Thoracic and Sleep Group Queensland People caring for how you breathe and sleep

Millions of people suffer from asthma. Many report having poor control of their symptoms. Fortunately, new research shows there is a simple antidote: 30 minutes of exercise a day, year-round.

In a study recently published in BMJ Open Respiratory Research, experts from Concordia University, the Hôpital du Sacré-Coeur de Montréal and several other institutions* analyzed the exercise habits of 643 participants who had been diagnosed with asthma.

Results were overwhelmingly clear: those who engaged in optimal levels of physical activity on a regular basis were nearly two-and-a-half times more likely to have good control of their symptoms, compared with those who did no exercise.

The workout doesn’t have to be strenuous. “We’re not talking about running marathons here,” says Simon Bacon, the study’s lead author and a professor in the Department of Exercise Science at Concordia. “Just 30 minutes a day of walking, riding a bike, doing yoga — anything active, really — can result in significant reduction of asthma symptoms.”

Traditionally, people with the condition have been discouraged from exercising because of a belief that it triggers shortness of breath and attacks. Bacon explains that simple precautionary measures can be taken to avoid the discomforts that can be caused by physical activity.

“The issue of exercise-induced bronchospasm is real — but if you use your reliever medication, blue puffer, before you exercise, and then take the time to cool down afterwards, you should be okay,” he says. “Even if you have asthma, there’s no good reason not to get out there and exercise.”

That’s a message Bacon hopes resonates. Within his sample group of 643 individuals, a whopping 245 reported doing no physical activity. Only 100 said they engaged in the optimal 30 minutes a day.

“Those numbers reflect the population in general,” says Bacon, who is also director of the Centre de réadaptation Jean-Jacques-Gauthier at Hospital du Sacré-Coeur. Forty per cent of people don’t exercise at all, he says.

“We need to keep in mind that doing something is better than nothing, and doing more is better than less. Even the smallest amount of activity is beneficial.”

It’s something to keep in mind during winter months, when fitness levels tend to drop along with the temperature, and cold air provides another trigger for asthma symptoms.

“Our study shows that those who were able to engage in physical activity on a regular basis year-round benefit most,” says Bacon. If necessary, he suggests finding an indoor place to move, whether it’s the gym, a staircase or a shopping mall.

“It’s all about being creative and finding environments where the cold doesn’t become an issue.”

Could a prescription for exercise be the result of this study? Bacon is hopeful. “It would be great to see physicians recommending physical activity to patients with asthma, alongside traditional pharmacological treatments,” he says.

Journal Reference:

1. Simon L Bacon, Catherine Lemiere, Gregory Moullec, Gregory Ninot, Véronique Pepin, Kim L Lavoie. Association between patterns of leisure time physical activity and asthma control in adult patients.BMJ Open Respiratory Research, 2015; 2 (1): e000083 DOI:10.1136/bmjresp-2015-000083

Story Source:

The above post is reprinted from materials provided by Concordia University.

Firstly let me set the scene; I am a 33 year old male and I have been keeping my partner warm with my body heat all winter. I even get into her side of the bed first so that I can warm it up before she gets in. Night after night I keep her warm, I swear I am her favourite person in winter. Well that was until that fateful night three weeks ago when this all changed. I did an unspeakable thing. I stole the blanket while she was asleep, truly a heinous crime. But I ask myself “why would she be so protective of the blanket? Is it that big of a deal?”

Lan Li and Lian Zhiwei from Shanghai University recently published a review article in the journal of Building and Environment in which they aim to answer 10 questions concerning thermal environment and sleep quality. One of these questions was “Are there any gender differences in sleeping thermal comfort?” It turns out that there are some differences between men and women and their thermal comfort.

Females appear to be more sensitive to the ambient air temperature than males (this includes both hot and cold). When compared to males, the hot and cold receptors on the female’s skin are more sensitive to changes in temperature, their skin temperature also changes quicker in response to environment and the female brain receives and responds to this thermal information quicker than males. In short, women are more sensitive to changes to air temperature (like blanket removal) and women also prefer a higher ambient air temperature than males do.

Sadly in addition to sensitivity to hot and cold, women are also thought to have poorer sleep quality than men and females are also more susceptible to insomnia than men are. So it makes sense that any irritant (eg hot or cold temperatures) which may cause arousal from sleep or prevent sleep happening should be avoided. I guess I understand now that my poor partner shouldn’t have to defend herself against blanket stealing marauders (like myself). I hope this helps you to sleep well ladies – be sure to keep warm in winter and remember to stay cool in summer!

Tag a friend who knows a blanket thief. #sleep #winter #warmblankets

If you are beginning CPAP therapy and having trouble adjusting to either wearing a mask, the therapy pressure or just struggling overall with the treatment, you are not alone. Unfortunately this adjustment can be exacerbated from side-effects of the mask or therapy pressure. As fatigue and sleepiness can be common symptoms of Obstructive Sleep Apnoea you might still experience these after you begin CPAP therapy but previous research suggests that these symptoms should dissipate within two to three weeks. At first if you experience a dry nose or throat an adjustment to your humidity level may help. However, if you develop nightly nasal irritation or symptoms pertaining to sinusitis a nasal spray may be an effective treatment to ease this and keep your sinuses clear. Here are some useful tips on how to minimise the side-effects of CPAP therapy.

Mask claustrophobia

A technique to assist with feeling claustrophobic when wearing a CPAP mask is desensitisation training. This is where you become accustomed to having the CPAP mask on your face and eventually forget that it is there. This can be achieved by placing the mask on while awake and distracting yourself by watching TV or read a book.

Mask fitting

Correct mask fitting – a mask size that is too large may cause leaks and too tight may cause discomfort and leave unsightly strap marks in the morning. Check that your mask is not damaged at all, i.e. there are no tears in the mask cushion, the mask frame is intact and that the mask straps are still elastic.

How to adjust to wearing the CPAP mask and using the device

Once again practice wearing the CPAP mask for short periods of time while awake to grow accustomed to how the mask feels can assist with getting used to wearing the mask every night. Wearing the CPAP mask nightly will be a lifestyle adjustment for a lot of people so it is best to approach the therapy as “one night at a time”. The more positive your attitude is to your CPAP therapy the faster your adjustment time. If you decide to have a “night off” or only wear the mask on certain nights you only delay this process.

Pressure adjustment

Tolerating CPAP therapy when the pressure increases is one of the most difficult adjustments and as most patients will find unfortunately leads to fragmented sleep.  The CPAP ramp comfort feature allows you to start your therapy at a lower pressure and gradually increase to your required therapy pressure. This simple adjustment can make a big difference and enable you to fall comfortably asleep.

Once you have overcome some of these issues the positive outcomes that you were told to expect such as improved quality of life by having more energy and getting a better night’s sleep will hopefully start to take effect.

Sleeping is an essential part of our lives. Most of us aim to achieve around 7-8 hours per night. When we wake up in the morning we feel refreshed and ready to start the day! But have you ever stopped to wonder what would happen if we didn’t sleep? At some time during our lives we may become sleep deprived. Lifestyle changes can affect the amount of sleep we achieve; having children, working extra hours, out late to dinner or seeing a show, or even staying up to watch a sun rise. When we are tired the brain will send signals to the body to sleep. We also receive signals from the environment when it gets dark that it is time to rest. Toward the end of the day Adenosine and Melatonin levels rise and send us into a light dose. As we fall deeper into sleep our breathing and heart rate slow down, our temperature decreases and our muscles relax. This sleep stage called Non REM, which occurs before REM, not only replenishes energy for the next day but is integral to DNA repair.  Thus going without sleep our bodies would struggle to perform to their full potential impairing our next-days physical and mental performance.

There is an accumulation of waste products in the brain during the day. Our cells use the energy source in the body and when they are broken down by-products such as Adenosine build up and increase the urge to sleep, a phenomenon known as sleep pressure. For the coffee lovers, this is how caffeine keeps us awake by blocking the Adenosine receptor pathways. The Glymphatic system which is a clean-up mechanism, removes the build-up of waste products in the brain. This system is much more active when we sleep by releasing cerebrospinal fluid to remove the accumulation of the cells toxic by-products. The pathways of immune cells, lymphatic vessels, were recently discovered in the brain to also assist with the clearing out of these waste products.

So what happens if we didn’t sleep? Around 30% of adults and 66% of adolescents are regularly sleep deprived. Not getting enough sleep can cause hormonal imbalances leading to serious health consequences. Human Growth Hormone, or HGH, peaks during sleep, insufficient sleep may decrease cell growth and cell-repair throughout the body. This alteration in hormones, particularly the regulation of appetite and metabolism, can lead to type 2 diabetes and obesity. Chronic poor and restricted sleep can cause serious bodily harm, affecting your learning, memory, mood and reaction time. Sleeplessness may also cause high blood pressure, inflammation, hallucinations and more seriously death. Did you know that regularly sleeping less than 6 hours a night can increase your risk of stroke by 4 and half times? Research suggests that when the brain is sleep deprived it will not function normally, with reduced energy levels, unstable moods and excessive sleepiness during the day causing micro sleeps, episodes that contribute to traffic accidents when drowsy drivers fall asleep at the wheel. In the extreme case fatal familial insomnia, a rare inherited autosomal brain disease, is a genetic mutation where you lose the ability to fall asleep causing progressive deterioration of mental and movement functions. From onset of symptoms dementia or death can occur in as little as 9 months.

The current lifestyle of children and adolescents, who have been occupied in new technologies and new forms of communication, has changed the sleep and dietary habits increasing unfavourable impacts on their health.

A group of researchers of Sao Paulo Brazil studied if night-time feeding habits could influence sleep, and especially parasomnia, in children. Their method was a cross-sectional, observational study evaluating the Sleep Disturbance Scale for Children – SDSC, a dietary recall, starting time to school, physical activity and nutritional status in children of private and public elementary schools.

Investigators claiming that reductions in the time of sleep are could be associated with metabolic and nutritional derangements, and evidence suggests that individuals who sleep less are more likely to become obese[1]. The type and timing of meals influence metabolite levels, substrate use, and hormone production. This sleep deprivation is particularly harmful to growing children and adolescents inducing excessive daytime sleepiness, changes in their mood.

Children are particularly affected by parasomnia, undesirable physical phenomena or experiences that occur while sleeping, while falling asleep, or on arousal. The main features that this study discussed were: The probabilities of parasomnia in children who consumed stimulant foods or beverages were 2.6 greater the chance of children who consumed non-stimulant foods.  The most prevalent stimulant foods reported were chocolate milk and carbonated soft drinks, both of which contain caffeine.

Caffeine is present in many foods, including coffee beans, tea leaves, chocolate, cocoa beans, cola, nuts, and guarana berries, and it is often added to beverages and, to a lesser extent, to drug formulations. Approximately 80% of the general population consumes or has consumed caffeine at some point.

The main limitation of this study was the use of questionnaires completed by the parents or guardians of participants. Despite the widespread popularity of this method, it can fail to provide the most accurate information, as most parents work outside the home and may be unaware of their children’s true dietary habits.

The findings in this study suggest that intake of stimulant foods is associated with development of parasomnias in children. Nevertheless, emotional and psychological aspects involving family dynamics and academic life should be considered in the pathogenesis of parasomnia, and might even prompt changes in dietary habits.

[1] Spiegel K, Leproult R, Tasali E, Penev P, VanCauter E. Sleep curtailment results in decreased leptin levels and increased hunger and appetite. Sleep. 2003;26:A174.

Pulmonary Rehab is a program of exercise, education and training for patients with chronic and advanced lung diseases, such as chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). It is designed to help patients improve their functional status and quality of life. It is done, usually, at either a free-standing pulmonary rehab facility or at a hospital or clinic multi-use rehab facility. A multi-disciplinary team of professionals guide patients through the usually 8 – 12 week long program, consisting of 2 – 3, one to two hour sessions, per week.

Pulmonary rehab, as a distinct program for patients with advanced lung disease, was first conceived and developed by Dr. Thomas Petty, a giant in the world of pulmonary diseases, at The University of Colorado in the 1960s. The program spread, and by the 1990s enough scientific evidence of its effectiveness had accumulated that all the major societies for the treatment of lung diseases, including The American Thoracic Society, and the American College of Chest Physicians, strongly endorsed the program. Around the year 2000 Medicare approved it as therapy for a number of advanced lung diseases, as well.

Pulmonary rehab is designed to improve several physical problems that arise as a result of advanced lung disease. Rehab program exercises specifically improve peripheral muscle weakness, and respiratory muscle weakness. Advance lung disease, itself, causes muscle protein breakdown. Additionally, the lack of muscle exercise, because lung function can’t support exercise (I’m too short of breathe to exercise), causes muscle loss. A major focus of rehab is cardio-pulmonary conditioning. That is, “aerobic” exercises that improve endurance. Such exercises include walking, stationary cycling, etc. These exercises are often done while using oxygen. Therapist will train patients on when and how much oxygen to use when exercising.

Pulmonary rehab also trains patients in optimal breathing techniques such as “pursed lip breathing”. Occupational therapists teach patients about “energy conservation techniques”, and even physical equipment that can be used by the lung patient to extend and improve day to day function.

Nutritionists sometimes counsel patients about strategies to combat the weight loss and nutritional deficiencies that occur in some chronic lung diseases. Alternatively, nutritionists can counsel patients about excess weight that contributes to functional limitation.

Social workers are sometimes involved to help patients optimize their lifestyles, and living situations, toward a situation that best fits their lung disease.

One of the unexpected benefits of rehab is that patients discover that they are not alone in their struggles. At rehab patients meet others with similar challenges. These other patients and the overall positive and supportive environment of a rehab centre can be very educational and encouraging to a patient with lung disease.

Source:

http://www.houstonlungdocs.com