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Sleep deprivation
and snoring can endanger health Never ignore leg
pain if you are obese Role of exercises
in managing fatigue syndrome Health
Notes
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Sleep deprivation and snoring can endanger health While the song “Yaad mein teri rat bhar karvatein badalte hain” may bring back the romantic nostalgia of the 1970s, it highlights the perils of sleep deprivation in medical parlance. Those who do not get enough sleep may be subjecting their bodies to various health concerns that can range from mild fatigue to severe heart attacks. Chronic sleep deprivation can cause body pain, memory loss and difficulty in learning. It can also lead to weight gain and diabetes, and mistakes such as medical errors, air traffic mishaps and accidents. In the long run, it can alter immune functions besides mood changes like irritability, impatience, inability to concentrate and even sterility and impotence. The sleeplessness can also cause wrinkles on the face, cold and flu, high blood pressure and obesity. If a person has excessive daytime sleepiness along with night time snoring, a condition called obstructive sleep apnoea (OSA), many problems can arise. Often, snoring (khurrate marna) has been taken amusingly by various people. Remember, snoring is no laughing matter. It is a serious health issue and you can ignore it at great health peril. Untreated OSA can severely affect the quality of married life, health and mortality, and can be a contributing factor to several health problems as mentioned above. The possibility of this disorder increases with a person’s age and weight. The redeeming feature is that OSA is now manageable.
What is OSA?
Sleep apnoea — cessation of breathing during sleep at night for 10 seconds or more — affects about 20 per cent of the adult population. When an apnoea occurs, sleep is disrupted. Sometimes this means the person wakes up completely, but sometimes this can mean the person comes out of a deep level of sleep and into a more shallow level. It is estimated that about 90 per cent people with OSA remain undiagnosed and less than 1 per cent get treated. Research shows that 50 per cent of type2 diabetics also have OSA. In a patient with high blood pressure, stroke, daytime sleepiness, ischemic heart disease, OSA can worsen the situation. There are an estimated 30 million suspected sleep apnoea sufferers in the urban and metro areas alone in India, and there are only about 100 sleep laboratories in the country to cater to these patients. How to help so many sleep sufferers? Sleep apnoea is detected through ApneaLink, a compact automatic device that records the apnoea index, snoring, oxygen desaturation and pulse during sleep, and determines whether a person has sleep apnoea. The device can be comfortably worn by the person just before sleeping. It is an overnight study that can be done at the privacy and comfort of a person’s home. In the morning, a simple, summarised and easy-to-interpret report with a colourcoded risk indicator is generated for the doctor to diagnose the existence of OSA.
CPAP treatment
Once a person is diagnosed as a patient of OSA, the doctor prescribes continuous positive airway pressure (CPAP) therapy. It is the most common and widely accepted treatment for OSA. It is safe, effective and non-invasive, and does not require drugs or surgery. In CPAP therapy, a portable bedside device gently pushes air via a mask and the slight air pressure keeps the airway open and prevents apnoeas from occurring. Earlier CPAP devices were complex and bulkier. However, with technological advancements driven by innovation, CPAP devices have become smaller, lighter, and more sophisticated. Patient compliance and comfort levels have been enhanced. However, awareness and accessibility still remain a challenge. By eliminating apnoeas, CPAP therapy improves a person’s sleep, reduces OSA-related health risks and enables him/her to lead an energetic, healthy and potentially longer life. Among diabetics, CPAP therapy has shown improved insulin sensitivity, aftermeal blood glucose and HbAlC level, blood pressure and cardiovascular health, and reduced diabetesrelated complications. It also prevents marital discords due to snoring. The writer is a Chandigarh-based author of medical books
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Never ignore leg pain if you are obese There are multiple causes responsible for this condition, but the common ones are mostly diagnosed and treated successfully. However, there are fairly common causes that are mostly missed by the doctor due to lack of knowledge or some other reason. These are mostly vascular causes related to the arteries or the veins. The commonest venous cause is due to venous hypertension, mostly secondary to varicose veins. As we know, varicose veins are easy to diagnose as they are obvious to the patient and the doctor. However, in obese legs these veins are not visible and so missed for years. The patient continues to suffer from severe leg pain and later develops colour changes at the ankle (stasis dermatitis). If still not diagnosed, he or she starts to develop an ulcer at the site of the previous discolouration. This only adds to his misery. The easiest way to diagnose it is by doing a colour Doppler study. The normal vein which is 2 mm in size may have increased to over 10 mm in size causing venous hypertension and is responsible for the severe leg pain followed by colour changes at the ankle and ulcer. Once the diagnosis has been made, the treatment is fairly simple. Initially, we start with elevation and stockings. At night we elevate the legs (toes above the level of the nose) while during the day we wear stockings before getting out of bed in the morning and doing normal activity. Remove them when we take a bath and put them on again. Normal activity is recommended all day. The stockings are removed at night when we get into bed. This surely gives relief but is, by no means, curative. You will still develop the complications of varicose veins — dermatitis, ulcers, bleeding, inflammation (phlebitis) and DVT. However, they may take longer to develop. Then there is surgery which today is done by an endovenous technique where a laser fiber or radio-frequency catheter is inserted into the vein through a needle puncture and the diseased vein is obliterated. This is a minimally invasive, scarless surgery easy to perform and is very patient-friendly. It is a day-care surgery where the patient does not stay in the hospital overnight and returns to work in a couple of days. The painful obese legs are no problem as the pain disappears. The writer, a senior surgeon, is associated with Batra Hospital, New Delhi.
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Role of exercises in managing fatigue syndrome Individuals visiting clinics with chronic shifting pains are often not taken seriously. Diagnosis could also be frustrating and is usually arrived at by exclusion. Fibromyalgia or the chronic fatigue syndrome is more prevalent than is commonly thought of. This condition is characterised by widespread pain and stiffness in the muscles, joints and tendons. The disease afflicts millions of people, particularly females, between the age of 30 and 35 years. Family members are irritated by constant complaint and nagging regarding pain by the patient. The pain experienced is genuine, although there is no localised inflammation or damage to the tissues. The durations of symptoms may vary from months to years. No specific tests are available to diagnose this condition. Treatment is done on the basis of the presence of tender spots on different parts of the body. Slightest pressure on these tender points leads to pain and distress. Pain all over the body, particularly on pressing the bones, could also be due to calcium/vitamin D deficiency, especially in menopausal women. It is believed that the symptoms due to fibromyalgia may be owing to some chemical changes in the brain, the history of past injury, certain viral/bacterial infection, sleep disturbances, etc. Some symptoms indicate thyroid hormone disease, rheumatoid arthritis, neuropathies, etc. Among such symptoms are muscular pain, anxiety and sleep disorder. Treatment is a combination of medication and physical therapy. It is important to encourage patients to have a positive attitude which helps in early recovery. Analgesics, muscle relaxants and anti-anxiety drugs help in reducing pain and improve sleep. Some doctors believe that exercises may worsen the symptoms. So, patients are advised rest. The fact is that exercises play a major role in the treatment of fibromyalgia. Exercises strengthen muscles, provide sound sleep and improve the overall sense of well-being. Aerobic exercises improve the functioning of the heart and lungs, leading to a decrease in blood pressure, the cholesterol level, etc. Due to inactivity (because of pain and fatigue) exercises should be initiated slowly and increased gradually so that the body gets acclimatised. A vigorous exercise programme and over-exertion can make the symptoms worse. Starting with three to five minutes of low impact aerobic exercises like walking, cycling and swimming, increase these by one minute per session every third or fourth day until one exercise is done for a period of 20 to 30 minutes. Ideally, the exercises should be done up to 40 minutes at least three times a week. But one should not try to meet unrealistic goals. Stretching exercises as in yoga help in improving flexibility, reducing joint and muscle stiffness, etc. Here are some exercises: Low back stretch-Lying on the back with the knees bent, press the lower back against your bed. Repeat five times and then pull both knees to the chest. Hold for five seconds and release slowly. Repeat ten times Shoulder rolls Raise the shoulders five times, then squeeze them first in front and then in the back five times. While standing breathe in deeply and slowly, raise your arms upwards as high as possible. Then bring the arms straight to the sides. Repeat this five times. Neck Stretch Hold the right side of the head with the left hand. Gently pull it towards the left shoulder. Repeat on the other side. Leg lifts Lying in side on the position, raise and lower each leg 10 times. Deep breathing exercises and meditation help in reducing the stress level. When suffering from fibromyalgia, having a positive attitude and following a regular exercise regimen can prevent pain, anxiety and many other problems. The writer is a former doctor/physiotherapist, Indian cricket team.
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Health Notes Melbourne: Stressed people who consume five cups of coffee per day to deal with stress can exhibit signs of hallucination, according to a La Trobe University study. Prof Simon Crowe from the School of Psychological Sciences, who examined the effect of stress and caffeine on 92 participants, found that the stressed people who had consumed about 200 mg of caffeine during the day were more likely to imagine hearing things. “What we did is we brought people into the lab while listening to White Christmas and then told them we were going to play some white noise,” News.com.au quoted him as telling mX.
— ANI
Excessive usage of computers, mobiles leads to a hunchback
London: Doctors have warned that excessive use of mobiles for texting, e-mailing, choosing a song on the iPod could lead to a hunchback, as it requires constantly looking down. Despite making communication easier, the new technology has exposed us to a gamut of upper back-related problems, especially the neck area. “If you’re constantly looking down, you develop a forward curvature that rounds the whole spine,” the Daily Mail quoted Kirsten Lord, Managing Director of the Edinburgh Physiotherapy Centre and a chartered physiotherapist, as saying. “Your shoulders come forward and become more rounded, and standing upright and lengthening the neck may feel abnormal because the muscles you need to use have become shortened through lack of use,” she explained.
— ANI
Peptide that can block chronic pain
London: A new study, led by an Indian-origin scientist at the Indiana University School of Medicine, has reported the discovery of a peptide that short-circuits a pathway for chronic pain. Unlike current treatments, this peptide does not exhibit deleterious side-effects such as reduced motor coordination, memory loss, or depression. The peptide, CBD3, has been shown in mice to interfere with signals that navigate calcium channels to produce pain. Unlike other substances that block pain signals, CBD3 does not directly inhibit the influx of calcium. This is important as the influx of calcium regulates heart rhythm and vital functions in other organs.
— ANI
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Leg pain is one of the most common problems all over the world and causes a lot of distress to the sufferer. The patient has normally been to a lot of doctors and has been prescribed a host of pain killers, still he/she continues to suffer.