Mayo Clinic Q&A: smoking cessation; sound sleep; peripheral neuropathy
Published Jan. 5, 2017


Sleep may seem elusive at times, especially as you age. Although you might not be able to control all of the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Here are some tips:

Set a good foundation: Physical activity increases the amount of energy you expend, raises your feel-good hormones (endorphins) and helps regulate body temperature, all of which contribute to better sleep. Avoid heavy food or alcohol, both of which can hamper sleep. If you're sensitive to caffeine, avoid that, too.

Boost your circadian rhythm: Getting plenty of sunlight during the day can help synchronize your biological clock with the course of the day and get you ready for nighttime. Going to bed and getting up at roughly the same time every day also reinforces your body's sleep-wake cycle and helps promote sleep.

Shed your worries: If you tend to worry, jot down your concerns and possible solutions. Then, set them aside for tomorrow. Practice a relaxing ritual each night, such as reading, listening to a podcast, stretching or thinking of things to be grateful for in your daily life.

Make your bedroom a sleep sanctuary: Keep activities such as eating, watching TV, browsing the internet, answering emails or talking on the phone out of the bedroom.

Keep your bedroom cool, dark and quiet: Consider using room-darkening shades, earplugs, a fan or other devices. Choose comfortable bedding, and make sure you have room to stretch out.

(Adapted from Mayo Clinic Health Letter)


I am finally ready to quit smoking for good. Is it better to quit smoking abruptly or gradually taper off tobacco use?

Congratulations on taking that first step: deciding to quit smoking. Smokers and tobacco users are more likely to develop disease and die earlier than people who don't use tobacco. Because nicotine is highly addictive, it may take more than one try to quit. But it is possible. Thinking about how to go about quitting is important, and there are a number of resources available to help you quit.

While quitting either abruptly or gradually can work, quitting abruptly may work better, according to a recent study published in the Annals of Internal Medicine.

The study involved about 700 smokers randomly assigned to either quit tobacco use abruptly with the aid of nicotine replacement patches or gradually reduce tobacco use with the aid of nicotine patches and a two-week structured cigarette reduction program. Behavioral counseling was provided leading up to the quit day for both groups.

After four weeks, 49 percent of the abrupt quit group and 39 percent of the gradual reduction group remained tobacco-free. At six months, 22 percent of the abrupt quit group and 15.5 percent of the gradual reduction group remained tobacco-free.

It's not entirely clear why this gap exists. It may be that the taper for the gradual reduction group was too sudden or the tapering schedule may have made it more difficult to initiate the quit date.

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One thing is known: The best way to quit smoking is with the aid of one of several nicotine replacement products and behavioral counseling. Stopping smoking with no help — gradually or suddenly — isn't as likely to help you quit.

In addition, each time a person tries to stop, the likelihood for success increases. If you've tried to stop smoking but failed, don't give up. You're more likely to succeed with repeated attempts, and behavioral counseling and medications to help.

Every state has a telephone quit line that you can access by calling toll-free 1-800-784-8669. Or go online to or, where you'll find more information and support to help you stop smoking for good.

Jon Ebbert, M.D., Nicotine Dependence Center, Mayo Clinic, Rochester, Minn.

(Adapted from Mayo Clinic Health Letter)


I was diagnosed with diabetes a few months ago, and I am concerned about peripheral neuropathy in my feet. Is there anything I can do to prevent this?

Peripheral neuropathy is a common problem that can happen as a result of diabetes, but it isn't inevitable. To help prevent peripheral neuropathy, closely follow your health care provider's instructions for managing your diabetes and make healthy lifestyle choices.

Peripheral neuropathy happens when nerves in your feet or hands — your peripheral nerves — become damaged. Diabetes may lead to peripheral neuropathy because excess sugar in the blood can injure the walls of the tiny blood vessels known as capillaries, which deliver blood to the nerves. That injury hampers the capillaries' ability to carry sufficient amounts of blood. Without proper nourishment, the peripheral nerves lose their ability to function properly.

Although peripheral neuropathy can affect both the hands and the feet, for people with diabetes, it's more common in the feet. It usually involves a slow progression of numbness, prickling or tingling that may then spread into the legs. Some people with peripheral neuropathy also feel a sharp, jabbing, throbbing, freezing or burning pain, and their feet may be extremely sensitive to touch.

The best thing you can do to help prevent peripheral neuropathy is keep your blood sugar under control. Monitor your blood sugar regularly and take your diabetes medications exactly as directed.

Exercising regularly also can help control your blood sugar and help prevent peripheral neuropathy. Try to make physical activity part of your daily routine. Thirty minutes of moderate exercise, such as brisk walking, on most days of the week is recommended. A combination of exercises — aerobic exercises, such as walking, biking or swimming on most days, combined with resistance training, such as weightlifting or yoga twice a week — often helps control blood sugar more effectively than either type of exercise alone.

A healthy diet is important, too. Eat plenty of fruits, vegetables, whole grains and legumes each day, and limit the amount of food you eat that contains saturated fat. If you have questions about your diet, talk to your health care provider or consider meeting with a dietitian who specializes in working with people who have diabetes.

Exercise and diet also can help if you need to lose weight. If you're overweight, getting to and staying at a healthy weight can lower your blood sugar significantly, thus reducing your peripheral neuropathy risk.

If you smoke, stop. Smoking can affect your blood circulation and raise your risk of developing peripheral neuropathy.

Because peripheral neuropathy can sometimes begin slowly with just numbness in the feet, it's important that you are vigilant about foot care. Check your feet daily for any cuts or other injuries. Left unchecked, a small injury can turn into a major infection. To avoid foot damage, be careful when you trim your toenails, wear shoes that fit properly and don't go barefoot.

If you notice any foot injuries or sores on your feet that do not heal, make an appointment with your health care provider to have them checked as soon as possible. Also, talk to your health care provider right away if you notice any foot numbness or pain. Early diagnosis and treatment of peripheral neuropathy offer the best chance for controlling its symptoms and preventing further damage to your nerves.

Elizabeth Cozine, M.D., Family Medicine, Mayo Clinic Health System, Zumbrota, Minn.

Mayo Clinic Q & A is an educational resource and doesn't replace regular medical care. Email a question to MayoClinicQ& For more information, visit © 2017 Mayo Foundation for Medical Education and Research. Distributed by Tribune Content Agency LLC. All rights reserved.