House Calls

WIN 2018

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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26 { winter 2018 } h o u s e c a l l s BEDTIME IN A BOTTLE f lifestyle tweaks and other treatment options for insomnia have proved unsuccessful, your doctor may prescribe sleep-aid medication. "Prescription sleep medications like Lunesta and Ambien are generally safe and effective, though there is a risk of dependence with long-term use. Other sleep aids such as Doxepin, Belsomra, and Ramelteon have less potential for physical dependence," says Dr. Carswell. Since no medical literature backs the effectiveness of any over-the-counter sleep aids, supplements, and teas, he recommends steering clear. Melatonin, however, might be beneficial for treating sleep-onset insomnia, when rest remains just out of reach. What's Kŗping Us Awake? Such a statistic is certainly enough to keep a person up at night, but what else prevents a peaceful night's sleep? Nighttime wake-ups can be the result of daytime dealings, including eating too much, too little, or too late; excess stress; inactivity; and consumption of alcohol, caffeine, or nicotine close to bedtime. Environmental factors can also hinder the onset of sleep as light from street lamps and electronics as well as close-range use of devices like laptops, phones, and tablets mix up the brain's internal clock. Many medical conditions, from depression and anxiety to chronic pain, can also interrupt our slumber. Insomnia, an inability to sleep through the night, affects one-third of Americans age 55 to 64 and one-quarter of those 65 to 84, per a recent survey from the National Sleep Foundation. Repeated awakenings also occur when heart or lung diseases cause shortness of breath, or when prostate problems urge men toward the toilet. Another common condition, obstructive sleep apnea (OSA), plagues some 22 million Americans. With OSA, a person's airway becomes partially or fully blocked, cutting off airflow and briefly waking them, sometimes without their knowledge, as many as 30 times or more each hour, all night. "While the primary risk factors for OSA are being male, getting older, and carrying excess weight, I have plenty of OSA patients who are young, thin, and female," says Dr. Carswell. "Sometimes the shape of a person's airway leads to the syndrome." Smokers, too, puff up their risk for sleep apnea; they're three times more likely than nonsmokers to suffer from the condition. Finally, restless leg syndrome hinders sleep for 10 percent of the U.S. population. The nervous system disorder—which causes uncomfortable itching or a feeling of pins and needles in the limbs and creates an uncontrollable urge to move the legs—commonly affects women and can be associated with pregnancy, anemia, and kidney problems. Catch those Z's So when is it time to sound the alarm and talk to your doctor? "It's not normal to be sleepy in the daytime," says Dr. Carswell, explaining that if such drowsiness persists for more than a couple of months without a good explanation (i.e., you're caring for a sick loved one, tending to a newborn, or there's a barking dog next door), it's time to seek medical advice. To form an understanding of what might be causing a patient's daytime drowsiness, doctors perform a physical, ask about sleep and social habits, and may turn to a home sleep testing device that, when worn overnight, measures oxygen levels, heart rate, snoring, and pauses in breathing. If the test indicates obstructive sleep apnea, doctors typically prescribe the use of a continuous positive airway pressure (CPAP) mask, which blows a constant stream of air into the airway to hold it open. As a result, breathing

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