Why do people who have strokes feel fatigue? Well on Friday I went back to Queen Square for more tests to try and discover exactly that. I was met at the door of No 33 by the lovely Anna who took me to the special room where the testing takes place. First off she asked me how tired I felt on a scale of 1-10 at that precise moment. I felt slightly ashamed to say I was totally knackered. I had had no lunch and had traipsed round the shops for over an hour. Not only that but I had been fighting off a virus which had been trying to take hold for more than two weeks. So I guess I should not have been surprised I didn’t feel 100%. Anna explained what I was going to do and that it required a lot of concentration. The idea was to measure strength and whether I could tell how much energy I needed to perform a task. In typical high tech fashion that I am getting used to at these sessions, I had to hold my forefinger against a slightly Heath Robinson contraption involving a piece of metal and a pencil. The metal was linked up to Ann’s computer to record measurements. Anna would then press the end of the pencil twice against my finger and record on the computer how hard she had pressed and how accurately I guessed the pressure of the pencil was on my finger. Next she pressed the pencil and handed the pencil to me to press at at exactly the same pressure (I told you the test was high tech!) I could see why you needed concentration as it’s vital to remember exactly how it felt when she pressed the pencil into my forefinger so as to try and match the pressure as accurately as possible. The whole test took around an hour. As ever we had a good laugh about the strange set up and the fact that of course I couldn’t be told whether I had got the answers right or not! All that data will now be put into the study which hopefully will help answer the question why so many stroke survivors suffer fatigue.
Tag Archives: heart disease
In 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.
An 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.
Discussions about the link between oral health and heart disease has been rumbling on for many years. A study of over 11,000 people in Scotland in 2010 showed that poor oral hygiene was associated with higher risks of cardiovascular disease.
And now, new research shows there may be a connection between serious gum disease (periodontal disease) and the build up of fatty deposits on the lining of artery walls which can lead to blood clots causing atheroscelerotic disease (ASVD).
There have been more than 50 studies looking into whether periodontal disease puts people at greater risk of ASVD. In a recent assessment of all the literature the American Heart Association stated that the relationship between periodontal disease and ASVD is potentially a massive pubic health issue of because of the growing prevalence of gum disease in the general population.
Dr Brian Clapp from Guys and St Thomas’ Hospital London says the gum disease/heart disease link is interesting and complex. ‘Some argue that it is a direct effect of bacteria being involved in both processes. Most people including myself think that this is an epiphenomenon or a secondary symptom which may be unrelated to the original disease or disorder’ he says.
‘Nevertheless, there is no doubt that poor dental health correlates with an increased inflammatory state within the body (probably by a causal relationship) and this increased level of inflammation which can be measured by the increased levels of C-reactive protein in the blood, leads to increased atherosclerosis’ says Dr Clapp.
New research from Bristol University has recently shown that dental plaque may actually trigger blood clots in other parts of the body. Researchers found that streptococcus gordonii which normally inhabits the mouth can cause problems when it enters the bloodstream via bleeding gums. The theory is that the bacteria mimics the clotting factor, fibrinogen which in turn activates platelets causing them to clump together inside the blood vessels.
Signs of gum disease include:
Gums that bleed when you brush your teeth
- Blood in your saliva
- Red, swollen gums
- Bad breath
- Wobbly or loose teeth
- Abscessed teeth
- Tooth loss
The good news is that brushing your teeth properly and looking after your gums can prevent and treat gum disease, improve your overall health and help reduce your risk of health problems, such as heart disease. It’s important to have a routine of brushing your teeth for a full two minutes twice a day with a fluoride toothpaste, plus cleaning between your teeth with floss or interdental brushes.
Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, says: ‘The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only one in six people realises that gum disease may place them at an increased risk of stroke or diabetes. And only one in three is aware of the heart disease link.’
Dr Carter recommends visiting your dentist and dental hygienist regularly for cleaning and check-ups. It’s especially important to look after your teeth and gums if you’re pregnant. NHS dental care is free for pregnant women and during the 12 months after you’ve given birth.