They say sleep is the best medicine. Living in the modern world we all know how important sleep is to overcome stress and most importantly to remain fit and healthy. People who struggle to get the right amount of sleep will tell you the joy and comfort that comes with a good night’s sleep. Insomniacs go great lengths to find an answer to their disorderly sleep patterns.

Sleep is a comforting experience. Did you know that we spend 33% of our lives asleep? But it’s the quality of sleep that is more important than the quantity. If you haven’t slept properly, you are more likely to feel stressed out, tired and lethargic. It not only affects your physical well-being but mental well-being too. To attain both a healthy body and mind you need a good sleep.

Insomnia amongst the elderly

Lack of sleep can seriously affect your health, especially if you are an elderly person. Sleep-inducing drugs are known to work on a short-term basis, but they often are blamed to cause drowsiness, increase falls and impact memory. A review of studies conducted amongst older people with insomnia, published in the British Medical Journal, highlighted that although drugs worked to improve sleep, but it did not justify the significant risk.

A research team at the University of Pittsburgh devised a method to help elderly people suffering from long-term insomnia. Their unique treatment works on changing the behavioural patterns and does not involve drugs at all. They have successfully tested it out on elderly patients and the results have been quite positive.

The big question is: How many hours of sleep do we actually need? Is it eight hours or seven or six? In fact, you need enough sleep so that you feel active and recharged when you wake up to help you stay alert for the rest of the day. Its not unusual for people to get by on just 3-4 hours a sleep most nights. Apparently that’s how much sleep a few famous names like Napoleon, Florence Nightingale, Margaret Thatcher, the former British Prime Minister, functioned on.

A good night’s sleep is the result of observing some simple rules. You don’t have to make drastic changes to your current lifestyle. Here are 10 rules that you can consider:

1. Learn to relax – the modern world gives us ample opportunities to worry about. But if you are thinking about office work and worrying about what to do the next day, you won’t fall asleep. Put your worries aside and make a list of things to tackle it the next day.
2. Follow a sleep pattern – Make sure you go to bed at night and wake up in the morning at the same time everyday, including weekends. This will help the body to function better.
3. Light supper – Don’t eat too much or to less before you sleep or else your stomach might demand attention in the middle of the night.
4. Stop using an alarm clock – In the modern world we have become slaves of time. Using an alarm clock to wake you up is a bad idea as it deprives you of sound sleep and affects your mood and temper once you wake up. However, you may want to keep an alarm clock at the ready as a precaution and set it for sometime after your regular get up time if there are strict times to meet. You don’t want to wake up at 8 AM if you have to be at office at that hour.
5. Light exercises – try to get fresh air by going out for a walk, it not only helps you remain fit but relieves stress too. Moderate exercises like walking or swimming are recommended but not close to bedtime.
6. Cut down on alcohol – Although alcohol might help you fall asleep quickly, but it subdues deep sleep and should be consumed three to five hours before you sleep, otherwise you are likely to wake up at night. If you really want to drink something, a glass of hot milk before bed will help induce sleep quickly.
7. Say no to cigarettes – Studies have proved that it takes longer to fall asleep after you’ve smoked a cigarette and it also causes a disturbed sleep.
8. Caffeine and sleepiness – Drinks like coffee and coke contain caffeine and induce insomnia. They can be taken five to six hours before you sleep and not after that.
9. Limit naps – taking a siesta, or an afternoon nap can affect your sleep at night. If you do want to take a nap, make it no longer than thirty minutes.
10. Getting ready to sleep – Relax your body by taking a warm bath with aromatic oils in the evening. Make your bedroom comfortable by making it dark and quiet as possible. Try listening to some soft, soothing music or read a nice book. Avoid watching violent films or TV programmes just before you sleep.

SleepTracks Sleep Optimization Program

Fix insomnia through easy to do hypnosis techniques

As we gain better and better control of the body and its health, we are exposed to worse moral dilemmas.  Here are some of the toughest ethical issues in health & medicine.

Being a medical ethicist has never been harder.

1) Genetic modification

The complete sequencing of a copy of the human genome was a tremendous breakthrough.  Since then, however, treatments and cures based off of genetics have been limited.

That said, right now innovative treatments based off genetic modification are becoming more and more plausible.  For instance, recently a man was cured of AIDS when he received a bone marrow transplant (because he also had leukemia).  We are reaching the stage where we might be able to harvest some cells from your body, inject them with new genetic material, and put them back in.

Another area of concern is that of “designer babies.”  We are now able to tell at an extremely early stage if a baby will have certain genetic disorders.  And that allows selective abortions to take place, which can prevent tragedies like a child who will die an agonizing death over several months.  It can also allow selection for traits like sex and even height.

It could get worse.  We could reach a point where fetuses are normally removed from the womb, injected with genetic data, and reimplanted.

This can lead to a society where only the rich can afford to make their babies healthier, smarter, better looking.

2) Premature babies

We are turning the clock back on when a baby needs to be born in order to survive.  As science gets better and better, extremely premature babies have switched from certain death to possible struggle to survive.

The problem is that such care can be very expensive and doesn’t guarantee health.  A baby could survive with retardation and barely functional lungs, for instance, at the cost of several million.  By contrast, that same money could have saved hundreds of fully healthy people from starvation.

(Can you imagine having to tell a parent that?)

Being able to save babies that are very young also indirectly threatens the morality of abortion.  If a month old fetus could live a happy and healthy life if supported in a laboratory, it somehow seems more of an ethical quandary to commit an abortion.

3) Performance Drugs

As we understand the brain in greater detail, we are able to develop drugs that stimulate it.  This has proven a life-saver for the millions of people with attention deficit disorder, and could be a tremendous breakthrough for those suffering from Alzheimer’s disease.

It could also, however, be of great use to normal people.  If a pill could improve your memory, focus and concentration – why not take it?  This also leads to a slippery slope.  You can imagine a workforce where it is the culture to take performance enhancers routinely, and your boss yelled at you if you didn’t do so as well.

This pressure to take pills for focus is already intense at the best schools.  Spend time in the library at any top college, and you will overhear students talking about using pills like Adderall for better focus and attention.

4) Resuscitation and Life Support

With modern technology, we can keep people alive for a long time.  In the vast majority of cases, this has proven a godsend, and can be of especial use to save someone who has slipped into a temporary coma.  It has, however, led to controversy.

Is it worth spending a large amount of resources on keeping someone who is totally brain-dead alive?  Some medical ethicists have reported that question is on the easier side of what they face!

Imagine you’re a doctor operating on a patient whose life you could save.  But if you do, they will spend their entirely life completely immobilized, only able to move their eyes.  Worse, they would be in tremendous pain.

Fully conscious but unable to do anything whatsoever.

All you would have to do to prevent this from happening is slow down a little.  If your operation took 2 hours instead of 1 and a half, the patient would die.  And no one would ever know.

That’s an ethical dilemma.

5) Euthanasia

What do you do when someone is undergoing a slow, horrible death – and they want your help out?  People who suffer from amyotrophic lateral sclerosis slowly become paralyzed and lose the ability to swallow or talk and eventually die.

What on earth do you do for someone who has that and wants to die?

Intuniv for treating ADHD

Shire’s Intuniv medication is quite new.  It was approved recently, on September 3rd, 2009, but is gaining increasing recognition as a treatment for ADHD.

Chemically, Intuniv is an extended release form of guanfacine, a blood pressure med that has been on the market for quite some time.

It works by stimulating alpha-2 receptors – this lowers blood pressure and may work in the prefrontal cortex to increase focus, attention and memory.

Intuniv is one of many options for treating ADHD.  To learn what all the main options currently are (and, more importantly, what they do and how well they work), see a Full List of ADHD Medications.

And if you want to learn about ADHD in general, see here.

How well does Intuniv work?

Several studies so far have been done into how well Intuniv works for treating ADHD and what kind of side effects it has.

So far, they say that Intuniv works somewhat less than the stimulants like Ritalin and Adderall and – possibly – somewhat more than the traditional non-stimulants like Strattera.

This is important because, though they are the best current treatment for ADHD, 30% of people can’t take or don’t respond to stimulants.

Parents in particular have concerns about traditional treatment for their children.  Intuniv can be used as sole therapy or with stimulants, to round out treatment.

What kind of side effects does Intuniv have?

In general, the type of side effects that you’d expect from a blood pressure lowering medication.  That said, we’ve noticed a few issues you should know about and that you might not learn about elsewhere.

The pros

Intuniv could possibly fill a lot of the role as a non-stimulant treatment that Strattera was supposed to play but didn’t.  It has a long duration of effect and can even be used in combination with stimulants.

And the short acting form of Intuniv has been on the market for some time, so we know that it is fairly safe in general.

The cons

Intuniv is very new, and studies so far have shown that it is not as effective as the stimulants.  Some studies have hinted at potential problems such as high rates of serious side effects such as fainting.  While the short acting form has been on the market, Intuniv is long lasting.

Remember, roughly 50% of medication side effects are discovered after it is released onto the market.

Efficacy

How well does Intuniv work?

The studies seem to show that Intuniv falls just short of sending ADHD symptoms into remission.  Roughly 55% of those on Intuniv in one study reported significant improvement compared to 30% of those on placebo.

In one major study, on one scale, people who started with an ADHD score of around 40 and took Intuniv had their score go down to around 19 on average. The accepted number for remission of ADHD symptoms is a score of 18 or less.

Those who took Intuniv along with stimulants went from about a starting score of around 29 to around 13.

There are some more interesting hints towards Intuniv’s efficacy we found in that study.  On the one hand, only 10% of participants said that they stopped specifically because they thought Intuniv wasn’t working that well.  And of those taking Intuniv with stimulants, only one person stopped specifically because it wasn’t working well.

That said, around 80% of people in total dropped from that study.  It was done over two years, but that is still a somewhat high number.

Other studies into Intuniv have had much lower drop out rates.

In another, smaller study, roughly 30% of people on placebo reported significant improvement, as compared to around 55% of those treated with Intuniv.  This difference likely means that it has some benefit and is useful but falls short of the efficacy of the stimulants, which work in roughly 70% of those treated.

Analysis of that study concluded that at low doses Intuniv is about as effective as traditional non-stimulants, and at higher doses is superior to the current non-stimulants, such as Strattera, Wellbutrin, and possibly even Provigil.

Intuniv Side effects

Different studies show different side effect profiles for Intuniv.  Some say that it has about the same rate of issues as placebo, while others show that around 10-15% stop using it because of some side effect.  As far as psychoactive drugs, a 10-15% discontinuation rate due to side effects is on the lower/medium range.

The side effects of Intuniv also depend on its particular use.  When used in combination therapy with stimulants, for instance, it has much less rates of sedation and sleepiness, and users seem to report less problems.  This is probably because its sedative effects that lower blood pressure are counteracted by the stimulants effect of raising it.

Some of its side effects take time to start showing up, with sedation in particular starting after 3 weeks of treatment.

Most common:

30-40% report sleepiness

25% report headache

17% in one study reported upper respiratory tract infection

10% report sedation

Other common side effects include dizziness, nausea, irritability and reduced salivary flow.

Concerns

In one study, 5 participants out of 262 who took Intuniv  experienced syncope, or “temporary loss of consciousness.” In layman’s terms, they fainted or blacked out.

The clinical trials dedicated to exploring safety did not have such incidences, and it’s possible that the syncope events were environmentally based. One of the sufferers, after all, had a history of such issues. And guanfacine has a long history of use. So while those numbers are alarming, they are explainable.

Other possible side effects that may be an issue: head injury, suicidal ideation.

Like with all psychoactive medications, people using Intuniv should be monitored for anything abnormal like increased feelings of depression.

Dosing

Intuniv is given typically anywhere from 1-4mg/per day.  A dose typically lasts for 12 hours, but may have some effect for up to 24 hours.

Related articles:

1. Vyvanse vs Adderall XR
2. Dr. Tuckman Answers Questions About ADHD
3. Is There a Physical Test for ADHD?
4. The 4 Secrets to Success with ADHD

Adhd and Add Online Diagnostic Test

Suffering from Adhd – need help – don’t know what to do!

Overcoming Adhd: A Guide For Parents

Control Your Add/adhd, Control Your Life!

Swine flu, H1N1

Swine flu has hit us hard already, but with winter, the worst may be yet to come.

We’re likely to get massive incapacitation and illness.

Still, so far swine flu isn’t a big killer. In the Spring, roughly 800,000 New Yorkers had symptoms of swine flu, but only 54 died of it. The worst fatality rates have been seen in Mexico, which helped spread initial panic, but elsewhere it has been milder.

The bad news

Swine flu is unusually contagious. If you’re living with someone who catches the flu, normally you’d have around a 10-15% chance of catching it. If you’re in close contact with someone who has swine flu, by contrast, you have a 20-30% chance of infection.

Because of this much higher rate of spread, it’s entirely possible that 1/3 of the USA will be infected, and one much quoted White House report says it may be up to 1/2.

More bad news. Swine flu and the regular seasonal flu are quite different, which looks like it might be a serious problem. It’s entirely possible that come winter we’ll have a normal flu season – and have Swine Flu on top of that.

This is especially serious when you realize that Swine flu tends to infect younger people.  So a wider range of people and at higher numbers might catch the flu this winter.

The good news

It’s possible that Swine flu will simply overtake seasonal flu and that we won’t have extremely large numbers of people infected.

Best of all, Swine flu doesn’t seem to be  mutating to become more dangerous. From April to late July, for instance, the genetic structure remained mostly constant. And a recent study showed that swine flu doesn’t tend to remix with other influenza strains, meaning less risk of a deadly recombination.

Vaccines to swine flu are very rapidly being made. It has yet to be seen how effective they are, and if they will be ready in time. And because of the incredible time pressure, we’re simply not going to get the safety data we need and typically require for any health related product.

But they are being made, and they may help fight the spread of swine flu.

Leave with this message.  Unless you have very strong reasons not to, get the flu vaccine we do have.

We’ll next cover how to recognize if you have swine flu and what to do if you or a loved one has it.

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If this article helped you, I’m happy.  Thanks for reading!

]]> http://healthlifeandstuff.com/2009/09/the-winter-and-swine-flu-how-bad-is-it/feed/ 2 http://healthlifeandstuff.com/2009/08/how-to-improve-health-care-in-the-usa/ http://healthlifeandstuff.com/2009/08/how-to-improve-health-care-in-the-usa/#comments Fri, 28 Aug 2009 15:37:44 +0000 Admin http://healthlifeandstuff.com/?p=690

Obama is trying to change the health care system in America.  I agree with him that there needs to be change.  What’s not entirely clear is what his ideas actually are.

The fact is, we spend among the most on health care of all the major nations, and aren’t getting better health care.  We all have similar life spans and health results.

That said, our system does have its advantages.  The USA has produced the vast majority of the innovations in medicine over the past 50 years.  The free market is a powerful tool, and those who opposed it have been buried by the sands of time.

Yet we need change.  The system has become broken.  Here are 5 specific ideas that can make a significant impact on the quality and cost of health care in the USA.

1) Publicly funded research should be repaid

The National Institute of Health, or NIH, funds hundreds of millions of dollars of research. Sometimes that research plays a major role in the development of a medication.

The best selling cancer medication, Taxol, was in a large part discovered due to taxpayer dollars. The NIH invested $484 million in its development.

With that kind of investment, it only makes sense that the NIH should have significant ownership of the medication and get repaid. Taxol is a billion dollar drug, after all.

But as is, the government is heavily subsidizing research and not getting repaid. For Taxol, Bristol-Myers Squibb generously agreed to pay the NIH 00.5% of sales, a promise it actually didn’t even meet.

It’s absurd. Hundreds of millions of our tax-payer dollars go to develop drugs that are then sold to us at exorbitant prices.

When we’re the ones subsidizing the research, we should either get repaid by a percentage of revenue, or by our representative – the FDA and NIH – having a stronger say in drug pricing.

2) Recommend options

The fact is that there are hundreds of medications on the market, and for any given class, say cholesterol lowering pills or antidepressants, there are many, many options. Often one medication isn’t necessarily any better than another. They just cost different amounts and tend to have different side effects.

An impartial analyst should look at all the options and propose a best practice choice – a medication that works best in the cost-benefit analysis, including economic cost. While not binding, having an official recommendation based off good science will certainly help doctors make better prescribing choices.

And those choices will save money by avoiding expensive variants that don’t show significant advantage over the existing options.

3) Require improvement over old

The FDA should be able, in exceptional cases, to require a medication prove itself against existing options. When the consumer already has 20 options that are all essentially the same, the FDA should be able to require new medications to prove their efficacy not against just placebo but against the existing options.

This will fight the proliferation of me-too drugs. And it will promote research into new classes of medication, something that has been lacking.

4) Improve the patent law

Drugs are rightfully protected by patents. Unfortunately, those laws have become abused by drug companies to aggressively bully generic manufacturers. They have also become exploited by allowing minor changes to extend the patent and keep costs up.

Right now, once a drug goes off patent, the parent company typically sues the first generic manufacturer to prevent competition. These preemptive lawsuits hurt the consumer greatly, because they can delay the introduction of generics by thirty-months.

It’s an abuse of the law to thwart the market.

5) Strengthen dietary supplement control

In 1994, a law was passed that significantly reduced the control of the FDA over dietary supplements. As long as they avoided making any specific health claim, they didn’t have to pass the stricter controls that drugs typically undergo.

The result? Half of dietary supplements don’t contain what they claim or are poorly manufactured. Some are even contaminated with lead.

Poor quality dietary supplements have become a chronic problem. In August 2009 alone, several were recalled. Weight loss supplements are particularly thorny, as they have tended to contain amphetamine-like compounds that potentially cause heart problems.

We need stronger control of health supplements.

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Sources:

Powerful Medicines, Jerry Avorn, M.D
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Coronary heart disease (CHD) is the single biggest cause of health problems and death in the USA and the world.

Statins offer a way to help treat CHD, but have become perhaps too heavily pushed. And the target level of cholesterol to reach may have been lowered too far.

What causes CHD?

CHD is most often caused by the build up of plaques on arteries and other blood carrying vessels. The plaque is made of various components, but deposits of cholesterol tend to play a key role. When it becomes too thick, it can stop blood flow, causing a heart attack or other damage.

The plaque can also break off and float around the body. If that happens, it can harmlessly dissolve. Or it can clog a blood vessel pretty much anywhere, potentially causing a stroke, heart attack, or thrombosis.

Statins discovered

The late 1980s heralded the discovery of a class of drugs called the statins.

These medications, technically termed 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, lower levels of cholesterol. Because of the role cholesterol plays in plaque formation, the statins were found to dramatically decrease risk of serious heart damage.

Statins were so effective that a lot of influential doctors argued that the lower cholesterol levels were, the better. LDL, or low density lipoprotein, was specifically targeted. And in the early 2000s, aggressive new targets for treatment were released. LDL levels should be lowered below 100 mg/dL.

But a lot of the proponents of the new, lower levels were found to be on the pay for major drug companies. And it’s not entirely clear if aggressive lowering of LDL levels provides the most benefit.

LDL must be lowered?

It’s most likely that lowering of LDL follows a logarithmic pattern. In at risk patients, a small reduction provides a major reduction in risk of having a heart attack. As levels are lowered even further, however, the benefit becomes increasingly smaller.

A few major studies support the idea that LDL levels shouldn’t be over aggressively lowered. The HARP study showed that lowering levels below 100 mg/dL showed no increased benefit.

The WOSCOPS study gave similar results, as well as AFCAPS.  Additionally, several major studies into the non-statin drug Ezetimibe showed that its reduction of LDL did not mean better clinical results for patients.

Potential side effects:

There may be a downside to over aggressive treatment.  Low levels of LDL may theoretically contribute to hemorrhagic stroke. Statin therapy does have side effects including myopathy and we know especially little about the effects of the high doses needed to achieve the lowest levels of LDL.

Some data show a slight increase in certain types of cancer for statin use, although such an effect may be statistically insignificant.

Conclusion

There is no doubt that statins have played a major role in reducing heart disease across America. But it is also not entirely clear who should be given them, and how heavily they should be used.

With the guidelines for cholesterol treatment being written substationally by doctors on the payroll of major drug companies, skepticism is called for.

Sources:

The Aggressive Low Density Lipoprotein Lowering Controversy
“The Lower the Better” in Hypercholesterolemia Therapy: A Reliable Clinical Guideline?

What impact does food have on our health, both mental and physical?

A pretty big one.

One out of four Americans suffers from some sort of mental disorder, significantly more than in China and other countries, part of which may be because of diet.

And French people have a 40% less risk of heart infarction compared to the rest of Europe, though this contention – called the “French paradox” – is highly argued.

Eskimos consume very high fat diets yet tend to have lower risk of heart disease.  The answer may lie in their consumption of certain fish with important fatty acids.

Depression, a common malady, has been linked in part to dietary decisions.  Increasing folic acid, magnesium and Vitamin B12 may help treat depression.

A good diet at its basics has a combination of fruits, vegetables, whole grains and fish.  Studies tend to show that adding one serving of fruits and vegetables daily significantly reduces risk of heart disease and possibly stroke.

Red Wine

Consumption of two or fewer servings of wine daily has been shown to reduce risk of heart disease.*

Red wine is very high in natural substances called polyphenols, containing more than 200 of them.  They are powerful anti-oxidants, which means they help prevent degeneration and aging of your cells.

Importantly, red wine has resveratol, a substance that has been shown to increase the lifespans of various animals, but not mice.  Resveratol is a plant antibiotic that seems to fight the formation of cancer at every step of the process, including inhibiting ribonucleotide reductase and other carcinogenic processes.

Resveratol may also fight brain disease and help keep your blood healthy.  Research has not caught up with all the exciting claims made about resveratol, however.

Red wine – in moderation – may also help lower cholesterol and help your innate immune system.  Some research shows that regular consumption of small amounts of red wine can help both women and men with sexual response and enjoyment, though those studies have been with small samples and need verification.

*Note: the American Heart Association does not recommend drinking, and consumption of three or more drinks daily is associated with heart disease and stroke.

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Sources:
Resveratrol and its analogs: Defense against cancer, coronary disease and neurodegenerative maladies or just a fad?
A systemic review of the roles of n-3 fatty acids in health and disease

Questions are more powerful than statements.  They leave something unresolved, which creates room for the mind to fill in.

A question can turn your world upside down.

1) How can I make exercising fun?

2) What can I do that my grandkids will be proud of?

3) Who will calm you on a Monday night at 1am when your heart is broken?

4) Who am I holding a grudge against?  Why?

5) What does my gut feeling say?

6) What makes me happy?

7)  How can I help my community?

8) How can I make new friends?

9) How can I spend less time doing things I hate?

10) What’s an interesting new magazine that I can subscribe to?

Over the past 30 years, we’ve learned a lot about what food does to our bodies.  It doesn’t just give us energy.

What we eat plays a big role in how we feel and helps determine if we suffer from conditions like hypertension, diabetes or cancer.

Eating fast-food and artificial, chemical laced goo like doughnuts lays waste to our bodies and gets us addicted to sweeteners.

Focus on eating simple, basic foods.  They have surprising health benefits and are what our bodies naturally need.

Tea

Drinking several cups of tea a day may reduce blood pressure and promote a healthy immune system.  Interestingly enough, tea reduces the amount of sugar in your saliva.  It also naturally contains fluoride.  That means it also helps fight cavities.

Eggs

Eggs contain choline, a cognitive booster.  They also provide selenium and Vitamin K, in addition to essential proteins.

They may not be so bad for your cholesterol, too.  Recent research shows that eating more than four eggs a week didn’t raise cholesterol that much.  But as always, when in doubt, check with your doctor.

Honey

Made up of more than 180 compounds, honey contains flavonoids like apigenin and acacetin.  Eating honey may thicken your stomach mucus, reduce acidity, and help prevent ulcers.

Importantly, honey has been shown to reduce the effectiveness of viruses and bacteria, even possibly killing them.

Cranberry

Myricetin and quercetin are among the ingredients that might make cranberry effective in reducing risk of cancer.  It’s also theorized that cranberry can prevent and possibly help cure uterine tract infections.

Research shows that cranberry reduces bad lipids in blood and assists with healthy inflammatory response, both of which help your heart out.

Remember

In having a healthy diet, the key is diversity and simplicity.  Eat meats, fruits and vegetables along with carbohydrates.  Eating fish is good as well.

• If a food didn’t exist 100 years ago, it’s probably not too healthy.

A good diet can help you feel and think better.  Deficiencies like not enough Vitamin B12 have a real impact on your life.