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| HEALTH & FITNESS |
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Obstructive sleep apnoea — a snorer’s disease
Doctor says
EYESIGHT
Coping with old age, psychologically
Health Notes
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Obstructive sleep apnoea — a snorer’s disease
Are you having a pause in breathing during sleep? If yes, you may be suffering from sleep apnoea. Complete or partial obstruction of the airway during sleep causes loud snoring, a fall in body oxygen and frequent arousals. As a result, the sufferer has unrestful sleep and excessive daytime sleepiness. Incidence of hypertension, heart attack and stroke is higher in such patients. These patients often have impotence and emotional problems, depression, mood changes, poor memory, irritability and impaired concentration. What are the causes? Sleep apnoea is caused by repetitive airway obstruction during sleep as a result of the narrowing of the upper respiratory passages. Such patients are often overweight, with extra fats deposited in throat and / or with an increased size of the velum and tongue leading to decreased upper airway lumen. Decreased airway muscle tone during sleep and falling of the tongue backward in the lying posture further reduce airway opening, thereby hindering airflow. Patients with a severe form of the disease may have such episodes hundreds of times in an hour. This sleep fragmentation causes sleep deprivation and hence excessive daytime sleepiness. How to diagnose sleep apnoea? Even though sleep apnoea is as common as asthma and diabetes, it often remains undiagnosed. The studies suggest that middle-aged 2 per cent women and 4 per cent men have symptomatic obstructive sleep apnoea. Since it is associated with significant misery and mortality, the disease must be suspected in the patient who complains of snoring or daytime sleepiness to pick up such cases at the earliest. All suspected cases must undergo the “polysomnography test’ [sleep study] to confirm the diagnosis. In this technique, multiple physiologic parameters are measured while the patient sleeps in a laboratory. How does a typical case behave? Most patients are overweight and typically have a short, thick neck. Middle-aged men and post-menopausal women are at a higher risk for the disease. The patient is often brought to the doctor by a family member who is being disturbed by the patient’s loud snoring. The partner may describe episodes in which the patient stops breathing and then gives a loud gasp when aroused by the breathing cessation. The snoring and breathing cessation episodes may be worse after the patient drinks alcohol or takes sleeping pills, because these decrease throat muscle tone. Frequently, the patient falls asleep during sedentary activities, such as watching television or movie. In severe disease, the patient may report falling asleep in embarrassing situations, such as during meals or when sitting in a car stopped at a traffic light. The patient also complains of being tired on awakening in the morning. The patient often has to nap during the day but typically wakes up unrefreshed. What are the treatment choices? The options include Continuous Positive Airway Pressure [CPAP] treatment, wearing an oral appliance at night, surgery and lifestyle changes like smoking cessation and weight loss. However, CPAP is the most common, most effective treatment and is considered as gold standard for these patients. With CPAP, the patient wears a snugly fitting nasal mask attached to a fan that blows air into the nostrils to keep the airway open during sleep. Actually, it serves as “air splint” that keeps the airway from collapsing, thereby preventing breathing cessation. The writer is Head, Department of Pulmonary Medicine, Govt. Medical College and Hospital, Chandigarh.
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Doctor says
Incontinence, put in simple terms, is a state in which a person loses control over his/her bladder, leading to involuntary urination. It could either be a temporary phase, lasting a few hours or days, or, in extreme cases, can assume embarrassing proportions. Incontinence is of various types and can strike any person, at any stage. The condition can be prevented or treated, yet it has been a cause for concern because it can lead to various other ailments. A stressed and sedentary lifestyle adds to the problem. What are the main causes of urinary incontinence? Thinning and drying of the skin in the vagina or urethra, especially after menopause, weakened pelvic muscles, certain medicines, build-up of stool in the bowels, not being able to move around, urinary tract infection and diabetes are some of the major causes. Types of urinary incontinence: There are two types of urinary incontinence. One is called stress incontinence, which occurs when urine leaks because of sudden pressure on your lower stomach muscles. Such pressures are there when you cough, laugh, lift something or exercise. It usually occurs when pelvic muscles are weakened. The other is the urge incontinence that occurs when the need to urinate is felt too fast — before you can get to a toilet. Your body may only give you a warning of a few seconds before you urinate. It is most common in the elderly. How to prevent this disease? The best way to prevent and delay incontinence is to maintain a diet rich in protein and fibre, and have a regular exercise regimen. Young mothers should ensure that they regularly perform pelvic floor exercises to keep the urinary tract and bladder healthy. Will medicine or surgery help? Medicine helps in some cases. In the case of women who have mild stress incontinence, surgery, too, can be helpful. It is usually done if other things haven’t worked or if incontinence is severe. Surgery: A number of different procedures are available. Less invasive surgery to implant a sling to support the urethra may be suitable for some women. In conversation with
Anuja Jaiswal
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EYESIGHT
The worldwide prevalence of glaucoma is increasing. This is due, in part, to the rapidly aging population. At present there are more than 60 million people worldwide with glaucoma. Most interesting, about half of the people who have glaucoma don’t even know it. Glaucoma leads to blindness by damaging the optic nerve. Elevated pressure in the eye is a risk factor, but even people with normal pressure can lose vision to glaucoma. In terms of treatment, there is a challenge to diagnose and treat glaucoma before vision loss has occurred. The major hurdle to the prevention of glaucoma blindness is the fact that the patient never has any symptom. There have been many advances in the diagnosis and treatment of glaucoma. Risk factors
A patient with these risk factors should get his eye check-up done regularly to rule out the possibility of glaucoma, and should especially inform the doctor. Over the years glaucoma cases were diagnosed and monitored on the basis of intra-ocular pressure (IOP), visual field changes and optic nerve changes. Now it is known that IOP is affected by the central corneal thickness (CCT) of the patient. So, before labelling a person to have glaucoma it is mandatory to assess his CCT. The second advancement is regarding the nerve fibre layer analysis (RNFL) with the help of OCT. This is known to detect glaucoma at a stage where visual field changes are not manifest. That is why it detects glaucoma at a very early stage where it is much easier to treat. Newer advances are available with the visual field testing as well, where better techniques are available to detect the progression of glaucoma. The key to preserving vision is timely diagnosis and treatment through regular complete eye examinations. The main aim of glaucoma treatment is to allow the glaucoma patient to maintain his or her independence and quality of life. The writer is Chairman and Medical Director, Centre for Sight, New Delhi.
Email: drmahipal@gmail.com |
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Coping with old age, psychologically
Though old age is equated with wisdom and experience and is accorded universal respect, it is surprising to see that the very thought of growing old depresses most people. Somehow the later years of life are also identified with a number of negative emotions like stress, anger, fear and helplessness. It seems the truth regarding old age is more subjective and a person can shape his/her life and time with one’s attitude, either positive or negative. Since ancient times it has been understood that human mind is a powerful entity endowed with an inestimable capacity to influence our lives. All our actions, moods and emotions, which are controlled by the mind, have their bearing on our health. It is an established fact that by learning to use and control the power of our mind we can bring all-round positive changes in our lives. Positive attitude is a remarkable asset in all stages of life, but in old age it helps us to recognise the inevitability of the ageing process and also inspires us to develop a feeling of self-worth. There is no denying that a balanced lifestyle is necessary for a vibrant old age, and factors like diet, exercise and time management help us to maintain good health. But, above all, it is the our attitude towards life which holds the key to shaping many things in our favour. Modern researchers have found that psychological factors not only influence the health status of a person but also decide longevity. Persons who tend to always remain unsatisfied with their work and are in the habit of worrying without any reasonable cause or are caught in the web of financial burden, nurture bad temperament and fault-finding nature accelerate their own ageing. On the other hand, certain positive aspects like balanced lifestyle, job satisfaction, feeling of personal happiness, financial security or the practice of living within the means coupled with the capacity to make adjustments with the family always keep an old person in happy mode. Old age is generally associated with a number of ailments. Heart trouble, arthritis, hypertension, diabetes, insomnia and impairment of digestion or IBS are some of the age-related problems, which are best handled with a positive attitude. Conditions like stress, depression, irritability and the helplessness to change oneself aggravate these diseases. Loneliness or death of a close relative or spouse often bring negative feelings in old persons which can be best tackled by making them remain actively engaged in satisfying hobbies and interacting with friends. Good health in the shape of mental soundness and physical workability to look after one’s daily chores is necessary to enjoy the growing years. How much an old person can work depends upon personal choice or circumstances. Many elderly persons with advancing age start getting solace in spiritual vocations. But old age in no way puts restrictions on a person’s ability to enjoy and find satisfaction in life and also in being a useful citizen. Acharya Charaka has written that excellence of speech, thought and action can help to a great extent make a person graceful and acceptable in all stages of life. Aging is an inevitable process and we should not forget that it is the positive mindset which makes a person happy and peaceful, leading to a more joyous and fulfilling old age. The writer is Ludhiana-based senior ayurvedic physician. E mail:
yourhealth@rediffmail.com |
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Health Notes
Probiotic’s health benefits can extend to the entire body
Washington: New research suggest that the health benefits of a probiotic bacterial strain of human origin called Bifidobacterium infantis 35624 — known for its ability to modulate the inflammatory response in irritable bowel syndrome — extend to the entire body.
“Inflammation is a major factor in a number of chronic diseases affecting millions of people and can cause an unwanted impact on healthy tissue,” said Dr. Liam O’Mahony, lead investigator of the study published in the Public Library of Science (PLoS) Pathogens.—
ANI
Acne drug “may cause
more abortions”
Sydney: Using the controversial acne drug Roaccutane could lead to more abortions, according to specialists.
Roaccutane is used for the treatment of severe, persistent acne, but it has made headlines in recent years for its unproven links with depression and suicide.
According to dermatologists, a move by health authorities to allow GPs to prescribe the heavy-duty medication will push up prescription rates and endanger patients.
Dr Stephen Shumack, secretary of the Australasian College of Dermatologists, said that there was a risk that patients would not be informed of the dangers of birth abnormalities among babies born to women taking Roaccutane, forcing them to require an abortion. — ANI |
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Tips for healthy heart
SMOKING: If you smoke, the single most important thing you can do to protect your heart is to give up. Smokers are almost twice as likely to have a heart attack as people who have never smoked, because smoking damages the lining of the arteries, leading to the build up of atheroma. DIET: A healthy diet helps you maintain a healthy weight; lowers your blood cholesterol level; keeps your blood pressure down; helps prevent the build-up of fatty material; and prevents blood clots from forming. Eat five portions of fruit and vegetables a day and avoid saturated fat. EXERCISE: The heart is a muscle and needs exercise to keep fit. The British Heart Foundation recommends at least 30 minutes of moderate intensity physical activity five or more times a week. This should make you breathe more heavily than normal and feel slightly warmer. It's important to choose activities you enjoy, which may be swimming, cycling, walking, gardening and even sex. ALCOHOL: Moderate drinking, of one or two units a day, helps protect the heart from coronary heart disease. But excessive alcohol consumption causes high blood pressure — one of the risk factors in cardiovascular disease. —
The Independent |
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Prof Arup K. Mandal, Head of the Urology Department, PGI, talks about urinary incontinence in women:
London