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7 Medical Problems that Contribute to Insomnia

If you are one of those people who can`t fall asleep at night even though you really want to, or can`t stay asleep long enough, maybe you should read this. Given the statistics of people who suffer from insomnia, one can freely say that insomnia is one of the most common medical disorders in the 21 century, and it is not unusual if it happened to you. Many reasons lead to insomnia, but we are mostly concerned with the medical ones. Here are some of the medical reasons you could have insomnia.

Stress

Acute insomnia that is often described as a brief episode of difficulty sleeping, should not last longer than three months and is often caused by stressful life events such as loss of a loved one or some big unexpected changes in a person`s job. As much as unpleasant and worrying as it is, this type of insomnia should not worry you much, as it is usually resolved without any treatment. However, there is one type of insomnia that you should be concerned about, and that is chronic insomnia. Chronic insomnia is a long-term problem that lasts longer than three months. Panic attacks, PTSD and anxiety disorder are some of the conditions that may lead to chronic insomnia.

Irregular Sleep Times

If you are one of those who lack consistent bedtime due to working overnight or working in shifts or maybe even traveling for work between different time zones you are likely to confuse your body clock. A confused body clock leads to sleep distortion and keeps you up when it`s time for bed. Sometimes, not being able to sleep at “normal” times is only because you have a different circadian rhythm that puts you out of sync with regular activities.

Mental Illness

Clinicians find insomnia to be one the most common symptom of mental illnesses including anxiety, depression, bipolar, and obsessive-compulsive disorders. Their patients often come to seek help for insomnia, but they end up being diagnosed with a mental disorder. Patients suffering from depression are more likely to develop sleep disorders.

Breathing Problems

Sleep apnea is a serious sleep disorder where a person is short of breath and has interrupted breathing during their sleep. It is not unusual for people who suffer from sleep apnea to experience fatigue, difficulty concentrating, and headaches due to sleep deprivation. Asthma and nasal allergies may also cause sleeplessness, but luckily these conditions can be medically treated. It is not uncommon for obesity to be related to sleep apnea.

Dementia

“Sundown syndrome” or “sundowning” is a condition where people with Alzheimer`s and other forms of dementia become increasingly confused, anxious, aggressive,and restless which prevents them from sleeping. When this happens they may yell, pace, or wander off. As fading light is considered to be the trigger the symptoms may worsen at night.

Pain

Conditions like cancer, arthritis, fibromyalgia, or chronic back pain cause sleep disturbances. So chronic pain may not be the only thing you have to deal with. To make things worse disturbed sleep may additionally exacerbate chronic pain.

Itching

Conditions such as psoriasis and eczema give you Itchy skin that almost always goes hand in hand with burning red rash and pain. Sometimes itching can be so severe that you can hardly get distracted let alone fall asleep. And even if you do fall asleep, you may find yourself wide awake in the middle of the night scratching yourself. This kind of pain causes great discomfort, but luckily you can soothe your skin by using medicines prescribed by a doctor.

What Insomnia Does to You

There are serious health risks related to insomnia. It can disrupt your daily life and make you feel anxious, depressed, cranky, and even forgetful. People who suffer from Insomnia are more prone to car crashes. Obesity, high blood pressure, and heart disease are all closely related to insomnia.

What May Help

By making changes in your daily life routines you can relieve insomnia. It is well known that caffeine, even in normal doses, can cause insomnia. So it is better not to consume it. Stay away from difficult discussions, greasy foods, and noise. Enrich your life by exposing yourself to sunlight while doing exercise in the morning. A hot bath or reading before going to bed might help you relax and have better sleep.

Sleep Deprivation and Your Emotional Health

We all know that sleep deprivation makes us irritable and short-tempered. But, are we really aware of how deeply sleep deprivation hurts our emotional well being and affects our mental health?

Sleep Deprivation Makes You More Emotionally Reactive

Not getting enough sleep increases the probability that your emotional responses will be more impulsive and intense. Research shows that even a single night of sleep deprivation sets us up to react more strongly and impulsively to negative situations. And when you are dealing with chronic sleep deprivation, you contend with this heightened emotional reactivity on a daily basis.

Research suggests that sleep deprivation increases activity in the emotional rapid response center of the brain, the amygdala. The amygdala controls many of your instant emotional reactions. And when the amygdala is short on sleep, it goes into overdrive. And this causes us to be more intensely reactive to situations. But it’s not only about negative reactions, we’re more reactive across the whole spectrum of our emotions, both positive and negative.

You Have a More Negative Outlook

Sleeping poorly makes us concentrate more on the negative. It also increases repetitive negative thinking. This happens when your mind is stuck in a negative place. And it’s going over the same frustrating thoughts again and again. These repetitive negative thoughts are linked to the development of mood disorders depression and anxiety.

Studies show that sleep-deprived people have more repetitive negative thoughts. They are less able to control their minds’ fixation on the negative when compared with people that are well-rested. The greater the sleep deprivation, the more difficult it is for people to escape negative thoughts, feelings, and experiences. It’s definitely a difficult cycle to break.

You Worry More About the Future

Recent research suggests that sleep-deprived people tend to worry more about the future.

Scientists at the University of California, Berkeley carried out a fascinating study, in which they found that anticipatory anxiety is increased in sleep-deprived people. That’s worrying about the future. Sleep deprivation triggered more anticipatory anxiety in people who were already prone to worrying. So, if you are among the people that tend to worry, getting enough sleep is vital to maintaining a healthy emotional balance.

You Feel Less Connected to Your Partner

Sleep deprivation can undermine healthy and satisfying relationships. Sleep deprivation can sink a healthy sex life and it can mess with other forms of intimacy between partners.

Scientists at UC Berkeley found that lack of sleep reduces the gratitude we feel for our romantic partners.

Moreover, sleep deprivation diminishes our capacity for empathy. And empathy is an emotional skill that is essential to healthy relationships. When we are sleep deprived, we are less able to show empathy for others. We are less able to recognize and imagine other people’s feelings.

The skills of self-awareness, appreciation for others, and empathy are integral parts of our emotional intelligence. When sleep deprivation impairs these crucial skills, our bonds of trust and communication in the relationships weaken greatly.

Women and Men Experience Sleep-deprived Emotions Differently

One sleep study found that women experience more anger, more hostility, and more depression first thing in the morning than men do. We know that generally, women’s brains expend more energy than men’s do. And that additional energy expenditure means women need more sleep. When they don’t get the sleep they need, emotional difficulties may arise. Emotional difficulties arise for men too, but women’s may occur more quickly or more often due to women’s greater sleep needs.

All in all, studies show that your mental and emotional health depends on you getting plenty of high-quality rest.

Economics of Treating Insomnia

Insomnia is the most common sleep disorder in the US. However, many people who suffer from insomnia, are not treating it. Research shows that insomnia is frequently undiagnosed among Americans. Another problem with insomnia is that it’s often not accessible and affordable by insurers and healthcare organizations.

Many people with symptoms of insomnia try to manage their sleep problems on their own. And there are major consequences of insomnia on health, safety performance, and quality of life. Dr. Wickwire as an assistant professor of psychiatry and director of the Insomnia Program at the University of Maryland School of Medicine investigated the staggering financial costs linked with insomnia. Together with his colleagues, he concluded that insomnia costs the U.S. economy more than $100 billion a year. The costs are caused by increased healthcare reliance, lost productivity, and more frequent injuries and accidents.

What Makes a Treatment Cost-Effective?

One of the most used tools to assess the cost-effectiveness of healthcare treatment is the quality-adjusted life-year (QALY). A QALY figure calculates both the quantity of time and the quality of time of the treatment. QALY measurements can determine the cost-effectiveness of treatment on its own, and also compared with other health care treatments. Studies show that treatment for insomnia is highly cost-effective.

Treating Insomnia with Sleep Medications

Studies have shown that the prescription of sleep medications is effective, in terms of both treatment and cost. Treating insomnia with pharmacotherapy reduced healthcare costs, costs of workplace absenteeism and presenteeism, and costs linked with injury and accident.

Behavioral Therapy for Insomnia Pays Off

Behavioral treatments for insomnia deal with symptoms of sleep disorder by trying to modify thoughts, emotions, habits, and actions that impact sleep. Scientific research shows that Cognitive-behavioral therapy is very effective for insomnia. Cognitive-behavioral therapy can be as or even more effective than sleep medications in the treatment of insomnia.

Several studies that examine the cost of CBT for insomnia suggest that it’s therapeutically effective and also cost-effective. CBT for insomnia reduces healthcare utilization and healthcare costs.

Sleep Medications vs. CBT-I

One study for insomnia compares the cost-effectiveness of sleep medication to CBT. They analyzed the cost-effectiveness of these two treatments in a group of older adults.And a no-treatment group was used as a control. Among older adults, CBT for insomnia proved to be notably more cost-effective than pharmaco therapy.

Moreover, the American Geriatrics Society advises limiting the use of some of the most common sleep medications.This is based on research that suggests these medications deliver minimal improvements, but higher risks for falls, injury, and episodes of delirium in older adults.

Dr. Wick wire points out that insomnia among older adults has the potential for significant economic impact. Age is an important risk factor for insomnia. Insomnia is more common in older populations. And with the population in the US aging, insomnia might become a big health problem.

Delving Deeper into Cost Effectiveness

Dr. Wickwire and his colleagues’ analysis of the costs of insomnia suggests that the majority of insomnia-related expenses come from lost productivity in the workplace. The expenses are $67 billion annually in the U.S. They recommend that measuring costs should be a component of all insomnia trials.

Research and discussion of both therapeutic and economic values linked to insomnia disorder and the treatment are extremely important for the health care market.

They could move us closer to making the most effective therapies more widely understood and accessible. This would mean better care for more people and reducing society’s costs at the same time.

Clinical Phenotypes in COPD

Clinical characterization of COPD is unfolding fast. Concepts evolve from a disease manifested by fixed airflow obstruction with distinguishing between “pink puffers” and “blue bloaters” to the ongoing paradigm of COPD as a wide range of clinical phenotypes.

Defining Clinical Phenotypes in COPD

Clinical COPD phenotypes are a single or combination of disease attributes that describe distinctions between patients with COPD as they correlate to clinical meaningful results. These include symptoms, exacerbations, response to therapy, rate of disease progression, or death.

In a broader context, Feinstein characterized the two purposes of defining a clinical phenotype. And they are giving a certain name to a disease or condition – to identify a certain natural history or prognosis and to define a specific therapy.

While a multitude of supporting features can distinguish among patients with COPD, clinicians will particularly value distinguishing between COPD phenotypes to the extent that the patient’s management is influenced by identifying their phenotype.

The parameters on which the current spectrum of COPD phenotypes have been defined are the following:

  • Lung function in early adulthood and also the rate of progression
  • Symptom profile such as the presence of chronic bronchitis or linked asthma
  • Degree of physiologic derangement, for example, degree of FEV1 impairment
  • Radiographic features including airway thickening vs. emphysema, concomitant pulmonary fibrosis or bronchiectasis
  • Natural history
  • Associated biomarkers
  • Genetic risk factors

 Some of the currently described COPD phenotypes are:

  • Alpha-1 antitrypsin deficiency
  • Frequent exacerbator
  • Chronic bronchitis
  • Combined asthma-COPD
  • Combined pulmonary fibrosis-emphysema
  • Bronchiectasis

Identifying Increased Risk for COPD

Lange and colleagues in the New England Journal of Medicine did a study that highlights the utility of phenotyping in identifying populations at risk for developing COPD.

They utilized three large longitudinal cohort studies. The participants underwent serial spirometry over greater than 20 years, beginning before age 40.

The serial measurements allowed the calculation of the rate of decline in lung function and a determination of whether COPD ultimately developed based on GOLD diagnostic criteria.

Confirming observations ensued from previous studies, patients with a normal FEV1 before the age of 40, who eventually experienced an accelerated decline in lung function, defined one phenotype at an increased risk of developing COPD.

A second phenotype which hasn’t been previously identified was manifested by individuals with a low FEV1 in early adulthood and a relatively normal rate of decline in lung function.

Linking Phenotypes to Therapy

The most immediate and present impact of characterizing different COPD phenotypes is identifying specific therapy that is linked to the phenotype. This is of special interest to clinicians.

Let’s take a look at the example of alpha-1 antitrypsin deficiency (AATD). Identifying individuals with this particular genetic condition that predisposes to COPD has three potential managerial impacts:

  1. Since AATD is inherited as an autosomal co-dominant manner, first degree relatives are at risk for having a severe deficiency of alpha-1 antitrypsin (AAT) and they are ought to be tested for AATD.
  2. Because smoking cigarettes especially accelerates progression of emphysema in AATD, avoiding smoking or smoking cessation must be extraordinarily emphasized for affected individuals.
  3. Seeing that specific therapy exists, the clinician may consider recommending intravenous augmentation therapy with pooled human plasma-derived AAT.

Also, consider the value of identifying individuals with chronic bronchitis and moderately severe airflow obstruction. The efficacy of the phosphodiesterase-4 inhibitor, roflumilast, to avert exacerbations has been analyzed and demonstrated in this specific subset of COPD patients.

All in all, the current thrust to identify specific and distinctive clinical phenotypes in COPD will surely go on. Beyond the value of this line of inquiry in helping to identify specific pathogenetic mechanisms and prognosis in COPD, clinicians will particularly value identifying phenotypes that link to specific therapies.

Insomnia Tips When Living with Severe Eczema

Sleep is essential for everyone’s health, but when you have severe eczema, going to bed can be extra stressful. The ironic thing is that without enough sleep, your eczema can get worse.

Remember that you should be getting seven to eight hours of sleep per night. But, sometimes eczema can get in the way of us getting the recommended hours of sleep.

People that have eczema have a higher chance of experiencing fatigue, daytime sleepiness, and insomnia.

So, what can you do to improve sleep when living with severe eczema?

Room Temperature

For starters, you should be aware of the close relationship between your body temperature and eczema. The hotter you are, the worse your eczema will get.

A lot of people wake up during the night because they become overheated and the itching gets worse.

There is no universal temperature that works for everyone, so you need to find your ideal sleeping temperature and stick to it.

However, a temperature between 3 and 5 degrees seems to be comfortable and cool enough.

Linens

The material of the linens you sleep on is also very important when it comes to your body temperature when you sleep.

Protective dust mite covers for your pillow and mattresses could help you a great deal.

It’s best to sleep on 100% natural fabrics, like cotton and bamboo.

Change your bed linens frequently and keep them as clean as possible, so dust mites and skin debris won’t affect your sleep.

Nighttime Scratching

Throughout the day, you may be good at controlling yourself when it comes to scratching eczema patches. But, at night you might find yourself scratching them unconsciously.

Keep your nails trimmed and neat at all times to avoid making your eczema patches worse.

Also, you can try wearing soft cotton gloves at night to train yourself to stop itching.

Moisturize Your Skin Before Bed

Dry skin can wake you up during the night several times. You can prevent this by applying a moisturizer half an hour before going to bed. This way, the ointments have time to better sink into your skin.

You can also benefit from applying moisturizer right after you get out of a bath or a shower.

Sleep Hygiene

If you want to improve your sleep, it’s quite beneficial to practice good sleep hygiene.

That means to stick to a regular bedtime and wake-up time every single day.

It trains your body to go to sleep and also stay asleep.

In the evening hours, it’s useful to avoid eating heavy meals, drinking caffeine or alcohol, or smoking. These habits might disrupt your sleep.

Turn off all electronic devices that emit blue light an hour before going to bed. They can trick your brain that it’s still daytime and affect your sleep negatively.

A dark room will provide you a better night’s sleep.

By incorporating all these steps you can lower the feelings of stress and anxiety. And this can contribute to improving your eczema and reducing your flare-ups.

Sleepwear

Just like the fabrics on your bed, sleepwear can affect the quality of your night’s rest.

The more comfortable the sleepwear is, the better your sleep is.

The first thing you would like to avoid is sweating. So, pick something light to wear when it’s hot. Avoid anything that is rough, scratchy, or tight.

Your pajamas should be airy, loose, and made from breathable fabrics. If you can wear pajamas that are made of 100% cotton, that would be ideal.

By following our tips, you should be sleeping around seven to eight hours per night.