Obstructive Sleep Apnea Guidelines 2014

By | March 30, 2017

Natural Cures for Insomnia

Hey guys, Axe here from DrAxe . Oneof the most common things I'll hear from my patients, is they'll say, quot; Axe, I can'tsleep.quot; And if you're one of those people that have trouble falling asleep, or strugglewith insomnia, or you wake up during the night, that's very common. In this tutorial I'm goingto go through the exact steps you need to follow to get better quality of sleep andto help you fall asleep fast. Step number one in overcoming sleep deprivationis to change your diet, surprisingly. And, for a lot of people, their diets are keepingthem from falling asleep. Before you go to bed, you need to really drop your carbohydrateconsumption. If you're consuming too many

sugars and carbs, your body is burning those,it's getting warm. And so, lowering that sugar, and grain intake, and carbohydrate intakebefore bed is important. And get some good quality fats before you go to bed. Somethinglike an avocado is a great food to actually help you fall asleep at night, either avocadoor some organic yogurt. So again, avocado and organic yogurt, are the best foods tohelp you naturally fall asleep. The reason they work is those foods are high in magnesiumand potassium. Magnesium and potassium are two crucial nutrients you need to help relaxthe body and to help you fall asleep at night. So remember avocado and yogurt, the top twofoods you can consume just a little bit here

or there in the evening that will help youfall asleep at night. The second step you need to do to overcomeinsomnia is to reduce stress. And for most people, along with diet, this is the big thingthat's keeping you up at night, is your mind starts racing, you keep thinking and you can'tshut your brain off. And there are several reasons for that. One, is you watched TV upuntil the point that you went to bed. That visual stimulus you're watching constantly,especially the blue light, and that doesn't just include the TV screen, it also includesyour computer, your iPad, or your phone. And that light is blue light, which actually tellsyour pineal gland in your brain that it actually

needs to keep running, so it messes with yourcircadian rhythms and cortisol levels. It keeps you from falling asleep at night whenyou were looking at that bright blue light in the computer screens and TV screens. So,about 30 minutes at least, ideally, an hour, but at least 30 minutes before bed, you needto shut off all electronics, and you need to start reading something that helps yourelax. Or start journaling. So you can get out ajournal and start writing things down. You can look at your schedule for the next dayand write that down. But I really recommend reading a novel that you enjoy, reading adevotional, your Bible, or just something

that helps you relax and wind down at least30 minutes before bed. And that's going to help, and in general reducing stress. And if you have something that's really stressingyou out, that's keeping you from sleeping at night, I recommend you start writing downthose things that stress you out. Work on addressing those the best you can, and thenstart scheduling things into the week that you love to do. It is so important. If you'vehad a great day, and you've been happy all day, it actually creates certain hormonesin your body known as endorphins that actually help you fall asleep at night. So actually,having a good mood throughout the day can

help improve your sleep at night. So stepnumber two, shut down the computers and read a book before bed. As well as just add somejoy into your life. Reduce stress; it's very important for falling asleep at night. Step number three, is take quality supplements,especially a magnesium supplement. And taking a magnesium supplement, about 400 to 500mga night before bed, can help you naturally reduce stress, and really improve sleep. Andso I recommend a high quality magnesium chelate or magnesium citrate before bed. So takinga magnesium supplement can help you fall asleep. Also supplements like melatonin can help,or valerian root. But I don't recommend doing

2015 Atrial Fibrillation Patient Conference Managing AF Risk Factors Panel

Wilber: Well thank you. This is really,I think, a topic that I look forward to talking to people about and I think more and moreit's assuming increasing importance in how we take care of patients. We're going to tryto do a broad overview. We're going to focus specifically on diabetes, sleep apnea andexercise as 00:00:30 potential risk factors and how they can be modified in our care ofpatients with atrial fibrillation, but we'll try to give your broad overview of some ofthe other topics as well. So although I'm going to mostly talk about obesity today andatrial fibrillation, we'll talk about a couple of other things as well.

There are a variety of risk factors for atrialfibrillation and this was initially, I think, mostly of interest to epidemiologists, peoplewho study how disease, what the prevalence of it is, and how it comes to pass. I thinknow we've really begun to understand that central role, not only in sort of understandingthe disease but really in treating it, and if we don't consider these as we treat patientsthen I think our outcomes are not nearly as good as they might be otherwise. This is the traditional list and I think thereare probably even a few more. I've starred a few of them where I think that the evidencenow is becoming very clear that these are

potentially modifiable and that's really whatI want you to take home today. These aren't static risk factors that cause something andthen there's nothing you can do about it but treat the consequences, but in fact by intervening,both early and late, you have a chance to modify the disease and improve outcomes. What that means for you as patients is thatyou have to participate in your care and that's really something I want to emphasize; andif you're not invited to do so, then you must insist on doing it. Because I think your outcomesfor atrial fibrillation really depend on how you address each of these risk factors asthey apply to you individually.

Just to briefly talk about hypertension; wewon't spend a lot of time. It's certainly important; it's one of the most common riskfactors associated with atrial fibrillation. Somewhere between 60% and 80% of patientswho have atrial fibrillation in large populations studies have at least hypertension as a riskfactor, and by itself may account for the 20% to 25% of the overall risk of new onsetatrial fibrillation. There's some evidence that systolic bloodpressure probably plays a more important role than diastolic blood pressure, but there'sno clear threshold value. When you look in large population studies, each increment insystolic blood pressure is associated with

the increasing risk of atrial fibrillation.There's no sort of magic number necessarily that if you get below, your risk of atrialfibrillation goes away. It's probably reasonable and what I like to use as a therapeutic targetis somewhere around below 13080. What that means is that that's even below the sort oftraditional guidelines for treatment of hypertension, but it's very clear that even mild elevationsof blood pressure within the range of what we would call normal can still confer afibrisk. There's no clear superiority of one drug overanother although the control of atrial fibrillation certainly can improve the symptoms and thefrequency with which you have atrial fibrillation.

It's not clear that any single drug is absolutelybetter. There's some evidence that ACE inhibitors and ARBs, which are drugs that many of youmay be on to treat your hypertension, may be particularly beneficial, particularly whenyou have relatively advanced hypertension with end organ involvement like thickeningof the heart muscle, the left ventricular hypertrophy, as we call it. But there's also evidence that uncontrolledhypertension as you start antiarrhythmic drug treatment and after catheter ablation, ifyou enter into that with poorly controlled blood pressure, in fact, you have much pooreroutcomes than if your blood pressure is controlled.

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