis feels like fuzzy socks on a cold night compared with the clammy Polar H7 heart-rate monitor SleepRate uses to determine your sleep cycles.

It really destroyed my relaxing bedtime routine. Every night I had to wet the band’s electrodes, strap the cold band to my chest, then make sure the app was synced via Bluetooth to it.

That big, uncomfortable sacrifice made for some of the most informative and useful sleep data. Not only does it go deep on sleep stages, it cross references that information with any loud sounds your smartphone picks up when you sleep. Though I don’t remember it, the data shows a siren woke me up momentarily one night.

After the service has analyzed five nights (and you’ve filled out some waiting-room-like questionnaires), it begins to recommend a detailed sleep improvement plan. Since some of my issues might stem from frequently going to sleep after midnight, SleepRate suggested I try to get to bed earlier. 

Obvious, perhaps, but the data-driven advice was the most substantial I received all week.

On the Mattress

Withings Aura base and mattress pad ($300)

Instead of wearing a device, the Withings Aura has a pad you place beneath your bedding to monitor body movement, breathing cycle and heart rate, transferring data to your phone. There’s also a base for your nightstand that cycles through a selection of sounds and lights, which you can program for a before-bedtime routine and a wake-up call.

Hearing crashing waves as I drifted off was quite relaxing, but the reddish-orange lights, intended to increase melatonin, brought back memories of a past lava-lamp collection.

As a sleep tracker, the Aura falls behind the others. While it provides comparable information and an overall sleep score, it lacks context or advice on how to improve. I also had technical problems: It would frequently drop the Bluetooth connection or pick up my spouse’s sleep when she rolled over to my side of the bed. And it’s only compatible with iOS for now.

Aura wasn’t half as bad as the $149 Beddit, a similar under-the-sheets sensor. Beddit repeatedly told me I slept only four hours a night. The company explained it was likely because I am a restless sleeper, however the app didn’t provide ample data to back up the claim.

On the Nightstand

ResMed S+ monitor ($150)

The ResMed S+ takes a different approach: The milk-carton-size contraption sits on your nightstand aimed at your chest as its sensors collect information not only about your movement and respiration but also the room’s temperature, light and sound levels. All that information makes the ResMed S+ my top pick—and it only got in the way of my glass of water.

In addition to an attractive post-sleep report each morning, the system analyzes your environment and tells you what to fix for a better night’s sleep, including adjusting the lighting or temperature. It can also synchronize soothing audio sounds to your breathing rate, another cool, pre-emptive feature. And ResMed also suggested I go to sleep earlier and take more time to unwind before bed to increase time in REM.

I only wish I didn’t have to put the ResMed into sleep mode every night. It’s so good at watching me sleep, shouldn’t it just know when I nod off? Or maybe it’s just being respectful of my privacy since beds aren’t just for sleeping. (And speaking of privacy, these monitors register any voluntary physical activity simply as “awake” time.)

On the Bed

SleepCycle App (99 cents)

Smartphone apps like SleepCycle and SleepBot make the argument that you don’t need to buy a whole sleep system. Your phone already has an accelerometer and a microphone so you can just tuck it under the sheets and track your sleep behavior.

SleepCycle is the best stand-alone app for tracking time in bed and stages of sleep. It even has white noise and a feature that lets you log your mood when you wake up. However, the information often diverged from the others, a possible indication that a phone’s sensors alone aren’t accurate enough to tell the difference between being in bed and actually sleeping.

To truly get a good picture of sleep, you need to measure more than just movement. “The more things you add, like heart rate, respiration, eye movement, the closer the approximation gets to the actual measurement,” Dr. Epstein said.

While a 99-cent app like SleepCycle is a good place to start for those who want to get into sleep tracking, don’t forget that it does violate the sleep doctors’ cardinal rule: looking at that screen before closing your eyes.

—Write to Joanna Stern at joanna.stern@wsj.com or follow her @JoannaStern