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Monthly Archives: November 2015

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Pssst! Hey, do you want to know a secret? I’ve got a great one. It’s called … Flodgy Dodgy. Shhh! Don’t say it too loudly yet. I’m not supposed to tell anyone, but you’re a good friend. Well, no, I don’t technically know you yet, but you look like you could be a good friend. All friends start out as strangers, right?

Anyway, what is Flodgy Dodgy? It’s a made-for-TV product. Through viral marketing, we plan to put this product front and center, sharing it with the people who watch football every Sunday and with those addicted to highbrow features.

Flodgy Dodgy makes you feel good. It’s this incredible combination of things from column A, things from column B and things from column C. Each of these columns was based on years of scientific research. Well, it wasn’t actually conducted by scientists. We used these focus groups but, hey, what’s the difference? We don’t need initials. We pulled some of them directly off the Internet, so it has to be true.

We have an app, too. You can put it on your iPhone or your Samsung or whatever you’re supposed to silence before watching a movie.

So, before I get to the product, I want to let you know that the packaging of Flodgy Dodgy is not only recyclable, it’s wearable. You can take the packaging, peel off the simple sticker and, voilà, you have stickers you can put all over your notebooks and your office door. You can even put them over some of the holes in your fashionably torn jeans.

Can’t you see it? Popular kids in middle school sit down at their desks, put down their binders and there, in neon colors so bright people will practically need sunglasses to look at them, will be the name Flodgy Dodgy. When the teacher comes over and asks what it is, the kids can explain that it’s saving the environment because it doesn’t produce any waste. Well, technically, it does produce some waste, because the part you peel comes off in your hands and then you have to throw it out somewhere, but that’s not nearly as bad as the side effects from all those drugs advertised on TV.

But, wait, I haven’t gotten to the best part and, for this, we have Donald Trump to thank. He’s such an inspiration. You see, this guy doesn’t seem willing to get along with anyone in either party and he’s so far from the common man that he might as well be living on Mount Olympus, but, hey, that doesn’t matter. He’s on TV and he plays well on the small screen. He could be the first made-for-TV president who has the ability to say what we’re thinking. If we have no thoughts, he would convince us what we should be thinking because he’s The Man.

I digress. Our idea — and you’ll love this — is that we’re starting a Flodgy Dodgy network. We’re going to go out with cameras and find the people with the most Flodgy Dodgy stickers all over them and we’re going to give them 10 seconds to do a Flodgy Dodgy dance.

That’s right, TV. Ahhh! Can’t you picture it? And we’re going to let people link through the TV to all their social networks, so their friends and their jealous enemies will be able to watch them do their thing in full Flodgy Dodgy outfits.

Oh, sorry, my time’s up. I didn’t get to the product itself, but who cares? It’s not about the stuff inside, it’s about everything else and, when it comes to everything else, Flodgy Dodgy is No. 1. Now, remember, we don’t want you to tell anyone but your 20 or 50 best friends. OK?

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Chris Rosati rushes for yards in a game earlier this season. File photo by Bill Landon

So far it’s been another perfect season for the Shoreham-Wading River football team, as the No. 1-seeded Wildcats move into the Division IV finals today, where the team will take on No. 2 Elwood-John Glenn at Stony Brook University at 7 p.m.

After going 8-0 in league play, the Wildcats moved on to face No. 8 McGann-Mercy in the qualifying round, where the team demolished its competition, 41-7. Next up was Bayport-Blue Point in the semifinals, and again, Shoreham-Wading River came out on top, 21-6.

Kevin Cutinella lines up in a game last season. File photo by Bill Landon
Kevin Cutinella lines up in a game last season. File photo by Bill Landon

In the game against Bayport, the opposition scored first, which was just the second time the team had allowed an opponent to score first all season. The only other time, was when Elwood-John Glenn got on the scoreboard first in the second quarter of the team’s Oct. 17 matchup. But as has been the case with the Wildcats all along, the team found its groove and consistently piled on the points.

Scoring first was senior wide receiver Jon Constant on a five-yard run with six minutes left in the first quarter, which gave Shoreham-Wading River the lead for good, at 7-6. Junior quarterback Kevin Cutinella completed five of seven passes for 85 yards, and also rushed in the team’s next score, to put the Wildcats out in front, 14-6. Senior running back Chris Rosati scored the final touchdown of the game on a 47-yard run, and senior kicker Daniel Mahoney remained nearly perfect on the season, as he split the uprights for the final time of the game. Mahoney only had one kick blocked and two kicks miss the entire season.

Senior fullback Will Loper had 10 tackles with a forced fumble, and junior defensive end Ethan Wiederkehr had six tackles and a forced fumble in the win over Bayport-Blue Point.

As was the case last season, the Wildcats always found ways to score, while also limiting their opponents to two scores or fewer. Three of the team’s games were shutouts this season, and while Shoreham-Wading River tallied 353 points this season, the Wildcats only allowed 60 points against.

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Suffolk County Police Department detectives are investigating an incident in which a man’s body was found near a sandbar along the Kings Park Bluff. File photo by Rachel Shapiro

Suffolk County Police pulled a man’s body from the waters at Kings Park Bluff on Saturday.

The county police department responded to an incident during which a car plunged into the Kings Park Bluff waters around 10:40 p.m. on Friday night, authorities said. Marine Bureau divers investigated the scene soon after.

But the following morning, around 7:35 a.m., police received a 911 call reporting a body on a sandbar in the river.

Marine Bureau divers once again responded and recovered the body of an adult male. Police described the man’s location as “a distance away” from where the vehicle went into the water.

It was unclear if police knew the man’s identity, and it was not immediately known that it was his vehicle in the water.

The vehicle was removed from the water on Monday and the incident was classified as noncriminal, police said.

The county’s Homicide Squad detectives were still investigating the incident.

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Program makes it easier for residents to save money

An infrared temperature gun measures the surface temperature of a home. Photo from Neal Lewis

It just got easier for homeowners on Long Island to monitor their energy costs.

The not-for-profit Long Island Green Homes Initiative is a public-private partnership that launched Nov. 10 with the goal of setting up homeowners with a professional energy audit at no cost. The program links residents with the state’s Energy Research and Development Authority to generate savings, stimulate jobs, boost economic development and promote sustainability, organizers said.

The initiative is headquartered at the Sustainability Institute at Molloy College and is partnered with three non-profits: Community Development Corporation of LI, LI Green and United Way of Long Island. A state program that offers similar services has been in effect for several years, but some said it wasn’t getting its message across to enough people.

Neal Lewis, executive director of the Sustainability Institute at Molloy, said some residents argued that the state government website was too confusing to use.

“The conclusion was that the key way to get more participation was to provide resources to homeowners to help navigate the process,” Lewis said.

That was how the Green Homes Initiative was born.

It started with the goal of providing an easy-to-use website coupled with energy navigators who help answer any questions a homeowner has. Lewis said the energy navigators then schedule a free home energy assessment that provides an in-depth analysis of a home’s energy efficiency for each homeowner.

It was crafted after similar programs in neighboring municipalities, but has tweaked pieces of the process with hopes of making it better, supporters said. In an earlier version of this program started in 2008 in Babylon, an average homeowner saved about $1,000 each year in energy costs, according to a press release.

LIGH has also partnered with five towns, including Huntington and Smithtown along the North Shore, to further encourage residents of those towns to take advantage of this program.

“I am proud this newest LI Green Homes Initiative is kicking off in Huntington Station,” Huntington Town Supervisor Frank Petrone (D) said in a statement. “This is a prime example where much of the housing stock dates before the first energy conservation codes were adopted in the 1970s and can benefit dramatically by upgrading insulation and heating systems that are at or near their useful life expectancy.”

Huntington Councilman Mark Cuthbertson (D) said this program incurs few out-of-pocket expenses for homeowners.

Many improvements that require homeowner investment are eligible for cost reductions of up to 50 percent, depending upon household income, according to Cuthbertson.

In an interview, Lewis said the only contractors providing the free home energy assessments were licensed, local, insured, and certified by Building Performance Institute. The contractors test a house’s insulation, heating and hot water systems, ventilation and more.

Once the tests are completed, the homeowner is given a comprehensive report that includes where and how their home can save energy, a fixed cost for each recommended improvement, and projected dollar savings on their utility bills for each recommended improvement.

If a homeowner decides to go ahead with those suggestions, the program would then assign them a performance specialist to do the work on their property.

The LIGH program can pay the entire cost of the improvements, and under a contract with the homeowner, the town sets up a monthly payment plan, Lewis said.

LIGH also structures the payment so that your savings cover your monthly bill. If a homeowner saves $100 a month on energy costs, they only owe the town $90 a month.

“We’re trying to get people to test their homes and make them more energy efficient,” Cuthbertson said.

The Initiative is funded for three years by a Cleaner, Greener Communities competitive grant award from NYSERDA of $2.3 million, and a supplemental grant from the Rauch Foundation in Garden City.

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Business employs other local disabled individuals

Pictured, Brittney (left) and Logan (right) Wohl, co-owners of Our Coffee with a Cause, with their mother Stacey Wohl (center), company founder/president. Photo from PRMG New York

The sister-and-brother team, Brittney, age 18, and Logan Wohl, age 16, of Northport, are the newly appointed co-owners of Our Coffee with a Cause Inc., a business that employs individuals with cognitive and developmental disabilities and funds local charities that support them. These siblings with autism have dedicated their time to helping other special-needs teens and adults by providing gainful employment opportunities in a supportive business setting.

Our Coffee with a Cause was founded in 2012 by Stacey Wohl, mother of Brittney and Logan, in response to the growing concern for special-needs individuals on Long Island who are aging out of schools to find job opportunities and a learning environment to acquire real-life skills. The employees package coffee, apply labels to the bags and coordinate shipments. Additional opportunities are available during Our Coffee with a Cause’s sales and informational events, during which employees work with an assistant to sell coffee and products using a custom-designed iPad app and interacting with customers.

A portion of the business proceeds benefit Our Own Place, a non-profit organization that Stacey Wohl founded to provide unique opportunities to special-needs children and their single parents. The organization’s ultimate mission is to open a weekend respite home for families of children with cognitive disabilities that will provide job training and socialization skills to its residents and will feature a café at which Our Coffee products will be brewed and sold.

Stacey Wohl and her mother and business partner, Susan Schultz, bring to the company a combined 50 years of business experience, along with the knowledge of addressing the unique needs of teens and adults with disabilities.

“Our Coffee with a Cause is dedicated to employing special-needs adults and showing that there is ability in disability,” says Stacey Wohl. “I am proud to name Brittney and Logan as the owners of this business, which provides careers to people with disabilities who may not otherwise have the opportunity.”

Although 53 million adults in the United States are living with a disability, as many as 70 percent of this working-age population are currently unemployed. For many, the current systems in place to support both young adults and their families disappear once the teen “ages out” of the education system, typically when they turn 21. In 2016, nearly 500,000 autistic persons will enter this category, in addition to adults with Down Syndrome and other cognitive conditions.

For more information, visit www.ourcoffeewithacause.net.

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By Nancy Burner, ESQ.

The concept informally known as “portability” is now permanent as a result of the enactment of the American Taxpayer Relief Act of 2012. Portability allows a surviving spouse to use a deceased spouse’s unused estate tax exclusion (up to $5.43 million in 2015).

For those dying in 2011 and later, if a first-to-die spouse has not fully used the federal estate tax exclusion, the unused portion called the “Deceased Spousal Unused Exclusion Amount,” or “DSUE amount,” can be transferred or “ported” to the surviving spouse. Thereafter, for both gift and estate tax purposes, the surviving spouse’s exclusion is the sum of (1) his/her own exclusion (as such amount is inflation adjusted), plus (2) the first-to-die’s ported DSUE amount.

For example: Assume H and W are married, and H dies in 2015. H owns $3 million and W owns $10 million. H has the potential of leaving up to $5.43 million under federal estate tax to a bypass or credit shelter trust, which would avoid federal estate tax in both spouses’ estates.

However, because H only has $3 million, he does not take full advantage of the $5.43 exclusion. Prior to portability, $2.43 million would have been wasted. With portability, his $2.43 million can be saved and passed to W’s estate, increasing the amount she can leave heirs free from federal estate tax. With a 40 percent federal estate tax rate, this would save W’s estate approximately $972,000 in federal estate tax. 

With this plan, the estate would also avoid New York State Estate Tax at the husband’s death since the current exclusion is $3.125 million. The assets in this bypass trust would escape federal and New York estate taxation at W’s subsequent death.

In order for the surviving spouse to be able to use the unused exemption, the executor of the first-to-die’s estate must make an election on a timely filed estate tax return. A timely filed return is a return filed within nine months after death or within 15 months after obtaining an automatic extension of time to file from the IRS. Normally a federal estate tax return is only due if the gross estate plus the amount of any taxable gifts exceeds the applicable exclusion amount (up to $5.43 million in 2015). However, in order to be able to elect portability, a federal estate tax return would have to be filed even if the value of the first-to-die’s estate was below the exclusion amount.

The problem occurs when the first spouse dies and no estate tax was filed. In that event, the second-to-die spouse could not use the deceased spouse’s unused exemption. In the above example, the second spouse’s estate would have paid an additional $972,000 in estate taxes if the election was not made. What if the first spouse dies, no estate tax return is filed and no election was made on a timely basis? Does the surviving spouse lose the exemption?

In June 2015 the IRS issued its final regulations on portability. The final regulations make clear that the issue of whether an estate may obtain relief for making a “late” portability election will depend on whether or not the first estate was required to file an estate tax return.

In the instance where the first spouse’s estate was taxable and required to file an estate tax return (because the value of the estate was over the exclusion amount), the time to timely file was nine months from date of death of the first spouse or six months later, if an extension was requested and granted. If that estate tax return was not filed, then the IRS cannot extend the time to file and elect portability. 

If the estate is not required otherwise to file an estate tax return because the value of the estate is below the exclusion amount, then the IRS may grant relief via a private letter ruling. A private letter ruling, or PLR, is a written statement issued to a taxpayer that interprets and applies tax laws to the taxpayer’s represented set of facts. A PLR is issued in response to a taxpayer’s written request. The PLR may not be relied upon as precedent by other taxpayers. 

When seeking a PLR allowing the estate to file late portability election, there are some burdens that must be met. First, the election must be made by the representative of the estate, which may or may not be the surviving spouse. The representative will have to show that he or she acted in good faith and that this ruling will not prejudice the interests of the government. This option is generally available where there was either an oversight in handling the first spouse’s estate or the taxpayer was the victim of bad advice from an accountant or attorney.

For those that had spouses pass away after Jan. 1, 2011, portability can be a valuable estate planning tool to save a significant amount of federal estate tax on the death of the second spouse. If a surviving spouse has assets that are close in value to the current federal exclusion amount, it is important to examine the records of the deceased spouse to make sure that a portability election was made on a timely filed federal estate tax return. If no return was filed, and no estate tax return was required to be filed, it may not be too late to apply to the IRS for a private letter ruling.

Nancy Burner, Esq. has practiced elder law and estate planning for over 25 years.

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St. Louis de Montfort Roman Catholic Church in Sound Beach provides food for those in need. Photo by Giselle Barkley

A full stomach may hurt sometimes, but not around the holidays.

The holiday season is typically the busiest time of year for food pantries like those at the Sound Beach Community Church and St. Louis de Montfort Roman Catholic Church in Sound Beach. Each year the Sound Beach Civic Association sponsors one family from each church during the holidays. In light of this, Bea Ruberto, president of the Sound Beach Civic Association, said they thought their meeting on Monday, Nov. 9, was a good opportunity to discuss the churches’ work.

St. Louis de Montfort is no stranger to running a pantry. According to Jane Guido, the church’s outreach director, the facility established its pantry around 25 years ago. Around 150 families are registered for the pantry services at the church. The church saw an increase in those in need during the recession when countless businesses downsized staff and many were left without a job.

“A lot of our local families who were okay now find themselves without a job or [they’re] getting a job with less pay,” Guido said. “With the high cost of living on Long Island, it makes it very difficult to take care of the bills and the food.”

Though St. Louis de Montfort doesn’t prevent people of different faiths from using its pantry services, community members must live within the areas the church serves. This includes Sound Beach, Mount Sinai and Miller Place. While the church receives monetary donations and local organizations like schools, the fire department and the Girls and Boys Scouts donate food, Long Island Cares provides a good portion of food for both church pantries.

According to Hunger in America 2014, around 88 percent of households are food insecure within the Long Island Cares and Island Harvest area.

“It’s really sad to know that in an area that’s pretty well off, we need two pantries,” Ruberto said.

Pastor John D’Eletto of the Sound Beach Community Church said various organizations also donate food to his establishment. Members of the church also support by donating money, which goes toward buying food for the pantry. According to D’Eletto, the church’s five-year-old pantry serves 10 to 15 families weekly.

“We feel that because we’re a church, we have to go above and beyond just giving people food,” D’Eletto said. “Because we do care — we want to focus on the spiritual aspect of the people too — not just giving them physical things.”

D’Eletto’s church will also cater to residents facing additional hardships through prayer, to help them through their difficulties.

But one of the more difficult times for families to put food on the table doesn’t stop with the holidays. Ruberto said January and February are also difficult months for food pantries. According to the Sound Beach civic president, food donations slow down significantly following the holiday season.

“Yes, we’re all very generous over the holidays, but remember in February they still need food,” she said.

Guido added that pantries are an asset to the communities they serve.

“They know they have a place to go and get food … We live in a remote area [and] there’s not [many] places for people go,” Guido said. “There are soup kitchens, which are a blessing, but that’s only one day a week and one meal a day, so the pantry supplements that also.”

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Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Catherine Markham with the Kenyan field team. Photo by Jeanne Altmann
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham
Some of the baboons studied by Catherine Markham. Photo from Markham

While she’s brushing her teeth, she can hear elephants passing outside. She’s spotted lion footprints in the ground outside an electrified fence that gives her comfort when she sleeps on a bed in a tent at night.

Catherine Markham, an assistant professor in the Department of Anthropology at Stony Brook University, has been traveling to Kenya for the last 10 years to study baboons as a part of the Amboseli Baboon Research Project, a decades-long study of baboons on a savannah north of Mt. Kilimanjaro.

Markham and her colleagues recently discovered that there is something of a Goldilocks phenomenon when it comes to group size for baboons. A group that has a smaller number of baboons has to spend more time watching out for predators like leopards, lions and hyenas and foraging carefully amid competition with other baboon groups, while a group that has too many members travels over greater distances to find food.

Markham measured the amount of stress adult females felt by monitoring a glucocorticoid hormone. The least stressed baboons were the ones in the mid-sized group, where the benefits of social living — companions to pick bugs off their fur, extra eyes to watch out for predators and potential mates to raise and protect offspring — outweighed the challenges of competing with other group members for food. She published her results recently in the journal Proceedings of the National Academy of Sciences.

Susan Alberts, the Robert F. Durden professor of biology at Duke University, suggested Markham’s research provided “the most compelling empirical evidence ever produced that animals living in social groups experience a tension” within and between groups that is resolved at an intermediate size.

Alberts said that in this sweet spot for group size, she’d expect individuals would live longer and have higher fertility.

“This has changed the way we think of the costs and benefits of groups of different sizes,” Alberts said.

Jeanne Altmann, a founder of the Amboseli Baboon Research Project and emeritus professor of ecology and evolutionary biology at Princeton, said research like Markham’s will “facilitate predicting and potentially assisting with the challenges social groups of diverse species, including humans, will face in the changing environment of the future.”

Altmann added it was “especially wonderful to see how much the current generation of young scientists exemplified by Catherine Markham can accomplish by taking what’s come before them and developing new techniques and insights.”

As a behavioral ecologist, Markham is interested in how baboons, and other animals, manage the trade-off in group living.

The next set of questions could address whether group size, or hormone levels, can serve as a predictor for a fissioning of social groups, which happens infrequently.

When groups fission, social bonds break permanently, which can cause a different kind of stress that may help explain why groups that are above optimal size continue to stay together, despite the stress and intragroup competition, Alberts said.

While she’s observing the baboons, Markham generally tries to stay at least 10 meters from them. Scientists like Markham, or anyone else who visits Amboseli, need to follow rules that extend beyond the proximity to animals.

When she’s conducting research, she makes sure she’s with at least one other person. Once, she was watching a female baboon closely when a car came up behind her.

“This wonderful Kenyan, who is a good friend, said, ‘I’m saving you from the elephant.’ I looked and, sure enough, the elephant who, at my last check had been on the distant horizon, wanted to investigate” Markham and the baboons.

The elephant was close enough that she knew it was time to “get in the car.”

To gain insight into the stress levels of these baboons without poking or prodding them, Markham and her collaborators studied the clues the baboons left behind. They watched the animals carefully and, once an animal relieved herself and left the area, the researchers retrieved the droppings.

“It’s not the most glamorous part of my job, that’s for sure,” she said. “At this point, I am so motivated by the question and I see it as a tool to noninvasively understand what these animals are going through. It’s a way to have some window into their internal state without having to dart them.”

She said the success of a program like this wouldn’t be possible without the dedication and knowledge of an experienced and talented team of Kenyan researchers. The Kenyans know the individual baboons well, using scars on their faces, body size or individual markings.

Markham, who lives in St. James and is originally from Maryland, said she became interested in nature in part because of trips with her father Julian Markham to a book store, where she would buy National Geographic magazines for a dime or a quarter.

Markham, who joined the staff at Stony Brook last year, said she is excited to be a part of a strong anthropology program.

As for her time in Kenya, she gets to live out her childhood dreams, where, she finds the “ecosystem and animals beautiful. These are some of the happiest times in my life. Watching animals in the wild is something so special.”

Members of the community can hear directly from Markham at a talk she’s giving entitled the “Evolution of Social Complexity in Chimpanzees and Baboons” on Nov. 20 at 7:30 p.m. at the Earth and Space Sciences Lecture Hall 001 on the west campus of Stony Brook University.

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From left, Douglas Quattrock, Jeffrey Sanzel and Hans Paul Hendrickson in a scene from ‘A Christmas Carol.’ Photo by Elizabeth Castrogiovanni, Kayline Images

Theatre Three’s 32nd annual performance of “A Christmas Carol” opened last weekend. “Too early,” you may say. “It’s not even Thanksgiving yet.” Perhaps, but the spirit of Christmas — giving selflessly and spending time with the ones you love — is a message that holds true all year.

The show is based on Charles Dickens’ classic novel of cranky old miser Ebenezer Scrooge, who is concerned only with business. One Christmas Eve, the ghost of his deceased business partner Jacob Marley appears, wearing the chains he’d forged in life, “link by link,” and tells Scrooge he will be visited by three spirits — the Ghosts of Christmas Past, Present and Future, who help him discover the true meaning of Christmas.

Published more than 170 years ago, Dickens’ tale of redemption quickly resonated with the working class and has remained a holiday favorite ever since.

Adapted for the stage by Theatre Three Executive Artistic Director Jeffrey Sanzel in 1983, the production is constantly evolving, revising itself, with subtle changes that keep it fresh. The audience is led through a gamut of emotions, from fear to sadness to pure joy — a true testament to the magic of live theater.

The show brings back familiar faces year after year, with Sanzel (Scrooge), Douglas Quattrock (Bob Cratchit), Steve McCoy (Jacob Marley) and George Liberman (Mr. Fezziwig) leading a talented cast of 20 who, combined, play nearly 100 roles. The entire company, from the seasoned actors to the children, does a phenomenal job.

Sanzel, who also directs, is in every scene and is wonderful. In a scene with the Ghost of Christmas Past, he instantly transforms from an old, hunched-over tired man to a young man again, dancing the night away at Fezziwig’s holiday party. The transition is effortless and quite remarkable.

Quattrock’s performance as Bob Cratchit is particularly moving, especially in his scenes with Tiny Tim (played by Ryan M. Becker), and Steve McCoy is a daunting Marley. Other standouts include Liberman as the jolly Mr. Fezziwig, Kiernan Urso in the role of young Scrooge and Amanda Geraci, who reprises her role as the sweet but sassy Ghost of Christmas Past. James D. Schultz tackles a new role this year as the cheeky Ghost of Christmas Present “to show the joys of mankind” and does a tremendous job. Newcomer Hans Paul Hendrickson brings an elevated level of tenderness to the role of Scrooge’s optimistic nephew, Fred Halliwell, that is top-notch and operates the towering Ghost of Christmas Future with ease.

A Victorian set designed by Randall Parsons, period costumes by Parsons and Bonnie Vidal, lighting by Robert W. Henderson Jr., music and sound by Ellen Michelmore and the many special effects pull it all together nicely to create a first-class production. Be it your second time or your 32nd, Theatre Three’s “A Christmas Carol” is well worth revisiting.

Arrive a little early and be treated to a selection of Christmas carols by the actors in the lobby and stay afterward for photo ops with Scrooge (proceeds benefit the theater’s scholarship fund).

Theatre Three, 412 Main St., Port Jefferson, will present “A Christmas Carol” on the Mainstage through Dec. 27. New this year, all evening shows begin at 7 p.m. Tickets range from $15 to $30. For more information, call 631-928-9100 or visit www.theatrethree.com.

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Insomnia is an all-too-common complaint. Though the statistics vary widely, about 30 percent of Americans are affected, according to the most frequently used estimate (1). Women tend to be affected more than men. Insomnia is thought to have several main components: difficulty falling asleep, difficulty staying asleep, waking up before a full night’s sleep and sleep that is not restorative or restful (2).

Unlike sleep deprivation, patients have plenty of time for sleep. Having one or all of these components is considered insomnia. There is debate about whether or not it is actually a disease, though it certainly has a significant impact on patients’ functioning (3).

Insomnia is frustrating because it does not necessarily have one cause. Causes can include aging; stress; psychiatric disorders; disease states, such as obstructive sleep apnea and thyroid dysfunction; asthma; medication; and it may even be idiopathic (of unknown cause). It can occur on an acute (short-term), intermittent or chronic basis. Regardless of the cause, it may have a significant impact on quality of life. Insomnia also may cause comorbidities (diseases), two of which we will investigate further: heart failure and prostate cancer.

Fortunately, there are numerous treatments. These can involve medications, such as benzodiazepines like Ativan and Xanax. The downside of these medications is they may be habit forming. Nonbenzodiazepine hypnotics (therapies) include sleep medications, such as Lunesta (eszopiclone) and Ambien (zolpidem). All of these medications have side effects. We will investigate Ambien further because of recent warnings.

There are also natural treatments, involving supplements, cognitive behavioral therapy and lifestyle changes.

Let’s look at the evidence.

Heart failure

Insomnia may perpetuate heart failure, which can be a difficult disease to treat. In the HUNT analysis (Nord-Trøndelag Health Study), an observational study, results showed insomnia patients had a dose-dependent response for increased risk of developing heart failure (4). In other words, the more components of insomnia involved, the higher the risk of developing heart disease.

There were three components: difficulty falling asleep, difficulty maintaining sleep and nonrestorative sleep that is not restful. If one component was involved, there was no increased risk. If two components were involved, there was a 35 percent increased risk, although not statistically significant.

However, if all three components were involved, there was 350 percent increased risk of developing heart failure, even after adjusting for other factors. This was a large study, involving 54,000 Norwegians, with a long duration of 11 years.

Prostate cancer

Prostate cancer has a plethora of possible causes, and insomnia may be a contributor. Having either of two components of insomnia, difficulty falling asleep or staying asleep (sleep disruption), increased the risk of prostate cancer by 1.7 and 2.1 times, respectively, according to a recent observational study (5).

However, when looking at a subset of data related to advanced or lethal prostate cancer, both components, difficulty falling asleep and sleep disruption, independently increased the risk even further, 2.1 and 3.2 times, respectively.

This suggests that sleep is a powerful factor in prostate cancer, and other studies have shown that it may have an impact on other cancers, as well. There were 2,102 men involved in the study with a duration of five years. While there are potentially strong associations, this and other studies have been mostly observational. Further studies are required before any definitive conclusions can be made.

What about potential treatments?

Ambien: While nonbenzodiazepine hypnotics may be beneficial, this may come at a price. In a recent report by the Drug Abuse Warning Network, part of the Substance Abuse and Mental Health Services Administration, the number of reported adverse events with Ambien that perpetuated emergency department visits increased by more than twofold over a five-year period from 2005 to 2010 (6). Insomnia patients most susceptible to having significant side effects are women and the elderly. The director of SAMHSA recommends focusing on lifestyle changes for treating insomnia: by making sure the bedroom is sufficiently dark, getting frequent exercise, and avoiding caffeine.

In reaction to this data, the FDA required the manufacturer of Ambien to reduce the dose recommended for women by 50 percent (7). Ironically, sleep medication like Ambien may cause drowsiness the next day — the FDA is investigating if it is safe to drive after taking these medications the night before.

Magnesium: The elderly population tends to suffer the most from insomnia, as well as nutrient deficiencies. In a double-blinded, randomized controlled trial (RCT), the gold standard of studies, results show that magnesium had resoundingly positive effects on elderly patients suffering from insomnia (8).

Compared to a placebo group, participants given 500 mg of magnesium daily for eight weeks had significant improvements in sleep quality, sleep duration and time to fall asleep, as well as improvement in the body’s levels of melatonin, a hormone that helps control the circadian rhythm.

The strength of the study is that it is an RCT; however, it was small, involving 46 patients over a relatively short duration.

Cognitive behavioral therapy

In a recent study, just one 2½-hour session of cognitive behavioral therapy delivered to a group of 20 patients suffering from chronic insomnia saw subjective, yet dramatic, improvements in sleep duration from 5 to 6½ hours and decreases in sleep latency from 51 to 22 minutes (9). The patients who were taking medication to treat insomnia experienced a 33 percent reduction in their required medication frequency per week. The topics covered in the session included relaxation techniques, sleep hygiene, sleep restriction, sleep positions, and beliefs and obsessions pertaining to sleep. These results are encouraging.

It is important to emphasize the need for sufficient and good-quality sleep to help prevent, as well as not contribute to, chronic diseases, such as cardiovascular disease and prostate cancer. While medications may be necessary in some circumstances, they should be used with the lowest possible dose for the shortest amount of time and with caution, reviewing possible drug-drug and drug-supplement interactions.

Supplementation with magnesium may be a valuable step toward improving insomnia. Lifestyle changes including sleep hygiene and exercise should be sought, regardless of whether or not medications are used.

References:

(1) Sleep. 2009;32(8):1027. (2) American Academy of Sleep Medicine, 2nd edition, 2005. (3) Arch Intern Med. 1998;158(10):1099. (4) Eur Heart J. online 2013;Mar 5. (5) Cancer Epidemiol Biomarkers Prev; 2013;22(5):872–879. (6) SAMSHA.gov. (7) FDA.gov. (8) J Res Med Sci. 2012 Dec;17(12):1161-1169. (9) APSS 27th Annual Meeting 2013; Abstract 0555.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com or consult your personal physician.

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