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Impact of the aging population on health care
Aging population impact on healthcare
Impact of the aging population on healthcare
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Thank you fore referring Roberta Cecolini, a 67 year-old lady who has previously worked as a secretary and currently is caring for her 98 year-old mother. Roberta is a non-smoker and infrequently consumes alcohol. Regular medications include Avapro, Zoloft, Crestor and vitamin D. As you are aware, Roberta recently underwent a home-based diagnostic sleep study and much to my surprise, Roberta informs me that the technician did not actually perform an equipment set-up rather provided her the equipment in a suitcase and requested that she set herself up at home. The report from the study performed a couple of months ago indicates severe supine sleep related obstructive sleep apnoea with a respiratory disturbance index of 45 events/hr for the entire night. During supine sleep, the AHI was 66 events/hr as opposed to three events/hr during non-supine sleep. There was intermittent oxygen desaturation to a nadir of 81%. …show more content…
There is a history of snoring but no witnessed apnoeas or nocturnal choking/gasping episodes. She reports fragmented sleep but no history of nocturia. When she wakes at between 7.30 and 8.00am, she typically feels unrefreshed although is not aware of any significant daytime somnolence with a normal Epworth Sleepiness Score of 2/24. Roberta reports intermittent allergic rhinitis
Thank you for referring Ransley Mascurine, a 55 year-old gentleman who currently works as a counsellor and is also an avid body builder. Ransley is a non-smoker and of late, has been consuming alcohol two to three standard drinks each evening. The only regular medication is Lipitor.
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
I also highly recommend that she take her prescribed medications as directed, especially those for her mental health problems. Because of my concerns with the mixing of medications, her primary psychiatrist and I have created a treatment plan that involves a highly balanced set of medications which treat all of her disorders on as few drugs as possible, thus going off even one of her medications could deconstruct the entire plan. I also advise keeping a food journal to attempt to remind patient H to eat and fight the hypophagic instinct she has. While drinking on occasion is not unhealthy, the chronic binge drinking is, and I would recommend that she cut back on her alcohol consumption and try to develop a healthier relationship with alcohol so it isn’t used as a stress
These factors are relevant to the psychological effects sleep apnea can have on people. Using research available and a discovery of links between psychological effects caused and related to sleep apnea reveal pertinent information helpful to people living with this medical condition. Sleep apnea is defined as brief periods of recurrent cessation of breathing during sleep caused by obstruction of the airway or a disturbance in the brain's respiratory center and is associated especially with excessive daytime sleepiness. Obstructive sleep apnea is defined as sleep apnea caused by recurring interruption of breathing during sleep due to obstruction usually of the upper airway especi...
We live our entire life in two states, sleep and awake1. These two states are characterized by two distinct behaviors. For instance, the brain demonstrates a well-defined activity during non-REM sleep (nREM) that is different when we are awake. In the study of sleep by Huber et. al., the authors stated that sleep is in fact a global state2. It is unclear whether this statement means that sleep is a state of global behavioural inactivity or the state of the global nervous system. The notion that sleep is a global state of the nervous system served as basis for sleep researchers to search for a sleep switch. The discovery of the sleep switch, in return, provided evidence and enhanced the notion that sleep is a global state of the nervous system. The switch hypothesis developed from the fact that sleep can be initiated without fatigue and it is reversible1. It was hypothesized that there is something in the brain that has the ability to control the whole brain and initiate sleep. Studies have found a good candidate that demonstrated this ability3. They found a group of neurons in the Ventrolateral Preoptic (VLPO) nucleus. It was a good candidate because it was active during sleep, has neuronal output that can influence the wakefulness pathway, and lesion in the area followed reduce sleep3. The idea that there is something that can control the whole brain and result sleep state supports the idea that sleep is a global state of the nervous system.
Hirshkowitz, M., & Smith, P. B. (2004). Sleep disorders for dummies. Hoboken, NJ: Wiley Pub.
As patients grow older, and develop conditions that require prescription and over the counter medications, opportunities for dangerous alcohol/drug interactions increase.
Sleep apnea is a very serious disorder because you can easily die from it because you totally stop breathing. The pause in breathing usually last only a few seconds but can happen 30 or more times in an hour. When breathing will resume in usually results in a snore or a choking sound. People with sleep apnea are usually tired more than most throughout the day because when they start to snore or have pauses in their breathing they move out of a deep sleep and into a light sleep. Sleep apnea is very hard for doctors to diagnose because it only happens when you are asleep. The only way to become aware of your sleep apnea is usually by a family member or a spouse who notices you snoring or have pauses when you are asleep. One of the most common types of sleep apnea is called obstructive sleep apnea. Obstructive sleep apnea is when your airway is blocked during sleep resulting in pauses of breath. This is most common in people who are overweight but doesn 't have to be. If sleep apnea goes untreated the consequences can be very dangerous. It could increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes. The four known ways to cure sleep apnea is lifestyle changes, mouthpieces, breathing devices, and
Wilson, J.F. (2005). Is sleep the new vital sign? Annals of Internal Medicine, 142 (10), 877-880.
Sleep apnea is a sleep disorder in which breathing stops and starts repeatedly. Experts have estimated that 18 million Americans are affected by sleep apnea. There are three main types of sleep apnea. Obstructive sleep apnea is the most common form that occurs when throat muscles relax. Central sleep apnea occurs when your brain does not send proper signals to the muscles controlling breathing and Complex sleep apnea syndrome, a combination of both obstructive and central sleep. Symptoms of sleep apnea include loud snoring, breathing cessation, abrupt awakenings accompanied by shortness of breath, dry mouth, morning headaches, insomnia, daytime sleepiness,
Sleep apnea is a sleep disorder which causes frequent pauses in the breathing process during the sleep.
Nothing feels quite like waking up refreshed and ready to tackle the day ahead of you. However, while we all know how important sleep is, many of us still struggle to fall asleep at night. Moreover, I am willing to wager that many of us also always seem to wake up fatigued, no matter how long we have slept. If you have trouble sleeping it is possible that you may have one of several common sleeping disorders.
Technological advancements such as the electroencephalograph (EEG), that can measure activity of the sleeping brain, have facilitated various theories to explain the necessity of and the purpose of sleep. Sleep studies measure brain waves (EEG), eye movements (EOG), and muscle skeletal activity (EMG) using a polysomnography.
Sleep and Sleep Disorders. Centers for Disease Control and Prevention, 1 July 2013. Web. 7 May 2014. .
The test results were normal and the recorded long periods of silence and every now and then movement, a cough, maybe a little snore but that was all. At any rate, stage 2 (NREM-2) of the sleep cycle produces what is known as sleep spindles or bursts of rapid, rhythmic brain-wave activity which lasts about twenty minutes. As your heart rate begins to slow down and your body temperature drops you transition into a deeper sleep and this is stage 3 (NREM-3) of the sleep cycle. Slower brain waves or delta waves occur and a person becomes less responsive to any activity around them, such as noise. The person becomes like that of a dead person or at least that is what my Uncle Herbert would say. He told me I sleep like I am dead. He said he pinched me and hollered at me and I still would not wake up.