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Wellness Library

Wellness Library articles contain step-by-step guides to diseases and conditions, ranging from how a baby develops and grows, to memory care for Alzheimer's patients. Resources include information on disease and condition management, prevention and self-care, when to consult a physician, what to ask the physician and educational quizzes to test knowledge and track symptom progression.

What is HealthDay’s Wellness Library?

HealthDay's Wellness Library is a collection of more than 1,500 original encyclopedic health and medical articles. The reference-style library features informative articles, special reports, first-person essays, quizzes and much more. Arranged into 42 topic centers ranging from Alzheimer's to Women's Health, the Wellness Library offers "what you need to know" content on a wide variety of topics.

The stories contain step-by-step guides on diseases and conditions, ranging from how a baby develops and grows, to memory care for Alzheimer's patients. Resources include information on disease and condition management, prevention and self-care, when to consult a physician, what to ask the physician and educational quizzes to test knowledge and track symptom progression.


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How to Find a Caregiver: A Guide

Wellness Library

THURSDAY, March 23, 2023 (HealthDay News) -- Choosing a caregiver for a loved one is a decision no one takes lightly.

Figuring out the level of care your loved one needs can help make the process go more smoothly. That’s why it’s a great place to start your journey.

“The goal is to pick up clues early, before they start to impact day-to-day life in a significant way, so we can do something about them,” Cleveland Clinic's Dr. Ardeshir Hashmi said in a recent article.

Here's how to find a caregiver, including what websites to use, what questions to ask a potential caregiver, and how to research qualifications.

Know what level of care is needed

According to John Hopkins Medicine, caregiver services may include:

  • Doctor care to diagnose and treat diseases
  • Nursing care to create and deliver a health plan in consultation with a doctor, such as dressing wounds and administering medication
  • Therapist care to help with recovery from an injury or other health issue
  • Social work to assist with finding community resources
  • Mental health care to assist with receiving counseling
  • Home health aide care to assist with personal hygiene, such as showers, baths and dressing
  • Personal care to take care of chores, transportation, cooking and other non-medical activities
  • Companionship care to provide social and emotional support
  • Dietician care for nutritional guidance

Once you have decided on the type of care your loved one needs, you can start to ask more detailed questions. For instance, will they need a nurse around the clock, or just during the day? If they need personal care, is it for both the morning and evening, or just for food prep?

To help answer these questions, the AARP suggests writing down your loved one’s requirements and desires so you can match them with the best caregiving services.

If you have Medicare and Medicaid insurance, a level of care assessment must also be conducted by a doctor to show the need for in-home care.

Research caregiver qualifications

The term caregiver is very broad. It can range from someone who just makes food or assists your loved one to and from the bathroom to someone who’s an RN or other certified medical professional.

AARP offers some basic certification, licensing and training guidelines to look out for:

  • Personal care aides are generally not licensed or certified, and training may vary by state
  • Home health aides have to have at least 75 hours of federally mandated training
  • Licensed practical nurses must be licensed by the state, and some may be speech, occupational or physical therapists
  • Registered nurses must have a college degree, meet their state’s nursing board licensing requirements and pass the National Council Licensure Examination

What to ask potential caregivers

United Disabilities Services recommends covering your bases with several categories of questions, such as:

  • What’s your length of time in business and do you have references?
  • Do you have current liability insurance, and are you properly licensed and certified to provide care in the state?
  • What are your billing procedures and fees? Is a contract required?
  • What forms of insurance do you accept?
  • How do we communicate, and what’s your typical turnaround time for responding to my inquiries?
  • What’s your policy on background checks?
  • Can I expect the same caregiver each time?

5 websites for finding caregivers

To help you get started on finding a caregiver, here are five useful websites:

  • Community Resource Finder is a partnership between AARP Family Caregiving and the Alzheimer’s Association. It offers information on programs and services that help you find caregiving in your area, such as adult day care, transportation, home health care and support services.
  • Long Term Care is a government website that connects you with local caregiving services. These include an eldercare locator and Medicare-certified home health agencies.
  • The National Association for Homecare and Hospice offers some tips on hiring the right provider and a comprehensive agency locator of more than 33,000 home care and hospice providers.
  • The Caregiver Action Network breaks down caregiving organizations and resources into helpful categories. It provides several websites that can help you in your caregiver search.
  • CareNav™ is a free, personalized and secure caregiver resource portal. It pulls together caregiver resources into one dashboard for optimal organization to make finding a caregiver easier.

Ask your health care provider for suggestions

Your doctor or health care provider may also be able to offer a wealth of information on finding a caregiver for your loved one. According to AARP, this can give you peace of mind knowing that the agency or individual you hire is reputable and trustworthy.

For more on finding a caregiver, take a look at the Family Caregiver Alliance’s Hiring In-Home Help Guide.

Dealing With Caregiver Stress & Burnout: A Guide

Wellness Library

WEDNESDAY, March 22, 2023 (HealthDay News) -- If you’ve been suffering from caregiver stress, you've got plenty of company.

It affects about 36% of the 53 million unpaid family caregivers in the United States, according to a recent report by the AARP and the National Alliance for Caregiving -- and it can ultimately lead to caregiver burnout.

To give you some tools to better recognize caregiver stress and burnout, let’s explore some of the symptoms. Plus, experts offer several ways you can better manage caregiver stress, and when it’s time to seek help to prevent it from reaching the level of burnout.

What is caregiver stress?

Caregiver stress occurs when the emotional, mental and physical impacts of being a caregiver become overwhelming.

It can happen to anyone who takes care of a person with a disability, health condition or injury or someone who is elderly. However, more women say they experience stress from caregiving than men, according to the U.S. Department of Health and Human Services Office of Women’s Health.

One of the main challenges for a lot of caregivers is having too little time for themselves or their family and friends.

“Family caregivers spend an average of over 24 hours a week providing care -- that’s more than an entire day you don’t have for yourself,” Laura Kotler-Klein, a social work manager at the Hospital of the University of Pennsylvania, said in a Penn Medicine article.

Caregiver stress may be experienced in a variety of ways, including:

  • Overeating or not eating enough
  • Losing interest in the activities and people you once enjoyed
  • Experiencing feelings of isolation, depression or other negative emotions
  • Treating the person you’re caring for poorly
  • Feeling a loss of control
  • Using substances like alcohol and medications to try to relieve stress.

According to the Alzheimer’s Association, signs of caregiver stress may also include increased levels of irritability, anger, frustration, insomnia, anxiety and even denial of your loved one’s condition.

What is caregiver burnout?

Caregiver burnout comes from caregiver stress that’s left unaddressed and reaches the level of exhaustion.

The Cleveland Clinic notes that caregiver burnout may cause caregivers to experience depression, anxiety disorders, ongoing stress and fatigue. Oftentimes, people’s attitude shifts from caring and positive to detached and unconcerned due to being worn out.

While everyone has a unique experience of caretaking, here are some top reasons for burnout:

  • Too much workload or demand placed on the caregiver
  • Too little control stemming from a shortage of resources or knowledge, such as a lack of money or not understanding how to be a caregiver
  • Confusion about roles, especially if you’ve previously been a sibling, partner, parent or friend and must now take on an additional role with new responsibilities that are unclear
  • The emotional toll of seeing a person you’re caring for struggle with mental, physical or behavioral health issues
  • Neglect of your own physical, mental and emotional needs due to the demands of caregiving.

“These [caretaker] responsibilities can leave you feeling overwhelmed, unhappy and isolated,” said Kotler-Klein.

How manage caregiver stress

Here are some ways to manage caretaker stress, according to Penn Medicine:

  • Practice setting proper boundaries, including saying “no” when you already have enough on your plate
  • Acknowledge and practice strategies to help manage your feelings of stress, such as taking a few deep breaths throughout the day
  • Cook healthy meals to create positive experiences with the person in your care
  • Go outside for about 10 minutes each morning and afternoon to get some fresh air and sunlight
  • Prioritize time for yourself each day -- even if it’s just a few minutes
  • Ask for help and support from your family, friends and the health care community, including seeking professional help if you feel you need it
  • Schedule time for the activities and people you enjoy.

In addition, a 2018 study showed exercising at least three times a week for six months improved stress levels and even cellular health in family caregivers.

“What caregivers need is support for healthy behaviors, because that is one of the first things to drop when you become a family caregiver,” study author and University of British Columbia associate professor Eli Puterman said in a news release when the study was published.

When caregiver stress becomes burnout

Burnout is a serious health concern. When caregiver stress becomes too much to handle and the signs of burnout appear, it’s important to seek help.

If you think you may be experiencing depression, anxiety or another mental health condition due to caregiver burnout, a professional therapist can work with you to help reduce and eliminate your symptoms.

There are also services available for caretakers that the Cleveland Clinic recommends, including adult day care, home health aides, and caregiver support services. You can find helpful information and resources for caregivers at USA.gov.

Your Guide to Bedpans and Bedpan Alternatives

Wellness Library

WEDNESDAY, March 22, 2023 (HealthDay News) -- Sometimes a person may not be able to make it to the bathroom on their own, either because they are recovering from surgery or have long-term health issues.

It’s likely that many people will need to think about being able to change a loved one’s bedpan at home.

Research published recently in the journal Health Affairs found that the seniors most likely to need paid home care to continue living at home were also the least likely to be able to afford it.

"Most people who become frail at older ages rely on unpaid family caregivers," lead researcher Richard Johnson, a senior fellow with the Urban Institute's Income and Benefits Policy Center, in Washington, D.C., said when the study was published. "Those are the people who provide the vast majority of care."

Despite that grim fact, it is still possible to help your loved one meet their toileting needs with the kindness and dignity that everyone deserves.

If this is your first foray into the world of bedpans, alternatives and the best way to make this work, there’s a lot to know.

Fortunately, this simple item has been around a long time, so there is plenty of information on what is available and how to use it.

How do bedpans and bedpan alternatives work?

Bedpans and bedpan alternatives, such as portable urinals, allow someone to eliminate their urine or feces without getting up from their bed, according to Kaiser Permanente and the nonprofit HealthWise.

The devices are not so different than what existed in the 18th century, according to the National Library of Medicine (NLM).

Styles can be broken down into regular and fracture, according to the NLM. The fracture style is meant for people who are recovering from fractures, just like it sounds. It’s smaller.

Typically, bedpans are made of metal or plastic, according to Kaiser Permanente. Some have liners for easier cleaning. They are shaped to fit under a person, whether sitting or lying in bed.

How to use a bedpan

Good hygiene is, of course, a very important element in bedpan use.

Kaiser Permanente suggests wearing gloves after washing and drying hands.

It’s also important to be ready with cleaning supplies for the person you’re caring for, including toilet paper and wipes, a place to set aside the bedpan while cleaning the person and an incontinence pad to protect the bed in case of spills, Kaiser Permanente suggests.

The incontinence pad should be placed under the buttocks and thighs, the NLM suggests.

If the person you’re caring for is able to do so, have them pull down their own pants and underwear. You can help preserve dignity here by using a sheet or blanket as a privacy curtain.

It can be embarrassing for someone to use a bedpan, so it’s important to maintain patient dignity at all times, asking others to leave the room, the NLM recommends.

Tissue paper or powder may be used on the bedpan to help prevent the person’s skin from sticking to the bedpan, the NLM suggests. Placing the bedpan depends on the mobility level of the patient. If the person can sit up or lift their hips slightly, you can slide the pan under the person’s bottom, according to Kaiser Permanente. If not, you can help turn the person to their side, gently press the bedpan onto their bottom and then help them turn back onto the pan.

The NLM notes that the wide area of the bedpan points toward the patient’s head.

Never place the patient too close to the edge of the bed, so the person does not fall, the NLM cautions. Leave the room to offer privacy, if possible, Kaiser Permanente suggests, but check back often so that the pan can be removed as soon as possible.

Remove the pan by gently rolling the person off of it, away from you. Set the pan aside, while helping the person wipe if needed, Kaiser Permanente suggests.

Provide the patient with hand wipes, so they can ensure good hygiene, the NLM suggests.

Bedpan alternatives

A variety of catheters exist that are used to drain urine. They can be both internal and external or even used intermittently, according to the NLM.

Portable urinals come in varieties specifically for men and for women, according to a U.S. Centers for Disease Control and Prevention presentation on alternatives to catheters.

In men, a portable urinal can be used in patients who don’t have urological problems and who are cooperative, the CDC said. The device looks a bit like a jug with a wider opening.

In women, the design is a little different but similar, with an opening and small receptacle for the urine.

Numerous online retailers also sell commode chairs, a sturdy portable toilet to be used outside of the bed.

Adult diapers are another alternative. These can be used for incontinence or for a loved one who has mobility issues, according to the University of Pittsburgh Medical Center (UPMC).

Disposable adult diapers that are absorbent and have side fasteners are good for those who have heavy incontinence or trouble standing, according to UPMC.

Cleaning bedpans and bedpan alternatives

After helping a person you’re caring for use a bedpan, it’s important to dispose of the bedpan’s contents in a toilet, according to Kaiser Permanente.

The bedpan should then be rinsed and cleaned with a disinfectant diluted with water.

It is possible to get a small sprayer to attach to toilet water, making it easier to clean and rinse the bedpan, Kaiser notes.

The bedpan can be air dried or wiped dry.

Where to buy bedpans and bedpan alternatives

Bed pans can be purchased at local medical supply stores or online retailers.

These include chain pharmacy stores such as CVS, Rite Aid, Target, Walgreens and Walmart. Amazon.com also carries them. So do several online medical supply sellers, such as:

Online Medical Supply

Vitality Medical

McKesson

Discount Medical Supplies

Henry Schein

Allegro Medical

The Most Common Anxiety Symptoms and How to Deal With Them

Wellness Library

TUESDAY, March 21, 2023 (HealthDay News) -- Anxiety disorders are no small matter, but knowing which symptoms point to trouble may help you navigate your intense fears and worries.

First, you are not alone: Anxiety disorders are estimated to plague nearly 40 million people in the United States each year, according to the Anxiety & Depression Association of America.

James Maddux, an emeritus professor of clinical psychology at George Mason University in Fairfax, Va., explained that “the best way of thinking about anxiety…is to see it as having three interlocking, interacting components": thinking or cognition; feeling or emotions; and then behavior.

“Finding somewhere to intervene at one of those three points, that breaks up that pattern, is also a way of reducing or eliminating the physiological part of anxiety,” Maddux noted.

If you think you may be experiencing generalized anxiety disorder or any other type of anxiety, there are some telltale symptoms worth noting.

Here’s how you can recognize the most common anxiety symptoms, plus tips on how to calm them down if they flare up.

Common anxiety symptoms

The National Alliance on Mental Illness (NAMI) states that, while each type of anxiety is unique, they share some common symptoms:

  • Anticipating the worst or an excessive fear of a threat
  • Rapid breathing
  • Pounding heart or heart palpitations
  • Fatigue
  • Sweating and shaking
  • Nausea, diarrhea and increased urination
  • Restlessness or irritability

Anticipating the worst or excessive fear of a threat

“Typically, the cognitive component of any anxiety problem is the expectation or prediction that something bad is going to happen,” said Maddux.

This excessive thinking about something terrible happening to you can be caused by several factors, according to NAMI. These include:

  • Negative or traumatic life experiences
  • A family history of anxiety
  • Long-term illness

So how can you deal with your excessive fear?

Maddux noted that, while the natural reaction is to escape the situation or avoid it altogether, this tends to make things worse over the long term.

Instead, he recommended using cognitive behavioral therapy (CBT) and guided exposure therapy to work on becoming “more aware of what we are thinking and feeling, then…be able to assume more control over it.”

He suggested one way to do this is through meditation because “you're learning to observe what's happening in your brain. And anytime you become more aware of those things, they become a little easier to control. So, that can build over time…some resistance and some resilience to situational anxiety.”

Rapid breathing

Once you start thinking worrisome or fearful thoughts, your brain’s amygdala sends a crisis signal to your brain’s command center, the hypothalamus.

Your hypothalamus then signals your sympathetic nervous system and it kicks your stress response into gear by telling your adrenal glands to release epinephrine. Other stimulating hormones like cortisol may also be released if the perceived danger continues.

This response is sometimes referred to as “fight or flight,” according to Harvard Health.

One of its consequences? Your breathing becomes rapid and shallow.

On the upside, breathing may be the only physical anxiety symptom that is also its own solution.

“The rate and depth we breathe at is a huge determinant of our mental state,” University of California, San Francisco professor of psychiatry Elissa Epel, said in a recent article.

“If we’re breathing really shallowly and fast, it causes our nervous system to up-regulate and we feel tense and anxious. If we’re breathing slowly, it actually turns on the anti-stress response,” she noted.

Breathing exercises and yoga practices like a Tibetan form of breathing and meditation called "tummo" can help you learn to decrease your rate of breathing and even improve other anxiety symptoms.

Heart palpitations

According to the Cleveland Clinic, the most common cause of heart palpitations outside of heart problems is anxiety. These can manifest as a pounding or racing heart, irregular heartbeat or a fluttering in your chest.

Like rapid breathing, heart palpitations are caused by the fight-or-flight response.

Diaphragmatic breathing exercises, massage therapy and biofeedback treatments can help slow your heart rate. Exercising, especially yoga or tai chi, can also bring on a more relaxed state. This also helps other symptoms triggered by the fight-or-flight response, such as nausea, diarrhea, restlessness, irritability, sweating and shaking.

Fatigue

Fatigue or exhaustion can be a result of the constant worry associated with anxiety, states NAMI.

You also may experience fatigue after a fight-or-flight response when your parasympathetic nervous system works to calm your mind-body systems down. The U.S. National Library of Medicine notes that this response’s main role is to help you conserve your energy and “rest and digest.”

Getting enough sleep is one of the main ways to overcome fatigue.

Anti-anxiety medication may also be prescribed to treat the multiple symptoms of anxiety.

According to Anxiety.org, antidepressants such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) can be part of an anxiety treatment plan as well.

One of their potential benefits is that they may increase your brain’s neuroplasticity. This can make it easier to rewire your brain to think more positive thoughts — and increase your resistance to anxiety.

SOURCE: James Maddux, emeritus professor, clinical psychology, George Mason University, Fairfax, Va.

The Most Common Anxiety Disorders, Explained

Wellness Library

MONDAY, March 20, 2023 (HealthDay News) -- Sometimes an anxiety disorder feels like worry and ruminating about lots of little and big things.

Other times it’s focused on a specific phobia, such as a fear of flying or being in social situations. It can also be expressed as intense feelings about separation from loved ones.

What’s clear is that someone experiencing anxiety disorder symptoms isn’t alone. About 40 million American adults have one or more types of anxiety disorders, according to the Anxiety and Depression Association of America (ADAA).

If you think you may be among those dealing with these issues, it is possible to get help. There are a range of treatment options for anxiety disorders.

A common experience

The pandemic exacerbated anxiety issues, which led the U.S. Preventive Services Task Force to recommend screenings for all adults under the age of 65.

"COVID has taken a tremendous toll on the mental health of Americans," panel member Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, said when the screening recommendations were changed. "This is a topic prioritized for its public health importance, but clearly there's an increased focus on mental health in this country over the past few years."

Anxiety disorders are so common that nearly 30% of adults will experience one at some point in their lives, according to the American Psychiatric Association (APA).

While anxiety itself is a normal reaction to stress, the feelings involved in anxiety disorders are excessive in relation to the circumstances.

More women than men have these conditions, according to the APA. Only about 43% of people who have generalized anxiety disorder are receiving treatment, according to the ADAA.

Here is a breakdown of the most common types of anxiety disorder.

Generalized anxiety disorder

Persistent anxious feelings can interfere with daily life over months and years, according to the U.S. National Institute of Mental Health (NIMH).

You might be restless, irritable, have trouble concentrating or find it hard to control your worries. Physical symptoms can include fatigue, headaches, muscle aches, stomachaches or trouble sleeping, according to the NIMH.

The worries can be about everyday issues, including job responsibilities and family health, according to the APA.

Social anxiety disorder

Someone might experience intense fear about social situations, causing them to avoid taking part in events or gatherings, according to the National Alliance on Mental Illness (NAMI).

It can be driven by irrational worries about humiliation, according to NAMI.

Symptoms can include blushing, sweating, trembling, a pounding heart, stomachaches, difficulty making eye contact, rigid body posture and feelings of self-consciousness, according to the NIMH.

Separation anxiety disorder

This can come with fears of being separated from those you love or worry that harm will come to them, according to the NIMH. The feelings are greater than what would be expected for a person’s age, according to the APA.

Symptoms can include nightmares.

Panic disorder

This can include panic attacks, according to the NIMH, with a racing or pounding heart, chest pain, trembling, feeling of impending doom, tingling or sweating. Some may fear dying, feel they are choking or experience shortness of breath, according to the APA.

This can happen multiple times throughout the day or only a few times a year, according to the NIMH.

Not everyone who has a panic attack has a panic disorder, the NIMH noted.

Phobias

These can include a fear of flying, heights, injections, blood and certain animals, such as spiders or snakes.

People with phobia-related disorders or specific phobias have an intense fear about these particular objects or situations that are out of proportion with their actual danger, according to the NIMH.

Someone might avoid their fear or experience immediate intense anxiety when they do encounter it.

Agoraphobia is the fear of a particular situation that the person feels may be difficult to escape, according to the APA. Commonly, this can include fear of being in open or enclosed spaces, being in a crowd, using public transportation or even just being outside the home.

Symptoms can include avoidance of the situation or needing a companion to endure it.

Anxiety disorder treatment

Several different types of treatments are commonly used to treat anxiety disorders.

Most will respond well to a type of talk therapy called cognitive behavioral therapy (CBT) or to anxiety medication, either used together or separately.

CBT can help someone learn a new way of thinking that may include exposure to a specific fear.

Acceptance and commitment therapy (ACT) is a newer alternative that uses mindfulness and goal setting to reduce these negative feelings, the NIMH said.

Anxiety disorder medications include a range of anti-anxiety drugs and antidepressants that can balance brain chemicals, such as benzodiazepines, atypical antidepressants and beta blockers.

Anxiety Attacks: Symptoms and Calming Techniques

Wellness Library

MONDAY, March 20, 2023 (HealthDay News) -- Anxiety attacks can seem overwhelming when you’re in the middle of one, but with the right coping tools you can come out the other side.

What is an anxiety attack?

According to the Detroit Medical Center, an anxiety attack is a stretch of time during which you experience “intense” anxiety symptoms, especially fear. It can last anywhere from minutes to weeks.

So, what does an anxiety attack feel like?

A racing heart, dizziness and being out of breath are common experiences for people who are having an anxiety attack, according to Harvard Health. In addition, this "fight-or-flight" response that is triggered by worry or fear can cause more fear to develop, creating a negative loop of panic.

“If you’re feeling lightheaded, your heart racing and chest tightening, it really contributes to a sense that something terrible is going to happen,” said Jacqueline Bullis, an assistant psychologist at Harvard-affiliated McLean Hospital, told Harvard Health. "But physical symptoms themselves aren’t the problem. It’s really the way we respond to them. We want people to learn that these distressing physical sensations aren’t dangerous and they can learn ways to tolerate them."

Anxiety attack symptoms

According to Harvard Health, anxiety attacks occur when your symptoms become so intense that they interfere with everyday activities.

These anxiety symptoms may include:

  • Steadily increasing feelings of fear or worry
  • Panting or gasping for breath
  • Extreme nervous and restless sensations
  • A racing, pounding heart
  • Sweating hands
  • Sensations of dizziness and nausea
  • Feeling panicked because you think something awful is about to occur
  • Feeling like you’re having a heart attack or stroke

It’s always recommended to seek medical care if you’re experiencing symptoms that could indicate a life-threatening medical condition. However, if your doctor finds no signs of an underlying health issue, these symptoms may be markers of an anxiety attack.

Panic attack versus anxiety attack: what’s the difference?

“It is possible to feel really anxious without having a panic attack,” said James Maddux, an emeritus professor of clinical psychology at George Mason University, in Fairfax, Va.

“You probably have sat in situations where you felt really nervous, but you weren't experiencing what the DSM [psychiatric conditions manual] calls a panic attack… which is the sudden onset for no apparent reason of extreme debilitating, terrifying anxiety,” Maddux added.

According to the National Library of Medicine, the DSM lists a panic attack as a period of “intense fear” that comes on suddenly, reaches its maximum strength within 10 minutes and includes at least four of the following symptoms:

  • Heart palpitations, pounding heart or accelerated heart rate
  • Sweating
  • Shaking or trembling
  • Shortness of breath or sensations of smothering
  • Nausea or abdominal distress
  • Choking sensations
  • Chest discomfort or pain
  • Dizziness, lightheadedness, or faintness
  • Feelings of unreality or feelings of being detached from oneself
  • Fear of losing control
  • Fear of dying
  • A numbness or tingling sensation
  • Heat sensations or chills

Nationwide Children’s Hospital acknowledges that the terms anxiety attack and panic attack are sometimes used “interchangeably,” and notes that a person’s fight-or-flight response is activated in both.

But a key difference is that the symptoms of a panic attack are unexpected and take the person by surprise, while anxiety attacks are more expected because the feelings of worry or fear grow steadily more intense.

How to calm an anxiety attack

While experts may not always agree on the exact definition of anxiety versus panic attacks, what they do find common ground on are some scientifically backed tools that work best to help calm yourself when panic hits.

“Whatever you are doing in that situation, one good strategy is to slow down, including slowing down your breathing and breathing more deeply. And slow down your rate of speech. That's one way of breaking up … this interaction between the danger you expect to occur and the need to avoid or escape,” Maddux explained.

He added that “meditation over time teaches you to control your physiological reactions.”

One recent study of over 100 participants conducted by Stanford Medicine researchers revealed that just 5 to 6 minutes a day of breath work and mindfulness meditation improved people’s anxiety and panic levels — with controlled breath work being the more effective of the two strategies for calming the physical and emotional symptoms of anxiety.

Maddux also recommended guided exposure therapy, particularly for people who experience anxiety attacks due to phobias, such as a fear of snakes.

If you’d like to learn more about managing anxiety attacks, the National Alliance on Mental Illness lists several treatment options for anxiety, including cognitive behavioral therapy, exposure therapy and anti-anxiety medications.


SOURCE: James Maddux, emeritus professor, clinical psychology, George Mason University, Fairfax, Va.

The Most Common Sleep Disorders, Explained

Wellness Library

Almost everyone has trouble sleeping occasionally, but when you toss and turn often enough that it affects your health, moods and safety, your bad nights of sleeping may be elevated to the level of a sleep disorder.

Sleep disorders are among the most common medical problems that health care providers see in their practices, according to the book Sleep Disorder published on the National Center for Biotechnology Information government site. Many people with sleep disorders find they have trouble staying awake during the day because they haven’t gotten quality sleep at night.

There are more than 80 sleep disorders, according to the U.S. National Library of Medicine. Some common ones include:

  • Insomnia
  • Narcolepsy
  • Sleep apnea
  • Restless leg syndrome (RLS)
  • REM sleep behavior disorder
  • Shift work sleep disorder (SWSD)

Here, learn about the most common sleep disorders, their signs and symptoms, and what treatments may be available.

Insomnia

Insomnia, the most common sleep disorder, is defined as having difficulty falling asleep, staying asleep or being able to get quality sleep, according to the National Heart, Lung, and Blood Institute (NHLBI).

Insomnia may be:

  • Short term (lasting a few days or weeks). This type may develop from stress or schedule or environment changes.
  • Long term or chronic (lasting 3 months or more and for 3-plus nights per week). Chronic insomnia may increase your risk of high blood pressure, diabetes, heart disease and cancer. Often, the cause of chronic insomnia is difficult to determine.

Having another health issue may also contribute to insomnia.

Some things to try when sleep eludes you include:

  • Establishing a routine and sticking to it. Go to bed close to the same time every night, and wake up at the same time each morning (yes, even on weekends and holidays).
  • Getting regular exercise. Exercising at least 30 minutes most days of the week may help you sleep better. Be sure to finish at least 2 or 3 hours before bedtime though to keep your workout from affecting your sleep.
  • Nixing caffeine and nicotine before bed. Both are stimulants, and their effects may last up to 8 hours. Plus, if you smoke, you may wake up because you feel a craving to smoke.
  • Relaxing before you go to bed. Unwinding by reading, taking a bath or listening to calming music may make you feel sleepy.

If you can’t sleep, don’t toss and turn — it’ll only make you more anxious. Instead, get out of bed and do quiet activities until you feel sleepy again (such as reading), and then return to bed.

Narcolepsy

When you have narcolepsy, your brain is unable to regulate sleep-wake cycles properly, so even if you sleep well at night, you’re still severely sleepy during the day, and the sleep you get isn’t restful. Excessive daytime sleepiness may cause you to fall asleep in the middle of doing something else, such as driving, eating or talking. Narcolepsy can be very dangerous.

People with narcolepsy may also lose muscle tone, especially when they laugh, feel angry or feel excited. The effect can range from drooping eyes to looking like you’re having a seizure. While scary, episodes tend to be brief and over quickly.

Other symptoms include sleep paralysis, which is the inability to move or speak while you’re falling asleep or waking up, and hallucinations.

Narcolepsy is a chronic condition that doesn’t go away or get worse as you age. It affects men and women equally, and though it may start in childhood, it may occur at any time over the course of your lifetime.

While there’s no cure, narcolepsy may be treated with medications and certain lifestyle changes. According to the National Institute of Neurological Disorders and Stroke (NINDS), medications may include stimulants, antidepressants or an H3 receptor antagonist/inverse agonist. Talk to your health care provider if you think you may need medication to treat narcolepsy.

Lifestyle changes for those with narcolepsy include:

  • Taking short naps
  • Sticking to a regular sleep schedule
  • Avoiding caffeine or alcohol, especially later in the day
  • Exercising, making sure to finish at least 4 to 5 hours before bedtime
  • Avoiding large, heavy meals before sleeping
  • Making time to relax before bed
  • Keeping your bedroom cool and comfortable, which is optimal for sleep

Sleep apnea

Sleep apnea is a sleep condition that causes you to stop breathing over and over again as you sleep, which prevents you from getting adequate oxygen. This lack of oxygen interferes with your ability to get a restful night’s sleep.

Sleep apnea can be one of two types:

  • Obstructive sleep apnea, the most common type, is when your upper airway is blocked, reducing or stopping airflow. It may be caused by obesity, large tonsils or hormone level changes.
  • Central sleep apnea is when your brain doesn’t send your body the signals required to tell you to keep breathing. If you have a health condition that affects how your brain controls your airway and chest muscles, you’re more susceptible to central sleep apnea.

A sleep study is often used to determine whether you have sleep apnea.

According to NHLBI, the most common treatment for sleep apnea is a breathing device known as a continuous positive air pressure (CPAP) machine. The machine keeps your airway open as you sleep by providing constant air pressure on your throat.

Other treatment options NHLBI notes include:

  • Oral appliances. You may be fit with a customized oral device to wear in your mouth when sleeping to help prevent your upper airway from becoming blocked. There are two types:
    • A mandibular repositioning mouthpiece to hold your jaw in a way to keep it from obstructing the upper airway
    • A tongue retaining device to keep your tongue forward to keep it from obstructing the upper airway
  • Surgery. Possible procedures include:
    • Removing your tonsils and adenoids (called an adenotonsillectomy)
    • Implanting a device that monitors breathing and helps control muscles that open your airways
    • Removing soft tissue from your mouth and throat to help make your upper airway bigger
    • Moving your upper jaw (maxilla) and lower jaw (mandible) forward, which also helps your upper airway become bigger
  • Orofacial therapy. You may be given exercises to help position your tongue and strengthen certain muscles, such as muscles in the lips, tongue, upper airway and face.

Restless leg syndrome (RLS)

Restless leg syndrome (RLS) is a sleep disorder and a movement disorder that may start at any time over the course of your life. Women are more likely to have RLS than men, but it affects both sexes.

RLS causes uncomfortable sensations in your legs, most often and most intensely at night while you’re asleep. According to NINDS, the sensations cause you to move your legs and disrupt your sleep, and may feel like:

  • Aching
  • Throbbing
  • Pulling
  • Itching
  • Crawling
  • Creeping

Most often, the sensations affect both legs, but they may affect just one. Sensations in your arms, chest or head may occur, too, but are less common.

Symptoms may vary from day to day in frequency and severity, and they may become more frequent as you age.

According to NINDS, more than 80% of those with RLS also have periodic limb movement of sleep (PLMS), where your legs twitch and jerk usually every 15 to 40 seconds throughout the night.

While there’s no cure, RLS symptoms may be treated. Treatments may include:

  • Iron supplements
  • Anti-seizure medications
  • Dopaminergic agents, which increase dopamine in the brain
  • Certain opioids, such as methadone, codeine, hydrocodone and oxycodone
  • Benzodiazepines, which may be used to treat anxiety, insomnia and muscle spasms

Lifestyle changes may also help, such as:

  • Drinking little or no alcohol or caffeinated beverages
  • Stopping smoking
  • Maintaining a regular sleep schedule
  • Getting moderate exercise on a regular basis, especially aerobic and leg-focused exercises
  • Giving yourself a leg massage
  • Taking a warm bath
  • Applying heating pads or ice packs to legs

REM sleep behavior disorder

Most people spend about 20% of their sleep time in rapid eye movement (REM) sleep, which is the sleep stage where you dream. Typically, REM sleep is in the later part of the night.

People with REM sleep behavior disorder have unpleasant dreams and act them out with sudden, sometimes violent arm and leg movements.

REM sleep behavior disorder may come on gradually, and the condition may worsen over time.

The disorder may be associated with other neurological conditions, such as Parkinson’s disease, Lewy body dementia and multiple system atrophy (MSA).

According to the Mayo Clinic, symptoms may include:

  • Punching, kicking, flailing limbs
  • Jumping out of bed in reaction to dreams that are violent or action-filled
  • Making noises, such as talking, laughing, shouting, cursing and crying out while dreaming

You may recall your dream if you wake up while having an episode.

REM sleep disorder is treated with medications. According to the Mayo Clinic, medication options may include:

  • Melatonin. Most people are able to take this dietary supplement with little or no side effects.
  • Clonazepam (Klonopin). This is a prescription medication used to treat anxiety. It may cause you to be sleepy during the day, and it may worsen sleep apnea if you have that condition as well.

If you have REM sleep behavior disorder, it’s imperative you make your sleeping environment safe for you and your bed partner. You may want to:

  • Pad the floor near your bed
  • Place rails on the side of the bed where you sleep
  • Rid the room of dangers, such as weapons and sharp objects
  • Remove furniture and clutter from the bedroom
  • Fortify windows

Shift work sleep disorder (SWSD)

People who work different shifts and who work at night may have shift work disorder (SWSD). According to the Cleveland Clinic, up to 40% of people who work different shifts might have this disorder.

Symptoms may include:

  • Trouble sleeping
  • Sleepiness
  • Difficulty concentrating when awake
  • Headaches
  • Lack of energy

According to the Cleveland Clinic, people with SWSD are also prone to:

  • Accidents and making errors at work
  • Dependency on drugs and alcohol
  • Irritability or mood issues
  • Gastrointestinal, cardiovascular and metabolic health conditions

Treatments may include:

  • Aiming for 7 to 9 hours of sleep a day
  • Making sleep a priority
  • Limiting the number of night shifts in a row to 5 or fewer
  • Having days off in between shifts
  • Avoiding long commutes if possible
  • Practicing good sleep hygiene, which includes sticking to a sleep schedule and avoiding stimulants such as caffeine, alcohol and nicotine
  • Napping before starting a night shift
  • Getting exposure to light during the early part of your shift
  • Keeping a sleep diary to identify your problem and monitor your progress

If you live with others, ask them to respect your sleep time by keeping their voices down, not running noisy appliances such as the vacuum or dishwasher while you’re trying to sleep, and wearing headphones when they’re watching television or listening to music when you’re sleeping.

As a last resort for SWSD, you may want to talk to your health care provider about the use of prescription sleep aids.

References:

U.S. National Library Of Medicine National Center for Biotechnology Information (NCBI): Sleep disorder.

U.S. National Library of Medicine MedlinePlus: Sleep Disorders.

Mayo Clinic: Sleep disorders.

National Heart, Lung, and Blood Institute (NHLBI): What is Insomnia?

National Heart, Lung, and Blood Institute (NHLBI): Guide to Healthy Sleep.

National Institute of Neurological Disorders and Stroke (NINDS): Narcolepsy.

National Heart, Lung, and Blood Institute (NHLBI): What Is Sleep Apnea?

National Heart, Lung, and Blood Institute (NHLBI): Sleep Apnea Treatment.

National Institute of Neurological Disorders and Stroke (NINDS): Restless Leg Syndrome.

Mayo Clinic: REM sleep behavior disorder.


Cleveland Clinic: Shift Work Sleep Disorder.

Why Do I Sleep So Much? Reasons for Oversleeping

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WEDNESDAY, March 15, 2023 (HealthDay News) -- Your eyes close and your mind shuts down the second your head hits the pillow, but you wake up 10 hours later still feeling tired.

Many people complain about sleeping too little, but some struggle with the opposite problem: oversleeping.

Oversleeping, or hypersomnia, is a sleep disorder characterized by complaints of excessive daytime sleepiness occurring regularly or often, even after sleeping 10 or more hours a night.

“Healthy sleep encompasses three major things,” Marishka Brown, a sleep expert at the U.S. National Institutes of Health (NIH), said recently. “One is how much sleep you get. Another is sleep quality — that you get uninterrupted and refreshing sleep. The last is a consistent sleep schedule. If you’re sleeping more than nine hours a night and you don’t feel refreshed, there may be some underlying medical issue.”

If you are asking yourself, “Why do I need so much sleep,” here are the most common reasons for that and some tips on how to revamp your sleeping routine.

While individual sleep needs may vary depending on age and conditions such as illness, stress or physical activity levels, the American Academy of Sleep Medicine notes that experts recommend that schoolchildren get nine hours of sleep per night and teens get eight to 10 hours, while adults may only need seven hours or more. Some adults, known as long sleepers, naturally require up to 10 to 12 hours of sleep per night, and not because of a medical condition but because is their natural biological predisposition.

Why do I sleep so much?

You may require more sleep than usual for the following natural reasons: an increase in physical activity, stress, jet lag, or during and right after recovering from illness or surgery. Not only that, a commentary published in The Lancet Respiratory Medicinejournal recently suggested that getting more sleep when you receive a vaccination improves antibody production and your overall immune response.

Mental health conditions like depression or a past history of trauma can also cause oversleeping. The condition is present in 15% of people with depression, Michelle Drerup, of the Cleveland Clinic Sleep Disorders Center, said during a recent podcast.

Sleep disorders like sleep apnea or narcolepsy can also trigger oversleeping, the NIH says. Sleep apnea, which involves a repeated stopping and starting of breathing throughout the night, is a common cause of oversleeping. Meanwhile, narcolepsy also disrupts sleep. People with narcolepsy may suddenly fall asleep without warning, and they may experience extreme daytime sleepiness and fragmented nighttime sleep.

If you think that you may have a sleep disorder, NIH experts recommend that you consult your health care provider and consider a sleep study. The American Academy of Sleep Medicine provides information on testing for sleep apnea.

Nutritional factors may also play a role in oversleeping. For example, recent research has linked low vitamin B levels with oversleeping. And substance abuse, whether it involves alcohol, tobacco or illicit drugs, is also linked with oversleeping, according to the NIH. People with obesity or other chronic health conditions may also experience oversleeping.

Lastly, certain medications or withdrawal from a medication can cause oversleeping. According to Harvard Health, medications that can cause fatigue include allergy drugs, antidepressants, anxiety medications, blood pressure pills, muscle relaxants, opioids, seizure or epilepsy drugs, Parkinson’s drugs and cancer treatments. Discuss any concerns with your health care provider if you think your prescription medications may be causing oversleeping, and do not take medications to help you stay awake without your health care provider’s approval.

How to get better sleep

Revamping your sleeping routine may eliminate, or at least ease, oversleeping, as long as no underlying medical condition exists. In addition to improving sleep hygiene, consider improving your lifestyle choices in areas like physical activity, nutrition, stress management and social support.

NIH experts recommend the following sleep hygiene tips for getting a better night’s sleep:

  • Stick to a consistent sleep schedule
  • Get some daily exercise
  • Go outside for natural light exposure
  • Avoid nicotine and caffeine at least eight hours before sleep, to reduce wakefulness
  • Avoid naps after mid-afternoon, and when napping take naps of less than 1 hour
  • Avoid large meals and alcohol right before bedtime
  • Limit your use of electronic devices for 30 minutes before bedtime
  • Avoid lying in bed awake. Get up if you fail to fall asleep within 20 minutes

If you make these efforts but still struggle to get a restful night’s sleep, see your health care provider to determine whether you may have an underlying medical condition or need better strategies to ease excess stress.

What are the Best Sleeping Positions for a More Comfortable Day

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MONDAY, March 13, 2023 (HealthDay News) -- If you were asked your favorite sleep position, you’d probably be able to answer pretty quickly.

But it can be a little trickier to figure out the best sleeping position -- one that helps you reduce your aches and pains and maximize the enormous health benefits that research has shown a good night’s sleep can provide.

Here are the positions that the experts recommend, whether you’re pregnant, prone to snoring, dealing with back or neck pain, or have other conditions that can benefit from the right position while you rest.

Plus, experts offer tips on making the most of your current favorite position and "training" yourself to sleep in different ones that might be better for you.

What are the best sleeping positions?

“The best sleep position is the one you are most comfortable with,” said Dr. Harly Greenberg, medical director at Northwell Sleep Disorders Center in New Hyde Park, N.Y.

“However, there may be better sleep positions for persons with specific health or orthopedic issues,” he added.

So, what is the best position to sleep in for your particular needs? To help you pick your position, the Sleep Foundation offers some suggestions about sleeping on your back, stomach and side.

Sleeping on your back

Advantages:

  • Reduces aches and pains in the lower back and neck
  • Supports your spine so your muscles can relax and recover
  • Helps relieve congestion, especially if you elevate your torso
  • Helps reduce the risk of developing facial wrinkles

Disadvantages:

  • Increases the risk of airway collapse for those who snore or have sleep apnea
  • Raises pressure levels for certain types of back pain
  • Increases episodes of acid reflux
  • Raises gravity pressure to make it more difficult to breathe, making it unsuitable for older or heavier people
  • Causes a fetus to put more pressure on the heart in pregnant women, especially in the third trimester

Sleeping on your stomach

Advantages:

  • Opens the airway to help reduce snoring

Disadvantages:

  • Causes increased gravity on your ribs to make breathing less energy-efficient
  • Provides the least back and neck support of the three positions
  • Contributes to facial wrinkles
  • Makes it difficult to get comfortable when pregnant

Sleeping on your side

Advantages:

  • Advances spinal alignment, making it ideal for those with back pain, particularly when using support pillows
  • Reduces snoring and heartburn, which means it’s beneficial for those with acid reflux, gastroesophageal reflux disease (GERD) and sleep apnea
  • Promotes comfort, ease of breathing, and reduced pressure on the spine and internal organs, making it a top choice for pregnant people and older adults

Disadvantages:

  • Increases pressure on the shoulders, which means it’s not ideal for those with pain in this region
  • Contributes to facial wrinkles

So which side is best? A recent study published in the journal Sensors found that sleeping on your right side, combined with lower rates of turning, promoted higher quality sleep.

However, left-side sleeping is ideal for those with acid reflux and GERD because it decreases pressure on internal organs, according to the Sleep Foundation.

Greenberg shared the same conclusion. “As far as right or left side, left-side sleeping may be better, as it may reduce gastroesophageal reflux,” he said.

Left-sided sleeping has another distinct advantage: It's the best position during pregnancy, experts say.

“Pregnancy, especially during the third trimester, may cause discomfort during sleep. Side sleeping relieves gravitational pressure of the uterus on the blood vessels in the abdomen and improves blood flow,” Greenberg explained.

“Sleeping on the left side is better than the right side as it helps to relieve pressure on other abdominal organs and is preferred, although brief periods of right-side sleep are OK as well to relieve pressure on the left hip,” he added.

One study published recently in the Journal of Clinical Sleep Medicine found that reducing back-sleeping time in favor of a side position may be particularly beneficial for the fetus during late pregnancy.

What’s the best sleep position for neck and back pain?

“Back sleeping may be most comfortable for those with back or neck pain,” said Greenberg.

“If back pain is a problem, back or side sleeping may help with spine alignment and reduce back pain. Side sleeping with knees bent and a pillow between the knees may be helpful as well,” he advised.

Can you "train" yourself to sleep in a different position?

Greenberg noted that “for those people who should avoid supine sleep for sleep apnea, a sleep positioner that prevents inadvertent rolling on the back may be useful.”

He noted that “there are other options as well, including devices that sense your position and provide a vibratory or other signal to urge you to move.”

SOURCE: Harly Greenberg, MD, medical director, Northwell Sleep Disorders Center, New Hyde Park, N.Y.

Postpartum Anxiety: What It Is, Symptoms and Treatments

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MONDAY, March 13, 2023 (HealthDay News) -- You may have heard of postpartum depression and “the baby blues,” but did you know that there’s another widely studied mental health condition called postpartum anxiety?

Dr. Erica Newlin, an obstetrician-gynecologist in Westlake, Ohio, said in a Cleveland Clinic podcast that, “Peripartum and postpartum anxiety and depression, and just mental health concerns in general, are super, super common. Most studies really cite a prevalence of around 10%. But we think that that might be vastly underreported."

And postpartum anxiety doesn’t just affect mothers: A recent review published in the Journal of Psychosomatic Obstetrics & Gynecology revealed that about 1 in 10 dads were impacted.

To understand how to better manage postpartum anxiety and reduce your risk factors for developing the condition, it's important to learn what it is, its causes and key symptoms, and the treatments that are recommended by doctors, including commonly prescribed medications.

What is postpartum anxiety?

Postpartum anxiety is named after the time period immediately following delivery or becoming a parent.

“You can start to experience it any time during the pregnancy and in that first year after delivering,” said Newlin.

According to the Cleveland Clinic, what sets postpartum anxiety apart from normal worry is the severity of its symptoms.

The condition is marked by irrational fears that go well beyond the natural concerns parents have for their children’s health and well-being. For example, you might have unfounded, repetitive thoughts that someone or something is going to harm you or your baby.

Postpartum anxiety causes

The causes and risk factors for postpartum anxiety are varied and may include:

  • Shifts in hormones, which decrease in women after pregnancy and make it more difficult to manage stress
  • Added life stressors, such as difficulty breastfeeding or issues during pregnancy and delivery
  • Being overwhelmed due to the responsibilities of caring for a newborn
  • A lack of sleep, which is common for new parents
  • Certain health conditions, such as a history of eating disorders, anxiety or depression
  • Life events that increase your risk for developing anxiety, such as a previous miscarriage or loss of a child
  • Lifestyle factors, such as caring for multiple children at once or having a child with health issues

“There can be an expectation of how motherhood will be,” said Newlin. “And sometimes if reality doesn't always match expectations, that can be a contributor [to postpartum anxiety] as well."

Postpartum anxiety symptoms

According to Harvard Health, postpartum anxiety shares some symptoms in common with postpartum depression, including irritability, issues with relaxing, and trouble falling or staying asleep.

The Cleveland Clinic states that other common postpartum anxiety symptoms include:

  • Shortness of breath
  • Heart palpitations or increased heart rate
  • Restlessness
  • Nausea and decreased appetite
  • Racing or irrational thoughts, particularly fearful ones
  • Poor focus
  • Social avoidance
  • Control issues
  • Overly cautious behavior

It’s also not uncommon for postpartum anxiety to manifest as a type of anxiety disorder known as obsessive compulsive disorder (OCD), according to the U.S. National Institute of Mental Health.

Postpartum anxiety treatments and medications

Luckily, there is help for postpartum anxiety. These include:

  • Therapy: Cognitive behavioral therapy is used to treat different types of anxiety, including postpartum anxiety and OCD. A psychologist or counselor helps you identify your thoughts, emotions and behaviors, and helps you work to change them.
  • Medication: Postpartum anxiety medications can be prescribed by your doctor to help you manage and improve the physical, behavioral and emotional symptoms of the condition. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and the antidepressant mirtazapine.
  • Social support: “There are national postpartum support groups that provide both virtual outlets, as well as organizing things like stroller walks or get-togethers that may help,” said Newlin. “Just talking with women that are going through the same thing and validating these feelings that you're having for some women is enough."

Harvard Health offers additional suggestions to help you ease your symptoms:

  • Cuddle your child to release mood-enhancing oxytocin
  • Include workouts that incorporate calming breathwork, such as yoga
  • Wean your child from breastfeeding slowly to help keep hormone levels from shifting too quickly
  • Do everything you can to get more sleep

When to seek help

“If you find that you're having what I call perseverating thoughts — like if you can't move past that worry, if the worry is keeping you from living your life, or if you're constantly worried about something happening to you or something happening to the baby, or it's affecting your sleep or ability to function — that's not on the normal side of things. And that would be a reason to seek care,” Newlin advised.

If you’re wondering if you may have postpartum anxiety, you can start by taking this short anxiety quiz from Anxiety.org.

How to Help Your Child Deal With Separation Anxiety

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MONDAY, March 13, 2023 (HealthDay News) – For some children, it can be hard when mom or dad leave them at daycare, school or even just with the other parent.

It’s normal for small children to feel some separation anxiety.

But it can be more concerning when a child doesn’t outgrow these feelings or feels them very intensely. This significant fear is known as Separation Anxiety Disorder (SAD).

“It’s rare that separation anxiety persists on a daily basis after the preschool years. If you’re concerned that your child isn’t adapting to being without you, chat with the pediatrician,” Dr. Wendy Sue Swanson, a member of the American Academy of Pediatrics Council on Communications and Media, suggested in a story about separation anxiety for the American Academy of Pediatrics (AAP).

What is separation anxiety?

Fear or acting out because of a desire to not be separated from a parent is normal for babies ages 9 to 18 months old, according to the Children’s Hospital of Philadelphia (CHOP).

It can even start as early as 4 to 5 months, according to the AAP.

It typically ends around age 2, according to the National Library of Medicine. That’s when kids are old enough to understand that after a separation their parents will return.

But about 3% of kids continue to experience these feelings into elementary school, according to CHOP. That can increase again during adolescence, as about 8% of teens have separation anxiety because of concerns about how violence or accidents may separate them from a caregiver.

Different from typical separation anxiety, SAD is an intense fear, according to the Cleveland Clinic. It can lead to mental and physical issues, affecting work, school and a child’s social life.

It might be SAD if it continues to disrupt your child’s life and your family life, according to Boston Children's Hospital.

About 4% of children experience SAD, according to the hospital.

Symptoms

When an infant or toddler is experiencing separation anxiety, it can be loud, with lots of tears and tantrums.

Separation anxiety might be worse if your infant or young child is hungry, tired or feeling ill, according to the AAP.

A child dealing with more significant separation anxiety, such as SAD, may have a number of physical symptoms such as vomiting and nausea, quick breathing, fatigue, headache, stomachache and bedwetting.

The worry is often about something that isn’t likely to happen, such as death or harm to a loved one or the child, fear of being alone or worry about having nightmares, according to Boston Children’s.

Symptoms of SAD tend to start around third or fourth grade, according to Stanford Medicine Children's Health. It might happen after your child has been closer to you for a while, such as during summer vacation.

Some other common symptoms are clinginess, panic attacks or tantrums when it’s time to separate and refusing to sleep alone or to go to school.

Risk factors

SAD can be rooted in a variety of factors, according to Stanford and CHOP. This includes:

  • A traumatic event, including a death in the family or parental separation/divorce
  • Geographic move or relocation
  • Change of school or home
  • Parental absence
  • Foster care/adoption
  • Parental alcoholism
  • Biology, such as with an inheritance of an imbalance in the brain chemicals norepinephrine and serotonin.

A study published recently in the journal JAMA Network Open found that children may learn anxious behavior from a parent, but that it isn’t inevitable and is treatable.

"Parents should seek help with their own anxiety, not just for their own health but also for the health of their children," study author Barbara Pavlova, a clinical psychologist in the mood disorders program at Nova Scotia Health Authority in Halifax, Canada, said at the time.

How to deal with separation anxiety

When it’s typical separation anxiety in young children, the AAP suggests creating quick farewell rituals that are consistent.

Don’t return to the room after you’ve left, the AAP recommends, and don’t cancel plans based on your child's separation anxiety.

CHOP recommends not sneaking away while your child is distracted. Also, validate your child’s feelings by allowing them to talk, share worries and cry.

You should be fully attentive, loving and affectionate to your child at separation time, the AAP suggests.

Be specific about when you’ll return, and build trust and independence by sticking to your promise about when your return will happen.

Practice being apart through playdates and weekends at Grandma’s house, the AAP says.

When to seek help

Talk to your pediatrician if your child’s separation anxiety continues past the typical age, the AAP suggests.

Early treatment for SAD can lessen symptoms, according to Stanford Health. Treatment can include cognitive behavioral therapy and anti-anxiety medications.

Some ways you may be able to help your child deal with SAD are to offer reassurance and encourage age-appropriate independence. Know what stresses your child and plan ahead, Stanford suggests.

You may need to talk with your child’s teacher about the circumstances and ask them to provide extra reassurance and support.

How to Keep Your Heart Healthy

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Here’s a sobering stat: heart disease is the No. 1 cause of death for men and women, according to the Centers for Disease Control and Prevention (CDC). The good news? You can take actionable steps to improve your heart health and lower your chances of developing heart disease.

What is heart disease?

Heart disease is an umbrella term for many different conditions, some that you can be born with (congenital heart diseases) and some that develop over the course of your life due to age and other lifestyle factors.

According to the U.S. National Library of Medicine, the most common heart disease type is coronary artery disease (CAD). This type of heart disease is marked by the buildup of plaque and cholesterol in the arteries that supply the heart with blood. Plaque blocks blood flow and can set the stage for crushing chest pain (angina), heart attacks, irregular heart rhythms (arrhythmias) and heart failure.

Other heart disease types may impact the valves of the heart or the heart muscle itself.

How to prevent heart disease

The central tenets of heart disease prevention include:

A heart-healthy lifestyle helps address certain risk factors for heart disease, including:

  • High blood pressure
  • High blood cholesterol levels
  • High levels of unhealthy blood fats called triglycerides
  • Diabetes
  • Being overweight or obese

When heart disease prevention efforts aren’t enough, heart medications are also available to help manage your heart health.

What’s involved in a heart-healthy lifestyle?

Here’s where to start if you’re looking to put some of these heart disease prevention tips into action:

Update your diet

One of the cornerstones of heart disease prevention is to eat a heart-healthy diet, but what exactly does that include?

According to the American Heart Association (AHA), a heart-healthy diet is rich in fruits and vegetables, whole grains and protein, which are found in foods such as:

  • Legumes
  • Nuts
  • Seeds
  • Fish
  • Skinless poultry
  • Oatmeal
  • Whole wheat bread
  • Lean meats

It also includes healthy, non-artery-clogging fats like avocado and certain oils (such as olive, avocado, peanut, safflower, sesame and canola oils).

Another aspect of a heart-healthy diet is inflammation-fighting foods. More research is needed on its exact role in heart disease, but inflammation is commonly found in those with heart disease, according to the AHA. Omega-3 fatty acids — a type of healthy fats — help fight back against inflammation.

Fatty or oily fish are solid sources of omega-3s, so adding fish to your weekly meal planning is important. The AHA recommends eating at least 8 ounces of non-fried fish per week. Some omega-3-rich fish options include:

  • Albacore tuna
  • Herring
  • Lake trout
  • Mackerel
  • Sardines
  • Salmon

Don’t like fish? Don’t worry: edamame, walnuts and ground flaxseed are also good sources of omega-3s.

Avoiding unhealthy foods is another key part of a heart-healthy diet. This means steering clear of processed foods and added sugars when and where possible.

It’s also smart to rein in your sodium intake. We get most of our sodium from packaged and prepared foods, not the saltshaker, so you may be taking in more sodium than you realize. The Dietary Guidelines for Americans recommends consuming less than 2,300 milligrams (mg) of sodium daily to help maintain a normal blood pressure. This is roughly equivalent to 1 teaspoon of salt.

If possible, an even better goal — especially for those with hypertension (high blood pressure) — is to cut back to no more than 1,500 mg of sodium daily, the AHA says.

Watch your alcohol consumption

If you drink alcohol, do so in moderation, which is defined as no more than 2 drinks per day if you’re a man and no more than 1 drink per day if you’re a woman, according to the Dietary Guidelines for Americans. Keep portions in mind: one drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof spirits.

The AHA notes that consuming alcohol in moderation may help raise “good” high-density lipoprotein (HDL) cholesterol levels and lower your diabetes risk, but these benefits go out the window when you overdo it. Drinking too much alcohol can raise blood pressure, increase the risk of stroke and promote irregular heartbeats.

Make exercise a priority

Regular physical activity may help reduce blood pressure, lower diabetes risk, keep your weight where it should be and fight inflammation throughout your body, all of which help lower the risk of developing heart disease.

So, how much exercise should you get for a healthy heart? The current Physical Activity Guidelines for Americans suggests adults strive for at least 150 to 300 minutes a week of moderate-intensity exercise, 75 to 150 minutes a week of vigorous-intensity aerobic physical activity, or some combination of moderate- and vigorous-intensity aerobic activity.

What counts as exercise? Any aerobic activity that gets your heart pumping can tick this box, such as:

Adults should also do strengthening exercises that involve all major muscle groups on 2 or more days a week to help burn fat and tone muscle. This includes the following strength-training ideas:

  • Lifting weights, including hand weights or dumbbells
  • Using weight machines at the gym
  • Using your own bodyweight as resistance for moves like push-ups and squats
  • Using resistance bands

These two forms of exercise provide synergistic benefits for your heart by raising high-density lipoprotein (HDL), the “good” cholesterol, and lowering low-density lipoprotein (LDL), the “bad” cholesterol.

Lose weight, if needed

According to the AHA, carrying around excess weight is linked to certain heart disease risk factors, including:

  • High cholesterol
  • High blood pressure
  • Diabetes

What to aim for: A body mass index (BMI) between 18.5 and 24.9 in adults is typically considered healthy, according to the National Heart, Lung, and Blood Institute. BMI takes both height and weight into account.

How to do it: Lose weight slowly. Set achievable goals, such as losing 10% of your current weight. Shoot for about 1/2 pound to 2 pounds a week. If you lose too much weight too quickly, you’re less likely to keep it off. Eating a healthy diet and getting regular exercise can help you lose weight and maintain your weight loss.

Stop smoking

If you smoke, quit. There have never been as many smoking cessation tools available to help you kick the tobacco habit as there are today.

How to do it: Nicotine replacement products — such as patches, gum, lozenges and other medications that help reduce your cravings for nicotine — can work alone or in combination with counseling support groups. Talk to your doctor about the best way for you to stop smoking, set a quit date and stick to it.

Know where you stand numbers-wise

Knowing your numbers for key heart risk factors can help determine how well you’re doing when implementing heart-healthy changes. The three numbers to consider include:

  • Blood pressure
  • Cholesterol
  • Blood sugar

Blood pressure

Ideal blood pressure levels are less than 130/80 millimeters of mercury (mmHg), according to the AHA. Systolic pressure (the top number) is the pressure in your arteries when your heart beats while pumping blood. In contrast, diastolic pressure (the bottom number) describes the pressure in your arteries when your heart rests between heartbeats.

Cholesterol

According to the CDC, men and women should aim for the cholesterol levels below:

  • A total cholesterol of about 150 milligrams per deciliter of blood (mg/dL)
  • LDL cholesterol of about 100 mg/dL
  • HDL cholesterol of 50 mg/dL or higher in women and 40 mg/dL or higher in men
  • Triglycerides less than 150 mg/dL

Blood sugar (glucose)

High blood sugar or glucose levels are a sign of diabetes. According to the CDC:

  • A normal fasting blood sugar level is 99 mg/dL or lower
  • A fasting blood sugar level that suggests prediabetes is 100 to 125 mg/dL
  • A fasting blood sugar level that indicates diabetes is 126 mg/dL or higher

Know when heart medication may be needed

Prevention tactics, such as eating a heart-healthy diet, losing weight and getting regular exercise, remain the best ways to stay on top of heart disease risk factors, but these measures aren’t always enough.

Many types of medication are available to help lower your risk and treat heart disease. Talk to your doctor about what medication may be appropriate for you.

According to the AHA, if you have high blood pressure, a significant risk factor for heart attacks and strokes, your doctor may prescribe:

  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers
  • Beta blockers
  • Calcium channel blockers (CCBs)
  • Diuretics

Beta blockers may also help prevent future heart attacks in those who’ve already had a heart attack.

Anticoagulants (blood thinners), including aspirin, may help prevent blood clots from developing and reduce heart attack risk.

According to the AHA, for high cholesterol, medication options include:

  • Statins
  • Cholesterol absorption inhibitors
  • Nicotinic acids
  • Combination statin and cholesterol absorption inhibitors

In addition, sometimes surgery is needed to treat underlying heart issues or open blocked blood vessels to restore blood flow to the heart.

References:

Centers for Disease Control and Prevention (CDC): Heart Disease Facts.

American Heart Association (AHA): Inflammation and Heart Disease.

American Heart Association (AHA): What is a healthy diet? Recommended Serving Infographic.

American Heart Association (AHA): Shaking the Salt Habit to Lower High Blood Pressure.

U.S. Department of Health and Human Services (HHS): Physical Activity Guidelines for Americans, 2nd edition.

Johns Hopkins Medicine: 3 Kinds of Exercise That Boost Heart Health.

National Heart, Lung, and Blood Institute (NHLBI): Aim for a Healthy Weight.

American Heart Association (AHA): Keeping a Healthy Body Weight.

American Heart Association (AHA): How to Quit Tobacco Fact Sheet.

American Heart Association (AHA): Know Your Numbers.

U.S. National Library of Medicine: Heart Diseases.

American Heart Association (AHA): Types of Heart Medications.

Is 6 Hours of Sleep Enough?

Wellness Library

FRIDAY, March 10, 2023 (HealthDay News) -- When work, parenting and a packed social schedule leave you little time for shut-eye, you might think that getting by on just six hours of sleep a night is a good compromise.

If so, you’re not alone.

According to the U.S. Centers for Disease Control and Prevention, over 25% of U.S. adults don’t meet the sleep recommendations of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society.

Yet, fresh evidence indicates that getting a good night’s sleep could add years to your life.

So how much sleep is too little, and how much is enough to support a long, healthy life? Here's what the experts have to say about how much sleep you actually need.

Is 6 hours of sleep enough?

“Everyone wants the magic number, but life is all about a range,” AASM spokesman Dr. Raj Dasgupta recently told HealthDay Now. He’s also an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California.

He said the range of sleep he recommends is “seven to nine hours a night, with the sweet spot being around eight.”

Dr. Nitun Verma, a sleep physician and spokesperson for the AASM, stressed that anything less could have dire consequences for your health. “Long-term consequence from inadequate sleep duration has been associated with obesity, diabetes, high blood pressure, and other cardiovascular disease,” he said.

How much sleep do I need?

The CDC bases its daily sleep recommendations on your age. Adults aged 18 to 60 should strive for a minimum of seven hours of sleep each night, while older adults may need closer to nine hours.

For teenagers, that number increases to 8 to 10 hours of sleep a night. Verma noted that “the American Academy of Sleep Medicine has recommended increased sleep time for teenagers [8 to 10 hours], but early school times often mean teenagers are getting far less than that.”

That’s why the AASM recommends school start times of 8:30 a.m. or later for middle school and high school students. This helps keep sleep patterns in line with natural circadian rhythms, which change during adolescence, leading teens to stay up later at night and sleep longer in the morning.

How to get more sleep

“It’s difficult to get good sleep,” Dasgupta acknowledged. He suggested focusing on both the quality and quantity of sleep you get each night, rather than just the number of hours.

“Very special things happen in those deeper sleep stages, in REM [rapid eye movement] sleep stages, that help every single part of our body,” he explained.

Verma stressed the importance of keeping a regular sleep schedule to optimize sleep quality.

“It's better to get all your sleep hours at once and at consistent times. If your daytime schedule allows it, have a goal of 7 to 9 hours of sleep daily at consistent times,” he said. “For some people, this may require organizing daily activities to finish before bedtime. For others, having an alarm reminding you to wind down and prepare for bed can be helpful."

If you want to adjust your sleep schedule, the Sleep Foundation recommends picking your ideal sleep and wake times and then adjusting your sleep schedule in 15 to 30 minute increments each day.

The foundation also suggests:

  • Limiting caffeine and alcohol because they can interfere with natural sleep cycles
  • Keeping your room dark and quiet to support your body's production of melatonin, which helps promote sleep
  • Exercising regularly, and making sure to finish any strenuous physical activity at least two hours before going to bed
  • Putting your laptop, phone or tablet “to bed” at least an hour before you do the same for yourself, to avoid the impacts of blue light emissions on sleep-wake timing

How else can you get more sleep? One study of more than 3,500 adults that was published recently in the journal Behavioral Medicine discovered a surprising path towards more restful slumber.

"Results from this study revealed significant associations between optimism and various characteristics of self-reported sleep,” study author Rosalba Hernandez, a University of Illinois professor of social work, said in a university news release.

Participants who reported higher levels of optimism were 74% more likely to have no insomnia symptoms than those who were less positive.

"Optimists are more likely to engage in active problem-focused coping and to interpret stressful events in more positive ways, reducing worry and ruminative thoughts when they're falling asleep and throughout their sleep cycle," Hernandez explained.

If you’d like more tips on how to get more sleep, you can check out the AASM Sleep Education Center.

SOURCE: Nitun Verma, MD, sleep physician, AC Wellness, Cupertino, Calif., and spokesperson, American Academy of Sleep Medicine

Should I Take Melatonin for Sleep? An Expert Has Answers

Wellness Library

THURSDAY, March 9, 2023 (HealthDay News) -- There’s nothing worse than having trouble falling asleep or staying asleep. Watching the time go from minutes to hours only stresses you out and decreases the chance of a good night's rest.

Is it time to try melatonin supplements, a popular sleep aid?

Plenty of folks might want to know: In a recent study from the U.S. Centers for Disease Control and Prevention (CDC), 14.5% of American adults said they struggled to fall asleep while nearly 18% had trouble staying asleep during the 30 days before the study.

The human body secretes melatonin on its own to help with sleep. But when might you need more than your body produces?

First, what is melatonin?

“Melatonin is a natural hormone that’s mainly produced in your pineal gland,” according to the Cleveland Clinic. Located in the brain, this gland responds to daylight and darkness by secreting melatonin. It secretes more melatonin at night and less during the day.

“When it gets dark in the evening, melatonin starts being secreted. It peaks around 3 o’clock in the morning and then it starts decreasing, and by 7 a.m. it’s suppressed,” explained Dr. Sanjeev Kothare, co-director of the Pediatric Sleep Program at Cohen Children’s Medical Center in New Hyde Park, N.Y.

But when the melatonin you produce doesn’t seem to be doing the job, you want relief.

That's when melatonin supplements and natural sources of melatonin from the food you eat can be worth considering.

Is melatonin safe to take?

Melatonin supplements are manufactured and sold as dietary supplements. The U.S. Food and Drug Administration regulates dietary supplements under a different set of rules than prescription drugs and over-the-counter medications.

That means the purity and strength of melatonin supplements are unreliable, Kothare said.

With this in mind, the National Center for Complementary and Integrative Health (NCCIH) says only short-term use of melatonin supplements is safe.

And the American Academy of Sleep Medicine issued a health advisory in 2022 warning parents to be careful about giving melatonin supplements to their children.

To reduce the risks, they recommend parents keep all supplements out of their child's reach and consult a pediatrician before giving children melatonin.

How much melatonin should you take?

Kothare suggests taking 1 to 3 milligrams (mg) about an hour before you are ready to sleep.

He also recommends turning down the lights and staying off electronics and away from the TV during this time because the benefits of melatonin can be “suppressed because of the bright light” from electronic devices.

Does melatonin have side effects?

The side effects of melatonin are mild and can include headaches, dizziness, nausea and daytime drowsiness, according to the NCCIH.

Nightmares have also been linked to melatonin use, Kothare added.

Another consideration is the interactions melatonin can have with certain types of prescription medications, according to the Mayo Clinic. These include:

  • Medicine that slows blood clotting
  • Medicine that prevents seizures
  • Birth control medicine
  • High blood pressure medicine
  • Diabetes medicine
  • Medicine that suppresses the immune system
  • Medicine that is broken down by the liver

Is it OK to take melatonin every night?

While it’s safe to take melatonin on a short-term basis, the NCCIH says there’s not enough evidence to recommend using it nightly over the long term.

Melatonin is not known to be addictive, but taking it every night can lead to psychological dependency. What this means is, you believe you need it every night to sleep, which is unhealthy.

Can you overdose on melatonin?

Melatonin overdose in adults is rare. But, adults who have taken too much melatonin reported symptoms of vomiting, trouble breathing, changes in blood pressure and disorientation.

Melatonin poisoning in children is also a concern. A recent CDC study reported a 530% increase in unintentional pediatric melatonin ingestions.

Kothare explained that the pandemic prompted an increase in adult use of melatonin. Careless storage of the supplement resulted in children getting their hands on it and accidentally taking “mega doses.”

Food sources of melatonin

If using melatonin supplements gives you pause, you can also get extra melatonin from eating certain foods.

Kothare noted there’s a reason why your grandmother told you to drink a warm glass of milk before bed. “It’s because there’s tryptophan in milk, and tryptophan converts to melatonin in the body," he explained.

The National Center for Biotechnology Information lists several other dietary sources of melatonin:

  • eggs and fish
  • tart cherries and grapes
  • tomatoes and peppers
  • mushrooms
  • germinated soybean seeds
  • pistachios
  • pigmented rice with black rice having the highest concentration

Eating these foods before bedtime can boost natural melatonin levels in the body, Kothare noted.


SOURCE: Sanjeev Kothare, MD, director, Pediatric Sleep Program, Cohen Children’s Medical Center, New Hyde Park, N.Y.

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