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Restless Legs Syndrome

Restless Legs Syndrome

What Is Restless Legs Syndrome?

Restless legs syndrome (RLS) is a sleep disorder in which a person experiences unpleasant sensations in the legs described as creeping, crawling, tingling, pulling, or generalized pain. These sensations usually occur in the calf area but may be felt anywhere from the thigh to the ankle. One or both legs may be affected; for some people, the sensations are also felt in the arms. These sensations occur when the person with RLS lies down or sits for prolonged periods of time, such as at a desk, riding in a car, or watching a movie. People with RLS describe an irresistible urge to move the legs when the sensations occur. Usually, moving the legs, walking, rubbing or massaging the legs, or doing knee bends can bring relief, at least briefly. RLS symptoms worsen during periods of relaxation and decreased activity. RLS symptoms also tend to follow a set daily cycle, with the evening and night hours being more troublesome for RLS sufferers than the morning hours. People with RLS may find it difficult to relax and fall asleep because of their strong urge to move, walk or do other activities to relieve the sensations in their legs. Persons with RLS often sleep best toward the end of the night or during the morning hours. Because of less sleep at night, people with RLS may feel sleepy during the day on an occasional or regular basis. The severity of symptoms varies from night to night and over the years as well. For some individuals, there may be periods when RLS does not cause problems, but the symptoms usually return. Other people may experience severe symptoms daily. Many people with RLS also have a related sleep disorder called periodic limb movements in sleep (PLMS). Involuntary jerking and bending leg movements during sleep that typically occur every 10 to 60 seconds characterizes PLMS. Some people may experience hundreds of such movements per night, which can wake them and their sleeping partners, disturbing their sleep. People who have RLS and PLMS have trouble both falling asleep and staying asleep and may experience extreme sleepiness during the day. As a result of problems both in sleeping and while awake, people with RLS may have difficulties with their job, social life, and recreational activities.

 

Common Symptoms

 

  • Unpleasant sensations in the legs (sometimes the arms as well), often described as creeping, crawling, tingling, pulling, or painful
  • Walking, stretching, knee bends, massage, or hot or cold baths relieves leg sensations
  • Leg discomfort occurs when lying down or sitting for prolonged periods of time
  • The symptoms are worse in the evening and during the night
  • Involuntary leg (and occasionally arm) movements while asleep
  • Difficulty falling asleep or staying asleep
  • Sleepiness or fatigue during the daytime
  • Cause of the leg discomfort not detected by medical tests
  • Family members with similar symptoms

What Causes It?

Although the cause is unknown in most cases, certain factors may be associated with RLS:

 

  • Family history. RLS is known to run in some families–parents may pass the condition on to their children
  • Some women experience RLS during pregnancy, especially in the last months. The symptoms usually disappear after delivery
  • Low iron levels or anemia. Persons with these conditions may be prone to developing RLS. The symptoms may improve once the iron level or anemia is corrected
  • Chronic diseases. Kidney failure quite often leads to RLS. Other chronic diseases such as diabetes, rheumatoid arthritis, and peripheral neuropathy may also be associated with RLS
  • Caffeine intake. Decreasing caffeine consumption may improve symptoms

Who Gets RLS?

RLS occurs in both sexes. Symptoms can begin any time, but are usually more common and more severe among older people. Young people who experience symptoms of RLS are sometimes thought to have “growing pains” or may be considered “hyperactive” because they cannot easily sit still in school.

How Is It Diagnosed?

There is no laboratory test that can make a diagnosis of RLS and, when someone with RLS goes to see a doctor, there is usually nothing abnormal the doctor can see or detect on examination. Diagnosis therefore depends on what a person describes to the doctor. The history usually includes a description of the typical leg sensations that lead to an urge to move the legs or walk. These sensations are noted to worsen when the legs are at rest, for example, when sitting or lying down and during the evening and night. The person with RLS may complain about trouble sleeping or daytime sleepiness. In some cases, the bed partner will complain about the person’s leg movements and jerking during the night.

To help make a diagnosis, the doctor may ask about all current and past medical problems, family history, and current medications. A complete physical and neurological exam may help identify other conditions that may be associated with RLS, such as nerve damage (neuropathy or a pinched nerve) or abnormalities in the blood vessels. Basic laboratory tests may be done to assess general health and to rule out anemia. Further studies depend on initial findings. In some cases, a doctor may suggest an overnight sleep study to determine whether PLMS or other sleep problems are present. In most people with RLS, no new medical problem will be discovered during the physical exam or on any tests, except the sleep study, which will detect PLMS if present.

How Is It Treated?

In mild cases of RLS, some people find that activities such as taking a hot bath, massaging the legs, using a heating pad or ice pack, exercising, and eliminating caffeine help alleviate symptoms. In more severe cases medications are prescribed to control symptoms. Unfortunately, no one drug is effective for everyone with RLS. Individuals respond differently to medications based on the severity of symptoms, other medical conditions, and other medications being taken. A medication that is initially found to be effective may lose its effectiveness with nightly use; thus, it may be necessary to alternate between different categories of medication in order to keep symptoms under control.

A non-drug approach called transcutaneous electric nerve stimulation may improve symptoms in some RLS sufferers who also have PLMS. The electrical stimulation is applied to an area of the legs or feet, usually before bedtime, for 15 to 30 minutes. This approach has been shown to be helpful in reducing night time leg jerking.

Due to recent advances, doctors today have a variety of means for treating RLS. However, no perfect treatment exists and there is much more to be learned about the treatments that currently seem to be successful.

 

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Insomnia

Insomnia

Can’t Sleep?

If you can’t sleep, you may be wondering if you have insomnia. Insomnia is a complicated condition. What is the definition of insomnia? According to guidelines from a physician group, insomnia is difficulty falling asleep or staying asleep, even when a person has the chance to do so. People with insomnia can feel dissatisfied with their sleep and usually experience one or more of the following symptoms: fatigue, low energy, difficulty concentrating, mood disturbances, and decreased performance in work or at school.

How long does insomnia last? Insomnia may be characterized based on its duration. Acute insomnia is brief and often happens because of life circumstances (for example, when you can’t fall asleep the night before an exam or after receiving stressful or bad news). Many people may have experienced this type of passing sleep disruption, and it tends to resolve without any treatment.

Chronic insomnia is disrupted sleep that occurs at least three nights per week and lasts at least three months. Chronic insomnia disorders can have many causes. Changes in the environment, unhealthy sleep habits, shift work, other clinical disorders, and certain medications could lead to a long-term pattern of insufficient sleep. People with chronic insomnia may benefit from some form of treatment to help them get back to healthy sleep patterns. Chronic insomnia can be co morbid, meaning it is linked to another medical or psychiatric issue, although sometimes it’s difficult to understand this cause and effect relationship.

People with insomnia tend to have difficulty falling asleep (onset), staying asleep (maintenance), and/or they wake up too early in the morning. Treatment for insomnia can include behavioral, psychological, medical components or some combination thereof. You and your doctor will need to talk about your particular situation and history of insomnia, as well as its causes, to decide on the best treatment plan.

What are some facts about insomnia? Insomnia is a common sleep problem for adults. The National Institutes of Health estimates that roughly 30 percent of the general population complains of sleep disruption.

Insomnia is a common problem encountered in family medicine that causes significant morbidity for patients. A survey of Canadian adults found that 40.2% met at least one symptom of insomnia, 13.4% met all criteria and 13% had consulted a healthcare provider for sleep difficulties at least once in their lifetime. Patients with insomnia have daytime fatigue, increased physical discomfort and increased psychological distress.

Patients with Chronic Insomnia have an increased risk of major depression, anxiety and substance use disorders. Chronic insomnia often has a bi-directional relationship with co morbid chronic disease including chronic pain and mental illness. Treating insomnia can provide relief to the direct symptoms of insomnia but also improve the suffering from co morbid disease.

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Is Grinding Your Teeth Bad for Your Health?

Teeth Grinding.

Bruxism?

Most people probably grind and clench their teeth from time to time. Occasional teeth grinding, medically called bruxism, does not usually cause harm, but when teeth grinding occurs on a regular basis the teeth can be damaged and other oral health complications can arise.

Why Do People Grind Their Teeth? Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite or missing or crooked teeth. It can also be caused by a sleep disorder such as sleep apnea.

How Do I Find Out if I Grind My Teeth? Because grinding often occurs during sleep, most people are unaware that they grind their teeth. However, a dull, constant headache or sore jaw when you wake up is a telltale symptom of bruxism. Many times people learn that they grind their teeth by their loved one who hears the grinding at night. If you suspect you may be grinding your teeth, talk to your dentist. He or she can examine your mouth and jaw for signs of bruxism, such as jaw tenderness and excessive wear on your teeth.

Why Is Teeth Grinding Harmful? In some cases, chronic teeth grinding can result in a fracturing, loosening, or loss of teeth. The chronic grinding may wear teeth down to stumps. When these events happen, bridges, crowns, root canals, implants, partial dentures, and even complete dentures may be needed. Not only can severe grinding damage teeth and result in tooth loss, it can also affect your jaws, cause or worsen TMD/TMJ, and even change the appearance of your face.

What Can I Do to Stop Grinding My Teeth? Your dentist can fit you with a mouth guard to protect your teeth from grinding during sleep. If stress is causing you to grind your teeth, ask your doctor or dentist about options to reduce your stress. Attending stress counseling, starting an exercise program, seeing a physical therapist, or obtaining a prescription for muscle relaxants are among some of the options that may be offered. If a sleeping disorder is causing the grinding, treating it may reduce or eliminate the grinding habit. Other tips to help you stop teeth grinding include: Avoid or cut back on foods and drinks that contain caffeine, such as colas, chocolate, and coffee. Avoid alcohol. Grinding tends to intensify after alcohol consumption. Do not chew on pencils or pens or anything that is not food. Avoid chewing gum as it allows your jaw muscles to get more used to clenching and makes you more likely to grind your teeth. Train yourself not to clench or grind your teeth. If you notice that you clench or grind during the day, position the tip of your tongue between your teeth. This practice trains your jaw muscles to relax. Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

If you’re keeping your family members awake at night with the sounds of your teeth clenching and grinding, you have a condition called bruxism.

Grinding or clenching your teeth usually occurs at night, and if it only happens occasionally, you may not be aware of it. But when bruxism becomes a regular occurrence, it may affect your dental health. Why Bruxism is So Damaging, when you grind or clench your teeth while sleeping, your conscious or rational brain has no control over the process – therefore, the force your jaws exert is three to ten times greater than during regular chewing. When you’re eating, part of the intensity of chewing is buffered by the food, but with sleep bruxism, your teeth receive the entire force of your jaws.

Signs of Bruxism: dull headaches, especially in the morning; sore, tired muscles in your jaw; and pain that radiates to your ear. You may also notice that your teeth are sensitive and beginning to wear down, or that they are chipped, cracked or starting to feel loose. The inside of your cheek may be damaged from chewing or biting it, and your tongue may also have indentations.

Causes of Bruxism: misaligned teeth or an improper bite can cause you to clench or grind your teeth. But for most adults, stress and anxiety are common causes – and if you already have a grinding habit, any increased stress in your life will cause it to worsen.

Bruxism can also be the result of acid reflux, the side effects of some medications or a complication of Huntington’s or Parkinson’s disease. Sleep apnea and other sleep disorders often coincide with bruxism, and your risk of grinding and clenching increases if you smoke tobacco, drink caffeinated or alcoholic drinks or use illegal drugs.

Grinding and clenching are common in young children, usually due to misaligned teeth, allergies or an irritation in the mouth, such as teething. Fortunately, most children outgrow the habit by the time they are teens.

Dental Complications: Catching bruxism early is important because frequent grinding can remove some of the enamel from your teeth and, in more severe cases, expose the underlying layer of dentin. This can lead to sensitivity and tooth decay. Other outcomes from heavy grinding are flattened cusps and fractured teeth or fillings. If you are a grinder with sensitive teeth, toothpastes like Colgate® Enamel Health™ Sensitivity Relief are very helpful. Although rare, long-term bruxing can cause muscles in your face to enlarge from overuse, blocking the opening of your parotid salivary glands. This may lead to swelling, pain, inflammation and dry mouth. Temporomandibular joint disorder (TMD) is another possible outcome of bruxism that early treatment can prevent.
Signs of TMD include chronic pain or soreness in the joint area, clicking or popping sounds when chewing and difficulty opening your mouth.
Treatments even if you aren’t aware of grinding and clenching, your dentist may see signs when examining your teeth at a checkup appointment. Before recommending treatment options, he will want to determine the cause. If your grinding is the result of improper tooth alignment, he may suggest adjusting your bite or orthodontic treatment to realign your teeth. If your teeth are severely worn down or fractured, or you have broken fillings, your dentist may need to restore them with new fillings or crowns. To prevent further wear to your teeth, he will most likely recommend wearing a splint or a mouth guard at night. This separates your teeth so that they are not damaged by grinding or clenching.
Although teeth clenching and grinding are not life-threatening, many of the consequences of long-term bruxism can be difficult to live with. Whether your family is telling you that you’re grinding or you’re noticing the signs of bruxism yourself, it’s best to get to your dentist sooner rather than later to get the help you need to stop.

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Are Waterbeds good for you?

Waterbeds or Spring Mattresses?

So are water beds really bad for your back? Honestly I’m looking for the answer too and it seems that there is no good evidence or solid research about various mattresses sold today, including waterbeds. Throughout my years of investigating this very question I have come up with some interesting information. My goal has been to find out if one mattress type example a waterbed is good for specific ailments like arthritis or circulatory issues, while another mattress type like mattresses and box springs may be more helpful for things like bulging or degenerating discs.

Unfortunately, I have yet to find such proof positive information. I wish I had a dime for every time a customer entered the store and said they needed a firm mattress and couldn’t have a waterbed because of their bad back. Curious to know who recommended this? I nearly always learn that it was not their physicians’ or chiropractors’ suggestion, only that they know soft mattresses are not good for them. So why is it that opinions by individuals seldom substantiated by physicians become the governing rule and standard of whether mattresses like waterbeds are any good for us?

 

Is it true that a firm mattress is better for our backs and a waterbed is bad for them or is ignorance and predetermined biases keeping us from getting good comfort and support from products like waterbeds? Proof that waterbeds are either good or bad for back problems I have yet to see an all out mattress study or scientific proof to demonstrate the myths that waterbeds are bad for our backs. During my research an even bigger question came to mind. Knowing that coil spring mattresses were developed around 1900 by Simmons and waterbeds were invented in the 1970’s wouldn’t one be technologically better than the other? Granted both are not exactly the latest and greatest new ideas in sleep technology in comparison to products like memory foam, yet consumers overwhelmingly purchase the 110-year-old technological dinosaur we call the mattress and box spring.

This is only an opinion but having 24 yrs experience in selling various mattresses I would love to share them with you. My expertise has found that people who experience joint pain due to excessive pressure often found in the common coil spring mattress have not experienced relief but have in waterbeds. In addition people who suffered from arthritis especially arthritis that is responsive to the warmth found in temperature controlled and heated waterbeds seem to experience positive results. Waterbeds seem to help with things like; Bedsores (pressure sores) Offers some of the best pressure relief of any mattress today. Sunburn, Bedbugs, Allergies / dust mite allergies. Waterbeds can be cleaned. Support- We don’t recommend Free Flowing mattresses, get fully baffled models Recommended by doctors and chiropractors- Many still recommend them and sleep on them themselves.

 

Nowadays, you seldom hear about waterbeds. When you do hear about it, you associate it with hippies or back pains. The main question about waterbeds is still this: “Are waterbeds bad for you back?” Some say it is, while others say it’s not. As with traditional beds, it’s all a matter of choosing the right one.

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Are Sleep Disorders Common?

TEN MOST COMMON SLEEP DISORDERS

Insomnia

Insomnia is when it is hard to get to sleep or stay asleep. Often, the cause is discomfort from an illness. Other times, it can be feeling upset, sad or stressed. In these cases, what needs to be done is to get rid of the cause. But in other cases, there is no obvious cause. Here it can help to adopt good habits. If this is not enough, there are more complex treatments. One of these is known as cognitive behavior therapy. This needs a skilled therapist. Sedative drugs will, at best, only work in the short term.

 

Snoring

Snoring is a common problem. It affects up to 40% of men and 20% of women on a regular basis. It gets worse with age and weight gain. Someone who snores can really disturb their partner. This can cause distress for both of them. As well, many regular snorers also have obstructive sleep apnea.

 

Obstructive Sleep Apnea

This means losing your ability to breathe freely. It happens over and over while asleep. It is caused by a narrow, floppy throat. Most people who have sleep apnea snore too. The period when the sleeper has trouble breathing ends with them waking up. This arousal is often very brief with no memory of it. But arousing over and over like this disrupts sleep and causes excessive tiredness during the day. There are treatments that work. These include weight loss, cutting down on alcohol, dental devices and continuous positive airway pressure (CPAP) therapy.

 

Sleep Hypoventilation

The muscles that we use to breathe need to be told to do so by the brain. When we sleep, there is less drive to do this from the brain. This means that people who have breathing muscles that are weak or under excessive load from severe lung disorders or obesity may not breathe strongly enough during sleep. This is known as sleep hypoventilation. With no treatment, this can lead to breathing and heart failure during the day. Devices to help breathing during sleep will work in treating this. This treatment is called non-invasive positive pressure ventilation.

 

Restless Legs Syndrome

People with restless legs syndrome have uncomfortable feelings in the legs. The only way they can stop these is to move their legs. How severe it is tends to vary over the day. The worst time is from the evening through to the early hours of the morning. For some people, it can make their sleep a lot worse. Sometimes it is caused by the body not having enough iron. There are several medications that can stop it.

 

Bruxism

This involves grinding of the teeth during sleep. It is quite common. If not treated, it can cause permanent damage to the teeth. Sometimes it causes jaw discomfort. But often the people who have it aren’t aware of anything. If they use dental guards they can protect their teeth.

 

Narcolepsy

About 1 in 2000 people has Narcolepsy. It relates to unstable switching between being awake and asleep. People who have it can feel more sleepy more often than they would like, but may have disrupted sleep as well. People with it can also hallucinate. This happens when falling asleep or waking up. Sometimes when they wake up, they can’t move for a moment. This is called sleep paralysis. They can also have what is known as cataplexy. This means sudden feelings of muscle weakness. They only last a moment and happen after laughing or feeling a strong emotion. Not everyone with Narcolepsy has all these problems. Drug therapies can work very well. Sleep paralysis can occur by itself with no relation to Narcolepsy.

 

Sleep Talking, Sleep Walking and Other Automatic Behaviours

There are many things that we normally only do when we’re awake. These include walking and talking. But some people do these things while asleep too. This happens when they only partially wake up. It is common for this to happen in children. These problems usually go away by the time they become adults. But sometimes they don’t. There are other complex behaviours that can happen while asleep e.g. binge eating and sexual behaviour. They can be embarrassing or worse for both the person who does them and their partner. There are treatments that work for these problems.

 

Nightmares and Night Terrors

These also happen because of not fully waking up. Again, they are much more common in children than adults. They can be very disturbing for the person who has them and those around them. They can also make people anxious about going to bed. Poor sleep habits make them worse. In general, counselling will make things better. Every now and then, medications are needed.

 

Rapid Eye Movement Behavior Disorder

The period when we sleep can be split up into several phases. Dreams happen most often in a phase called REM. REM stands for Rapid Eye Movement. At this time all limb muscles are usually relaxed. However in REM sleep behavior disorder the muscles are active. People who have this will act out their dreams. This can involve violent movement and lashing out. There is a threat of injury to both the person who has it and their partner. There are treatments that work well for this.

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Why Sleep Apnea is Dangerous.

Why Obstructive Sleep apnea is dangerous.

There are seven health problems linked to Obstructive Sleep Apnea:

High blood pressure:

Obstructive Sleep Apnea can contribute to high blood pressure in people who have it.

Frequent night time waking that plague people with Sleep Apnea  cause hormonal systems to go into overdrive, which results in high blood pressure levels at night. A CPAP Machine may be an option.

Low blood-oxygen levels, caused by the cut off of oxygen, may also contribute to hypertension in people with Sleep Apnea.

Some good news … some people with high blood pressure who are treated for Sleep Apnea can cut back on their blood pressure medications. CPAP Machines may help in this area.

Heart disease:  

People with Obstructive Sleep Apnea are more likely to suffer heart attacks and even die in the middle of the night. The causes may be low oxygen or the stress of waking up often during sleep.

Stroke and atrial fibrillation: 

A problem with the rhythm of the heartbeat is also associated with Obstructive Sleep Apnea. The disrupted oxygen flow caused by Sleep Apnea makes it hard for your brain to regulate the flow of blood in arteries and the brain itself.

Type 2 diabetes:

Sleep Apnea is very common among people with type 2 diabetes – up to 80% of diabetics have some obstructive Sleep Apnea. Obesity is a common risk factor for both disorders. Although studies haven’t shown a clear link between Sleep Apnea  alone and type 2 diabetes, sleep deprivation can cause insulin resistance, a precursor to diabetes. A CPAP Machine may help.

Weight gain:

Adding weight raises your risk of Sleep Apnea, with up to two-thirds of people with Sleep Apnea severely overweight. Obstructive Sleep Apnea can often be cured if you lose enough weight, but that can be tough to do. Being overweight causes fatty deposits in the neck that block breathing at night. In turn, Sleep Apnea impairs the body’s endocrine systems, causing the release of the hormone ghrelin, which makes you crave carbohydrates and sweets. Also, people with Sleep Apnea who are tired and sleepy all the time may have a lower metabolism, which can also contribute to weight gain. Getting treatment for Sleep Apnea (CPAP Machine) can make you feel better, with more energy for exercise and other activities.

Adult asthma:

Although the link to Obstructive Sleep Apnea is not proven, people who are treated may find they have fewer asthma attacks. Acid reflux:

There’s no proof that Sleep Apnea causes acid reflux, persistent heartburn, but many people complain of acid reflux, and treating it seems to improve Sleep Apnea symptoms, say sleep physicians.

Car accidents:

Daytime tiredness can put people with Sleep Apnea at increased risk of falling asleep behind the wheel. People with Sleep Apnea are up to five times more likely than normal sleepers to have traffic accidents. A CPAP Machine may give you more restful sleep.