Why ‘good’ sleep is so important

UnknownIn today’s society we are expected to fit more and more into our lives. Yet this work-life balance struggle is causing many of us to trade in precious sleeping time to ensure we complete all the jobs expected of us. Sadly this is a ticking timebomb for our health.

Scientists now believe that if we sleep less than six hours a night and have disturbed sleep we stand a 48% greater chance of dying from heart disease and a 15 per cent greater chance of developing or dying from a stroke. So our ‘work hard, play hard’ society encourages us to sacrifice sleep to the detriment of our health.

More than 3.5million of us suffer from excessive sleepiness usually caused by poor sleep. Everyone has experienced the occasional night without sleep. It makes us feel tired and irritable the next day but won’t harm our health. After several sleepless nights however, the mental effects become more serious.

Brain fog, difficulty concentrating and inability to make decisions follow. Some people drop off during the day causing injuries at home, work and on the road. Long term lack of sleep affects our overall health. A recent Sleep Alliance Report showed how excessive sleepiness is damaging the health and economy of the nation. Sleep disorders are a major contributing factor to fatal road accidents, heart disease, strokes, lost productivity and the breakdown of marriages.

A recent Dutch study in the European Journal of Preventative Cardiology showed that good quality sleep can reduce 57% of heart related deaths each year. It looked at the risk of chronic disease in 14,000 people over a 12 year period and showed that poor sleep is as important a risk factor for Cardiovascular Disease as other lifestyle factors such as being overweight or smoking.

Over 3.5 million people in the UK suffer from excessive sleepiness but what’s the answer. If you have trouble sleeping your first port of call should be your GP who will be able to advise you about what you can do at home to help you sleep. This is known as good sleep hygiene and includes:

  • establishing fixed times for going to bed and waking up (try to avoid sleeping in after a poor night’s sleep)
  • trying to relax before going to bed
  • maintaining a comfortable sleeping environment (not too hot, cold, noisy or bright)
  • avoiding napping during the day
  • avoiding caffeine, nicotine and alcohol late at night
  • avoiding exercise within four hours of bedtime (although exercise in the middle of the day is beneficial)
  • avoiding eating a heavy meal late at night
  • avoiding watching or checking the clock throughout the night
  • only using the bedroom for sleeping and sex

Disturbed sleep may be caused by snoring with more than 3.5 million of us being regular snorers. Snoring occurs because of the vibration generated as air rushes past the tissues of the mouth, nose and throat. When most people think of snorers they picture an overweight, beer drinking bloke. Yet snoring is not confined to men. Older women and children also snore. In fact after the menopause women catch up with their male counterparts.

Snoring can be caused by a number of factors. Being overweight often means you have extra fat around the throat which can stop air flowing smoothly. Sleeping on the back causes the tongue to fall back into the throat narrowing the airway. Colds and allergies can also trigger snoring as sufferers end up breathing through the mouth. Drinking too much alcohol or taking sleeping tablets at night can cause the throat muscles to relax.

‘People with respiratory disorders such as asthma or Chronic Obstructive Pulmonary Disorder (COPD) are also more prone to snoring’ says Dr Matthew Hind who runs the Sleep Clinic at the Royal Brompton Hospital, London. Lifestyle changes such as losing weight can sometimes improve the problem. There are also a range of anti-snoring devices such as mouth guards and nasal strips which can help prevent snoring.

The health consequences of snoring can be serious. Around 6-7 per cent of men and 3-4 per cent of women have obstructive sleep apnoea (OSA) where they repeatedly, stop breathing at night (see above). As well as daytime sleepiness and concentration problems, the condition is linked to a raised risk of high blood pressure, heart disease and type 2 diabetes.

‘We have to stop treating snoring as a bit of a joke. Snoring can affect all aspects of life if left untreated. It can cause excessive tiredness, poor concentration and relationship problems’ explains Dr Hind.

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Goodbye Asthma!

stock-photo-a-conceptual-look-at-asthma-and-the-problems-it-brings-145677698OK. It’s time I let everyone into a big secret. I have cured my asthma! Yes that word cure is a funny one isn’t it? Doctors don’t like it at all. When I told my GP I no longer wish to be registered as asthmatic and she could stop prescribing me inhalers she was genuinely shocked.

How had I done it she asked. Buteyko Breathing I replied. The look on her face was a picture. Clearly she had never heard about this alternative treatment for asthma (and incidentally, a whole raft of other health problems).

So who was Buteyko? Konstantin Buteyko was a Russian doctor who, in 1952, was the first scientist to discover the major cause of a number of diseases of the respiratory, hormonal, cardiovascular and nervous systems which were incurable by modern medicine.

Scientific trials of the method in the treatment of asthma in Russia during the 1960s and in Australia in the 1990s showed amazing results.  The secret of the method is correct breathing.

Sounds too good to be true but it is based on good science. Most of us breathe too deeply so we don’t take in enough carbon dioxide to enable our systems to absorb the oxygen we need. The Buteyko exercises aim to reprogramme our breathing and get rid of asthma forever.

In the only clinical trial carried out outside Russia, on 40 people in Australia in 1994, asthma sufferers who tried the Buteyko method reported a 90% reduction in their dependence upon medication. The results however were deemed controversial and the trial considered too small to be conclusive.

Well now I can report that it has worked for me. I have been doing the exercises for more than two years and can honestly say I have not used my inhaler in all that time. The exercises are tricky and need real persistence but once you get the hang of them, any time you feel that familiar wheezing start, simply find somewhere quiet, sit down and do the exercises and the wheezing will pass.

It can be frightening to begin with as it is not the quick fix an inhaler gives. But if you persevere it is a fantastic feeling to know that your own body has the ability to sort the problem out. As time goes on the attacks have grown fewer and fewer until now I very rarely have one and am confident I could deal with one if it did occur.

So how can you find out how this amazing breathing method works? One of the best known Buteyko therapists is Patrick McKeown who has a website at: http://www.buteyko.ie. There you will find everything you need to know about the method including YouTube clips of how to breathe correctly. It has been the best thing I have done in a long time and wanted to share this with my faithful SurgeryCat followers!

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How to be dementia friendly!

I am now officially a dementia friend.  Dementia Friends is a joint initiative between Alzheimer’s Society and Dementia UK to try and raise awareness of what exactly Dementia is. I duly registered online and turned up at the local library where Josette Simon (a very beautiful and talented actor) was ready to tell us all about how we could help.

I was a little bit nervous I would be asked to befriend someone with dementia. Both my parents lived with the condition and it was a very difficult time for all the family. However Josette had a lively way of describing why ‘there is more to a person than the dementia’.

She explained the five things we should all know about dementia. Firstly it is NOT a natural part of ageing. It is caused by diseases of the brain, the most common of which is Alzheimer’s. Dementia is more than just losing memory, it can affect thinking, communication and undertaking everyday tasks.

However, it is possible to live well with dementia-especially if everyone in society plays their part in being more understanding of those who have it and trying to make people with dementia feel included in their communities.

Josette, being a brilliant actor, had a fabulous way with words. She explained how dementia affects two main parts of the brain-the Hippocampus which is where we store our memories and the Amygdala which is really ‘who we are’.

She compared the Hippocampus to a rather shoddily built bookcase which when dementia strikes rocks back and forth displacing all the books. The books on the top shelves represent the most recent memories and the bottom bookshelf represents childhood memories.

She then compared the Amygdala to an extremely well built and solid oak bookcase which represents the ‘who we are’ bit. That does not change when dementia strikes. She then told a poignant story about someone whose mother was living with Alzheimer’s. Often she would wonder if it was worth visiting because her mother would soon forget her visit.

But once she understood about the ‘bookcase’ she realised that although her mum may have forgotten her visit she she still knew her daughter and what she meant to her. So although her memory might have been going she never forgot her family and the warm feelings they all evoked.

If I took away one thing from that meeting it was that dementia is not the frightening thing I once thought but that with a little help and understanding we can all be ‘imagesdementia friends’.

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Ditching the statins

ImageOccasionally at the surgery I get the chance to read through old newspaper articles. I just came across this one by Dr Haroun Gajraj a vascular consultant based in Dorset who had recently been prescribed statins for high cholesterol.

For eight years he faithfully popped his pills without side effects until one day last year he stopped. Not because of side effects but because he had a good look at the research. He concluded that statins would not save him from a heart attack and that his cholesterol levels were pretty irrelevant anyway.

Why this bolt from the blue? Gajraj had discovered the amazing Norwegian Hunt 2 Study which I wrote about last year. The study came out in 2011 and followed 52,000 men and women aged between 20 ad 74 for 10 years. It showed that contrary to all the hype, the lower a woman’s total cholesterol, the greater her risk of dying, either of heart disease or anything else including cancer. The study backed up others which have linked high cholesterol levels with increased longevity in older people.

He, like many other experts such as Dr Aseem Malhotra, are not convinced by the idea that cholesterol is the baddie in the heart disease story but believe it might simply be an innocent bystander. In fact, these experts are beginning to believe that sugar is emerging as the true villain and after years of demonisation, saturated fat is fast being acquitted of causing heart disease.

In a recent survey by Pulse, six in 10 GPs opposed the recent draft proposal to lower the risk level at which patients are prescribed statins. And 55 per cent said they would not take statins themselves or recommend them to a relative based on the proposed new guidelines. Surely this must say something about these horrendous drugs?

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Tiny tyrants

ImageSuzanne Moore’s brilliant piece in the Guardian yesterday about the worship of children was thought provoking, particularly for those of us of a certain age who have already brought up a family.

The parents Suzanne refers to can be seen in any up and coming area of London. The child is wheeled around in a grotesquely large buggy, hogging the pavement, and woe betide any lesser mortal who may want to share the space. I have been pushed, shoved or had abuse hurled at me for daring to suggest I too have a right to walk where I want.

Stopping for a coffee is a nightmare. The coffee shop has often been commandeered by a whole raft of yummy mummy fascists. It is nigh on impossible to weave your way around the buggies to get to a small table in a corner.

Once seated your ears are likely to be assaulted by screaming, yelling out of control kids who run amok whilst mums are either deep in conversation or glued to their i-phones unaware of the havoc being wreaked around other people.

I am going to sound like my grandmother now but in our day, when we had children, even if we were working mums, we viewed it as a commitment. Having children meant you automatically gave up things like the freedom to do what you wanted when you wanted.

When our babies cried, rather than stuff a bottle in its mouth we would communicate with it, pick it up, jiggle it about, coo to it until it was soothed. Sometimes, dare I say it, we would decide it was better to take it home where it was in familiar surroundings and if it was tired, it could sleep.

Not for today’s mum is there any notion that she must forego her own pleasure in order to meet her baby’s needs. If she wants to meet up with friends the baby must take second place. If the baby makes a noise it is merely an interruption to what she sees as her real life.

Once the baby can walk however things soon change and they are bestowed with the status of demigod. The lack of communication and bonding between the mother and the tiny baby then usually comes home to roost.

You see these children in a department store as you are idly browsing. You may suddenly come upon an uninhabited buggy and see a mother desultorily chatting on her phone and rifling through the rails. Be assured there is a little tyrant of a child close by. And soon you will hear it as it hurtles around the store, tripping up staff, completely out of control.

None of the mothers are even vaguely aware that their offspring is causing so much mayhem. How boring it is for a young child to be carted from pillar to post while mum goes shopping. How much easier it would be for all concerned if the mother had sorted out some care for her child so that she could shop in peace (as could we). The whole experience would be so much less stressful for all concerned.

Eating out on a recent visit to Spain brought home that the way we treat our children in the UK is pretty unique. Over there, little ones are seen as part of the family. When they are out and about very few children were in a buggy. Often Dad was seen carrying a baby or small child in his arms and sitting the baby on their lap at the dinner table.

Over here children seem to be unable to eat out without squealing and shouting and being the centre of attention. They have to be carefully placed in a special high chair whereas  abroad a small cushion will suffice. Children then sit up and socialize with the family and are expected to fit in.

When are we going to learn in the UK that children are simply small people who need to learn to be sociable with adults as well as their peer group. Whilst we let them believe that every time they speak or make a noise all conversation stops and all eyes are upon them there is little hope that will ever happen.

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The myth of saturated fat and heart disease

ImageAn article in the BMJ today by leading cardiologist, Dr Aseem Malhotra of Croydon University Hospital in the British Medical Journal today states that it is time to “bust the myth of the role of saturated fat in heart disease”.

In the article he also blames the food industry for lowering saturated fat levels in food by replacing it with sugar which also contributes to heart disease.

He believes that saturated fat has been “demonised” and the link with heart disease is not fully supported by scientific evidence.

“Adopting a Mediterranean diet – olive oil, nuts, oily fish, plenty of fruit and vegetables and a moderate amount of red wine – after a heart attack is almost three times as powerful in reducing mortality as taking a statin” he writes.

The saturated fat link to heart disease was first put about in 1953 when a respected US physician Dr Ancel Keys published a paper comparing saturated fat intake and heart disease mortality.

Keys looked at six countries in which higher saturated fat intake correlated with high rates of heart disease.

However, what Keys conveniently ignored was that data from 16 other countries did not fit his theory. This tenuous link between saturated fat and heart disease became enshrined in the public consciousness and has remained so ever since.

Dr. Stephen Sinatra, a US cardiologist who’s been practicing for over 30 years and is the author of The Great Cholesterol Myth, does not believe cholesterol is the bad guy in the heart disease mystery. “Cholesterol may be at the scene of the crime for heart disease, but it’s not the perpetrator,” he says.

Sinatra is among a growing number of doctors who believe that inflammation rather than cholesterol is the real villain of the piece.

Inflammation is caused by a number of things but sugar in our diet is a major factor-particularly high fructose corn sugar which is present in so many fizzy drinks. “Sugar damages arteries, increases blood pressure, and ages your organs” he explains.

Yet still doctors are prescribing more statins than ever. Cholesterol-lowering has become a huge global industry, generating at least $29 billion each year.

More and more health professionals are beginning to believe we have been focusing too hard on cholesterol and may be missing the point. If we have spent the last fifty years chasing the wrong demons the greatest sadness is the lost opportunity to tackle heart disease.

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Aluminium-the silent visitor

ImageNew research shows that some types of baby formula contain 100 times more aluminium than breast milk. Experts like Dr Chris Exley, Professor of Bioinorganic Chemistry at Keele University are now calling on the government to take action. 

Their study, published in the journal BMC Pediatrics, examined 30 types of formula sold in the UK, including infant first milks and toddler milks. ‘It is widely recognized that aluminium is a neurotoxin and that it can cause cognitive deficiency’ says Exley.

Study leader Professor Chris Exley, who raised the alarm three years ago with a similar study, said some formulas have aluminium levels 100 times higher than the same amount of breast milk. He said ‘We believe this is too much aluminium to be subjecting a human to at their most vulnerable stage of life.

‘What we don’t know is whether aluminium is accumulating in the bodies of formula-fed babies. If it is, aluminium has no biological function at all, you have no requirement for it. ‘Simply the fact we don’t have experiments showing that it’s either safe or not safe in humans certainly doesn’t mean it’s not an issue.’

Dr Exley’s concern about aluminium is the lack of research into safe levels at which it can be tolerated in the body. ‘Aluminium has no function in the human body and there are hundreds of publications which demonstrate that it is not safe. Yet nobody is doing any research in this area-least of all the people who should be protecting us like the WHO and FSA’ says Dr Exley.

Most people remember that aluminium was linked to early onset Alzheimer’s many years ago. In fact, the earliest link between Alzheimers disease and aluminium was published in 1921 by J Spofforth in the Lancet where it was suggested that aluminium poisoning caused memory disorder in humans.   Then in 1976 D R Crapper et al showed aluminium was associated with plaques and tangles in the brains of people with Alzheimer’s disease.

More recently Rondeau et al demonstrated that high daily intake of aluminium correlated with an increased risk of dementia or cognitive decline in a 15 year follow up French cohort study known as PAQUID.

There is no doubt that aluminium is toxic. During the 1960/70s kidney dialysis patients used to have their blood flushed out with ordinary tap water. ‘In areas where there was a high level of aluminium in the water these patients got extremely ill and some of them died from the neurotoxic effects’ says Dr Exley.

Aluminium is the most common metal on our planet forming 8% of the Earth’s crust so needless to say it is naturally absorbed by many plants and foodstuffs we grow to eat. However it is also added in almost everything else we come into contact with. All of us consume it daily-often without realizing it.

For example, Aluminium sulphate is added to our water to improve its clarity. All foods which need raising agents or additives such as cakes and biscuits contain aluminium. Children’s sweets contain aluminium-enhanced food colouring, it is in beverages such as tea, cocoa and malt drinks, in some wines and fizzy drinks and is also in most processed foods.

It is in a variety of cosmetics including sunscreens and antiperspirants. It is used as a buffering agent in aspirin and in a wide range of antacids. It is even used in vaccines. And now we know it is in extremely high levels in certain types of infant formula.

You might wonder why we have not adapted to deal with aluminium in the body. But Exley points out it was only 100 years ago we learned how to make aluminium metal from the stuff locked up in the Earth’s crust.  ‘This heralded the advent of the Aluminium Age and 100 years of humans being exposed to a burgeoning concentration of biologically available aluminium. So all the aluminium in our body is a silent visitor’ he says.

Toxic effects of aluminium are dependent upon the amount we consume, tissue distribution and excretion rate. When the amount of aluminium consumed exceeds the body’s capacity to excrete it, the excess is then deposited in various tissues including nerves, brain, bone, liver, heart, spleen and muscle.

We are also exposed to aluminium by other routes such as our skin, nose and lungs which may be just as important as our exposure via the gut.  Eighty per cent of vaccines contain aluminium which acts as an adjuvant to boost the immune response. ‘If you think most infants get around 14 vaccinations before the age of 13 then we believe the aluminium load is unacceptably high’ says Exley.

Dr Exley has been working in the field of aluminium for more than 25 years. Not for nothing has he been affectionately dubbed Mr Aluminium-a nod to his remarkable expertise in a field which does not traditionally attract plaudits or huge research funds.

‘Everyone has some aluminium in their bodies but infants below the age of six months are more susceptible because their gut, kidneys and blood brain barrier are immature so they are especially prone to absorbing it and not so good at getting rid of it’ he says.   The FSA does not provide a ‘safe’ limit for aluminium in formula milk but Dr Exley wants manufacturers to lower the level or print it on the label so that parents can make an informed choice.

Diane Benford, Head of the Chemical Risk Assessment Unit at the Food Standards Agency, is confident that babies are not at risk. She does concede however, that children may be consuming too much aluminium, simply because they eat more than adults.

‘Some small groups of the UK population may now be consuming more than the safety guideline amount of aluminium. This may particularly affect children who consume food with higher amounts of aluminium such as bread and bakery products, cocoa and cocoa products, and some leafy vegetables.

There is a Tolerable Weekly Intake which was recently set by the European Food Safety Authority’s Scientific Panel on Food Additives. ‘The TWI is not an estimate of people’s intake but an expert opinion of an amounts that EFSA considers can be safely consumed every day over a whole lifetime’ explains Benford.

So how do consumers know how much is safe? ‘There is no way an individual can actually check because aluminium is everywhere and can be found in so many different foods. In 2008 EFSA estimated that some people would exceed the TWI. However the available data do not show an increase in intake and because the TWI was increased by the WHO to 2mg per 1kg fewer people will now exceed it’ says Benford.

Yet Exley takes issue with their science. ‘To put out these ‘safe tolerable levels’ suggests we know something we do not. More scientific research is desperately needed’ he says.   ‘Our research demonstrating the vulnerability of infants to early exposure to aluminium serves to highlight an urgent need to reduce the aluminium content of infant formulas and no longer use aluminium as an adjuvant in vaccines agains childhood diseases’ he says.

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