Tag Archives: Sleep

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
http://www.aarp.org/health/brain-health/
www.luminosity.com
Whatever you choose to do, do something!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Why Are You So Sleepy (aka Hypersomnia)?

hypersomnia-and-narcolepsy-overlap-445x275-445x273

This is part of a Straight, No Chaser series on sleep disorders.

Are you one of those individuals who is always tired and sleepy? You take iron, you exercise and you’re getting sleep at night. However, you’re still tired! What’s that about?
Hypersomnia (i.e., excessive sleepiness) is characterized by prolonged nighttime sleep and/or recurrent bouts of excessive daytime sleepiness or prolonged nighttime sleep. This is not the variety of sleepiness due to physical or mental exhaustion or insufficient sleep at night.  Hypersomnia makes you want to nap repeatedly during the day. Ironically, even if you do take a nap or even after you sleep overnight, you’re still fatigued.

hypersomnia

The functional importance of this is somewhat obvious. Hypersomnia interrupts your life, your work, your ability to normally interact with others. Symptoms are what you might expect from someone not getting enough sleep. Here’s a typical list:

  • restlessness
  • anxiety and irritation
  • decreased energy
  • slow thinking
  • slow speech
  • loss of appetite
  • hallucinations
  • memory difficulty
  • loss the ability to function in family, social, occupational, or other settings

Hypersomnia is difficult. It takes time to realize you’re affected beyond just regular fatigue. It’s also difficult to pin down the cause. Consider the following potential groups of causes:

  • Physical causes may include damage to the brain (e.g., from head trauma) or spinal cord, or from a tumor.
  • Medical and mental/behavioral health causes may include obesity, seizure disorder (epilepsy), encephalitis, multiple sclerosis and other sleep disorders (e.g., sleep apnea, narcolepsy).
  • Mental/behavioral health causes may include depression, drug or alcohol use.
  • Medications or medication withdrawal may cause hypersomnia.

hyperinsomnia

Unfortunately, treatment is symptomatic and often requires some degree of trial and error. For some individuals, stimulants, antidepressants and other psychoactive medications are effective. For others, behavioral changes appear to be more effective.
Any disruption in the quality or amount of sleep warrant investigation. Discuss your concerns with your physician if you have the opportunity. You always have the option of discussing with your SterlingMedicalAdvice.com expert consultant.
Special thanks go to the Hypersomnia Foundation for use of the lead logo for this posting. Please visit their website at http://hypersomniafoundation.org for more information on their efforts to combat this condition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

Straight, No Chaser: Sleep Apnea

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.
Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!
http://www.youtube.com/watch?v=Wm-TZ-dO_rQ
This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

Straight, No Chaser: Narcolepsy – The Sleep Attack

narcolepsy-in-media

This is part of a Straight, No Chaser series on sleep disorders.

When you hear about narcolepsy, it’s usually in the context of some joke, but it’s a horrifying condition. Looking at the lead picture, imagining blacking out while driving a car.  A diagnosis of narcolepsy should prompt certain lifestyle changes. Narcolepsy is a chronic sleep disorder that causes overwhelming daytime drowsiness and is characterized by an extreme tendency to fall asleep whenever in relaxing surroundings.

To better understand this condition, let’s look at certain truths of narcolepsy.

Narcolepsy doesn’t happen just because you’re tired.

Narcolepsy is a brain disorder. The part of your brain that regulates your cycle of being awake vs. being asleep is disturbed. The drop attack is not fading into sleep. It is an irresistible shut down. Now, narcoleptics do suffer from severe sleepiness throughout the day, but the sleep attacks aren’t predictable based on how tired one is.

narcolepsy awareness

Narcoleptics have severe disruptions of the activities of daily living.

Just remembering that this is a drop attack will help you appreciate the danger of narcolepsy. It can occur at any time during any activity. The unpredictability of the condition renders it very dangerous to the sufferer, and it makes performing at work, at school, in social and in many other settings very difficult.

Narcoleptics are likely suffering from other sleep disorders.

Understand that narcolepsy is a disruption of the sleep/wake cycle. That disturbance can manifest in other ways, including poor sleep quality and frequent nighttime waking. However, narcoleptics do not tend to spend more total time asleep during the day than unaffected individuals.

In addition to the sleep attacks, the main symptoms are excessive daytime sleepiness and cataplexy.

Cataplexy is a sudden voluntary muscle loss while one is still awake—the horror before the horror, if you will. Individuals feel limp and/or unable to move. Other symptoms may include hallucinations and an extension of the cataplexy to outright paralysis before and after the episode. Now the drop attacks themselves typically last seconds to minutes and result in a temporary feeling of refreshment before the sleepiness phenomenon reoccurs.

There’s no special rhyme or reason to who suffers from narcolepsy.

Narcolepsy occurs the world around and in men and women at a roughly equal rate. It typically occurs in children through young adulthood, but it can occur at any age. Surprisingly, it often is underdiagnosed. Don’t let that happen to you. With any form of a blackout or sleep attack, please get evaluated and be sure to ask if the episode could have been narcolepsy. 

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
http://www.aarp.org/health/brain-health/
www.luminosity.com
Whatever you choose to do, do something!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Sleep Apnea

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.
Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!
http://www.youtube.com/watch?v=Wm-TZ-dO_rQ
This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
www.brain.aarp.org
www.luminosity.com
Whatever you choose to do, do something!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Horror of Night Terrors

night-terrors-280x280

I wonder how many of you have been exposed to night terrors.  These are different than nightmares, which we all know and experience.  In a nightmare, Little Johnny has had a bad dream, maybe thinking there’s a monster under his bed.  He wants to be comforted by you, and he is still upset the next morning.  That’s not what a night terror looks like.
During a night terror, Little Johnny may be sleep walking, or he seems to wake up in the middle of the night and just starts screaming.  He’s really not communicative; he’s just terrified.  These episodes generally last about 15 minutes. Then he goes back to sleep.  The next morning, the child has no recollection of the event.
The cause of night terrors is unknown but they seem to be triggered by emotional stress and lack of sleep.  Febrile illnesses also seem to correlate with the presence of these episodes.
Who gets these?  Children less than age seven, more frequently boys.  These episodes usually stop by age 10.  There often is a family history.
There’s really no testing or treatment for these until they are frequent and prolonged, or unless a secondary injury occurs from all the trashing about.
I bring this to your attention because many parents are aware of this phenomenon and have no idea what to do when it occurs.  My best advice is to ensure that the child is safe during the episode for otherwise stress free children.  You may want to consider medical or psychological screening if the problem worsens.  Sleep well…
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Sleep Apnea

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.
Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!
http://www.youtube.com/watch?v=Wm-TZ-dO_rQ
This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

It’s National Sleep Awareness Week, and Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
www.brain.aarp.org
www.luminosity.com
Whatever you choose to do, do something!
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Sleep Apnea

This is part of a Straight, No Chaser series on sleep disorders.

We’ve discussed many components of sleep and sleep disorders. Sleep apnea is a very common condition that many of you are walking around with undiagnosed.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
apnea111
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would be otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction within the airway—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.
sleep-apnea
Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty, which can lead to inadequate levels of oxygen getting into your bloodstream and circulating throughout your body. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

sleep-apnea consequences

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.

sleep apnea cpap

Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
Straight, No Chaser has reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!

This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

normal sleeping

This week is National Sleep Awareness Week, so Straight, No Chaser wants you to wake up, pay attention and learn why sleep is such an important part of your life!
Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes an enormous amount of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
sleep_cycle_graph_1
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two categories, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after awakening at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day, and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.

sleep how much do you need

How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a full sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation. Throughout this week, Straight, No Chaser will review several sleep disorders. Until then, sweet dreams.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Horror of Night Terrors

night-terrors-280x280

I wonder how many of you have been exposed to night terrors.  These are different than nightmares, which we all know and experience.  In a nightmare, Little Johnny has had a bad dream, maybe thinking there’s a monster under his bed.  He wants to be comforted by you, and he is still upset the next morning.  That’s not what a night terror looks like.
During a night terror, Little Johnny may be sleep walking, or he seems to wake up in the middle of the night and just starts screaming.  He’s really not communicative; he’s just terrified.  These episodes generally last about 15 minutes. Then he goes back to sleep.  The next morning, the child has no recollection of the event.
The cause of night terrors is unknown but they seem to be triggered by emotional stress and lack of sleep.  Febrile illnesses also seem to correlate with the presence of these episodes.
Who gets these?  Children less than age seven, more frequently boys.  These episodes usually stop by age 10.  There often is a family history.
There’s really no testing or treatment for these until they are frequent and prolonged, or unless a secondary injury occurs from all the trashing about.
I bring this to your attention because many parents are aware of this phenomenon and have no idea what to do when it occurs.  My best advice is to ensure that the child is safe during the episode for otherwise stress free children.  You may want to consider medical or psychological screening if the problem worsens.  Sleep well…
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Sleep Apnea

apnea111

We’ve discussed many components of sleep and sleep disorders. A very common condition that many of you are walking around with undiagnosed is sleep apnea.  Sleep apnea is a common, recurring sleeping disorder in which your breathing temporarily pauses during your sleep. Have you ever awakened and felt as if you were choking or coughing? We may be talking to you.
The pauses of sleep apnea range in frequency and severity. They can last seconds or minutes. They may occur about 30 times in an hour.
Let’s pause there. I just told you that many of you are suffering from a disorder in which you stop breathing while asleep. Think about what that means.
Physiologically, if you’re not breathing while you’re asleep, your body will adjust. If you are in a stage of deep sleep, you’ll be kicked into light sleep, which is a lesser quality of sleep, and your body won’t be as replenished as it would otherwise. Your body will be less rested as a result, and you will suffer throughout the day.
Sleep apnea is most commonly due to some level of obstruction—obstructive sleep apnea. Do you have a large tongue or big tonsils? Are you overweight? Are you a big snorer? We may be talking to you. That snoring may be the sound of air moving past some obstruction. By the way, obstructive sleep apnea occurs more often in overweight  people, but it can occur in anyone.

sleep-apnea

Now to the “So What?” of the conversation. This is about the quality of your life. Sleep apnea is about insufficient quantity and quality of sleep. It’s about excessive daytime sleepiness. It’s about recurring episodes of inadequate levels of air resulting from the breathing difficulty. These facts have consequences. Refer to the lead picture above for an illustration of the various types of symptoms and problems that are associated with sleep apnea. Sleep apnea also brings risks for the following conditions and diseases if left untreated.

  • Diabetes
  • Heart attacks
  • Heart failure
  • High blood pressure
  • Irregular heartbeats (arrhythmias)
  • Obesity
  • Strokes

Sleep apnea is easy and hard to diagnose at the same time. Many of you are suffering with it unsuspectingly as we speak. The person you sleep with may have expressed concern about your snoring or choking while you sleep. If so, get checked.
Sleep apnea once diagnosed is treatable with some combination of lifestyle changes, breathing devices and mouthpieces. Surgery is used in some cases.
We’ve reviewed many components of sleep and sleep disorders. Be mindful that sleep is your body’s time to rest and recover from the day’s activity. Any disruption in its ability to do that does not bode well for you over the long term. If your sleeping habits are problematic for you, you really should get evaluated. Getting this situation addressed can dramatically improve the quality of your life.
Finally, review the attached video for an illustration of what’s happening during sleep apnea. Excuse the scary music!
http://www.youtube.com/watch?v=Wm-TZ-dO_rQ
This discussion has focused on obstructive sleep apnea and not the less common form, central sleep apnea. The symptoms are similar, so if you have the other condition, it would be determined by your physician.
This post is part of a Straight, No Chaser series on sleep and sleep disorders.

  • Click here for a discussion of normal sleep and how much you need a day.
  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Click here for a discussion of narcolepsy (sleep attacks).

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Understanding Normal Sleep and How Much Sleep You Need

sleep_cycle_graph_1

Do you ever think about why we sleep? Our bodies are highly efficient machines that utilize a lot of energy over the course of a day. In particular, our brain utilizes a lot of oxygen and energy. Sleep is meant to be a process organized by the brain and responsive to our body’s needs. Sometimes those needs are immediate, and sometimes those needs are scheduled. Contrary to what is often thought, we’re not designed to just black out when we’re tired. Sleep is actually a process orchestrated by the brain.
How and when we sleep is governed by a number of factors. These include factors under our control, such as whether or not we are sleep deprived, and factors beyond our conscious control. Chief among the latter consideration is the fact that we actually do have an internal “clock” that regulates our biologic rhythm (also called a circadian rhythm) over a 24-hour period. The circadian rhythm maintains our sleep-wake cycle and prompts us to want to sleep during similar times of the day and/or night. Sometimes that internal rhythm and the body’s routine call for sleep can be disrupted, making sleep a response to abnormal functioning within the brain (such as occurs in narcolepsy).
Sleep also has an internal organization—the sleep cycle—regulated by different areas of the brain. Sleep occurs in two stages, which recur through the night: rapid eye movement (REM) sleep and non-rapid eye movement (non-REM) sleep. Non-REM sleep is further divided into four stages (1 through 4), with stages 3 and 4 often referred to as “deep sleep.” In adults, non-REM sleep occupies around 80 percent of the night, and REM sleep 20 percent. REM sleep occurs every 90-110 minutes. These cycles recur until we awaken due to a schedule or decision to arise. You will feel most refreshed after sleeping and waking up at the completion of the final stage in a sleep cycle.
The body replenishes and restores itself during non-REM sleep, releasing hormones to repair damage done during the day. During REM sleep, you process memories and thoughts from the day and you dream. As best as we understand dreams, they also represent a form of processing mental information that you received during the day. During REM sleep, we normally lose the use of our limb muscles. Yes, it’s true that while we’re sleeping (at least in REM sleep), we have an active mind in an inactive body. This is actually a good thing. This normal loss of muscle activity during REM sleep helps prevent us from acting out our dreams. Thus, it stands to reason that sleepwalking and night terrors usually occur in non-REM sleep. When disorders of REM sleep occur and patients lose that protective phase of muscle inactivity, patients may act out violent dreams and harm themselves or others.
How much sleep you need is best defined by how well you function on different amounts of sleep, and as such, there is quite a bit of variation on what is considered normal and needed. For many adults, the average normal amount of sleep is around 7.5 hours per night. Many of you know people that can function on much less, and others that require as much as 9 hours per night. In general, your body feels most rested if you awaken at the end of a sleep cycle. Given that each cycle takes about 90 minutes, many people find that they’re more refreshed if they sleep some increment of 1.5 hours (e.g., 6, 7.5 or 9 hours).
If you are getting what you consider to be an adequate amount of sleep but are still unrefreshed and sleepy, then you might have an organic sleep disorder and should consider seeking professional consultation.
Additional Straight, No Chaser Blogs have addressed several of the sleep disorders.

  • Click here and click here for discussions about insomnia.
  • Click here for a discussion of night terrors.
  • Click here for a discussion of hypersomnia (excessive sleepiness).
  • Click here for a discussion of narcolepsy (sleep attacks).
  • Check back for a discussion of sleep apnea.

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