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One morning around week six of the COVID-19 lockdown, I woke up to discover I’d gnashed a molar-sized crack down the back of my night guard, the device I wear to protect my teeth from the grinding I do in my sleep. I’d worn the acrylic barrier every night for years with minimal erosion, but suddenly I’d gnawed right through it. Like many Americans who have spent the last few years wondering where the stress and fear building up in their bodies could possibly go, the answer turned out to be my mouth.

Since 2020, dentists and other oral health professionals around the world have recorded a sharp uptick in the number of patients seeking treatment for issues caused by bruxism, a fancy word for grinding and clenching your teeth together with force. While bruxism is fairly common, with pre-pandemic data suggesting that as many as 31% of adults were chronic chompers to some degree, some major clinics saw nearly three times as many bruxers as usual when lockdowns began. The increase still hasn’t let up, some experts say. “My patients that had soft pain and bruxism got worse, and the people that I’d never seen it in before were now having lots of pain,” says Mark Drangsholt, chair of the department of oral medicine at the University of Washington’s dental school.

Most people who have bruxism grind in their sleep, and those without symptoms may never even know they do it. Though experts often make a distinction between this nighttime mashing, known as sleep bruxism, and daytime grinding (awake bruxism), in many individual cases the line between the two is blurred by a mix of patterns and behaviors.

Read More: Why Not Everyone Needs 8 Hours of Sleep

Bruxism doesn’t always cause pain, but when it does, it can be bad. Certain patterns (particularly sustained clenching), can lead to chronic pain in the temporomandibular joints—TMJ for short—found on each side of your face near the ear. These joints, which are often compared to hinges, allow the jaw to move away from the rest of the skull and are directly stressed by bruxism. People who grind their teeth frequently can experience TMJ issues that include clicking noises or pain while eating, general tenderness, and even jaw lock.

Then, there’s the risk to your teeth themselves. Aside from the small bits of time we spend eating, “your teeth don’t really come together much during the day,” says Drangsholt. Even an hour spent grinding at work is a huge amount of extra wear and tear, which can put you at risk for cracked or worn-down teeth.

Bruxism only gets more hazardous once you hop into bed. Ever seen those videos of hippos eating whole watermelons like they’re blueberries? That’s basically humans’ unconscious superpower. When we’re deep in REM sleep, says Drangsholt, we’re capable of exerting as much as three times the amount of force with our bite than we ever could consciously.

Bruxism has always been closely associated with anxiety in the dental world, and recent studies have begun to affirm the stories that clinics have been telling about the pandemic boom. One small paper published in 2021 that looked at Turkish health care workers found that roughly a third of those with no history of bruxism began to experience symptoms in the first months of the pandemic. Another study looking at Google Search trends worldwide found a notable increase between May 2020 and October 2020 in searches for bruxism, teeth grinding, and teeth clenching when compared to similar periods from 2016 to 2019.

Some psychoactive medications may also affect bruxism. Antidepressants such as SSRIs and SNRIs can trigger the onset of bruxism within a month of use, and are one of the first things Drangsholt says he asks new patients about when assessing their symptoms. Most people on antidepressants don’t develop bruxism, but “it does look like there is a relationship for some people,” he says. “That’s something we look pretty carefully at, because if you can switch out or change your dosing, then that can be helpful.” Though new antidepressant prescription rates in the U.S. dropped in the early months of the pandemic, the overall numbers over the last few years point to a continuing increase in new prescriptions.

Read More: Feeling Off? It Could Be “Ambient Stress”

Michele Schultz-Robins, secretary of the American Academy of Orofacial Pain and a professor at Rutgers School of Dental Medicine, says that other lifestyle factors may have had an impact on the still-rising numbers of bruxism cases she’s seen. “COVID—it’s been insane,” she says. For years, adults and kids have been confined more to their homes during the day: staring at tiny screens, working from couches and in bed, and changing their daytime posture habits in ways that could lead to more clenching. “You’re holding your face differently,” she says. “You are now constantly bending over and your jaw is not aligned properly, and you may start clenching. You’re a little more tense about it, and when you clench with your temporalis muscle and your masseter muscle, you’re going to get a headache.”

The effects of stress, she adds, can be enormous. “I ended up with a 17 year old who couldn’t open up his mouth beyond one finger because he was so stressed,” Schultz-Robins says. “During COVID, he was the only one supporting his family; his parents had both been laid off.” Schultz-Robins says that she’s seen children as young as 6 come in with pain caused by excessive grinding.

This intense psychological connection can sometimes make temporomandibular joint disorders (TMD) difficult to treat. Something as simple as tweaking medication dosages to improve symptoms requires communication and coordination between psychiatrists and orofacial pain specialists, two specialties who don’t otherwise work together much. But successful TMD and bruxism treatment varies from case to case, and combinations of approaches can be hugely beneficial in alleviating symptoms, says Drangsholt.

On the psychological side, techniques like mindfulness, cognitive-behavioral therapy, and other proven anxiety-easing practices can have an impact on bruxism behaviors and TMJ pain, and are more accessible than ever thanks to online therapy options. Still, treatment should always start with an orofacial pain expert, says Schultz-Robins. A specialist can offer more physical treatment options, such as mouth exercises, night guards that prevent your top and bottom teeth from touching, and even regular injection therapies of anesthetics for severe pain.

“The treatment with the real big jump in use most recently has been neurotoxin, or Botox,” says Drangsholt. Though it’s a more expensive treatment reserved for the most severe cases, regular Botox injections every three or four months can make a world of difference for some grinders. “They don’t fracture the appliances, and they don’t have any of the tooth fractures,” says Drangsholt. “We’re able to decrease the volume of their muscles in a reversible manner.”

As Schultz-Robins puts it: “Does your jaw feel like you had a party in your mouth all night? Do you have a headache when you wake up?” These are signs that visiting a professional—namely one from the directory available on the American Academy of Orofacial Pain’s website—might be a good idea.

Contact us at [email protected].

Humans prefer their weather in something of a Goldilocks zone—a not-too-hot, not-too-cold temperature window which not only affects our physical comfort, but also our mood. During heat waves or deep freezes, tempers fray, patience wears thin, and behavior can suffer. Now, a new study in The Lancet Planetary Health, has found that this holds true not only in our in-person interactions, but online too. As temperatures rise or fall above or below a comfort zone of 54ºF to 70ºF (12ºC to 21ºC), online hate speech in the U.S.—at least on Twitter—increases accordingly.

The research team, led by Leonie Wenz, working group leader at the Potsdam Institute for Climate Impact Research (PIK), took a deep dive into online speech to reach their conclusions, beginning by vacuuming up more than 4 billion geolocated tweets posted in the U.S. over a six-year time frame from May 2014 to May 2020. They programed an artificial intelligence algorithm to scan the tweets for hate speech, which they defined, according to United Nations standards, as any communication that “attacks or uses pejorative or discriminatory language with reference to a person or a group on the basis of … their religion, ethnicity, nationality, race, color, descent, gender or other identity factor.”

That’s a broad definition and the algorithm could sometimes be flummoxed by it. While the researchers could train the program to recognize hateful words and terms, some have multiple meanings. Notably, the software had to learn the meaning of the N-word. One variant of the word, which ends in “-a”, for example, has been “reappropriated as a type of endearment in some communities,” the authors wrote. In that case, they taught the software to look for surrounding words that were “aggressive or derogatory.”

Read more: Summers Are Becoming Unbearably Hot Before They Even Start

Overall, just over 75 million tweets—or 2% of the four billion total in the six-year window—analyzed by the algorithm qualified as hate speech. But exactly when the tweets occurred and where they originated could vary widely. The study geolocated the source of the tweets containing hate speech to 773 different U.S. cities and cross-referenced that information with what the temperature was in those places on the date the tweet was posted

In general, the study did not find that any one city or region produced more hate tweets than any other; the critical variable they did find was all about the thermometer. The fewest hate tweets occurred in a narrow six-degree temperature range of 59ºF to 65ºF (15ºC to 18ºC), within the identified broader comfort zone. Outside of that 54º F to 70º F sweet spot, things could vary widely. On extremely cold days, for example—more common in the northern tier than elsewhere in the country—when temperatures ranged from 21ºF to 27ºF (-6ºC to -3ºC), hate tweets increased by 12.5%. On extremely hot days—especially in the desert southwest—when temperatures maxed out between 108ºF and 113ºF (42ºC to 45ºC)—hate tweets rose by 22%.

“Even in high-income areas where people can afford air conditioning and other heat mitigation options, we observe an increase in hate speech on extremely hot days,” said Anders Levermann, head of complexity science at PIK and a co-author of the study, in a statement accompanying its release. “There are likely limits of adaptation to extreme temperatures and these are lower than those set by our mere physiological limits.”

That’s not to say we don’t adapt at all. The study divided the 773 cities from which the tweets originated into five different climate zones: cold, hot-dry, mixed humid, hot-humid, and marine (or, coastal). Broadly, they found that increases in hate tweets varied, with, say, people in the cold region—which covered most of the northern part of the 48 contiguous states—showing less of a bump in online misbehavior during an extreme cold snap than people in the hot-humid region, who would not be as accustomed to sudden thermometer plunges.

“This could suggest that the hate tweet increases are dependent on the temperatures we are used to,” the authors wrote.

Read more: How Psychology Can Help Fight Climate Change—And Climate Anxiety

Limitations in the study didn’t allow researchers to use geographical information to tease out any differences in weather-related hate tweeting depending on socioeconomic status, faith, race, political party membership or more. “Groupings based on income, religion and partisan [affiliation] are not perfect since cities are never perfectly homogenous,” they wrote; their geolocated data, however, did not control for those factors.

While it may have been hard to tease out exactly which demographics were doing the hate-tweeting, it was not hard to determine who the targets were. The study cites existing research showing that 25% of Black people and 10% of Hispanic people have been subjected to race-based online harassment. These communities are also among the most vulnerable to the impacts of extreme weather, made worse by climate change. Members of the LGBTQ community are also four times more likely to report online harassment than others, the study found. These same groups, the authors warn, are the likeliest to suffer from all hate tweets, including temperature-related ones—and that poses a danger to their well-being.

“Being the target of online hate speech is a serious threat to people’s mental health,” said Annika Stechemesser, a doctoral researcher at PIK and a co-author of the study, in a statement. “The psychological literature tells us that online hate can aggravate mental health conditions especially for young people and marginalized groups.”

That threat will only grow, the authors warn, as human-caused climate change worsens and temperature extremes become more common. “Assuming little adaptation and similar communication patterns,” they write, “this would mean that hate expressed online could increase under future global warming.” Hate is a uniquely human quality, and climate change is one of our most regrettable handiworks. Together, they make for a very nasty pair.

Write to Jeffrey Kluger at [email protected].

The last two flu seasons in the U.S. were mercifully mild—one of the few silver linings of the pandemic, as COVID-19 mitigation measures likely also prevented many cases of influenza.

But our luck may run out this year. Australia, which often serves as an (imperfect) predictor of what’s to come for the U.S., has had its worst flu season in half a decade this year, CNN reports. Flu season also started early in Australia this year, another possible harbinger of what’s to come in the Northern Hemisphere.

Dr. Alicia Fry, chief of the epidemiology and prevention branch within the U.S. Centers for Disease Control and Prevention’s (CDC) influenza division, cautions that “if you’ve seen one flu season, you’ve seen one flu season”—meaning the virus is unpredictable and guesses about it aren’t always accurate. “Whether it will be a severe season or a mild season, or what to expect, or what viruses might circulate—that we really just don’t know,” Fry says.

Nonetheless, there are some factors that could set up the U.S. for a more serious flu season this year, says Dr. Brandon Webb, an infectious disease specialist at Utah’s Intermountain Medical Center. Flu season severity varies quite a bit from year to year, depending on factors including immunity in the population and which influenza strain is circulating. “Individuals who get influenza the year prior probably carry over some incomplete or partial immunity,” Webb explains. Since few people got infected during the past two flu seasons, “we’re looking at globally, and especially in the U.S., record low community immunity levels to influenza.”

The relaxation of COVID-19 mitigation measures like masking, social distancing, and remote working and schooling could also allow influenza to spread as it did before the pandemic, Fry says.

Read More: You Can Still Get Long COVID If You’re Vaccinated and Boosted

The possibility of a heavy flu season colliding with the still widely circulating SARS-CoV-2 virus is concerning for the health care system, Webb says. “If we have even a moderate-to-high influenza season that generates 300,000 or 400,000 hospitalizations and are also having to deal with a fall or winter COVID wave, that could put a strain on hospital systems around the country,” he says.

The best thing for individuals to do is get vaccinated sooner rather than later, Fry says.

On Sept. 1, federal health officials recommended that people 12 and older get a new bivalent COVID-19 booster, which targets currently circulating Omicron variants. The updated shots are available to adolescents, teenagers, and adults who are at least two months out from their last COVID-19 vaccine dose (though some experts recommend waiting a bit longer). Meanwhile, the CDC recommends getting a flu shot by the end of October.

“If a person wants to get both at the same time, they can,” Fry says. In a Sept. 6 press briefing, White House COVID-19 Response Coordinator Dr. Ashish Jha concurred. “I really believe this is why God gave us two arms—one for the flu shot and the other one for the COVID shot,” he said.

Someday, it may be even easier to get dual protection against COVID-19 and the flu. Vaccine makers Moderna and Novavax are working on shots that would target both viruses in a single injection. It’s not clear if or when these combination shots might be available, but their development offers a glimpse into what living with both COVID-19 and influenza may look like moving forward.

Many unknowns remain about even this year’s looming flu season. Webb recommends keeping an eye on both COVID-19 and influenza rates and taking precautions accordingly. People at higher risk for severe respiratory disease, including elderly people and those with underlying conditions, might want to consider wearing a mask in crowded settings.

At least one thing makes Webb optimistic about this year’s flu season: Despite all the talk of pandemic fatigue, he thinks there’s been a cultural shift in the way people manage infectious diseases.

“People are, in general, much more aware now about the importance of infection control,” Webb says. “I would hope that we have a different culture in terms of recognizing that when you’re ill, it’s best to stay home.”

Write to Jamie Ducharme at [email protected].

Phew, this summer was hot — and some places are still roasting! With people around the world experiencing dangerously high, record-breaking temperatures, we’ve all been sweating it.

You might find perspiration a nuisance most of the time, but that salty liquid oozing from your skin is key to keeping you cool. And there’s so much more to the briny stuff than meets the eye.

Several NPR science staffers braved the heat this summer to get the dirt on sweat. These lessons are based on their reporting:

1. Sweat keeps you cool by turning into a gas

Let’s start with the basics. Sweat is mostly just water and salt secreted by millions of glands in your skin. Those glands are basically coiled loops that help move some of the liquid sloshing around in the spaces between your cells, bones and organs up and out through the body’s surface.

When the sweat on your skin evaporates, transforming from a liquid into a gas, it takes some heat from the blood right under your skin with it. The now-cooler blood then travels around your body and back to your core, helping keep all your inner parts at the right temperature to function.

2. Most sweat doesn’t stink

Perspiration is mostly odorless — at least that’s true of the sweat dripping from your forehead and arms after a run. But something is different about the sweat from your armpits and groin that makes it stink. The sweat glands in those places are called apocrine glands, and they release a protein-rich form of perspiration that gets eaten by bacteria. It’s the byproducts of these bacteria, feeding on your sweat, that produce body odor.

3. The bacteria behind BO are actually your allies

Even if you’re worried about your smelly sweat, don’t go scrubbing yourself with antibacterial soap in pursuit of fresh pits just yet. The microbes that give rise to body odor help protect your skin from dangerous pathogens and even help prevent eczema.

A light sudsing with regular gentle soap should be enough to knock down the stink, at least temporarily, without wiping out bacterial pals.

4. Most animals don’t sweat

Now let’s be clear. You are the sweatiest of them all. OK, well not just you, but all humans.

Scientists think our ancestors evolved sweat glands between 1.5 million and 2.5 million years ago as we moved from under the cool canopy of the forests into the grasslands and prairies, long before we evolved our big brains.

But most other animals don’t sweat, and they need to find other ways to keep from overheating — through panting, for example — if they can’t find shade, a river or a pool. As NPR’s Rebecca Hersher recounts in her rhyming exploration of the ways various creatures stay cool, lions in a Maryland zoo this steamy summer got an extra treat — frozen bloodsicles — to help lower everyone’s temperature.

5. A warm bath is better than a cold shower to prevent overheated nights

It may seem counterintuitive, but when you get out of a warm or lukewarm evening bath, researchers say, the water evaporates from your skin, pulling heat from your body and cooling you down before you go to sleep. This life hack works best about an hour before bedtime, scientists told NPR reporter Joe Palca — and you’ll sleep better and more deeply when you’re cooler.

6. Some insects seek the salt in human sweat

Unfortunately for us, mosquitoes, along with many other insects, are attracted to human sweat. Insects need the sodium in salt, just like the rest of us, and our salty perspiration has what they need.

Scientists suspect that millions of years ago, some sweat-drinking ancestors of mosquitoes discovered there was an even more nutritious substance beneath human skin — our blood. Those bloodsucking biters gained an evolutionary edge over the nonbiters and thrived.

7. Astronauts need extra help to get rid of body heat

Perspiration can be a big problem for people in a low-gravity environment such as space because, even after great exertion, sweat doesn’t exactly drip off the skin without gravity. Instead, it just kind of sits there and pools up, which can disrupt electronic equipment and make spacewalks extra-uncomfortable.

So astronauts wear special underwear on their spacewalks; it’s filled with cooling tubes that whisk the heat away. One bonus in the controlled environment of a space station: Any extra moisture from sweat that does get into the air is sucked up by the ventilation system and recycled into fresh water for the astronauts to drink.

Reporting for this story was drawn from our summer series on sweat by NPR’s Geoff Brumfiel, Ari Daniel, Michaeleen Doucleff, Nell Greenfieldboyce, Pien Huang, Rebecca Hersher, Joe Palca and Lauren Sommer. Still thirsty for more sweet sweat science? Brumfiel, Greenfieldboyce and Hersher sat down recently with the hosts of NPR’s science podcast Short Wave to take more questions and spill what they’ve learned.

The new 988 Suicide and Crisis Lifeline is already reaching more Americans in distress – and connecting them to help faster — than the old 10-digit suicide prevention line it replaced July 16.

New data released Friday by the U.S. Department of Health and Human Services show that in August – the first full month that 988 was operational — the Lifeline saw a 45% increase in overall volume of calls, texts and chats compared to August 2021.

The number of calls answered went up from 141,400 to 216,000 – a more than 50% increase, according to HHS officials. And texts answered went up by a whopping 1000% – from 3,400 in August, 2021, to 39,900 in August of this year. The number of chats on the Lifeline’s website that were answered saw a 195% increase.

“Our nation’s transition to 988 moves us closer to better serving the crisis care needs of people across America,” said HHS Secretary Xavier Becerra in a statement.

The numbers encouraging, says psychologist Ben Miller, a mental health policy advocate.

“As far as data points go, this is good news,” he says. “People are using the line, which is what we want. It’s going to help save lives, which is what we want.”

Particularly heartening is the data showing people are having to wait less to connect to a trained counselor in one of the more than 200 call centers that make up the national 988 network, he adds.

HHS officials say that in August of 2021, the average response time for calls, chats and texts was 2 minutes and 30 seconds, which Miller says is a long time to wait for someone in crisis.

But, this August, that response time dropped down to 42 seconds – a significant improvement, he adds.

The Biden administration has invested historic amounts of money towards beefing up the 988 infrastructure, and much of the money has gone towards adding new backup call centers, as well as hiring more people to answer calls at the existing call centers.

“I don’t really know how this will play out over time, but to see such a huge increase, I have to attribute it to the fact that there’s more resources, meaning more call center staff, meaning more opportunities to develop the appropriate infrastructure to help get to people quicker,” says Miller.

Kellene Diana, 41, a resident of Baltimore and a mental health advocate says she’s used this the suicide prevention line several times, especially during the pandemic, when she had frequent panic attacks.

“It has been instrumental in getting me through dark nights, long nights, scary nights,” says Diana, who has also called 988 recently to help loved ones and community members in crisis.

But, while 988 is certainly helping more people overall, we don’t know yet how the system is faring in individual states, cautions Miller. The newly released data doesn’t have a state-by-state breakdown.

“There’s going to be massive disparities across the states,” he says.

While the 988 Lifeline is accessible nationally, with a national network of call centers, it essentially functions as a state-run system. And states vary vastly in how much they have invested in the former 10-digit Lifeline and associated services. According to a recent analysis by the National Institute of Mental Illness, very few states have passed legislation to supplement the recent federal funds into 988.

So, seeing how individual states are doing is key to understanding which states will need more help and funding, and in what way, explains Miller.

And the quality of service can even vary between people who work at the crisis call centers, says Diona, 34, a resident of Harlem, N.Y., and a member of Fountain House, a social club for people with mental illness.

Diona has long struggled with suicidal thoughts and attempts, and is a frequent caller to 988 and the previous 10-digit lifeline. (NPR is only using her first name because of the stigma of mental health conditions.)

“I think it really depends on who’s working there, who is answering the call,” she says, “because there have been a few times where the person has not been hopeful or hasn’t believed me.”

Though many of her calls to the line have helped her, she says one time, in June 2021, she felt even more hopeless after talking to the counselor on the line, and ended up attempting suicide.

And despite all the recent additional funding for the network, calls during the weekend still take a long time to be answered, says Diona.

“Workforce remains a major issue and will continue to be in the foreseeable future,” notes Miller. “Almost every state is looking to hire more professionals to staff the over 200 [call centers.]”

The pandemic has worsened a pre-existing shortage of mental health care providers and many call centers have had trouble hiring counselors at call centers. The level and quality of training counselors staffing the phone lines also varies widely, according to mental health experts.

“I think if we don’t aggressively pursue solutions in recruiting and retaining the workforce, we’re going to have a lot bigger problems down the road,” says Miller.

It’s a problem that HHS recognizes. Today, the agency also announced a new $35 million grant to support 988 services in tribal communities, where the need is high but access to care has additional challenges. This new funding is specifically to add more trained counselors to address the needs of tribal communities.

“The transition to 988 is just the beginning,” said Becerra in a statement. “We will continue working towards comprehensive, responsive crisis care services nationwide to save lives.”