May
18
2011
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WHY YOU CAN’T STAY AWAKE: THE PHYSICAL CAUSES OF SLEEP APNEA

WHY YOU CAN’T STAY AWAKE: THE PHYSICAL CAUSES OF SLEEP APNEA
What is the physical process that leads to sleep apnea? Almost always apneic episodes result from an obstruction of the pharynx occurring somewhere between the nose and the epiglottis— the membrane that prevents food from going down the wrong “pipe.” The upper airway, from the mouth and nose to the lungs, is not just a hollow tube through which breath moves: the coordinated activity of a number of muscles is required if this airway is to work efficiently and effectively. As we breathe in, these muscles must contract, in synchronized fashion, to pull the passage open: this muscle contraction, as well as our instinct to breathe, is controlled by the central respiratory drive in the brain. Like many bodily structures, the upper airway is pretty delicate: it doesn’t take a very big difference in air pressure between the atmosphere and the inside of the throat to cause the passageway to collapse. The muscles must therefore work continually to keep the tube open.
As we have seen, a number of factors—among them drugs, alcohol, and, to some extent, sleep itself—can suppress the central respiratory drive, especially during slow-wave sleep and the REM phase. Alcohol is a particular threat; not only does it suppress the breathing drive, it also relaxes the throat muscles, reducing their ability to keep the airway open. What’s more, alcohol weakens the mechanism that helps us wake up quickly, thus adding to the time it takes to become aroused enough to make the conscious effort needed to breathe. I tell all patients with apnea that use of alcohol, other than perhaps a very small quantity (less than an ounce), is inadvisable. If they must drink, I ask them to do so no later than four to six hours before bedtime.
*136\226\8*
What is the physical process that leads to sleep apnea? Almost always apneic episodes result from an obstruction of the pharynx occurring somewhere between the nose and the epiglottis— the membrane that prevents food from going down the wrong “pipe.” The upper airway, from the mouth and nose to the lungs, is not just a hollow tube through which breath moves: the coordinated activity of a number of muscles is required if this airway is to work efficiently and effectively. As we breathe in, these muscles must contract, in synchronized fashion, to pull the passage open: this muscle contraction, as well as our instinct to breathe, is controlled by the central respiratory drive in the brain. Like many bodily structures, the upper airway is pretty delicate: it doesn’t take a very big difference in air pressure between the atmosphere and the inside of the throat to cause the passageway to collapse. The muscles must therefore work continually to keep the tube open.
As we have seen, a number of factors—among them drugs, alcohol, and, to some extent, sleep itself—can suppress the central respiratory drive, especially during slow-wave sleep and the REM phase. Alcohol is a particular threat; not only does it suppress the breathing drive, it also relaxes the throat muscles, reducing their ability to keep the airway open. What’s more, alcohol weakens the mechanism that helps us wake up quickly, thus adding to the time it takes to become aroused enough to make the conscious effort needed to breathe. I tell all patients with apnea that use of alcohol, other than perhaps a very small quantity (less than an ounce), is inadvisable. If they must drink, I ask them to do so no later than four to six hours before bedtime.
*136\226\8*
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Written by admin in: Anti Depressants-Sleeping Aid |
Mar
18
2011
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OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING TRIVIALIZATION OF BDD

OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING TRIVIALIZATION OF BDD
It’s easy to trivialize BDD. Why should she care so much about how she looks? The fact that the person looks okay only compounds the problem. It may lead to reassurance—don’t worry, you look fine—rather than effective treatment. Sometimes BDD is mistaken for vanity. For BDD to be diagnosed and adequately treated, family members and clinicians need to take the symptoms seriously; BDD must be recognized as a serious psychiatric disorder that can cause severe suffering.
What To Do: I hope that after reading this book, you’re convinced that BDD is a serious disorder. If you want someone else in your life to take it seriously, you can talk with him or her about it. Or, you may want them to read this book; many people tell me this has helped other people understand BDD and realize that it’s bona fide disorder and a serious problem.
*234\204\8*
It’s easy to trivialize BDD. Why should she care so much about how she looks? The fact that the person looks okay only compounds the problem. It may lead to reassurance—don’t worry, you look fine—rather than effective treatment. Sometimes BDD is mistaken for vanity. For BDD to be diagnosed and adequately treated, family members and clinicians need to take the symptoms seriously; BDD must be recognized as a serious psychiatric disorder that can cause severe suffering.
What To Do: I hope that after reading this book, you’re convinced that BDD is a serious disorder. If you want someone else in your life to take it seriously, you can talk with him or her about it. Or, you may want them to read this book; many people tell me this has helped other people understand BDD and realize that it’s bona fide disorder and a serious problem.
*234\204\8*
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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
19
2010
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MANAGEMENT OF BED-WETTING: BEHAVIORAL TECHNIQUES

MANAGEMENT OF BED-WETTING: BEHAVIORAL TECHNIQUES
Behavioral techniques often prove effective. The child may be given bladder-stretching exercises, thus learning to become more aware of bodily signals. The technique of drinking large amounts of fluid and then refraining from urination for as long as possible helps improve functional bladder capacity, enabling the child to go for longer periods between voidings. Also, stream interruption exercises—stopping and starting the flow of urine— serve to improve the tone of the muscles that control the urinary sphincter and help make the child aware of the techniques necessary to control the voiding process. Studies show that stream interruption exercises alone can produce remission of enuresis in as many as 35 percent of cases. The process of visual sequencing—training the child to mentally envision and rehearse the process of waking and going to the toilet—can also help. Some experts suggest keeping a bedpan nearby to make voiding easier. Even reducing the amount of spicy or salty foods in the diet produces some results.
*184\226\8*
Behavioral techniques often prove effective. The child may be given bladder-stretching exercises, thus learning to become more aware of bodily signals. The technique of drinking large amounts of fluid and then refraining from urination for as long as possible helps improve functional bladder capacity, enabling the child to go for longer periods between voidings. Also, stream interruption exercises—stopping and starting the flow of urine— serve to improve the tone of the muscles that control the urinary sphincter and help make the child aware of the techniques necessary to control the voiding process. Studies show that stream interruption exercises alone can produce remission of enuresis in as many as 35 percent of cases. The process of visual sequencing—training the child to mentally envision and rehearse the process of waking and going to the toilet—can also help. Some experts suggest keeping a bedpan nearby to make voiding easier. Even reducing the amount of spicy or salty foods in the diet produces some results.
*184\226\8*
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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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ANXIETY IN THE BODY: NERVOUS RASHES

There is a close relationship between the skin and the nervous system. In the early development of the fertilized human ovum into the embryo, adjacent cells are split off so that some will ultimately develop into the skin and others into the nerve cells of the central nervous system. When our skin is gently stroked our nerves are calmed, but when our skin is tickled our whole nervous system is convulsed. It is therefore not surprising that activity of brain cells is often reflected in the activity of the cells of the skin. In other words, emotional stresses in the mind are apt to produce nervous rashes in the skin. This is such common knowledge that it is reflected in our everyday speech when we talk of something “getting under our skin”; and we can observe emotional reactions in the skin when people blush with embarrassment, go pale with fear, or turn livid in anger. Thus the self-management of nervous rashes involves both a reduction in the general level of anxiety and a reduction of responsiveness to emotional stress.

A doctor’s wife came to see me because of a nervous rash which she had had for the past two years. I showed her a little about relaxation, and as she lived in the country it was arranged that she would return to the city in a month’s time for an extended visit so that I could help her further. But she wrote cancelling her appointment, saying that the rash had already cleared.

She came to see me some two years later when she had a slight recurrence. The rash quickly settled down just as on the previous occasion.

*25/57/2*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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ST JOHN’S WORT IN EVERYDAY LIFE: A PROBLEM OF SUBSYNDROMAL DEPRESSION

While depression is in itself a common condition – according to one estimate it affects about one in ten people in any given year -many others are affected by depressive symptoms to a degree that would not qualify them for this more serious diagnosis. According to Dr Lewis Judd, former Director of the US National Institute of Mental Health, and colleagues, approximately one in five people interviewed reported suffering from one or more depressive symptom in the preceding month. Huge numbers of people are suffering from very distressing problems of mood, behaviour and bodily functions of the type that are associated with depression. Nor are these symptoms benign in terms of their impact on a person’s ability to function. Judd and his colleagues found that people with ‘subsyndromal depression’ reported more difficulties in their work and social relationships than were reported by a control group, and that significantly more people with these symptoms had been on disability. Given the reluctance that people have to seek medical attention even for full-blown cases of depression, and the ill-judged care they might receive once they make such a decision, it seems unlikely that a high percentage of people with subsyndromal depression will be properly treated through conventional medical channels. Such people are therefore excellent candidates for self-treatment with St John’s Wort and there is no reason to believe that it will not prove to be helpful for many of them, given its excellent track record in more severely depressed patients.

*21/75/2*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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ÑHILDREN’S SLEEP PROBLEMS/BUILDING THE BASICS: NORMAL DEVELOPMENT AFFECTS SLEEP

When children make developmental strides, it can send them into disequilibrium—and sleep is disrupted. This can affect a child in several ways. He may be so excited about learning a new skill that he has a hard time settling down—he may even be driven to practice skills in his sleep. During normal arousal, instead of going right back to sleep, the new “stander” stands in his crib. It may be easier to understand if you relate it to yourself: think about a time you were learning a new skill—when you were dreaming at tennis, going over that shot you missed, or worrying about the match next day.

Mastering one skill brings a child quickly to the next frustration. When stands in her crib, she may cry desperately because she hasn’t yet learned how to get herself down. She needs you to help until she can help herself again, needs a little extra reassurance, so separation difficulties are common.

Dealing with developmental sleep issues may be particularly frustrating because parents do not have control over a child’s development. Sometimes only “cure” is allowing the development to continue on its own with encouraging messages from you. It helps to recognize that the transition probably be short-lived. Overreacting and doing too much can only prolong problem if she becomes dependent upon your help to go to sleep.

Although each child is an individual, there are guidelines and Ü information that apply to all. Table 3 summarizes the affect of development sleep. With this foundation, you can begin to look at the specific is concerning you about your child.

*21/67/8*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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ÑHILDREN’S SLEEP PROBLEMS: SLEEPING TROUGH THE NIGHT

“Sleeping through the night” is a phrase that is probably best banned from our vocabulary. Let’s face it, no one really sleeps through the night. If you poll a group of adult friends and ask them how they slept last night, you will undoubtedly hear such things as: The wind woke me up.

At 3:00 am I looked at the clock and was relieved to see I had two more hours before the alarm would ring.

If you poll a group of parents, and get past the “She has always slept through the night,” you will hear a variety of comments:

When he is teething, he has a little trouble sleeping.

She seems so hungry at around 2:00 am—must be a growth spurt.

He has been waking with bad dreams.

If sleeping all night long, every night, is your expectation for your child,

you may be setting yourself up for frustration. Sleep needs and patterns

change with age, illness, and emotional or even environmental factors. Just as

with other parenting issues, our goals, expectations, and approaches must be

constantly re-evaluated.    

It is misleading to think of sleep as a state we simply fall into at night and wake from in the morning. Sleep research has shown that there are definite patterns and fluctuations during the night. They play important roles to help refresh us and can reveal some causes behind sleep disturbances.

The descriptions of these cycles can be quite technical. Because a basic understanding is crucial, an effort has been made to give a very simple explanation of what occurs and how your child might be affected.

*1/167/8*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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CHILDREN’S SLEEP: WHY WORK ON IT?

The bags under your eyes, the weight you have been losing or gaining, the grumpiness and sheer exhaustion—these are the obvious reasons to make some changes. Your child’s physical and emotional well-being are also reasons.

Dr. Burton White, author of The First Three Years of Life, feels that sleep problems understandably occur in families where children are loved and whose needs have been met. So, in some ways, the emergence of sleep problems is not necessarily a bad sign. He notes that it is the continuance of sleep disturbances that can cause deeper problems.

Dr. Marc Weissbluth, author of Healthy Sleep Habits, Happy Child, states that the development of healthy sleep habits is not automatic. If your child has not learned them, then his functioning during wakefulness is not “optimal.”2 Put simply, a sleep-deprived child (waking several times a night or missing out on even an hour) is not at his best. His cognitive processes will be fuzzy and his social functioning will be marked by grumpy unpredictability.

A child can “adjust” to whatever sleep patterns he has fallen into. (Look at how you have “adjusted.” Do you say “I didn’t know it was possible to exist with so little sleep”?) However, there are signs—some subtle, some blatant—that he is not at his best.

It is the parents’ job to insist on healthy sleep, just as they insist on healthy nutrition, to give the child the strongest base from which to grow. Good sleep habits do not necessarily happen spontaneously. This is a skill that can be learned by children and facilitated by parents.

*6/97/8*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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POWER OVER PANIC/ QUESTIONS AND ANSWERS: WILL HYPNOSIS HELP? AND PEOPLE BECOMING HOUSEBOUND

Question

Will hypnosis help?

Answer

Hypnotism can produce a very positive response in the short term. The result will not last if we have no understanding of the disorder and don’t know how to manage the attacks and anxiety ourselves. In conjunction with panic/anxiety management skills, hypnotism can help while we work with aspects of the disorder. If we use an audio tape of the hypnosis session during periods of high anxiety and attacks, the tape must teach us how to control the anxiety and the attacks. The control does not come from a cassette tape.

Some people use subliminal tapes in an effort to ease their symptoms. We must know what the subliminal message of the tape is and, more importantly, we should consciously know and learn how to manage anxiety and the attacks ourselves.

Question

I have heard about people becoming housebound. I am the opposite. I can’t bear to be in the house. As soon as my husband goes to work I have to get out of the house. I spend my days travelling on buses or walking around shopping centres. Is this part of the disorder?

Answer

This does happen to some people. If they have difficulty in being alone, going out and being around other people is better than staying home. It can also happen to people who were housebound, but for another reason. As people progress in their recovery, some may go through a stage where the thought of being home all day brings back too many memories of their disorder. They prefer to go out as much as they can. This stage does pass.

*112/94/8*

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Written by admin in: Anti Depressants-Sleeping Aid |
Dec
09
2009
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POWER OVER PANIC: WHO AM I?

Panic anxiety management skills allow many of us to be free of our anxiety disorder. The skills can give us a control over our lives that we have never had before; but sometimes even this isn’t enough. A little-known aspect of the working-through process can hold us back, and be the final factor in the perpetuation of the disorder. It is our lack of sense of self.

Although this aspect is not related only to anxiety disorders, it can be the single most important issue in the disorders. Despite our ongoing attacks and anxiety, it can be the one issue we are most concerned about. It is as if we intuitively know the root cause of our suffering.

The lack of identification goes beyond our cry of ‘this is not me’. When we say ‘this is not me’ we are referring to the image we had before the disorder. Despite the image we had of ourselves, we have always known that we never felt any sense of who we are. We never had a real sense of self. This essential element was always lacking in our lives, and it is from this that our feelings of inadequacy, lack of confidence and lack of self-esteem arose.

We counteracted these by our need to be perfect. Over the years we adapted and modified our behaviour to what we perceived were other people’s expectations of us. We became who we thought we should be, and in doing so suppressed much of who we could be. Our identity became dependent on other people’s perceptions of us. The more dependent we became, the more we had to suppress our real self, even if we didn’t realise we were doing it. The more we suppressed our self, the more inadequate we felt. The more inadequate we felt, the more we felt the need to be perfect.

*100/94/8*

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Written by admin in: Anti Depressants-Sleeping Aid |

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