Sleep Better Starting Tonight

08/27/2010

If you can’t remember the last time you woke up feeling rested and refreshed, you’re not alone. Many of us have trouble falling asleep or awaken during the night and can’t go back to sleep. Women are more likely than men to have such insomnia.

Poor sleep takes a toll no matter what time of year it is. Sleep disruption produces fatigue, reduced functioning, impaired memory and lowered mood, among other problems. It’s also associated with conditions such as diabetes, high blood pressure, congestive heart failure, anxiety and depression.

Yet you can get more, and better, sleep—without drugs—by understanding your own sleep profile, adjusting so me of your daily behavior patterns and making sleep-friendly nutritional choices.

“Behavioral treatments are usually more effective in treating insomnia long-term than medications,” says Matthew R. Ebben, PhD, assistant professor of psychology in neurology, the Center for Sleep Medicine, New York Presbyterian Hospital-Weill Medical College of Cornell University. “Managing what you do is the most important factor to help you sleep at night.”

Know what you need

How often do you steal time from sleeping in order to catch up on work, house chores, family activities or just watch something entertaining on TV?

To make sure you’re sleeping enough, you have to know your sleep need. That might not be the proverbial eight-hours-a-night we always hear about. Individuals differ in the sleep duration that’s right for them, as well as in how little sleep it takes to make them drowsy in the daytime.

“If you happen to be a 10-hour sleeper, the fact that there are so me people who get along on five hours of sleep and feel fully rested doesn’t help you. You’re still going to need your 10 hours,” Dr. Ebben says.

To find your sleep need, allow yourself to sleep and see how many hours it takes for you to feel refreshed. You might be so sleep-deprived that it will take sometime to figure out your actual need. Use that number of hours to schedule a standard bedtime and wake time.

Keep to those times as consistently as possible, even on weekends. Staying up late and then sleeping to noon messes with your natural sleep-wake cycle as controlled by your circadian clock, which are set by sunlight. When your circadian rhythms shift, it’s harder to fall asleep and wake up on schedule. If that pattern continues, you can develop a delayed sleep phase and become very sleep deprived.

Allowing more time than you need for sleep isn’t the answer. An eight-hour sleeper who stays in bed for 10 hours will get eight hours of fragmented sleep stretched over those 10 hours, Dr. Ebben explains. “They won’t sleep longer than their sleep need.”

Food timing matters, too

What you eat and drink influences how well your body gets ready for bed. If your habit is to have a late dinner and then go to sleep within an hour or two, the activity of digestion will keep your brain and body awake longer, says Lisa Dorfman, MS, RD, spokesperson for the American Dietetic Association, sports nutritionist and adjunct professor at the University of Miami.

“For your evening meal, you don’t want to exceed 500 to 700 calories at least two hours before bedtime,” Ms. Dorfman says. Avoid eating a lot of protein in that meal because protein contributes to alertness, she says. Carbohydrates, which tend to have a calming effect, are a better choice.

You might want to re-think that brownie after dinner or late afternoon cup of tea as well. People with sleep problems who drink caffeinated coffee, tea or soda, or eat chocolate (which contains caffeine) ought to eliminate, or reduce, their caffeine intake. Caffeine stays in your system for up to seven hours and may keep you alert for 20 hours.

It also stimulates restless leg syndrome, a condition that can cause insomnia and makes it hard to fall asleep, Dr. Ebben says. If you don’t want to give up caffeine entirely, Ms. Dorfman recommends timing your consumption to end by midday.

Does a full bladder regularly wake you up at night? It helps to time your last beverage for about three hours before bedtime. Even if you don’t have that problem, forget the nightcap. Alcohol may make you drowsy at first, but it causes fragmented or light sleep once your body starts metabolizing it.

More ideas for restoring good sleep:

If you can’t fall asleep, get out of bed. Avoid spending time awake in your bedroom. That means no TV, laptop use or even reading under the covers.

  • Nix naps. Sure, you want a daytime nap after a poor night’s sleep. Fight that urge. Napping takes away from your nighttime sleep need and makes it harder to fall asleep. That sets up a continuing cycle of disrupted sleep and napping that keeps you from getting meaningful rest.
  • Exercise at the right time. Morning exercise may help your body clock stay active during the day and become ready for sleep at night. “Exercise can help sleep, particularly in people who are very anxious,” Dr. Ebben says. “As long as you don’t do it too close to bedtime, it’s something that definitely can help you sleep.”
  • Another good reason for losing weight. A higher body mass index (BMI) contributes to shortened sleep. Excessive weight appears to increase insomnia, Dr. Ebben says. Obesity also increases your risk of obstructive sleep apnea, in which you stop breathing during sleep. Those interruptions wake you briefly and cause fragmented sleep. See a health care professional if you think you might have sleep apnea (treatments exist even if you don’t lose weight).
  • Help for night shift workers. If you come home in the dawn or daylight, wear dark sunglasses to prevent confusing your body clock. Cut out all light from your bedroom while you sleep in the daytime.
  • Mom was right. Warm milk gets your body ready for sleep. So does taking a hot bath. When you’re warm, cozy and relaxed, you’ll be sound asleep before you know it.

For more information on the health topics mentioned in this article visit the HealthyWomen.org areas below.

Sleep Disorders: www.healthywomen.org/condition/sleep-disorders

Diabetes Health Center: www.healthywomen.org/healthcenter/diabetes

Managing Stress: www.healthywomen.org/ages-and-stages/healthy-living/managing-stress

Anxiety and Depression Center: www.healthywomen.org/healthcenter/anxiety-and-depression

© 2010 HealthyWomen All rights reserved. Reprinted with permission from HealthyWomen. 1-877-986-9472 (toll-free). On the Web at: www.HealthyWomen.org.


Risk Factors for Abdominal Aortic Aneurysm Studied

08/24/2010

An aortic aneurysm occurs when the walls of the main blood vessel that carries blood away from the heart (the aorta) bulges or dilates.  An abdominal aortic aneurysm (AAA) is located in the abdominal area, near the navel.  Aneurysms can also occur in other areas of the aorta, although the abdomen is the most common site.


Research from the Society for Vascular Surgery® in collaboration with the Mount Sinai School of Medicine Department of Health Evidence and Policy in New York City evaluated the data of 3.1 million patients who were at risk for an abdominal aortic aneurysm (AAA). Their work as a data coordinating center for this project was funded by a grant to the SVS from Life Line Screening, Independence, Ohio. Results have been published in the September issue of SVS’ Journal of Vascular Surgery®.

“During our research we determined that approximately half of the patients having AAA disease are not eligible for screening under current guidelines, so we created a high-yield screening algorithm that expands the target population,” said Craig Kent, MD, a vascular surgeon and Chair of Surgery at University of Wisconsin.
     

This predictive scoring system also identified aneurysms more efficiently, added Dr. Kent. Data was collected from more than 20,000 screening sites across the nation from patients who had completed a medical and lifestyle questionnaire and were evaluated by ultrasound for the presence of AAA by Life Line Screening. Risk factors associated with AAA were then identified using multivariable logistic regression analysis.                                           

 “Our researchers reaffirmed well-known risk factors for AAA, including male gender, age, family history, and cardiovascular disease,” said Dr. Kent. “However, our algorithm expands the data to included females, non-smokers and individuals 65 years and younger. Using this current model on national statistics of risk factors prevalence, we estimated that there are 1.1 million AAAs in the United States, of which 569,000 are among the women, patients that did not smoke and persons age 65 or younger.”
The study also showed that smoking cessation and a healthy lifestyle are associated with lower risk of AAA. Researchers also observed an increased rate of AAA with increasing years of smoking and the number of cigarettes smoked. There was a reduction in the risk of AAA with smoking cessation.  Excess weight was associated with increased risk, whereas exercise and consumption of nuts, vegetables, and fruits were associated with reduced risk.  Blacks, Hispanics and Asians had lower risk of having AAA than Whites and Native Americans.                               

“Abdominal aortic aneurysm is an insidious condition with an 85% chance of death following rupture,” said Dr. Kent. “Screening using noninvasive ultrasound can save lives but its use is advocated only for a limited subset of the population at risk. Patients who are not in an emergency situation prior to a rupture, have an option to undergo elective surgical repair or their aneurysms which is a safe an effective intervention.”

Discuss your risk factors for AAA with your healthcare provider and whether screening may be appropriate for you.  Aneurysms do have a genetic component so investigate your family health history.


Biggest Health Threats Among Hispanics Today

08/21/2010
Heart disease is the #1 killer of Hispanic men and women in the U.S. Hispanics are at a higher risk to develop diabetes which is a strong risk factor for heart problems. Heart disease and diabetes risk factors specific to the Hispanic/Latino population will be discussed and strategies to reduce risk.


American Red Cross Statement On Compression-Only CPR

08/18/2010

“Articles published in The New England Journal of Medicine (NEJM) cite a pair of studies on Compression-Only Cardiopulmonary Resuscitation (CPR), sometimes called continuous chest compressions, Hands-Only CPR, or cardio cerebral resuscitation (CCR).

“These articles validate the American Red Cross guidance on Compression-Only CPR. The Red Cross encourages everyone to be trained in full CPR and how to use an automated external defibrillator (AED). The American Red Cross supports the links in the Cardiac Chain of Survival including: early recognition and early access to the 911 system, early CPR, early use of an AED until professional medical responders arrive and take over.

“The American Red Cross recognize that upon witnessing the sudden collapse of an adult, calling 9-1-1, and providing Compression-Only CPR until an AED is available is an acceptable alternative for those who are unwilling, unable, or not trained to perform full CPR.

“The NEJM articles also support the Red Cross position that further research is needed. It is important to note that the Red Cross is helping to lead this research through a CPR skill retention study which looks at different educational models and Compression-Only CPR versus full CPR.

“Full CPR is recommended for infants and children since they experience sudden cardiac arrest primarily due to respiratory problems causing a loss of oxygen. Since a child’s oxygen levels in the blood are low at the time of cardiac arrest, they need rescue breaths to improve oxygen levels and aid in resuscitation. Despite this, Compression-Only CPR is still better than no action at all.”

If you are looking for more info about taking a CPR course visit The American Red Cross site http://www.redcross.org/portal/site/en/menuitem.86f46a12f382290517a8f210b80f78a0/?vgnextoid=aea70c45f663b110VgnVCM10000089f0870aRCRD


Left-Ventricular Assist System Continues To Grow

08/15/2010

More than 22 million people suffer from heart failure worldwide with approximately one million new patients diagnosed annually. In the setting of an aging global population, heart failure is the number one reason for hospitalization. The most severely ill patients need heart transplants in order to recover. More than 8,000 people worldwide are on the list of eligible candidates for heart transplants annually, but less than 3,000 receive a transplant each year. A large number of people who suffer from severe heart failure do not qualify for transplantation due to other health issues. An alternative for these patients is access to artificial mechanical assist.

A Left Ventricular Assist Device or LVAD is a surgically implanted mechanical device that helps the heart pump blood. In other words, they are “heart pumps” or “heart assist devices.” If both your heart’s pumping chambers are failing, 2 heart pumps may be used, one for each ventricle.  An LVAD either takes over or assists the pumping role of the left ventricle – the heart’s main pumping chamber. Newer LVADs are meant to be permanent in people with severe heart failure.  Part of the device is implanted in your heart and abdomen, and part remains outside your body. You carry the external part of the device on a belt around your waist or on a shoulder strap. Most LVADs right now have an electric pump, an electronic controller, an energy supply (usually a battery weighing about 8 pounds) and 2 tubes. One tube carries blood from your left ventricle into the device. The other tube takes blood pumped from the device into your aorta (artery) to be circulated throughout your body.

Terumo Heart, Inc., announced this week that another patient implanted with the DuraHeart™ Left Ventricular Assist System (LVAS) has surpassed four years after receiving the mechanical circulatory support device. Helga Gieseke, 66, who lives in the south of Saxony-Anhalt, Germany is now one of the longest-living heart failure recipients of this device designed to aid the pumping action of the heart in order to circulate blood throughout her body.

Mrs. Gieseke received the DuraHeart LVAS as an investigational device in May of 2006 after suffering from heart failure for many years. She was treated by the Physicians at The Deutsches Herzzentrum Berlin as part of the DuraHeart LVAS clinical study that ultimately lead to CE Mark and commercialization in Europe.

Mrs. Gieseke has had a long history of heart problems; her first heart surgery was performed in 1994. Since then, Mrs. Gieseke had undergone several procedures including implantation of stents, pacemakers and implantable defibrillators in an attempt to manage her condition. Despite all these treatments, Mrs Gieseke’s condition continued to deteriorate until she found herself unable to walk or carry out simple activities around the house without getting chest pain. It was after admission to the local hospital in April of 2006 that Mrs. Gieseke was told by her cardiologist, also a school friend, that she required additional treatment. It was then that she was referred to The Deutsches Herzzentrum Berlin.

The DuraHeart LVAS can be used as a bridge to heart transplant in patients with end stage heart failure. Due to the scarcity of donor organs, patients can sometimes be on the waiting list for many months until a suitable donor becomes available. During that time, a patient’s condition can deteriorate dramatically until no other alternative is available to them. The left ventricular assist systems offer the patient a second chance while waiting for a suitable donor.

The DuraHeart LVAS is currently being studied in the DuraHeart Pivotal U.S. Trial for Bridge-to-Transplant (BTT), a multi-center, prospective, non-randomized study, involving 140 patients. The study, which granted unconditional approval in early 2010 by the U.S Food & Drug Administration (FDA), will evaluate the safety and efficacy of the device in helping to sustain patients awaiting heart transplant who are at risk of death due to end-stage heart failure. 

For more detailed information about the DuraHeart BTT Trial, visit www.clinicaltrials.gov, and for more information about the DuraHeart LVAS, visit www.terumoheart.com.


Food Hero – New Kids Game about Nutrition

08/12/2010

Think you know all about nutrition and exercise? Try your luck at Food Hero, a new game created by a team at Children’s Hospital Boston.

The free app is competing in a contest initiated by First Lady Michelle Obama’s Let’s Move campaign (you can vote until Aug. 14), but it’s also part of a larger strategy to use social networking to improve health. Ben Reis, a professor of pediatrics at Harvard Medical School, and his colleagues previously came up with apps that let your friends know when you give blood (I Saved a Life!) or get a flu shot (I Got the Flu Shot!). (You get the idea.) A future version of Food Hero would post your victories on your Facebook wall, for example.

Complete with stirring music and multiple levels, Food Hero is aimed at kids who are 9 to 12 years old. Its cartoon characters run, bike, or swim, but to do their best they must eat a balanced diet. Eat too little and they droop; eat too much and they almost explode. It’s not as easy as it looks, by the way.


Do Calcium Supplements Really Increase Your Risk for a Heart Attack?

08/11/2010

On July 29, the British Medical Journal published a meta-analysis on the effects of calcium supplements on the risk of heart disease. The results were reported in the general media. The study’s conclusion suggested that calcium supplements may increase the risk of a heart attack.

 In response to the story, Daniel Fabricant, Ph.D., vice president of Global Government and Scientific Affairs for the Natural Products Association notes the following:

“There are thousands of studies on calcium, but the authors selected only eight to do this meta-analysis. None of the selected studies had cardiovascular outcomes as the primary end-points, and data on cardiovascular events were not gathered in a standardized manner, so it would appear much more of a predetermined outcome versus one of great scientific rigor.”

Unfortunately this happens all to often a new study comes out and the media headlines saturate the public with only half the story. You never hear all the facts of the study. Surprisingly many studies I hear quoted on the news are inaccurate or incomplete. In order to find out the truth you should either read the study yourself or ask your healthcare provider for all the facts.

 Bottom Line: Do NOT stop taking your calcium supplements without first discussing your risk with your healthcare provider.