Archive for October, 2017

Type 2 diabetes and sleep apnea are closely related - this man wearing a CPAP mask should probably get tested for type 2 diabetes.

Correlations Between Type 2 Diabetes and Sleep Apnea

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You may already know that sleep apnea is a breathing issue that actually affects over 22 million Americans in some form or another. However, what you may not know is that sleep apnea can be an early sign of diabetes developing within the body.  This ultimately comes down to the concentration of oxygen within the bloodstream. Below, we’ve compiled all the details you need to know regarding type 2 diabetes and sleep apnea how presence of each disease affects the other.

Type 2 Diabetes

Firstly, this is a chronic condition that increases the blood glucose levels to unnatural highs. Over time, the body becomes immune to the effects of insulin or it fails to use the store your body offers and this leads to several consequences. At first, the pancreas will step in to make up for the extra insulin. However, this isn’t a sustainable solution and not enough insulin is produced to maintain natural levels. Unfortunately, the condition is actually largely preventable which means our lifestyles are to blame including obesity and history of the disease in the family.

Sleep Apnea

Also known as obstructive sleep apnea (OSA), this is a sleep disorder that directly affects the breathing during the night. With snoring and sudden wakefulness as the two main symptoms, OSA can actually lead to several health complications including heart disease and, of course, diabetes. In addition to this, it can impact people who are obese or have a history of the issue in the family, much like diabetes.

Type 2 diabetes and sleep apnea can both be triggered by obesity and stress. This man is lying down with a CPAP mask on, and he has sleep apnea.

Obesity and stress are the two most common causes of both type 2 diabetes and sleep apnea.

The Correlation Between Type 2 Diabetes and Sleep Apnea

Scientists have actually known about the correlation between type 2 diabetes and sleep apnea for three and a half decades. Proving a significant percentage of diabetics also suffered from sleep breathing disorders, interest grew and we’ve been learning more about the relationship ever since.

According to the Center for Disease Control and Prevention, nearly 26 million people suffer from diabetes with up to 95% of these people having the type 2 variety. Of this huge number, 7 in every 10 also have OSA and one study even suggested a total of 72%, which is significant.

Why? Most commonly, the issue starts with sleep apnea. A certain percentage of people don’t manage this condition very well, making it very difficult for our bodies to control the blood sugar levels. As the condition gets worse and we still don’t manage sleep apnea effectively, type 2 diabetes and sleep apnea will both cause more complications as a result.

In addition to this, there’s also a link between the two with excess stress and body fat. When we wake up during the night due to sleep apnea, this causes frustration and stress because we aren’t able to relax before we fall asleep (knowing it will come during the night), leaving us feeling tired the next day. With this interrupted sleep, our bodies are strained beyond comfortable levels and this will further increase blood sugar levels.

Obesity

As we saw previously, obesity is commonly involved in both these issues. For people who are overweight and develop sleep apnea, any excess fat around the neck will actually obstruct the airways and exacerbate the problem. Overnight, your breathing will be interrupted further and this leads to less sleep and increased stress. In turn, this causes a higher risk for both type 2 diabetes and sleep apnea.

Does it Work in Reverse?

With this in mind, can it work the other way where diabetes causes sleep apnea? Ultimately, people with diabetes tend to have poorer sleep than most anyway and this is because the high glucose levels lead to the kidneys excreting excess sugar during the night. In addition to this, diabetes sufferers can struggle with leptin resistance which depresses the respiratory function and causes a destabilization in breathing patterns.

For this reason, people with either condition will automatically be checked for the other because they’re so closely related. As one occurs, it will lead to the other, with each disease causing a positive feedback loop in the other, and your body will continue on a negative spiral until treated.

Careful Management

All things considered, the best solution to both problems will always be careful management after diagnosis. With OSA, the doctor is likely to recommend a CPAP machine while type 2 diabetes needs to be controlled via blood glucose levels and diet, exercise, and injections (if necessary). Thanks to a recent study at the University of Chicago, we actually know that CPAP machines can reduce blood glucose levels which cuts off this negative spiral and prevents the conditions from worsening.

A yellow road sign that says "Allergy Season Ahead." Sublingual immunotherapy may help allergy sufferers get the relief they need.

Is Sublingual Immunotherapy (SLIT) Right for You?

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If you have allergies but you dislike having your allergy medicine injected intravenously, there is another solution – sublingual immunotherapy (SLIT). If you’re surprised this solution even exists, you aren’t alone.  There is a general lack of information available regarding this topic. With this in mind, we’ve decided discuss sublingual immunotherapy so you can decide whether it can benefit you.

What Is Sublingual Immunotherapy?

With many preventative medicines, they expose your body to a small amount of the disease or illness in order to build your immunity. For example, your seasonal flu vaccine works the same way – you’re given a small amount of the virus and this allows the body to recognize the virus and then build an immunity. For some, they’ll experience a light cold for a couple of days after but the idea is that it prevents a heavier illness later in the season.

With sublingual immunotherapy, an allergist (or you, but we’ll discuss this later) will give you tiny amounts of the allergen underneath the tongue. In the same way we’ve seen, this allows the body to build a tolerance to the illness and prevent symptoms from occurring. At this time, many different allergens are actually being tested within the United States.  However, not all of these solutions are ready for administration or even available just yet. New tests are constantly being performed by the FDA, hopefully leading to more allergy solutions in the future.

Will You Benefit From Sublingual Immunotherapy?

Currently, if your body has an overreaction to allergens within the immune system, you could benefit. Available for both adults and children, sublingual immunotherapy is designed for those who suffer from this overreaction (allergic rhinitis) more than once a year. Furthermore, you may also benefit if your existing treatments aren’t sufficiently addressing your allergy concerns. Sometimes, the traditional treatments can become ineffective and this is where SLIT gets to work.

If you have mild allergies or you only experience an illness every so often, SLIT may not be recommended. Elsewhere, you might also be dissuaded from this treatment if your mild allergies can be contained with traditional medicine. Until the procedure becomes more common and accessible, only the most severe cases will be considered for this treatment

A woman with a tissue to her nose is suffering from allergies and may benefit from sublingual immunotherapy.

Talk to your allergy doctor to see if sublingual immunotherapy is right for you.

Is It Safe and Effective?

Whenever the topic of SLIT arises, the questions of safety and effectiveness aren’t far behind. First and foremost, there has been several clinical trials and surveys over the past two decades alone that show SLIT is safe for all patients. Furthermore, it’s also effective for those that suffer with allergies for cat dander, tree pollens, dust mites, ragweed, and even grass.

As time goes on, we’re also getting more evidence to suggest its use in the treatment of the itchy red eyes that often comes with pollen during the worst time of year for sufferers; hay fever season. Also, we should note an ongoing study investigating the relationship between SLIT and children with eczema as well as treating certain food allergies. With these studies and the general excitement surrounding the topic, it’s fair to say there is potential in SLIT and the coming years could be very important.

Are There Any Risks Associated With Sublingual Immunotherapy?

Compared to other treatment methods, the risks aren’t exactly severe but many worry about the fact it’s normally administered at home without any supervision from a professional. If you’re considering this treatment, we highly recommend discussing the option with an allergist because they can provide you with advice while informing you of how to manage adverse reactions. Additionally, you’ll learn what is and isn’t normal in the time after the treatment.

SLIT Facts

To finish, we have some extra information you should know about sublingual immunotherapy including the fact it’s used within the gold standard of care throughout much of Europe. However, it remains as an ‘off-label’ solution in the US by the FDA despite the support it’s received from many professional bodies including the American Academy of Otolaryngic Allergy (AAOA). This being said, more products are now being approved and the growing number of studies/evidence falling in the ’positive’ column could certainly change this.
For now, you’ll have to pay out of pocket since it isn’t covered on most insurance policies. After the treatment has been administered, you should start to see results after six months so it isn’t an instant solution. On a positive note, the effects can last up to five years with symptom improvement continuing even after this.

Ultimately, a conversation with your doctor and allergist is always advised as they can tell you whether or not you would benefit from sublingual immunotherapy. If they advise against it, they may just suggest a more effective medicine you haven’t yet tried for your allergies!

Dry coughs can be indicative of more serious health issues. This image depicts a woman in a blanket, suffering from a dry cough.

What Causes a Dry Cough?

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Have you had a dry cough nagging away at you for the past few weeks? At first, we attribute it to the flu or just a cough that will ‘go away soon’. As time goes on, we start to ignore it and actually grow accustomed to the cough but this is incredibly dangerous for a number of reasons. Today, we’re going to uncover these reasons and see what your cough could mean (and why you should seek medical attention).

What Is a Dry Cough?

In case you were unaware, a dry cough is any type of cough that produces no mucus or phlegm. Otherwise known as a ‘non-productive’ cough, they quickly become irritating and cause frustration. Often, they get worse at night as you lie down and this prevents a good nights’ sleep and leads to further issues – trouble concentrating at work, constant daytime fatigue, and even impacts on your personal and professional relationships.

Normal Duration of a Cough

With this in mind, how long does a “typical” cough actually last? According to most experts, a cold or flu-related cough should disappear within two weeks. Though some will be shorter and some may extend to three weeks, this is the average duration a cough lasts.

If the cough lasts for more than eight weeks, this is treated as a chronic cough and for children this lasts around four weeks. If you’ve had a dry cough that has lasted for more than eight weeks, now is the time to see the doctor – especially if it’s affecting work/school, sleep, personal life, or produces bloody phlegm.

Diagnosis

When you first visit the doctor, they’ll look into your medical history before beginning a medical examination. In this testing phase, they may take an x-ray as well as a computerized tomography (CT) scan. With a CT scan, they’ll be able to see the condition of your lungs as well as any issues that would produce a cough or issues within the sinus cavities. After this, they could also go for lung function tests, scope tests, and lab tests.

A woman in front of a white background suffering from a dry cough.

Have a dry cough that has persisted for a while? It’s best to get it diagnosed and treated as soon as possible – dry coughs can be indicative of more serious health issues.

Possible Issues

Possible diagnoses could include the following, some of which produce a dry cough:

  • Asthma – First and foremost, a cough relating to asthma may come as the seasons change or after an upper respiratory tract infection. With asthma, it means there is an issue within the lungs and this leads to regular coughs, difficulty breathing, and many other side-effects. If this is the cause, you may be given an inhaler to aid with your breathing, help your lungs, and clear up the cough.
  • Postnasal Drip – As the nose produces excess amounts of mucus, it can actually drip down into the throat and trigger the cough reflex. Also known as upper airway cough syndrome (UACS), it can continue for some time without treatment.
  • Infections – After a bad case of the flu or an infection in the upper respiratory tract, whooping cough can form which is a bacterial infection within the airways and lungs.
  • Gastroesophageal Reflux Disease (GERD) – With this issue, stomach acid can back up into the esophagus (which connects your throat and stomach). This can cause both a wet and dry cough, which causes GERD, causing further coughing, etc.
  • Bronchitis – Finally, this inflammation within the bronchial tubes (airways) can cause dry coughing. Although most sufferers are or were heavy smokers, it can occur in anyone and it falls into the spectrum for chronic obstructive pulmonary disease (COPD).
  • Other causes – Ultimately, these are the most common underlying problems for a dry cough but you could also be experiencing a side-effect from blood pressure drugs, cystic fibrosis, lung cancer, laryngopharyngeal reflux, and sarcoidosis.

Treatment

Ultimately, the treatment required will depend entirely on the issue found. For example, antihistamines and decongestants are common for allergies and postnasal drip while antibiotics will be the best solution for infections. Furthermore, acid blockers would be advised for acid reflux although surgery is an option for the more severe cases.

Elsewhere, cough suppressants might be issued if the doctor cannot find the reason for the cough. If the cough is preventing you from sleeping and severely affecting your life, this solution should see you through until test results are returned and the doctor can work towards a proper treatment to get you back on your feet.

If you have a dry cough that doesn’t seem to be disappearing or if you’re coughing up blood, get in contact with your doctor today and you can have the problem treated rather than living with a potentially dangerous health condition.

An alarm clock with sheep (counting sheep) to denote the consequences of hypersomnia.

Hypersomnia: Causes and Treatment

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Characterized as either excessive amounts of time spent tired or asleep during the day, hypersomnia affects around 0.5% of Americans each and every year. Although this doesn’t sound like a huge amount, it accounts for 1.6 million people and this is only the number that seek treatment (the amount who don’t seek medical treatment is thought to be significant). In fact, the National Sleep Foundation believes 40% of us to experience the symptoms of hypersomnia to some degree.

In terms of the health condition itself, the sufferers have trouble staying awake through the day whether it’s at work, at home, or even while driving. While the problem is purely related to sleep, it has all sorts of side-effects such as a lack of energy and trouble concentrating on even simple tasks.

Causes of Hypersomnia

When looking for causes, it’s hard to look past two other sleep conditions; narcolepsy and sleep apnea. While the former is related to daytime sleepiness once again, the latter deals with interruptions within the normal breathing patterns as you sleep. Both of these issues lead to hypersomnia and make it hard to stay awake during daylight.

After this, we could also point to the following:

  • Being Overweight
  • Alcohol or Drug Abuse
  • Lack of Sleep (Night)
  • Prescription Drugs (Antihistamines or Tranquilizers)
  • Neurological Diseases (Parkinson’s or Multiple Sclerosis)
  • Depression
  • Genetics

With so many different causes, it’s important to see a medical professional who can assess the issue and ask the right questions. While the internet and fantastic guides like this can give you an overview, we can’t provide you with personalized advice. In truth, your hypersomnia could be a combination of these causes.

A sleeping man on an orange background, to suggest hypersomnia in the daytime hours.

Hypersomnia can be caused by many different issues so it’s important for a healthcare professional to assess what they are and provide you with the treatment you need.

Treatment

When you first spot the pattern of drowsiness throughout the day, this is where your doctor should come in. Initially, they’ll discuss your personal life, including your sleeping habits, to get a better idea of why this might be happening. In addition to your sleep, they might also ask whether you’ve been through a stressful situation recently or whether you’re currently taking any drugs (prescription or otherwise).

If they can pinpoint the issue immediately, they’ll start working towards a solution as soon as possible. If not, they may take blood tests, a CT scan, and even a polysomnography; this is a sleep test where your brain waves are measured alongside your heart rate, breathing, and oxygen levels within the blood. If necessary, an EEG (electroencephalogram) could examine your electrical brain activity.

Depending on the cause, the doctor will take appropriate steps as a solution and this could involve stimulants, Provigil, Xyrem, or antidepressants. As mentioned, the applicable treatment will entirely depend on the issue.  Sleep apnea, for example, may require a CPAP (continuous positive airway pressure). With this treatment, you’ll wear a small mask over your face and this goes directly into a machine. Through the night, you’ll be provided with a flow of air to the nostrils which counteracts the condition. As the air flows into the nostrils, it keeps the airways open and you shouldn’t wake up in the night.

If you’ve been offered medication in the past and this didn’t work, don’t worry because they can switch your dosage or try a different solution. Sometimes, people need a heavier dose or a slightly different drug if the first didn’t have the intended reaction within the body. Often, people try medication once, feel disappointed with the results, and then forget the doctor altogether but this doesn’t have to be the case.

As we’ve seen, hypersomnia can also be caused by weight issues and a lack of sleep at night; sometimes, we get into the habit of staying up until 2am before the alarm then goes off for work at 6am. Although we all need different levels of sleep to operate, a sleep pattern of this nature won’t do any good at all. If your issue is one of these two causes, your doctor will recommend an adjustment to your lifestyle. Once again, it all depends on the cause but your solution might be a reduction in caffeine, more sleep at night, a diet to lose weight, less alcohol, etc.

If you’re currently suffering from hypersomnia, be sure to get medical attention because you don’t want to self-diagnose and then choose the wrong treatment. Instead, get assessed and have yourself back up to full health as soon as possible!

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