Author: Rakesh Kharwar
Source: ezinearticles.com

When I used to wake up for a late night snack, I sometimes found my grandma sitting on her favorite chair and sewing till late hours. I remember asking her why she was she up so late and her reply “now that I am old, I have trouble getting the sleep you all children get so easily.” Her being awake was great for me because she used to tell me the best stories late at night.

It is true that most of the common problems that elderly face today are sleeping disorders. They might have problem falling asleep or might be waking up in the middle of night and then have trouble in falling back to sleep again and getting only light sleep.

However, the amount of nightly sleep that we need in old age remains the same as what we needed when we were younger; it’s the ability to get sleep that changes. It has been found that it’s the various illnesses and the medication that are to be blamed for the sleep disorders among the elderly today.

Aging also affects the circadian rhythm or the natural body clock, which can alter the timing of sleep. That’s the reason that your mum is fast asleep by 10 and is up by 4 doing yoga. Other factors that affect the body clock are lack of physical exercise, lack of mental stimulation and excessive time spent in the bed.

The types of sleeping disorders are Insomnia or Sleep deprivation and Narcolepsy or Excessive Sleep.

Insomnia or sleep deprivation affects almost half of adults aged 60 and older. In some patients, insomnia can be caused by an underlying medical condition or a medication side effect which is called secondary insomnia. In the absence of a causative factor, it is referred to as primary insomnia. Women tend to complain more of insomnia than men; it may be due to the post menopausal period.

Narcolepsy is a neurological disorder that causes extreme sleepiness and may even make a person fall asleep suddenly and without warning. Specific causes of narcolepsy are not known but people with narcolepsy are lacking hypocretin, a brain chemical which regulates sleep and wakefulness. The “sleep attacks” experienced by people with narcolepsy occur even after getting enough sleep at night, and make it difficult for people to live normal lives.

Causes of disturbed sleep:

Chronic Pain: With Age come the various pains in the back or the legs. For some, this pain might prevent them from getting restful sleep. Even when asleep, the body continues to register the pain. With constant pain and light sleep, the body is deprived of the growth hormone released during deep sleep which helps body’s healing mechanism. With lack of sleep there is also increase in sensation of pain the next day, thus it seems like an endless loop.

Sleep apnea: Obstructive sleep apnea (OSA) affects almost 40 percent of adults, and is more common among older adults. In this condition, the upper airway becomes too narrow due to relaxing of muscles of the wind pipe. People with sleep apnea stop breathing repeatedly during their sleep, often for a minute or longer and as many as hundreds of times during a single night.

The alternatives are avoiding alcohol or muscle relaxants and losing weight but if it doesn’t work, other solutions are sleeping on the side, sleeping with 30 degrees elevation, using CPAP masks.

Restless Limb Syndrome: This condition causes uncomfortable feelings in the legs, such as tingling, or pins and needles. Periodic limb movements cause people to jerk and kick their legs every 20 to 40 seconds during sleep. One study found that about 40 percent of older adults have at least mild form of this condition.

Restless Limb Syndrome can cause chronic insomnia and one of the contributing factors for the day time fatigue felt by them. Some solutions are taking Folic acid and iron supplements, going for walks before sleeping and relaxation techniques like meditation.

Urinary Problem: It is common for the elderly to wake up many times at night to urinate. This condition is called as Nocturia. Due to age, the body reduces the production of anti- diuretic hormone which slows the production of urine so they tend to have bladder full at night. Also with age, the size of the bladder decreases and thus making trips to the washroom frequent.

Solutions are reducing fluids before sleeping, not taking diuretics like alcohol.

Depression, Stress and Worries: Most of the old people have a habit of worrying and this has a negative impact on sleeping pattern. As we age, our vulnerability to stress hormone Cortisol increases. Thus the prevalence of insomnia can be result of sensitivity to these stress hormones.

Like Stress even Depression has an impact on the sleep. Those who are suffering from depression are likely to be unsatisfied with the amount of sleep that they are getting. Other way around, not getting enough sleep also produces symptoms similar to those of depression. Risk factors for depression in older people include loss of a spouse, retirement, social isolation and onset of dementia.

The only way to fight depression is by taking steps to be positive and cheerful. Going out, socializing, joining a club are some of the ways to be positive and fight sleeping disorder.

Medication: Some widely used medications can have stimulating effects and cause sleep disruption. Included among them are some antidepressants, decongestants, bronchodilators, anti-hypertensives and corticosteroids. Night time use of diuretics can promote repeated sleep interruptions to go to the bathroom.

Lack of Sleep causes: There are significant effects on the overall health of the elderly. A study conducted by North Carolina State University indicates that inadequate sleep is one of the main causes of memory problems among elderly people.

Other functions like ability to learn and remember information, organize, plan, and problem-solve; focus, maintain, and shift attentions are also affected.

Research shows that sleep is critical for healing disease processes and for general well-being. When patients don’t get good sleep they tend to complain more of arthritic and other pains.

Should you go the medication way?

Medication should be the last resort to sleep, as they also have their side effects and can lead to dependency. It is advisable not to take sleeping pills for more than 2 consecutive days and not more than 3 times in a week.

Ways to deal with it:

Below are some of the alternative ways to cope with sleeping disorders.

* Avoid napping in the day time especially after 3 pm.
* Do not drink tea or coffee before going to bed
* Establish a routine for sleep
* Do not use the bed for any other activity than sleep or intimacy
* Keep your bedroom dark, quite and a little cool
* Make a sleep ritual like- having a warm bath, drinking milk, an oil massage before sleeping
* If you can’t sleep within 20 minutes into the bed, leave the room and do some other activity. Go back once you are mentally and physically tired

Research shows that individuals who receive counseling about their approach to bedtime have the best long-term chance of getting a good night’s rest than those who take medication for it.

Sleeping disorders are not a part of aging process, 50% of elderly get good sleep. Try relaxation techniques, get into some activity, have good sleeping habits and see how manageable the sleeping disorder seems.

http://www.medimanage.com

Author: Kurt Stammbergerbr
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The average hospitals asking price of an inguinal or femoral hernia surgery is $10,600 for an adult male in the United States in 2006. (Source: Healthia)
For a patient with viable insurance, the majority of hernia surgery costs will be covered. Unfortunately, more than 40 million Americans dont have insurance. In addition, some health plans qualify some forms of hernia surgery as elective.
A 1999 study in American Family Physician warned about the consequences of not covering hernia surgery because of cost concerns. In the managed-care environment, elective herniorrhaphy is under increasing pressure. Some state health plans do not reimburse for elective hernia repairs. The long-term impact of complications secondary to untreated herniation is not fully known. A decrease in surgical repair may lead to an increase in hospitalizations related to incarceration or strangulation. (Source: T. Bax, B Sheppard, R. Crass. Surgical Options in the Management of Groin Hernias. American Family Physician. January 1999.)
Typically, hernias are in the news when athletes get them. In August of 2006, Colorados Avalanche Hockey Club announced that defenseman Jordan Leopold needed to undergo hernia surgery, taking him out of the game for a number of months. After further medical testing and evaluation it was determined that rehabilitation alone would not correct the problem, Avalanche Head Trainer Matt Sokolowski told the press. We expect him to be back to full speed in 10-12 weeks.
In fact, the only real cure for a hernia is surgery, and sometimes once is not enough. Arkansas starting quarterback Robert Johnson, a fourth-year junior, underwent two hernia surgeries during two off-seasons in a row, according to the ARSN Sports Network.
Unfortunately, hernia symptoms arent always obvious. In 2003, Oakland Raiders receiver Jerry Porter had to undergo a hernia surgery. Initially, the condition was diagnosed by doctors as a strained stomach muscle.
The signs of a hernia can range from a painless lump to a protrusion that cannot be pushed back into the abdomen. A lump in the groin or abdominal wall that increases in size while coughing is a possible sign of a hernia. A pain followed by tenderness and symptoms of bowel obstruction could be the sign of a strangulated hernia, an emergency that requires hernia surgery. Key symptoms to watch out for are tenderness and pain. While not every hernia is an immediate surgical emergency, any hernia can become one. So if you notice the symptoms, you should take a prompt trip to your doctor.
While hernias have often been associated with sports and weight lifting, they can actually turn up without heavy exercise. A hernia patient was likely born with an area of weakness in his or her abdominal wall. Pressure from strenuous exercise, obesity or even coughing can cause part of an internal organ to bulge through a wall in the body. Other conditions that can contribute to the formation or worsening of a hernia include chronic lung disease and fluid in the abdominal cavity. But having a history of hernias in the family is also a contributor.
In the event of strangulation, when blood supply is cut off from the bulge, the condition can become a life-or-death emergency that requires hernia surgery. Without insurance, a patient could be faced with a choice: risk serious medical complications or face a financial crisis. Some patients without insurance have actually held off on surgery, hoping to raise the money, only to discover that the hernia got worse with time and became more expensive to treat.
Luckily, hernia surgery is often an outpatient procedure, sometimes performed with local anesthesia. Patients arent able to drive themselves home, but they typically dont have to spend the night at a hospital.
Unfortunately, hernias can appear suddenly. Even someone who believes he is too healthy for insurance can find himself suffering from a hernia. A costly surgery is the only cure.
Given the high price of a hernia surgery, it is essential for health consumers to select solid health plans that will cover non-emergency hernia repairs, and to never go without insurance. Independent sites that help consumers compare plans from different carriers, like Healthia inc, can help. Check the fine print in your policy. Affordable plans exist that will cover emergency and non-emergency cases. Health Savings Accounts can also be used with high-deductible plans to offset the financial burden of an operation.
Kurt Stammberger is VP, marketing at Healthia Inc. Healthia provides integrated comparison-shopping information on hernia surgeries and other medical procedures to empower the drive toward Consumer-Driven Healthcare.

http://www.healthia.combr

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