Why you put deodorant on before bed

Research suggests that applying antiperspirants at night is actually more effective.

Research suggests that applying antiperspirants at night is actually more effective.

Published May 29, 2016

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London - Should flu jabs be given in the morning?

This was the suggestion of a recent study, which found that elderly people vaccinated between 9am and 11am produced more antibodies against flu than those who had the jab in the afternoon.

Researchers at the University of Birmingham said levels of key chemicals in our immune system are higher earlier in the day, so the body responds better to vaccines.

But Bryony Dean Franklin, a London-based pharmacist and professor of medication safety at UCL School of Pharmacy, believes it is too early to draw any conclusions. “Producing antibodies is not the same as preventing a case of flu,” she says.

If the jury is still out on flu jabs, there is plenty of evidence that the time of day we take some medicines and use certain products can make a difference to how well they work, and may reduce their side-effects.

 

Are blood pressure pills best first thing?

When it comes to taking certain medications for cardiovascular health, there is an optimum time based on our body clock.

Our circadian rhythm controls everything from sleep patterns to hormones, metabolism, bowel movements, blood pressure and the functions of our organs.

Some statins - which reduce the amount of so-called “bad” LDL cholesterol produced by the liver - should be taken in the evening, says June Davison, a senior cardiac nurse at the British Heart Foundation. This is because liver production of cholesterol is highest at night.

However, this rule only applies to short-acting statins such as simvastatin, which lose half their strength in two to three hours. Longer-acting ones such as atorvastatin, which lose half their strength in 14 hours, can be taken regularly at any time of day.

Patients with high blood pressure will often be advised to take their medication - such as ACE inhibitors or calcium channel blockers - in the morning. This is because blood pressure normally rises as the body releases a “wake up” surge of the hormone cortisol.

The morning can also be a good time to take diuretics - which reduce pressure in the arteries by encouraging water excretion - so patients avoid having to get up at night to relieve themselves.

However, researchers are looking at whether certain patients should take their blood pressure medication at night.

A 2011 Canadian study, published in the Journal of the American College of Cardiology, found that for some people ACE inhibitors work best when taken at night because they reduce the effect of a hormone that is most active during sleep.

This hormone can cause the heart to enlarge, and can increase the risk of cardiac damage in patients with heart problems.

 

Use antiperspirant BEFORE bed

Applying deodourant first thing may seem like a sensible way to face the day. But research suggests that applying antiperspirant at night is actually more effective.

A study of 60 women aged between 18 and 65, cited in the journal The Dermatologist in May 2009, showed that those who used antiperspirant at night had much higher sweat reduction rates after three, seven and ten days than women who used the products in the morning.

Although the exact mechanism is unclear, it is thought that the antiperspirant has time to ‘set’ in the pores during sleep, then lasts for hours on waking.

“It is logical enough because if you apply antiperspirant in the morning, when you are more likely to sweat as a result of emotional triggers such as stress, the product will just be washed straight off,” says Dr Nick Lowe, a consultant dermatologist based in London.

And although it may seem obvious, it makes sense to apply some anti-ageing creams at night, too.

As Dr Lowe points out, the active ingredient retinoid, in some preparations, can degrade when exposed to visible light. Over-the-counter acne creams should also be applied last thing at night, says Sultan Dajani, a community pharmacist and spokesperson for the Royal Pharmaceutical Society.

“This allows the cream to do its work without being affected by things such as the weather and pollution,” he adds.

Many patients with eczema and psoriasis prefer to apply emollients at bedtime, as these itchy skin conditions often get worse at night.

 

Cancer drugs that work in your sleep

Cancer doctors are looking at how they can use the body clock to make chemotherapy more effective.

A drug known as 5-fluorouracil, used to treat colorectal cancer, is now often given before bedtime because this is when healthy cells seem to be at rest.

One theory is that they are less likely to interact with the drug at night, leaving the abnormal, and more active, cancer cells to take the full onslaught.

However, more research is needed to establish cause and effect, says pharmacist Professor Franklin, who adds that exact treatment and timings should be based on a patient’s individual response and side-effects.

During sleep, the function of the digestive system is also markedly reduced.

For this reason, it is best to take medications for chronic constipation, such as lactulose and Fybogel, last thing at night, explains Sultan Dajani.

“The drugs work by irritating the bowel slightly and are slow acting,” he adds.

“It helps that bowel movements have slowed right down at night so the drug can get to work. Eight hours later, the patient wakes and typically passes a bowel movement.”

 

The pills to pop before breakfast

Proton pump inhibitors (PPIs), which suppress acid production in the stomach, are widely prescribed for heartburn. The usual advice is to take them 30 minutes before breakfast, because eating causes acid to be produced.

However, recent research suggests these drugs may be more effective when taken at night. A 2003 US study, by the University of Kansas School of Medicine, found that heartburn sufferers who took a common PPI before their evening meal, were far more likely to report reduced symptoms than those who took the drug in the morning.

The theory is that taking them at night ensures levels of stomach acid are low when the patient goes to bed - lying prone can make heartburn worse because acid can “splash back” into the oesophagus.

Another pre-breakfast drug is alendronate, for the bone-thinning condition osteoporosis. “Sticking to this time ensures there is no food in the stomach that can bind to the medication and prevent it working properly,” says Sultan Dajani.

 

When to take asthma medication

Our lungs are influenced by the body clock in a number of ways that can affect when drugs are most effective, says Dr Richard Russell, a consultant chest physician at Lymington New Forest Hospital, Hampshire.

Asthma symptoms are often worse at night because the body’s natural levels of cortisol, which acts as an anti-inflammatory, and adrenaline, which helps the walls of the bronchi relax and stay open, are lowest between midnight and 4am.

Another issue is that the vagus nerve - which regulates the resting state of the lungs - is most relaxed in the early morning before waking.

This causes the airways to narrow, which can also make asthma symptoms worse. Therefore, doctors often recommend patients take steroid inhalers before they go to sleep.

However oral steroids, which are more powerful, can interfere with good sleep, so patients may be advised to avoid them after 6pm.

Taking steroid medication once in the morning and once in the evening should give relief for 24hours, according to Dr Russell, who is also a spokesman for the British Lung Foundation.

Meanwhile, people with chronic obstructive pulmonary disease (COPD), an umbrella condition that includes chronic bronchitis and emphysema, tend to have more severe symptoms during the day when they are physically active.

“Once-daily medication for this condition is usually taken in the morning so it works when needed,” explains Dr Russell.

 

How can shift workers get it right?

Around 3.5 million people work shifts, which can throw their body clocks out of kilter and make it hard to judge the best time to take prescribed drugs.

“Drugs such as low-dose daily aspirin, which can be prescribed to reduce blood pressure, should ideally be taken when you wake - whether that is 7am or 1pm - because this is when blood pressure rises,” says Sultan Dajani. However, it is better to take it at the same time each day to ensure you don’t forget.

Short-acting statins should still be taken at night, whether that is the beginning or end of someone’s working shift. Diuretics, which cause frequent trips to the loo, should be taken before a period of activity and wakefulness, whenever that falls in the day.

Sultan Dajani recommends that shift workers discuss their medications with their doctor - possibly arranging a drugs review with their pharmacist as well.

Daily Mail

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