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Posts Tagged ‘therapy

mind-racing

Insomnia can make you feel like your mind is racing out of control. A revealing new study explains why your brain may be unable to put the brakes on your thoughts. It links the problem to low levels of a brain chemical.

A new study shows that GABA levels are reduced by 30 percent in adults with chronic primary insomnia. The study was published in the Nov. 1 issue of the journal Sleep.

GABA is reduced in the brain of individuals with insomnia, suggesting over activity is present. It was explained that low GABA levels create an imbalance of brain activity. This may lead to an inability to shut down waking signals in the brain.

If your GABA levels are low, then your mind can’t slow down. It may race forward at full speed even when it is time to sleep. An over active mind is a key feature of psychophsicological insomnia. At bedtime you are unable to stop thinking and worrying. Your body may be ready for sleep, but your mind remains alert. This state of “hyperarousal” can make it hard for you to fall asleep.

Most with insomnia have “secondary” insomnia. It occurs along with another medical problem, mental illness or sleep disorder. It also may result from the use of a medication or substance. In contrast primary insomnia is unrelated to another health problem. Estimates that about 25 percent of people with insomnia have primary insomnia. The study only links low GABA levels to long lasting, primary insomnia.

All participants in the study had been suffering from primary insomnia for mor than six months. The average duration of their symptoms was about 10 years. The GABA connection affirms that primary insomnia is a legitimate disorder.

Recognition that insomnia has manifestations in the brain may increase the legitimacy of those who have insomnia and report substantial daytime  consequences. It was also explained that insomnia can affect your energy, concentration and mood. It also increases your risk of depression.

One solution for the problem of primary insomnia is the use of hypnotic medication. The short-term use of a sleeping pill can help break the cycle of sleepless nights. The study notes that many of the most effective sleeping pills increase activity at the GABA neurons.

Another treatment option is cognitive behavioral therapy. CBT helps you learn how to correct attitudes and habits that hinder your sleep. Many of these bad habits develop as people try to cope with chronic insomnia.

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badhabits

Bad Sleep Habits: it involves the things that you do normally everyday. Although, these habits keep your sleep from being refreshing. They can also keep you from feeling alert during the day. These activities are all the things that you should be able to control. These specific behaviors fall into the follow two general categories:

     1.  Practices that keep you awake.

     2.  Practices that bring disorder to your sleep schedule

Many common factors may keep you awake at night. At first, alcohol may make you sleepy; but it is also more likely to wake you up during the night. Drinking coffee or colas that contain caffeine can make you more alert. The nicotine ina cigarette can have the same effect. People often use these substances to “keep their edge” during the day. This “edge” is not always gone by the time they try to go to sleep.

Other factors that cause you to stay awake when they occure too close to bedtime include the following:

  • Worry
  • Excitement
  • Mental stress
  • Physical exercise

Many other practices can keep you from having a regular pattern of sleeping and waking up. Perhaps you are unable to fall asleep because you spend too much time in bed. Maybe you don’t go to bed and wake up at the same times everyday. Or maybe you nap too often, too long, or too close to your bedtime. These bad habits can confuse your body. This will cause you to stay awake when you should really be asleep.

You can be affected in the followig negative ways:

  • Mood changes
  • Depression
  • Short attention span
  • Poor concentration
  • Daytime sleepiness
  • Frustration with sleeping
  • Caffeine dependence
  • Alcohol abuse or dependence

It may often be obvious to other people around you that the things your are doing are hurting your sleep. You, however, may be completely unaware of it. You may also find that your sleep problems tend to come and go. This is because you are likely to change your sleep habits over time.

  Who gets it?
It is typically not found in younge children. It may develop though, as early as the teen years.

It may also begin at anytime throughout adulthood. The timing of when it begins depends on when the habits that distrurb sleep are developed. The rate at which it affects males and females differently is not known.

  How do I know if I have it?
First, you need to determine if you have insomnia:

  1. Do you have trouble falling asleep, staying asleep, waking up too early, or not feeling refreshed after sleeping?
  2. For a child, does the child resist going to sleep or sleeping alone?
  3. Does this problem occur even though you have the opportunity and the time to get a good night’s sleep?
  4. Dout have at least one of the following problems? You have:
  • Low energy
  • Lack of motivation
  • Attention, concentration or memory problems
  • Poor performances at school or work
  • Extreme mood changes
  • Daytime sleepiness
  • Trouble making errors at work or while driving
  • Tension, headaches or stomach aches
  • Frustration or worry about your sleep

If your answer to each of these questions is yes, then you might have insomnia. Now continue to see if you might have inadequate sleep hygiene”

  1. Have you had these problems for at least one month?
  2. Do you you have at least one of the following bad habits?
  • You have a bad sleep schedule. You nap a lot, go to bed and wake up at different times everyday, or spend too much time in bed.
  • You often use products with alcohol, nicotine, or caffeine near bedtime
  • You actively do things that excite your mind, body, or emotions near bedtime.
  • You often use the bed to do things other than sleep. This includes paying bills, talking on the phone and eating.
  • You do not keep a comfortable sleeping environment. Research shows that having your bedroom slightly cooler ( via a cieling fan and the slight noise of the fan) are helpful. Low dim lighting such as nightlights are requested, and lavender sented candles can help soothe you into a good sleep regimen.

If you also answered yes to these questions, then you may have inadequate sleep hygiene.

It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:

  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

  Do I need to see a sleep specialist?
Talk with a family doctor about your difficulty sleeping. See if you are able to correct the bad sleep habits that are affecting your sleep. Are you having a hard time improving your habits? Or are you still having a sleep problem even after making these changes? If so, then you made need to see a sleep specialist.

  What will the doctor need to know?
First, the doctor will need to know when your insomnia started. He or she will also want to know what else has been going on in your life. The doctor will need to know about any other medical problems you have today or had in the past. Be sure to tell the doctor if you are taking any medications.

Keep a sleep dieary for two weeks. The sleep diary will help the doctor see your sleeping patterns. The sleep diary information gives the doctor clues about what is causing your problem and how to correct it.

  Will I need to take any test?
Doctors do not need any tests to treat most insomnia patients. A sleep specialists may give you a written test to analyze your mental and emotional well-being. The specialist may need to test your blood in the lab if he or she thinks that you have a related medical problem.

  How is it treated?
Many cases of insomnia will respond to changes that you can make on your own. You can often sleep better by simply following the practices of good sleep hygiene.

Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep. There are also easy ways to make your bed and bedroom more comfortable.

  You need to seek help from a therapist if stress or depression is the cause of your sleep problems.

When self-treatment does not work, a doctor can provide help. Doctors can teach you different ways to improve your sleep. An example of this is to use relaxation exercises when you go to bed. They can also help you find ways to take your mind off of sleep. Staying out of bed until you are tired is a good way to start off slowly. These methods are a part of what is known as behavioral therapy. With slow changes, you will see the biggest change at the end, feeling refreshed and happy.

surgery.jpg

  The intention of surgery is to open the airway sufficiently to eliminate or to reduce obstructions to a clinically insignificant level. In order to do so, surgical therapy in adults often must reconstruct the soft tissues (such as the uvula and the palate) or the bony tissues (the jaw) of the throat.

If you have been diagnosed with OSA and are considering surgery, talk to a sleep specialist and/or experienced surgeon about the different procedures, and the chances they will be effective to you, with your anatomy and why, and most of all the risks involved with surgery. Untreated sleep apnea can be harmful to your health, and surgery cannot always address all the points of obstruction. Eliminating the snoring does not necessarily eliminate the apneas. Sometimes surgery does not cure sleep apnea but reduces the number of apneas so that more treatment options are available to you and/or more comfortable. Yet in some circumstances, surgery may actually worsen the apnea.Insurance typically covers surgery for sleep apnea but not all surgical procedures. However, insurance companies that initially refuse to pay for a surgery may be convinced otherwise upon an appeal that demonstrates the efficacy and appropriateness of the surgery in your case. Throat pain from the major surgeries varies but is generally significant, often for one to two weeks. Most surgical procedures for sleep apnea are conducted in a hospital under general anesthetic. (People with sleep apnea must be cautious about general anesthesia–no matter for what medical condition the surgery is–because of the effects anesthesia has on the airway.)The most common surgery for sleep apnea is the uvulopalatopharyngoplasty, or UPPP procedure, which is intended to enlarge the airway by removing or shortening the uvula and removing the tonsils and adenoids, if present, as well as part of the soft palate or roof of the mouth. (The uvula is the tissue that hangs from the middle of the back of the roof of the mouth; the word comes from the Latin “uva” meaning “grapes.”) According to the “Practice Parameters for the Treatment of Obstructive Sleep Apnea: Surgical Modifications of the Upper Airway,” issued in 1996 by the American Academy of Sleep Medicine, the overall efficacy is 40.7%. A more recent surgery using a laser (laser-assisted uvulopalatoplasty or LAUP, a modification of the UPPP where the surgeon cuts the uvula with a laser) is performed for snoring. There is not yet enough information to say whether LAUP is effective for OSA. 

There are other surgical procedures where a part of the tongue is removed, and two which try to enlarge the airway by moving the jaw forward. These surgeries do have very high success rates but are long and involved (lasting several hours) with a significant recovery period and potential complications that patients may reject. As a rule, success rates for these complicated surgeries are higher when preformed by an experienced surgeon. You may have to undergo more than one procedure to eliminate the apneas sufficiently. In review, when weighing surgery, consider whether the safety and efficacy of the procedure have met the medical journals and cases studied are similar to yours. Surgery helps many, but effectiveness varies from person to person. It is also highly recommended that with surgery you have follow up sleep studies often, to evaluate your current conditions. If unsure about proceeding, you should seek a second opinion. Only a doctor who has examined you and your airways/complications can advise you on finding the correct surgery best for your needs.

 **Physicians who perform surgery for sleep apneas are most commonly otolaryngologists (specializing in the ears, nose, and throat) and oral and maxillofacial surgeons. If you are seeking a referral to a surgeon or a second opinion, you may find one through your physician or through a sleep center, and keep in mind that your insurance policy may require you to get a referral for a specialist and/or to see a specific provider.**

 

 

 

 


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