Family Health.

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Body Shape: Does It Increase Your Risk Of Diabetes?

Q:I know that obesity is a risk factor for diabetes. But I've been told that body shape also plays a role. Is this true?
A:
Yes, it's true. People who carry most of their excess weight around their waist (often called "apples") are at greater risk of diabetes than are those who carry most of their excess weight below their waist (often called "pears").

The more fatty tissue you have, the more resistant your body's cells become to the effects of your own insulin. But this appears especially true if your weight is concentrated around your abdomen.

To determine whether you're carrying too much weight around your abdomen, measure the circumference of your waist at its smallest point, usually at the level of your navel. Using a flexible, cloth-like tape measure is best. A measurement of more than 40 inches in men and more than 35 inches in women indicates increased health risks.

The good news is that you can lower your risk of diabetes by achieving and maintaining a healthy weight.

Ref: Mayo Clinic Health - www.mayoclinic.com

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Double Trouble: The Link Between Allegies And Asthma.

If you have both allergies and asthma, you may wonder what they have in common besides a maddening ability to make you miserable. A lot, as it turns out. Allergy-induced asthma is the most common type of asthma in the United States; 60% of people with asthma have the allergic type. James T. Li, M.D., a Mayo Clinic allergy specialist answers your questions about the similarities and the differences between allergies and asthma.


What's the link between allergies and asthma?

Simply put, allergies can trigger or induce asthma. For people with allergic asthma, breathing in substances such as pollen, mold, dust mites and animal dander triggers the inflammation and swelling of the airways, leading to symptoms of asthma.

The lining of the nose and the lining of the airways are similar and are affected similarly by the allergic inflammatory process. Allergies are caused by the production of an antibody called IgE. The IgE antibodies cause a cascade of reactions in the body, including itchy skin or scratchy eyes or, for some, tightening of the airways. Simply put, if your immune system produces IgE antibody toward cat proteins, you're said to be allergic to cats. Exposure to cats triggers inflammation and swelling of the lining of the nose, bronchial tubes or both.


If I treat my allergies, will it prevent asthma?

Some studies suggest that treatment of allergic rhinitis actually improves asthma. Allergen immunotherapy (desensitization allergy shots) is a type of allergy treatment that can significantly improve asthma. In addition, if you have allergic asthma, reducing your exposure to the allergic substance can reduce your asthma problems and in some cases, completely control it.


Are allergies and asthma treated differently?

Medications aimed at reducing inflammation are effective for allergic rhinitis, allergic asthma, as well as nonallergic asthma. Corticosteroids for example, reduce inflammation. Intranasal corticosteroids, which you spray into your nose, reduce inflammation from hay fever. Corticosteroid creams applied to your skin reduce the inflammation of eczema. And inhaled corticosteroids, which you inhale into your lungs using an inhaler device, reduce inflammation of the bronchial tubes in asthma.

Another medication, called a leukotriene modifier, also is used to reduce inflammation. Leukotriene modifiers are taken in pill form and are used for both asthma and allergic rhinitis symptoms.

Other medications are clearly more effective for one condition over another. Antihistamines, for example, are commonly used to treat allergic rhinitis but have a very minor benefit for asthma. Bronchodilator inhalers, which open congested airways, are a big part of asthma treatment, though they aren't used to treat allergic rhinitis.


Who's at risk of allergic asthma?

A family history of allergies is the strongest risk factor having allergic asthma. If you have allergies, you're more likely to develop asthma — up to 78 percent of people who have asthma also have hay fever.


Is all asthma caused by allergies?

Though allergic asthma is the most common form of asthma, there are other forms and triggers of asthma, including exercise-induced asthma and nonallergic asthma triggered by infections or cold air or gastroesophageal reflux disease (GERD).


Nothing to sneeze at

While it may be a manner of semantics to those who suffer from allergy or asthma symptoms, recognizing the relationship between the body's immune system and how the airways react has led to improved treatment of asthma symptoms for many people.


Ref: James T Li MD, Mayo Clinic Health - www.mayoclinic.com

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Headaches And Migranes.

Should I have image tests to evaluate my headaches?

Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision
Consider the following when making your decision:

Most headaches are not caused by a serious medical condition. Even painful, recurring headaches, such as migraines or cluster headaches, are not caused by another serious condition (such as a brain tumor), and their cause will not show up on image tests.
It is unusual to develop new, painful headaches after age 50. Image tests may help diagnose the cause of these types of headaches.
Medications often effectively control the pain of recurring headaches—such as tension, migraine, or cluster headaches—and image test results will not affect your treatment.
If you have recurring headaches but medications aren't working or your headaches have recently changed—for example, they have gotten worse, wake you up at night, or you've developed symptoms such as numbness or tingling—image tests may help diagnose or rule out any new problems.
If you are concerned about the cause of your headaches and are losing sleep or feeling overwhelmed by fear, image test results may reassure you. However, you will have to weigh the fear and worry against the high cost of these tests, especially if you do not have insurance or the financial resources to cover their cost.

Ref: Jan Nissl RN BS - Healthwise.

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Infectious Diseases: How They Spread, How To Stop Them.
From your sniffling seatmate on the bus to the raw chicken on your cutting board, everyday life is full of potential infectious disease hazards. With germs so common and seemingly everywhere, the question is this: Just how do you protect yourself from germs that cause infectious disease?

Knowing how germs spread can help. Find out how infectious disease is transmitted, and more importantly, what you can do to minimize your risk of infection.

Infectious diseases spread through two types of contact

Direct contact

An easy way to catch most infectious diseases is by coming in contact with someone who has one. This "someone" can be a person, an animal or, for an unborn baby, its mother. Three different ways infectious disease can be spread through direct contact are:


Person to person. The most common way for infectious disease to spread is through the direct transfer of bacteria, viruses or other germs from one person to another. This can occur when an individual with the bacterium or virus touches, coughs on or kisses someone who isn't infected. These germs can also spread through the exchange of body fluids from sexual contact or a blood transfusion.
Animal to person. Your household pet might seem harmless, but pets can carry many germs. Being bitten or scratched by an infected animal can make you sick and, in extreme circumstances, could even cause death. Handling animal waste can be hazardous, too. For example, you can acquire a toxoplasmosis infection by scooping your cat's litter box, particularly if you're pregnant.
Mother to unborn child. A pregnant woman may pass germs that cause infectious diseases to her unborn baby. Germs can pass through the placenta, as is the case of the AIDS virus and the toxoplasmosis parasite. Or germs could spread during labor and delivery, as is the case for a mother infected with group B streptococcus.

Indirect contact

Disease-causing organisms can also be passed along by indirect contact. Many germs can linger on an inanimate object, such as a tabletop, doorknob or faucet handle. When you touch the same doorknob grasped by someone ill with the flu or a cold, for example, you can pick up the germs he or she left behind. If you then touch your eyes, mouth or nose before washing your hands, you may become infected. Some infections occur from organisms that naturally live in the environment but are not passed from person to person. Examples include fungal infections like histoplasmosis or blastomycosis, as well as bacterial infections such as anthrax.

Infectious diseases spread through the air

Droplet transmission

When you cough or sneeze, you expel droplets into the air around you. When you're sick with a cold or the flu — or any number of other illnesses — these droplets contain the germ that caused your illness. Spread of infectious disease in this manner is called droplet spread or droplet transmission.

Droplets travel only about three feet because they're usually too large to stay suspended in the air for a long time. However, if a droplet from an infected person comes in contact with your eyes, nose or mouth, you may soon experience symptoms of the illness. Crowded, indoor environments may promote the chances of droplet transmission — which may explain the increase in respiratory infections in the winter months.

Particle transmission

Some disease-causing germs travel through the air in particles considerably smaller than droplets. These tiny particles remain suspended in the air for extended periods of time and can travel in air currents. If you breathe in an airborne virus, bacterium or other germ, you may become infected and show signs and symptoms of the disease. Colds caused by viruses, influenza and tuberculosis are a few types of infectious diseases usually spread through the air, in both particle and droplet forms.

Infectious diseases spread through vectors and vehicles

Bites and stings

Some germs rely on insect carriers — such as mosquitoes, fleas, lice or ticks — to move from host to host. These carriers are known as vectors. Mosquitoes can carry the malaria parasite or West Nile virus, and deer ticks may carry the bacterium that causes Lyme disease.

The vector-borne spread of germs happens when an insect that carries the germ on its body or in its intestinal tract lands on you or bites you. The germs move into your body and can make you sick. Sometimes the germs that cause infectious disease need the insect for specific biological reasons. They use the insect's body to multiply, which is necessary before the germs can infect a new host.

Food contamination

Another way disease-causing germs can infect you is through contaminated food and water. Sometimes called common-vehicle transmission, this mechanism of transmission allows germs to be spread to many people through a single source. Food is often the vehicle that spreads the germs and causes the illness. For instance, contamination with Escherichia coli (E. coli) is common. E. coli is a bacterium present in or on certain foods — such as undercooked hamburger or unwashed fruits or vegetables. When you eat foods contaminated with E. coli, chances are you'll experience an illness — sometimes referred to as food poisoning.

Prevent the spread of infectious diseases

Decrease your risk of infecting yourself or others:


Wash your hands often. This is especially important before and after preparing food, before eating and after using the toilet.
Get vaccinated. Immunization can drastically reduce your chances of contracting many diseases. Make sure to keep your recommended vaccinations, as well as your children's, up-to-date.
Use antibiotics sensibly. Only take antibiotics when necessary. And if they're prescribed, take them exactly as directed — don't stop taking them early because your symptoms have gone away.
Stay at home if you have signs and symptoms of an infection. Don't go to work if you are vomiting, have diarrhea or are running a fever. Don't send your child to school if he or she has these signs and symptoms, either.
Be smart about food preparation. Keep counters and other kitchen surfaces clean when preparing meals. In addition, promptly refrigerate leftovers — don't let cooked foods remain at room temperature for extended periods of time.
Pay special attention to cleaning the 'hot zones' in your home. These include the kitchen and bathroom — two rooms that can have high concentrations of bacteria and other infectious agents.
Practice safe sex. Use condoms if you or your partner has a history of sexually transmitted diseases or high-risk behavior — or abstain altogether.
Don't share personal items. Use your own toothbrush, comb and razor blade. Avoid sharing drinking glasses or dining utensils.
Travel wisely. Don't fly when you're ill. With so many people confined to a small area, you may infect other passengers on the plane. And your trip won't be comfortable, either. Depending on where your travels take you, talk to your doctor about any special immunizations you may need.
Keep your pets healthy. Bring your pet to a veterinarian for regular care and vaccinations. Keep your pet's living area clean.

Ref: Mayo Clinic Health - www.mayoclinic.com

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Sleep Apnea - Sleep Disorders

Introduction

Have you been told that you snore loudly? Do you wake up feeling tired after a full night's sleep? Are you sleepy during the day? If so, you may have sleep apnea. In this potentially serious sleep disorder, breathing repeatedly stops and starts during sleep. "Apnea" is Greek for "without breath."

Sleep apnea occurs in two main types: obstructive sleep apnea, the more common form that occurs when throat muscles relax, and central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing. Additionally, some people have complex sleep apnea, which is a combination of both obstructive and central sleep apneas.

Obstructive sleep apnea occurs two to three times more often in older adults and is twice as common in men as in women. Treatments for sleep apnea may involve using a device to keep your airway open or undergoing a procedure to remove tissue from your nose, mouth or throat.


Signs and symptoms

The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making the type of sleep apnea more difficult to determine. The most common signs and symptoms of obstructive and central sleep apneas include:

Excessive daytime sleepiness (hypersomnia)
Loud snoring
Observed episodes of breathing cessation during sleep
Abrupt awakenings accompanied by shortness of breath
Awakening with a dry mouth or sore throat
Morning headache
Difficulty staying asleep (insomnia)
Disruptive snoring may be a more prominent characteristic of obstructive sleep apnea, while awakening with shortness of breath may be more common with central sleep apnea.


Causes

Obstructive sleep apnea occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), tonsils and tongue.

When the muscles relax, your airway narrows or closes as you breathe in, and breathing momentarily cuts off. This may lower the level of oxygen in your blood. Your brain senses this inability to breath and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.

You can awaken with a transient shortness of breath that corrects itself quickly, within one or two deep breaths, although this is rare. You may make a snorting, choking or gasping sound. This pattern can repeat itself 20 to 30 times or more each hour, all night long. These disruptions impair your ability to reach those desired deep, restful phases of sleep, and you'll probably feel sleepy during your waking hours.

People with obstructive sleep apnea may not be aware that their sleep was interrupted. In fact, many people with this type of sleep apnea think they sleep well all night.

Central sleep apnea, which is far less common, occurs when your brain fails to transmit signals to your breathing muscles. You may awaken with shortness of breath or headaches. The most common cause of central sleep apnea is heart disease. People with central sleep apnea may be more likely to remember awakening than people with obstructive sleep apnea are.



Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate, relax. When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off.

Risk factors

Sleep apnea may occur if you're young or old, male or female. Even children can have sleep apnea. But certain factors put you at increased risk:

Obstructive sleep apnea

Excess weight. Fat deposits around your upper airway may obstruct your breathing. However, not everyone who has sleep apnea is overweight. Thin people develop the disorder too.
Neck circumference. The size of your neck may indicate whether or not you have an increased risk of sleep apnea. That's because a thick neck may narrow the airway and may be an indication of excess weight. A neck circumference greater than 17 inches is associated with an increased risk of obstructive sleep apnea.
High blood pressure (hypertension). Sleep apnea is not uncommon in patients with hypertension.
A narrowed airway. You may inherit a naturally narrow throat. Or, your tonsils or adenoids may become enlarged, which can block your airway.
Being male. Men are twice as likely to have sleep apnea as women are. However, women increase their risk if they're overweight, and the risk also appears to rise after menopause.
Being older. Sleep apnea occurs two to three times more often in adults older than 65.
A family history of sleep apnea. If you have family members with sleep apnea, you may be at increased risk.
Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat.
Smoking. Smokers are much more likely to have obstructive sleep apnea than are nonsmokers. Smoking may increase the amount of inflammation and fluid retention in the upper airway. This risk drops after smoking cessation.
Central sleep apnea


Sex. Males are more likely to develop central sleep apnea than are females.
Heart disorders. People with atrial fibrillation or congestive heart failure are more at risk of central sleep apnea.
Stroke or brain tumor. These conditions can impair the brain's ability to regulate breathing.
Neuromuscular disorders. Conditions such as amyotrophic lateral sclerosis (Lou Gehrig's disease), spinal cord injuries and muscular dystrophy can affect central nervous system breathing functions.
High altitude. Sleeping at an altitude higher than you're accustomed to may increase your risk of sleep apnea.

When to seek medical advice

Consult a medical professional if you experience, or if your partner observes, the following:

Snoring loud enough to disturb the sleep of others or yourself
Shortness of breath that awakens you from sleep
Intermittent pauses in your breathing during sleep
Excessive daytime drowsiness, which may cause you to fall asleep while you're working, watching television or even driving
Many people don't think of snoring as a sign of something potentially serious, and not everyone who has sleep apnea snores. But be sure to talk to your doctor if you experience loud snoring, especially snoring that's punctuated by periods of silence. With sleep apnea, snoring typically is loudest when you sleep on your back, and it quiets when you turn on your side.

Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness (hypersomnia) may be due to other disorders, such as narcolepsy.


Screening and diagnosis

Your doctor may make an evaluation based on your signs and symptoms or may refer you to a sleep disorder center. There, a sleep specialist can help you decide on your need for further evaluation. Such an evaluation often involves overnight monitoring of your breathing and other body functions during sleep. Tests to detect sleep apnea may include:

Nocturnal polysomnography. During this test, you're hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep. Because treatments for other sleep disorders such as narcolepsy and insomnia differ, this test helps your doctor to arrive at an accurate diagnosis.
Oximetry. This screening method involves using a small machine that monitors and records your oxygen level while you're asleep. A simple sleeve fits painlessly over one of your fingers to collect the information overnight at home. If you have sleep apnea, the results of this test will show drops in your oxygen level during apneas and subsequent rises with awakenings. If the results are abnormal, your doctor may have you undergo polysomnography to confirm the diagnosis. Oximetry doesn't detect all cases of sleep apnea, so your doctor may still recommend a polysomnogram even if the oximetry results are normal.
Portable cardiorespiratory testing. Under certain circumstances, your doctor may provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually involve oximetry, measurement of airflow and measurement of breathing patterns.
If you have obstructive sleep apnea, your doctor may refer you to an ear, nose and throat doctor (otolaryngologist) to rule out any blockage in your nose or throat. An evaluation by a heart doctor (cardiologist) or a doctor who specializes in the nervous system (neurologist) may be necessary to look for causes of central sleep apnea.


Complications

Sleep apnea is considered a serious medical condition. Complications may include:

Cardiovascular problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. About half of people with sleep apnea develop high blood pressure (hypertension), which raises the risk of heart failure and stroke. If there's underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from a cardiac event.

The more severe the obstructive sleep apnea, the greater the risk for high blood pressure. In contrast, central sleep apnea usually is the result, rather than the cause, of heart disease.

A study published in November 2005 in the New England Journal of Medicine reported that obstructive sleep apnea greatly increases the risk of stroke, regardless of whether a person has high blood pressure. However, effectively treating obstructive sleep apnea can lower blood pressure and the risk of other cardiovascular diseases.

Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with sleep apnea often experience severe daytime drowsiness, fatigue and irritability. They may have difficulty concentrating and find themselves falling asleep at work, while watching TV or even when driving. Children and young people with sleep apnea may do poorly in school or have behavior problems.
Complications with medications and surgery. Obstructive sleep apnea also is a concern with certain medications and general anesthesia. People with sleep apnea may be more likely to experience complications following major surgery because they're prone to breathing problems, especially when sedated and lying on their backs. Before you have surgery, tell your doctor that you have sleep apnea. Undiagnosed sleep apnea is especially risky in this situation.
Sleep-deprived partners. Loud snoring can keep those around you from getting good rest and eventually disrupt your relationships. It's not uncommon for a bed partner to sleep in another room, or even on another floor of the house, to be able to sleep. Many bed partners of people who snore are sleep deprived as well.
People with obstructive and central sleep apneas may also complain of memory problems, morning headaches, mood swings or feelings of depression, a need to urinate frequently at night (nocturia), and impotence. Gastroesophageal reflux disease (GERD) may be more prevalent in people with sleep apnea. Children with untreated sleep apnea may be hyperactive and may be diagnosed with attention-deficit/hyperactivity disorder (ADHD).


Treatment

For milder cases of sleep apnea, your doctor may recommend lifestyle changes such as losing weight or quitting smoking. If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary.

Treatments for obstructive sleep apnea may include:

Therapies

Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.

Although CPAP is a preferred method of treating sleep apnea, some people find it cumbersome or uncomfortable. With some practice, most people learn to adjust the tension of the straps to obtain a comfortable and secure fit. You may need to try more than one type of mask to find one that's comfortable. Some people also benefit from using a humidifier along with their CPAP system.

Don't just stop using the CPAP machine if you experience problems. Check with your doctor to see what modifications can be made to make you more comfortable. Additionally, contact your doctor if you are still snoring despite treatment or begin snoring again. If your weight changes, the pressure settings may need to be adjusted.

Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more effective than oral appliances, but oral appliances may be easier for you to use.Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.

Surgery or other procedures
The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea. Surgical options may include:

Uvulopalatopharyngoplasty (UPPP). During this procedure, your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.
Maxillomandibular advancement. In this procedure, the upper and lower part of your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success.
Tracheostomy. You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.
Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) or with radiofrequency energy (radiofrequency ablation) are procedures that doctors sometimes use to treat snoring. However, these procedures aren't recommended for treating obstructive sleep apnea.

Other types of surgery may help reduce snoring and sleep apnea by clearing or enlarging air passages:

Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum)
Surgery to remove enlarged tonsils or adenoids
Treatments for central sleep apnea are more limited and may include:

Treatment for associated medical problems. Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.
Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.
Continuous positive airway pressure. This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway to keep it from collapsing. CPAP may eliminate snoring and prevent sleep apnea. As with obstructive sleep apnea, it's important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made.
Bilevel positive airway pressure (bilevel PAP). Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, bilevel PAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to boost the weak breathing pattern of central sleep apnea. Some bilevel PAP devices can be set to automatically deliver a breath if the device detects you haven't taken a breath after so many seconds.
Adaptive servo-ventilation (ASV). This more recently approved airflow device is designed to treat central sleep apnea and complex sleep apnea. The device learns your normal breathing pattern and stores the information into a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing.
Along with these treatments, you may read or hear about different treatments for sleep apnea, such as implants. However, while a number of medical devices and procedures have received FDA clearance, sleep doctors aren't currently recommending them because there's not yet enough evidence to support their use.



For moderate to severe sleep apnea, your doctor may recommend a common therapy device called a nasal continuous positive airway pressure (CPAP) machine. A CPAP machine delivers just enough air pressure to keep your upper airway passage open, preventing apnea and snoring.

Self-care

In many cases, self-care may be most appropriate way for you to deal with obstructive sleep apnea and possibly central sleep apnea. Try these tips:

Lose excess weight. Even a slight loss in excess weight may help relieve constriction of your throat.
Avoid alcohol and medications such as tranquilizers and sleeping pills. These relax the muscles in the back of your throat, interfering with breathing.
Sleep on your side or abdomen rather than on your back. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. To prevent sleeping on your back, try sewing a tennis ball in the back of your pajama top.
Keep your nasal passages open at night. Use a saline nasal spray to help keep your nasal passages open. Talk to your doctor about using nasal decongestants or antihistamines because these medications are generally recommended only for short-term use.

Ref: Mayo Clinic Health - www.mayoclinic.com

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Cold Or Allergy: Which Is It?

Q:I seem to get a lot of colds in the spring and fall. I'm wondering if maybe these "colds" are really seasonal allergies. How can I tell?
A:
If you tend to get frequent "colds" that develop suddenly and occur at the same time every year, it is possible that you are actually suffering from seasonal allergies. Although colds and allergies may share some of the same symptoms, they are very different diseases. Here's why:

Cause. Colds are caused by viruses. Allergies are an immune system response caused by exposure to an allergen — something you're allergic to — such as pollen or pet dander. Cold viruses are easily spread from person to person. You can't "catch" an allergy from someone who has an allergy.
Duration. Cold symptoms can develop at any time and usually last from two to 14 days. In contrast, seasonal allergy symptoms start at the same time every year and may last for months.
Treatment. Treatment of a cold may include rest, pain relievers and over-the-counter cold remedies, such as decongestants. Treatment of seasonal allergies may include over-the-counter or prescription antihistamines, nasal steroid sprays and decongestants.
Prevention. To help prevent colds, wash your hands frequently and thoroughly. To help prevent allergy symptoms, avoid exposure to known allergens.
The only way to truly know if you have allergies is to be tested for them in your doctor's office.

Symptom checker: Is it a cold or an allergy?

Symptom Cold Allergies

Cough Usually Sometimes
General aches and pains Sometimes Never
Fatigue Sometimes Sometimes
Itchy eyes Rarely Usually
Sneezing Usually Usually
Sore throat Usually Sometimes
Runny nose Usually Usually
Stuffy nose Usually Usually
Fever Rarely Never

Source: Adapted from National Institute of Allergy and Infectious Diseases

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Panic Attacks

Introduction

It can happen anytime, anywhere — when you're alone, with others, at home, in public, even awakening you from a sound sleep. Suddenly, your heart begins to race, your face flushes and you experience shortness of breath. You feel dizzy, nauseated and out of control. Some people even feel like they're dying.

You may have experienced a panic attack — a sudden episode of intense fear that prompts severe physical reactions in your body. Many people, thinking they're having a heart attack, go to the emergency room. Others try to ignore the signs and symptoms, not realizing that they're experiencing a panic attack.

More women than men are affected by panic attacks. Some people are affected by frequent panic attacks, a condition known as panic disorder.

Although panic attacks were once dismissed as nerves or stress, they're now recognized as a potentially disabling, but treatable condition. A variety of approaches, including medications, therapy and relaxation techniques, can help you control or prevent panic attacks.


Signs and symptoms

A panic attack often begins abruptly, peaks within 10 minutes and lasts about half an hour. But panic attacks have many variations. They may last hours or, on rare occasions, up to a day. You may feel fatigued and worn out after a panic attack subsides.

Signs and symptoms may include:

Rapid heart rate
Sweating
Trembling
Shortness of breath and hyperventilation
Chills
Hot flashes
Nausea
Abdominal cramping
Chest pain
Headache
Dizziness
Faintness
Tightness in your throat
Trouble swallowing
A sense of impending death
Other health problems — such as an impending heart attack, an overactive thyroid gland (hyperthyroidism) or drug withdrawal — can cause similar signs and symptoms.

People who experience panic attacks often are affected by other mental health conditions, including depression, fear of public places (agoraphobia) and social phobia.


Causes

Researchers aren't sure what causes panic attacks. Heredity, stress and certain biochemical factors may play a role. Your chance of having panic attacks increases if you have a close family member who has had them.

Many researchers believe your body's natural fight-or-flight response to danger is involved. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body readied itself for a life-threatening situation. Many of the same reactions occur in a panic attack. No obvious stressor is present, but something trips your body's alarm system.


When to seek medical advice

You may have a condition called panic disorder if:

Your panic attacks are frequent
You worry persistently for a month or longer about having more attacks
You change your behavior in response to ongoing panic attacks — for example, avoiding locations or situations in which you've previously had an attack
Panic disorder can greatly interfere with your life. It's also possible that other health problems can cause symptoms similar to panic attacks. See your doctor to determine what's causing your symptoms. Your doctor may refer you to a psychiatrist or psychologist.


Screening and diagnosis

Your doctor will ask you to describe your signs and symptoms, how often they occur and in what situations they occur. You'll probably undergo a complete physical exam so that your doctor can determine whether health conditions other than panic attacks are the cause of your symptoms. These other health conditions might include heart disease or an overactive thyroid. If you have no underlying health problems, your doctor may diagnose panic disorder based on your signs and symptoms and their frequency.


Complications

Panic disorder can become debilitating and destructive. Fear of recurrent attacks can lead you to adopt avoidance behavior — avoiding what most people consider to be normal situations, such as going to the mall or leaving the house alone. You can develop a fear of fear.

In children, panic attacks can interfere with normal development, disrupting your child's social life and schoolwork. Children and teenagers, for example, may not go to school or may not even leave the house in order to avoid situations in which they fear a panic attack.

Having panic disorder also increases your risk of depression, suicide, and abuse of alcohol and other drugs.


Treatment

Treatment for panic attacks and panic disorder is very effective. The outlook is good if you seek help, and most people are eventually able to resume everyday activities. Treatment may involve:

Medications. Your doctor may prescribe an antidepressant medication, such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac, Sarafem). Antidepressant medications usually improve or eliminate the symptoms of panic attacks. To relieve anxiety, your doctor may prescribe a type of medication called a benzodiazepine, such as clonazepam (Klonopin) or alprazolam (Xanax), either alone or with other drugs. The effectiveness of benzodiazepines often varies, and they may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. If you think you may have become mentally or physically dependent on a benzodiazepine medication, check with your doctor. Do not stop taking your medication suddenly. The duration of drug treatment for panic attacks depends on the severity of your disorder and your response to treatment.
Cognitive behavior therapy. During sessions with your psychiatrist or psychologist, you learn to better understand your panic attacks and how to deal with them. In the cognitive part of the therapy, you learn to recognize things that trigger your panic attacks or make them worse. The behavioral part of the therapy involves learning ways of coping with anxiety, such as using breathing and relaxation techniques. If you're avoiding common situations because of fear of panic attacks, behavior therapy can help you overcome this avoidance, which may be limiting the quality of your life.

Self-care

Learning how to relax may help you head off a panic attack. You can learn to relax through a variety of techniques, such as meditation, muscle relaxation, relaxed breathing and guided imagery (visualization).

Relaxation is more than getting away from the work-a-day grind, and it's more than the absence of stress. It's a specific, intentional action that's positive and satisfying — a feeling in which you experience peace of mind. True relaxation requires becoming sensitive to your basic needs for peace, self-awareness and thoughtful reflection and having the willingness to meet these needs.

Relaxation techniques can help lessen the discomfort and duration of the signs and symptoms of stress, such as headaches, anxiety, high blood pressure, trouble falling asleep, hyperventilation, and clenching or grinding your teeth. One simple method is to remove yourself from a stressful situation, block the world out and concentrate on your body. These steps can help you relax:

Sit or lie in a comfortable position and close your eyes. Allow your jaw to drop and your eyelids to be relaxed and heavy, but not tightly closed.
Mentally scan your body. Start with your toes and work slowly up through your legs, buttocks, torso, arms, hands, fingers, neck and head. Focus on each part individually. Where you feel tension, imagine it melting away.
Tighten the muscles in one area of your body. Hold the muscles for a count of five or more before relaxing and moving on to the next area. This is a good method for releasing tension. Tighten the muscles of your face, shoulders, arms, legs and buttocks.
Allow thoughts to flow through your mind, but don't focus on any of them. Many people find using autosuggestion to be a great help. Suggest to yourself that you're relaxed and calm, that your hands are heavy and warm (or cool if you're hot), that your heart is beating calmly, and that you feel perfectly at peace.
Breathe slowly, regularly and deeply during the procedure. Once you're relaxed, imagine you're in a favorite place or in a spot of great beauty and stillness. After five or 10 minutes, rouse yourself from the state gradually.
To maximize the benefits of these stress-reduction techniques, be sure to also get adequate sleep, eliminate caffeine and other stimulants from your diet, and engage in regular exercise. About 30 minutes of moderately intense physical activity most days of the week can improve your psychological well-being.


Ref: Mayo Health Research - www.mayoclininc.com

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High Blood Pressure (Hypertension)

Introduction

You can have high blood pressure (hypertension) for years without a single symptom. But silence isn't golden. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

High blood pressure typically develops without signs or symptoms. And it affects nearly everyone eventually. If you don't have high blood pressure by age 55, you have a 90 percent chance of developing it at some point in your life, according to the National Heart, Lung, and Blood Institute. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.


Signs and symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.

Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached an advanced — possibly life-threatening — stage.


Causes

In 90 percent to 95 percent of high blood pressure cases, the American Heart Association says there's no identifiable cause. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

The other 5 percent to 10 percent of high blood pressure cases are caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions can lead to secondary hypertension, including kidney abnormalities, tumors of the adrenal gland or certain congenital heart defects.

Certain medications — including birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs — also may cause secondary hypertension. In a 2005 study, women who took an average of 500 milligrams or more of acetaminophen (Tylenol, others) daily over several years were more likely to develop high blood pressure than were women who didn't take any acetaminophen. It's not known if the same holds true for men.

Various illicit drugs, including cocaine and amphetamines, also can increase blood pressure.


Risk factors

High blood pressure has many risk factors. Some you can't control.

Age. The risk of high blood pressure increases as you get older. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.
Race. High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.
Family history. High blood pressure tends to run in families.
Other risk factors for high blood pressure are within your control.

Excess weight. The greater your body mass, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
Inactivity. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction — and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
Tobacco use. The chemicals in tobacco can damage the lining of your artery walls, which promotes narrowing of the arteries.
Sodium intake. Too much sodium in your diet — especially if you have sodium sensitivity — can lead to fluid retention and increased blood pressure.
Low potassium intake. Potassium helps balance the amount of sodium in your cells. If you don't consume or retain enough potassium, you may accumulate too much sodium in your blood.
Excessive alcohol. Over time, heavy drinking can damage your heart.
Stress. High levels of stress can lead to a temporary but dramatic increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only fuel problems with high blood pressure.
Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea. Sometimes pregnancy contributes to high blood pressure.

In a 2006 study, adults who worked more than 40 or 50 hours a week — particularly clerical and unskilled workers — were more likely to have high blood pressure than were those who worked 40 hours or less a week. Researchers tied the higher risk for workers with longer hours to unhealthy eating, less exercise, more stress and less sleep.

Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits — such as an unhealthy diet and lack of exercise — contribute to high blood pressure.


When to seek medical advice

Ask your doctor for a blood pressure reading at least every two years. He or she may recommend more frequent readings if you have prehypertension, high blood pressure or other risk factors for cardiovascular disease.


Screening and diagnosis

Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).

The latest blood pressure guidelines, issued in 2003 by the National Heart, Lung, and Blood Institute, divide blood pressure measurements into four general categories:

Normal blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg — but some data indicate that 115/75 mm Hg should be the gold standard. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.
Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 or a diastolic pressure ranging from 80 to 89. Prehypertension tends to get worse over time. Within four years of being diagnosed with prehypertension, nearly one in three adults ages 35 to 64 and nearly one in two adults age 65 or older progress to definite high blood pressure.
Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 or a diastolic pressure ranging from 90 to 99.
Stage 2 hypertension. The most severe hypertension, stage 2 hypertension is a systolic pressure of 160 or higher or a diastolic pressure of 100 or higher.
Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension (ISH) — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50.

A single high blood pressure reading usually isn't enough for a diagnosis. Because blood pressure normally varies throughout the day — and sometimes specifically during visits to the doctor — diagnosis is based on more than one reading taken on more than one occasion. Your doctor may ask you to record your blood pressure at home and at work to provide additional information.

If you have any type of high blood pressure, your doctor may recommend routine tests, such as a urine test (urinalysis), blood tests and an electrocardiogram (ECG) — a test that measures your heart's electrical activity. More extensive testing isn't usually needed.


Complications

Excessive pressure on the artery walls can damage your vital organs. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to:

Damage to your arteries. This can result in hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack or other complications. An enlarged, bulging blood vessel (aneurysm) also is possible.
Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
A blocked or ruptured blood vessel in your brain. This can lead to stroke.
Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism — including elevated waist circumference, high triglycerides, low high-density lipoprotein (HDL), or "good," cholesterol, high blood pressure and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.
Uncontrolled high blood pressure also may affect your ability to think, remember and learn. Cognitive impairment and dementia are more common in people who have high blood pressure.


Treatment

Treating high blood pressure can help prevent serious — even life-threatening — complications. Your doctor also may suggest steps to control conditions that can contribute to high blood pressure, such as diabetes and high cholesterol.

Blood pressure goals aren't the same for everyone. Although everyone should strive for blood pressure readings below 140/90, doctors recommend lower readings for people with certain conditions. The goal is 130/80 if you have or have had chronic kidney disease or diabetes.

Changing your lifestyle can go a long way toward controlling high blood pressure. But sometimes lifestyle changes aren't enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. Which category of medication your doctor prescribes depends on your stage of high blood pressure and whether you also have other medical conditions. To reduce the number of doses you need a day, which can reduce side effects, your doctor may prescribe a combination of low-dose medications rather than larger doses of one single drug. In fact, two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication — or combination of drugs — is a matter of trial and error.

The major types of medication used to control high blood pressure include:

Thiazide diuretics. These medications act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. In a 2006 study, diuretics were a key factor in preventing heart failure associated with high blood pressure.
Beta blockers. These medications reduce the workload on your heart, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks — but they're effective when combined with a thiazide diuretic.
Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. ACE inhibitors may be especially important in treating high blood pressure in people with coronary artery disease, heart failure or kidney failure. Like beta blockers, ACE inhibitors don't work as well in blacks when prescribed alone, but they're effective when combined with a thiazide diuretic.
Angiotensin II receptor blockers. These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels. Like ACE inhibitors, angiotensin II receptor blockers often are useful for people with coronary artery disease, heart failure and kidney failure.
Calcium channel blockers. These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Researchers have identified the substance in grapefruit juice that causes the potentially dangerous interaction, which may one day lead to commercial grapefruit juices that don't pose a risk of interaction. For now, however, talk to your doctor or pharmacist if you're concerned about interactions.
Renin inhibitors. A new drug Tekturna (aliskiren) is a renin inhibitor. Renin is an enzyme produced by your kidneys that starts a cascade of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Tekturna acts earlier in your body's blood pressure regulation process than most other blood pressure medications. It also can be used well with the other major classes of blood pressure drugs to improve their actions. Tekturna can be used alone, but it's more effective when used in combination with existing high blood pressure medications, such as water pills (diuretics). Tekturna's effects on blood pressure last more than 24 hours, so it can be taken once daily in oral tablet form.
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:

Alpha blockers. These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.
Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
Central-acting agents. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.
Vasodilators. These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
Once your blood pressure is under control, your doctor may add aspirin to your regimen to reduce your risk of cardiovascular disorders.

Resistant hypertension: When your blood pressure is difficult to control
If your blood pressure has remained stubbornly high despite taking at least three medications from different classes of antihypertensive drugs, one of which is a diuretic, you may have resistant hypertension — blood pressure that is resistant to treatment.

This doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective. You may need to see a hypertension specialist if your primary care doctor isn't able to pinpoint a cause.

Your doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses.

If you don't strictly follow the prescribed medication regimen, your blood pressure can pay the price. If you skip doses because you can't afford the medication, because you have disagreeable side effects or because you simply forget to take your medications, talk to your doctor about solutions. Don't alter your treatment without your doctor's guidance.

In addition, you and your doctor can review medications you're taking for other conditions. Those or other substances or foods can worsen high blood pressure or prevent your medications from working effectively. Be open and honest with your doctor about all the medications, substances, supplements and products you take. Underlying causes of resistant hypertension should also be considered such as sleep apnea and kidney or hormonal abnormalities.


Self-care

Lifestyle changes can help you control and prevent high blood pressure — even if you're taking blood pressure medication. Here's what you can do:

Eat healthy foods. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat. Limit the amount of sodium in your diet. Although 2,400 milligrams (mg) of sodium a day is the current limit for otherwise healthy adults, limiting sodium intake to 1,500 mg a day will have a more dramatic effect on your blood pressure.
Maintain a healthy weight. If you're overweight, losing even 5 pounds can lower your blood pressure.
Increase physical activity. Regular physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.
Limit alcohol. Even if you're healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation — up to one drink a day for women, two drinks a day for men.
Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.
Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.
Practice slow, deep breathing. Do it on your own or try device-guided paced breathing. In various clinical trials, regular use of Resperate — an over-the-counter device approved by the Food and Drug Administration to analyze breathing patterns and help guide inhalation and exhalation — significantly lowered blood pressure.


 


Coping skills

High blood pressure isn't a problem that you can treat and then ignore. It's a condition you need to manage for the rest of your life. To keep your blood pressure under control:

Measure your blood pressure at home. Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications.
Take your medications properly. If side effects or costs pose problems, don't stop taking your medications. Ask your doctor about other options.
Schedule regular doctor visits. It takes a team effort to treat high blood pressure successfully. Your doctor can't do it alone, and neither can you. Work with your doctor to bring your blood pressure to a safe level — and keep it there.
Adopt healthy habits. Eat healthy foods, lose excess weight and get regular physical activity. Limit alcohol. If you smoke, quit.
Manage stress. Say no to extra tasks, release negative thoughts, maintain good relationships, and remain patient and optimistic.
Sticking with all this can be difficult — especially if you don't see or feel any symptoms of high blood pressure. If you need motivation, remember the risks associated with uncontrolled high blood pressure. It may help to enlist the support of your family and friends as well.


Ref: Mayo Health Clinic - www.mayoclinic.com

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Put Nightmares To Bed.

Nightmares can be triggered by factors including stress, medications, fear, sleep disorders, or a recent loss.


Here are suggestions to help conquer bad dreams, courtesy of the U.S. National Library of Medicine:

Reduce stress by talking to friends and relatives about what's bothering you.
Try relaxation techniques to reduce stress and anxiety.
If you started having nightmares after starting a new medication, talk to your doctor to find out if it could be causing your sleep problems.
If you're taking illegal drugs or drinking alcohol to excess, join a support group to help you stop using these substances.
Get regular exercise.
Start a regular sleep schedule. Going to bed and waking up at the same time each day may help prevent nightmares.

Ref: Healthday News.

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Do You Really Believe Those Weight Loss Ads?

The answer must be "yes" because the ads never stop.

I was especially revolted by a recent full-page newspaper ad introducing "Akävar 20/50," which began with the large-print headline, "Eat all you want and still lose weight!" and then followed up that doozie with, "And we couldn't say it in print if it wasn't true."

The advertisement went on to call the product "a major medical breakthrough" and, finally, included the obligatory outsized picture of an attractive young woman, whose relationship to the product, if any, was not described.

Of course, none of these statements is true. It is impossible to eat all you want and lose weight; and leading newspapers admit they pay no attention to the content of the ads they publish. Thus, pushers of fake weight-loss products can print whatever lies their senses of shame will permit. Major medical breakthroughs are in fact uncommon and, certainly, this product is not one of them.

Not surprisingly, the advertisers don't mention the composition of their product or exactly how it is supposed to work. Akävar apparently reduces appetite, but is also said (alarmingly) "to literally pull fat from all over your body." And you can get these benefits for only $39.99, for a two-month's supply.

Also mentioned in the ad is a study in which 23 out of 24 participants who used Akävar's "active compound" (whatever that may be) lost weight. My calls to the company to find where this study is published led to a runaround that left me without this information.

Soon after my dealings with the folks at Akävar, I came across a less-dramatic advertisement that mentioned something called "fucoxanthin," the active component of a weight-loss product called FucoTHIN. According to this ad, the "fucoxanthin contained in FucoTHIN actually burns fat."

I had never heard of fucoxanthin and so I searched online to verify its existence and fat-burning abilities. Sure enough, fucoxanthin is a carotenoid that gives the color to brown algae. A recent Japanese study, published in the reputable scientific journal Biochemical Biophysical Research Communications, found that feeding this carotenoid to mice or rats diminished the fat content in their bodies and stimulated the burning of fat.

Sounds good — and it's not surprising that FucoTHIN outperformed all five competitors mentioned, since the ad was paid for by FucoTHIN's manufacturer. But does fucoxanthin work in people? And, if so, how much is needed to burn enough fat for weight loss? And is it safe? Who knows?

If you are interested in reading glowing reviews of other equally worthless weight-loss products, you can check out "the Top 10 Best Diet Pills!." (Ironically, ConsumerPriceWatch's diet-pill raters found that Akävar 20/50 "scored poorly on Overall Value and Weight Loss Power."

A much more useful site is one hosted by the Federal Trade Commission and the Competition Bureau of Canada, which first sucks visitors in with fake ads for an eggplant extract (called "FatFoe") that supposedly burns fat, but which then educates consumers about diet rip-offs. According to the FatFoe Web site, a product is probably a diet rip-off if its advertisements promise that:

it can "burn" — or block absorption of —f ats, carbohydrates, or calories
it can make you lose more than three pounds per week
it will work for everyone
it will cause you to lose weight permanently
it's a patch, cream, gel, etc., that can help you lose weight
Such bogus ads will usually also promise that you can eat all your favorite, high-calorie foods and still lose weight, and that you will be able to lose weight without having to diet or exercise.

I would only add to this useful list any advertisement stating that a product is either "guaranteed" or a "breakthrough." The only thing you're guaranteed to lose is your money.

Ref: John Hopkins University.

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Back Pain - Herniated Disc, The Cause.
A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). As we age, our vertebral discs lose some of the fluid that helps them maintain flexibility. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments. See an illustration of a herniated disc.

Injury to the disc can occur from:

A sudden heavy strain or increased pressure to the lower back. Sometimes a sudden twisting movement or even a sneeze will force some of the nucleus—the material inside the disc—out through the disc's outer layer (annulus or capsule).
Activities that are done over and over again that may stress the lower back, including poor lifting habits, prolonged exposure to vibration, or sports-related injuries.

Author: Kerry V. Cooke
Medical Review: Adam Husney, MD - Family Medicine
Robert B. Keller, MD - Orthopedics

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Fibromyalgia.

What is fibromyalgia?
Fibromyalgia is a long-term problem that causes pain in the muscles and soft tissues of your body. You may lack energy or have trouble sleeping. These and other symptoms can be severe enough to affect your work and home life. But fibromyalgia does no permanent damage to your muscles, joints, or organs.

Fibromyalgia is a syndrome—a set of symptoms that occur together but do not have a known cause.

What causes fibromyalgia?
There are theories as to what may cause fibromyalgia, but at this point there is not enough evidence to support any single cause. Some experts think that fibromyalgia may be related to nerve cells that are too sensitive. Others think that chemicals in the brain (neurotransmitters) may be out of balance. Or it may be related to disturbances of the deep phase of sleep.

What are the symptoms of fibromyalgia?
Most people with fibromyalgia have pain in their muscles, soft tissues, back, or neck, as well as sleep problems. Many people get so tired (fatigued) that they become weak. If pain and fatigue are severe enough, the person can become disabled. A more specific sign of fibromyalgia is the presence of up to 18 specific tender points on the body. These are painful only when you press directly on them.

Although they are less common than pain, fatigue, and sleep problems, a variety of other symptoms may occur as well. These include headaches, morning stiffness, trouble concentrating, and irritable bowel syndrome. As with many conditions that cause chronic pain, it is common for people with fibromyalgia to have anxiety and depression. These can make symptoms worse.

Symptoms tend to come and go. Times when they are constant (flares) may be followed by times when they occur less often with less intensity, or are absent (remissions). Some people find that their symptoms are worse in cold and damp weather, during times of stress, or when they try to do too much.

How is fibromyalgia diagnosed?
Doctors diagnose fibromyalgia based on two things. One is widespread pain, defined as pain on both sides of the body above and below the waist. The other is tenderness in at least 11 of 18 tender points when pressed.

How is fibromyalgia treated?
There is no cure for fibromyalgia, but doctors can treat and control the symptoms. If you have fibromyalgia, you can help manage the symptoms by taking an active role in your treatment.

Treatment may be different for each person. It can include:

Getting regular exercise to help with muscle aches and stiffness.
Changing your routine, schedule, and surroundings to improve your sleep habits and reduce stress.
Taking medicine to help you sleep better and to relieve pain.
Getting counseling to help you to manage long-term (chronic) pain and find better ways to handle stress.
Some people with fibromyalgia also find complementary therapies helpful. These include acupuncture, massage, behavioral therapy, and relaxation techniques.

Author: Shannon Erstad, MBA/MPH
Medical Review: Martin Gabica, MD - Family Medicine
Benjamin Natelson, MD - Neurology, Chronic Fatigue Syndrome

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Depression

Symptoms

If you have depression, you may feel hopeless and sad or stop feeling pleasure from almost everything you do. You may feel “down in the dumps,” tearful, or discouraged. You may also be irritable or anxious or have low energy levels. The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that you might have depression.

The two most significant symptoms of depression are: 3

Sadness or hopelessness.
Loss of interest in or pleasure from most daily activities.
Other symptoms include:

Losing or gaining weight because of changes in appetite.
Sleeping too much or not enough.
Feeling restless and unable to sit still, or feeling that moving takes a great effort.
Feeling tired all the time.
Feeling unworthy or guilty without an obvious reason.
Having problems concentrating, remembering, or making decisions.
Thinking often about death or suicide.
If you have at least five of these symptoms for 2 weeks or longer, and one of the symptoms is either sadness or loss of interest, you are diagnosed with major depression. But, if you have fewer than five symptoms, you may still be depressed and need treatment.

If you have 2 to 4 symptoms for a period of at least 2 years (1 year for a child), you may have a long–term form of depression called dysthymic disorder (dysthymia).

Many women experience mood changes before menstruation. Physical and emotional premenstrual symptoms that interfere with relationships or responsibilities are known as premenstrual syndrome (PMS). However, women who have emotional and physical premenstrual symptoms that seriously interfere with daily life may have a type of depression known as premenstrual dysphoric disorder (PMDD). For more information see the topic Premenstrual Syndrome (PMS).

Many health professionals see people with general symptoms that may be difficult to link to depression. These symptoms, which commonly occur with depression, include:

Having headaches and other body aches and pains.
Having digestive problems, including constipation or diarrhea.
Losing interest in sex or being unable to perform sexually.
Feeling anxious or worried without an obvious reason.
Blaming yourself or others for your depression.
Not moving or talking for hours.
Other symptoms of depression may include: 4, 3

Overeating and weight gain (rather than loss of appetite).
Oversleeping (rather than insomnia).
Increased tearfulness, anger, and generally not feeling well, along with anxiety and tension.
Sometimes, a feeling of heaviness in the arms and legs.
Sensitivity to rejection.
Depression is a serious problem for people of any age, and older adults with symptoms of depression should seek treatment right away. Depression in older adults can cause confusion or forgetfulness (although some medications can cause these symptoms as well). Depression has also been identified as a significant risk factor for death in older adults with heart problems. 5

It is important to recognize the early warning signs of depression so that you can get treatment. If you think you may have depression, take a short quiz to evaluate your symptoms:

Interactive Tool: Are You Depressed?
The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that you might have depression. Symptoms of depression in children and teens are sometimes different than adult symptoms, which can make it more difficult to diagnose and treat. For more information, see the topic Depression in Childhood and Adolescence.

Depression can lead to suicide. The warning signs of suicide change with age.

Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.
Warning signs of suicide in adults may include alcohol or substance abuse, recent job loss, or divorce.
Warning signs of suicide in older adults may include the recent death of a partner or diagnosis of a life-limiting illness.

Author: Stuart J. Bryson
Medical Review: Patrice Burgess, MD - Family Medicine

[rangi15]

Sleep: What's Going On Behind That Shut Eye?

Have you ever watched someone sleep and wondered what he or she was dreaming? The person’s outward appearance would never give it away: slow breathing, eyes occasionally fluttering, but mostly the very picture of peace and stillness. But, appearances can be deceiving. When people sleep, there’s a lot more going on than meets the eye. The notion of sleep as the body’s ultimate “down time” has some truth to it, but sleep is also an active process, in which the brain can be remarkably active, even if the body remains (mostly) immobile.

What’s Going On During Sleep?
There is much about sleep that remains mysterious, but experts divide it into two main categories, based on observations of sleeping persons and recordings of the brain’s electrical activity during sleep:

Non-REM sleep– This is divided into four stages, with Stage 1 the lightest and Stage 4 the deepest.

Rapid-eye movement (REM) sleep - During REM sleep, dreaming is common, muscles (other than the eyes) are inactive, and electrical activity in the brain is similar to that of an awake person. The blood pressure and heart and breathing rates may suddenly increase for short periods of time, just as they do during wakefulness

During a typical eight-hour period of sleep, a person drifts from wakefulness to Stage 1 non-REM sleep, through Stages 2, 3 and 4 and finally REM sleep over the first several hours. During the last half of the night, REM sleep and Stage 2 sleep alternate for 90 to 120 minutes each. As we age, brief awakenings increase in frequency, while deeper stages of non-REM sleep decrease.

Why Do We Sleep?
The function of sleep is not entirely clear, but researchers believe that REM sleep is important for solidifying memories, and perhaps for even more critical functions. Rodents completely deprived of REM sleep die after a few weeks. Non-REM sleep, meanwhile, seems to be important in providing a sense of restored energy and ability to concentrate during the day. A number of theories about sleep attempt to explain its role or roles: a restorative for the mind and body in preparation for the day ahead; or a way of reducing energy consumption, to save energy for activities occurring during the day. Some scientists believe that sleep is evolution’s way of improving survival by preventing animals from preying on each other 24 hours a day.

Consequence of Sleep Deprivation
It is hard to define just how much sleep is normal; different people seem to need different amounts. Sleep experts define “enough” sleep as how long a person would sleep if there were no alarm clocks; that is, left to decide entirely on your own, how long would you sleep? The other way to define it is how long one needs to sleep in order to feel alert and rested the next day. However, duration of sleep is not the only thing that matters –; the quality of sleep also matters.

Too little sleep or poor-quality sleep can cause a number of problems, including difficulty with short-term memory, concentration, depression, anxiety, irritability, poor energy and reduced libido. In short, quality of life at work and at home may suffer terribly due to insufficient or poor sleep. All of these problems may resolve when sleep duration increases or sleep quality improves.

One problem related to sleep deprivation deserves particular emphasis: Automobile and truck accidents attributed to sleepy drivers account for thousands of deaths each year.

Although the impact is uncertain in humans, sleep-deprived rodents have reduced immune function and higher susceptibility to infection.

Sleep Disorders
There are more than 80 individual sleep disorders, but they are divided into 4 main categories:

Dyssomnias, in which there is insomnia (difficulty initiating or maintaining sleep), sleepiness during the day, and abnormal sleep-wake timing; examples include sleep apnea and the effects of medications or alcohol

Parasomnias, in which there is abnormal behavior around sleep, but without excessive sleepiness or insomnia; examples include sleepwalking or night terrors

Medical-psychiatric sleep disorders, in which a condition that causes other problems disrupts or impairs sleep; examples include anxiety, depression, Parkinson’s disease, dementia or gastroesophageal reflux disease (GERD)

Sleep problems that cannot be clearly separated from normal variation, or for which there is no consensus among experts; examples include pregnancy-associated sleep disorder and sleep hyperhidrosis (excessive and unexplained sweating during sleep)

Good Advice for Getting a Good Night’s Sleep
There are changes you can make to improve your chances of getting a good night’s sleep. Sleep experts call this “sleep hygiene,” and these measures are routinely recommended for almost anyone complaining of sleep trouble. Some are just common sense, but, unfortunately, many people for whom sleep is a problem do not recognize their importance. Here are some general guidelines to follow:

Establish a schedule and stick to it; sleep when you are sleepy but try to get up and go to bed each d