Healthy herbal life with art

Antioxidants

2009-01-26T05:08:00.000-08:00

Antioxidants are substances that may protect your cells against the effects of free radicals. Free radicals are molecules produced when your body breaks down food, or by environmental exposures like tobacco smoke and radiation. Free radicals can damage cells, and may play a role in heart disease, cancer and other diseases.

An antioxidant is a molecule capable of slowing or preventing the oxidation of other molecules. Oxidation is a chemical reaction that transfers electrons from a substance to an oxidizing agent. Oxidation reactions can produce free radicals, which start chain reactions that damage cells. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions by being oxidized themselves. As a result, antioxidants are often reducing agents such as thiols or polyphenols.

Although oxidation reactions are crucial for life, they can also be damaging; hence, plants and animals maintain complex systems of multiple types of antioxidants, such as glutathione, vitamin C, and vitamin E as well as enzymes such as catalase, superoxide dismutase and various peroxidases. Low levels of antioxidants, or inhibition of the antioxidant enzymes, causes oxidative stress and may damage or kill cells.

As oxidative stress might be an important part of many human diseases, the use of antioxidants in pharmacology is intensively studied, particularly as treatments for stroke and neurodegenerative diseases. However, it is unknown whether oxidative stress is the cause or the consequence of disease. Antioxidants are also widely used as ingredients in dietary supplements in the hope of maintaining health and preventing diseases such as cancer and coronary heart disease. Although some studies have suggested antioxidant supplements have health benefits, other large clinical trials did not detect any benefit for the formulations tested, and excess supplementation may be harmful. In addition to these uses in medicine, antioxidants have many industrial uses, such as preservatives in food and cosmetics and preventing the degradation of rubber and gasoline.

Antioxidant substances include
• Beta-carotene
• Lutein
• Lycopene
• Selenium
• Vitamin A
• Vitamin C
• Vitamin E

Antioxidants are found in many foods. These include fruits and vegetables, nuts, grains, and some meats, poultry and fish.

Antioxidants can cancel out the cell-damaging effects of free radicals. Furthermore, people who eat fruits and vegetables, which are good sources of antioxidants, have a lower risk of heart disease and some neurological diseases, and there is evidence that some types of vegetables, and fruits in general, probably protect against a number of cancers. These observations suggested that antioxidants might help prevent these conditions. There is some evidence that antioxidants might help prevent diseases such as macular degeneration, suppressed immunity due to poor nutrition, and neurodegeneration.

However, despite the clear role of oxidative stress in cardiovascular disease, controlled studies using antioxidant vitamins have observed no reduction in either the risk of developing heart disease, or the rate of progression of existing disease. This suggests that other substances in fruit and vegetables (possibly flavonoids), or a complex mix of substances, may contribute to the better cardiovascular health of those who consume more fruit and vegetables.

It is thought that oxidation of low density lipoprotein in the blood contributes to heart disease, and initial observational studies found that people taking Vitamin E supplements had a lower risk of developing heart disease. Consequently, at least seven large clinical trials were conducted to test the effects of antioxidant supplement with Vitamin E, in doses ranging from 50 to 600 mg per day. However, none of these trials found a statistically significant effect of Vitamin E on overall number of deaths or on deaths due to heart disease. Further studies have also been negative. It is not clear if the doses used in these trials or in most dietary supplements are capable of producing any significant decrease in oxidative stress.

While several trials have investigated supplements with high doses of antioxidants, the "Supplémentation en Vitamines et Mineraux Antioxydants" (SU.VI.MAX) study tested the effect of supplementation with doses comparable to those in a healthy diet. Over 12,500 French men and women took either low-dose antioxidants (120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of beta carotene, 100 μg of selenium, and 20 mg of zinc) or placebo pills for an average of 7.5 years. The investigators found there was no statistically significant effect of the antioxidants on overall survival, cancer, or heart disease. However, a subgroup analysis showed a 31% reduction in the risk of cancer in men, but not women.

Many nutraceutical and health food companies now sell formulations of antioxidants as dietary supplements and these are widely used in industrialized countries. These supplements may include specific antioxidant chemicals, like resveratrol (from grape seeds or knotweed roots), combinations of antioxidants, like the "ACES" products that contain beta carotene (provitamin A), vitamin C, vitamin E and Selenium, or herbs that contain antioxidants - such as green tea and jiaogulan.

Although some levels of antioxidant vitamins and minerals in the diet are required for good health, there is considerable doubt as to whether antioxidant supplementation is beneficial, and if so, which antioxidant(s) are beneficial and in what amounts.

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Asthma

2009-01-04T05:13:00.000-08:00

Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma is a very common chronic disease involving the respiratory system in which the airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers. These episodes may be triggered by such things as exposure to an environmental stimulant such as an allergen, environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. In children, the most common triggers are viral illnesses such as those that cause the common cold. This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators. Between episodes, most patients feel well but can have mild symptoms and they may remain short of breath after exercise for longer periods of time than the unaffected individual. The symptoms of asthma, which can range from mild to life threatening, can usually be controlled with a combination of drugs and environmental changes.

Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children. Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Nearly 6 million of these people are children.

In some individuals asthma is characterized by chronic respiratory impairment. In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise. Some or all of the following symptoms may be present in those with asthma: dyspnea, wheezing, stridor, coughing, a tightness and itching of the chest or an inability for physical exertion. Some asthmatics who have severe shortness of breath and tightening of the lungs never wheeze or have stridor and their symptoms may be confused with a COPD-type disease.

An acute exacerbation of asthma is commonly referred to as an asthma attack. The clinical hallmarks of an attack are shortness of breath (dyspnea) and either wheezing or stridor. Although the former is "often regarded as the sine qua non of asthma", some patients present primarily with coughing, and in the late stages of an attack, air motion may be so impaired that no wheezing may be heard. When present the cough may sometimes produce clear sputum. The onset may be sudden, with a sense of constriction in the chest, breathing becomes difficult, and wheezing occurs (primarily upon expiration, but can be in both respiratory phases).

Signs of an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate (tachycardia), rhonchous lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest. During a serious asthma attack, the accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck) may be used, shown as in-drawing of tissues between the ribs and above the sternum and clavicles.

During very severe attacks, an asthma sufferer can turn blue from lack of oxygen (so-called blue bloaters), and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person's feet may become icy cold. Severe asthma attacks, which may not be responsive to standard treatments (status asthmaticus), are life-threatening and may lead to respiratory arrest and death. Despite the severity of symptoms during an asthmatic episode, between attacks an asthmatic may show few or even no signs of the disease.

What Causes Asthma?
The exact cause of asthma isn't known. Researchers think a combination of factors (family genes and certain environmental exposures) interact to cause asthma to develop, most often early in life. These factors include:
• An inherited tendency to develop allergies, called atopy (AT-o-pe)
• Parents who have asthma
• Certain respiratory infections during childhood
• Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing
If asthma or atopy runs in your family, exposure to airborne allergens (for example, house dust mites, cockroaches, and possibly cat or dog dander) and irritants (for example, tobacco smoke) may make your airways more reactive to substances in the air you breathe.

Different factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma.
The "Hygiene Hypothesis"
One theory researchers have for what causes asthma is the "hygiene hypothesis." They believe that our Western lifestyle—with its emphasis on hygiene and sanitation—has resulted in changes in our living conditions and an overall decline in infections in early childhood.

Many young children no longer experience the same types of environmental exposures and infections as children did in the past. This affects the way that the immune systems in today's young children develop during very early childhood, and it may increase their risk for atopy and asthma. This is especially true for children who have close family members with one or both of these conditions.

Stimuli
• Allergens from nature, typically inhaled, which include waste from common household pests, such as the house dust mite and cockroach, grass pollen, mold spores, and pet epithelial cells;
• Indoor air pollution from volatile organic compounds, including perfumes and perfumed products. Examples include soap, dishwashing liquid, laundry detergent, fabric softener, paper tissues, paper towels, toilet paper, shampoo, hairspray, hair gel, cosmetics, facial cream, sun cream, deodorant, cologne, shaving cream, aftershave lotion, air freshener and candles, and products such as oil-based paint.
• Medications, including aspirin, β-adrenergic antagonists (beta blockers), and penicillin.
• Food allergies such as milk, peanuts, and eggs. However, asthma is rarely the only symptom, and not all people with food or other allergies have asthma.
• Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog, nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons for the high prevalence of asthma in urban areas.
• Various industrial compounds and other chemicals, notably sulfites; chlorinated swimming pools generate chloramines—monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3)—in the air around them, which are known to induce asthma.
• Early childhood infections, especially viral upper respiratory tract infections. However, persons of any age can have asthma triggered by colds and other respiratory infections even though their normal stimuli might be from another category (e.g. pollen) and absent at the time of infection. In many cases, significant asthma may not even occur until the respiratory infection is in its waning stage, and the person is seemingly improving. Eighty percent of asthma attacks in adults and 60% in children are caused by respiratory viruses.
• Exercise or intense use of respiratory system. The effects of which differ somewhat from those of the other triggers, since they are brief.
• Hormonal changes in adolescent girls and adult women associated with their menstrual cycle can lead to a worsening of asthma. Some women also experience a worsening of their asthma during pregnancy whereas others find no significant changes, and in other women their asthma improves during their pregnancy.
• Psychological stress. There is growing evidence that psychological stress is a trigger. It can modulate the immune system, causing an increased inflammatory response to allergens and pollutants.
• Cold weather can make it harder for asthmatics to breathe. Whether high altitude helps or worsens asthma is debatable and may vary from person to person.

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Hair Diseases and Hair Loss

2008-12-30T15:26:00.000-08:00

Also called: Alopecia

Your hair loss may have started with a few extra hairs in the sink or in your comb. But now you can't look in the mirror without seeing more of your scalp.

Baldness typically refers to excessive hair loss from your scalp and can be the result of heredity, certain medications or an underlying medical condition. Anyone — men, women and children — can experience hair loss.

Some people prefer to let their baldness run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the medications and surgical procedures that are available to treat hair loss. Before pursuing any of these treatment options, talk with your doctor about the cause of and best possible treatments for your hair loss.

Did you know that the average person has 5 million hairs? Hair grows all over your body except on your lips, palms and the soles of your feet. It takes about four months for healthy hair to grow an inch. Most hairs grow for up to six years and then fall out. New hairs grow in their place.

Men - and some women - lose hair as they grow older. You can also lose your hair if you have certain diseases, such as thyroid problems, diabetes or lupus. If you take certain medicines or have chemotherapy for cancer, you may also lose your hair. Other causes are a low protein diet, a family history or poor nutrition.

Causes of specific types of hair loss

* Pattern baldness (androgenetic alopecia). In male- and female-pattern baldness, the time of growth shortens, and the hairs are not as thick or sturdy. With each growth cycle, the hairs become rooted more superficially and more easily fall out. Heredity likely plays a key role. A history of androgenetic alopecia on either side of your family increases your risk of balding. Heredity also affects the age at which you begin to lose hair and the developmental speed, pattern and extent of your baldness.

* Cicatricial (scarring) alopecia. This type of permanent hair loss occurs when inflammation damages and scars the hair follicle. This prevents new hair from growing. This condition can be seen in several skin conditions, including lupus erythematosus or lichen planus. It's not known what triggers or causes this inflammation.

* Alopecia areata. This is classified as an autoimmune disease, but the cause is unknown. People who develop alopecia areata are generally in good health. A few people may have other autoimmune disorders including thyroid disease. Some scientists believe that some people are genetically predisposed to develop alopecia areata and that a trigger, such as a virus or something else in the environment, sets off the condition. A family history of alopecia areata makes you more likely to develop it. With alopecia areata, your hair generally grows back, but you may lose and regrow your hair a number of times.

* Telogen effluvium. This type of hair loss is usually due to a change in your normal hair cycle. It may occur when some type of shock to your system — emotional or physical — causes hair roots to be pushed prematurely into the resting state. The affected growing hairs from these hair roots fall out. In a month or two, the hair follicles become active again and new hair starts to grow. Telogen effluvium may follow emotional distress, such as a death in the family, or after a physiological stress, such as a high fever, sudden or excessive weight loss, nutritional deficiencies, surgery, or metabolic disturbances. Hair typically grows back once the condition that caused it corrects itself, but it usually take months.

* Traction alopecia. Excessive hairstyling or hairstyles that pull your hair too tightly cause traction alopecia. If the pulling is stopped before there's scarring of your scalp and permanent damage to the root, hair usually grows back normally.

Other causes of hair loss

* Poor nutrition. Having inadequate protein or iron in your diet or poor nourishment in other ways can cause you to experience hair loss. Fad diets, crash diets and certain illnesses, such as eating disorders, can cause poor nutrition.

* Medications. Certain drugs used to treat gout, arthritis, depression, heart problems and high blood pressure may cause hair loss in some people. Taking birth control pills also may result in hair loss for some women.

* Disease. Diabetes and lupus can cause hair loss.

* Medical treatments. Undergoing chemotherapy or radiation therapy may cause you to develop alopecia. Under these conditions, healthy, growing (anagen) hairs can be affected. After your treatment ends, your hair typically begins to regrow.

* Hormonal changes. Hormonal changes and imbalances can cause temporary hair loss. This could be due to pregnancy, having a baby, discontinuing birth control pills, beginning menopause, or an overactive or underactive thyroid gland. The hair loss may be delayed by three months following a hormonal change, and it'll take another three months for new hair to grow back. During pregnancy, it's normal to have thicker, more luxuriant hair. It's also common to lose more hair than normal about three months after delivery. If a hormonal imbalance is associated with an overproduction of testosterone, there may be a thinning of hair over the crown of the scalp. Correcting hormonal imbalances may stop hair loss.

* Hair treatments. Chemicals used for dying, tinting, bleaching, straightening or permanent waves can cause hair to become damaged and break off if they are overused or used incorrectly. Overstyling and excessive brushing also can cause hair to fall out if the hair shaft becomes damaged.

* Scalp infection. Infections, such as ringworm, can invade the hair and skin of your scalp, leading to hair loss. Once infections are treated, hair generally grows back. Ringworm, a fungal infection, can usually be treated with a topical or oral antifungal medication.

* Trichotillomania (hair-pulling disorder). Trichotillomania is a type of mental illness in which people have an irresistible urge to pull out their hair, whether it's from their scalp, their eyebrows or other areas of their body. Hair pulling from the scalp often leaves them with patchy bald spots on their head, which they may go to great lengths to disguise. Causes of trichotillomania are still being researched, and no specific cause has yet been found.

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Arthritis

2008-12-25T06:47:00.000-08:00

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin.

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions involving damage to the joints of the body. Arthritis is the leading cause of disability in people older than fifty-five years.

Arthritis is a condition that causes immobility and severe pain in the joints. The immobility varies with the condition and the pain becomes persistent over a period of time. Arthritis refers to numerous diseases and literally means inflammation of the joint.

Arthritis affects the body movements and is a long lasting condition. Depending on the management of the ailment you can get temporary relief.
Some forms of arthritis are a result of other tissue and organ disorders. Arthritis can affect people of all ages. Arthritis can cause swelling, redness, pain, and immobility in an affected area.

Inflammation occurs as a natural response to certain conditions within the body. It is a part of the defense control mechanism of the body. Many cells of the immune system move to the affected area for repair work causing inflammation. But in many cases the inflammation is persistent as the repair and damage work continue simultaneously in the absence of medication. The damage can change the structure of the bone and other tissues thus affecting movement and causing pain.

There are different forms of arthritis; each has a different cause. The most common form of arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Emerging evidence suggests that abnormal anatomy might contribute to the early development of osteoarthritis[citation needed]. Other arthritis forms are rheumatoid arthritis and psoriatic arthritis, autoimmune diseases in which the body attacks itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gout caused by the formation of rhomboid crystals of calcium pyrophosphate. This gout is known as pseudogout.

Two of the most common forms of arthritis are Rheumatoid Arthritis and Osteoarthritis. Rheumatoid arthritis is considered to be the most serious form of arthritis. It may vary from a few symptoms to severe and painful deformities. It normally affects the finger joints, toes, knees and wrists. This form of arthritis normally varies with stress, movement and environment. The causes of rheumatoid arthritis are still unknown.
Osteoarthritis is one of the oldest and most common forms of arthritis. In osteoarthritis, joint tissues breakdown causing joint pain and stiffness resulting in immobility. The areas most affected by osteoarthritis are hip, knee, spine and feet.

The treatment options available are medication and herbal supplements. The objective of the treatment is to control the inflammation and stop the degeneration of joints. Although both forms of treatment have shown good results in the patients, modern medicine has side effects that may cause serious problems. Herbal supplements control the problem safely and effectively.

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Cholesterol

2008-12-24T16:21:00.000-08:00

Also called: HDL, Hypercholesterolemia, Hyperlipidemia, Hyperlipoproteinemia, LDL
Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them.

Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It's normal to have cholesterol. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart disease (which leads to heart attack) and for stroke. Hypercholesterolemia is the medical term for high levels of blood cholesterol.
Although cholesterol is essential for life, high levels in circulation are associated with atherosclerosis. Cholesterol is synthesized in virtually all cells, and significant amounts of it can be absorbed from the diet.
The name cholesterol originates from the Greek chole- (bile) and stereos (solid), and the chemical suffix -ol for an alcohol, as researchers first identified cholesterol in solid form in gallstones by François Poulletier de la Salle in 1769. However, it is only in 1815 that chemist Eugène Chevreul named the compound "cholesterine".[3]

High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods.
You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol.

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Diabetes

2008-12-23T15:45:00.000-08:00

Also called: "Sugar", Adult onset diabetes, Non-insulin dependent diabetes

Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With Type 1 diabetes, your body does not make insulin. With Type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational diabetes.

Symptoms of Type 2 diabetes may include fatigue, thirst, weight loss, blurred vision and frequent urination. Some people have no symptoms. A blood test can show if you have diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed.

The classical triad of diabetes symptoms is polyuria, polydipsia and polyphagia, which are, respectively, frequent urination, increased thirst and consequent increased fluid intake, and increased appetite. Symptoms may develop quite rapidly (weeks or months) in type 1 diabetes, particularly in children. However, in type 2 diabetes symptoms usually develop much more slowly and may be subtle or completely absent. Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible fatigue. All of these symptoms except weight loss can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled.

When the glucose concentration in the blood is raised beyond its renal threshold, reabsorption of glucose in the proximal renal tubuli is incomplete, and part of the glucose remains in the urine (glycosuria). This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst.

Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. Blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.

Patients (usually with type 1 diabetes) may also initially present with diabetic ketoacidosis (DKA), an extreme state of metabolic dysregulation characterized by the smell of acetone on the patient's breath; a rapid, deep breathing known as Kussmaul breathing; polyuria; nausea; vomiting and abdominal pain; and any of many altered states of consciousness or arousal (such as hostility and mania or, equally, confusion and lethargy). In severe DKA, coma may follow, progressing to death.

Diabetic ketoacidosis is a medical emergency and requires immediate hospitalization.
A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more common in type 2 diabetes and is mainly the result of dehydration due to loss of body water. Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.

Diabetes mellitus is currently a chronic disease, without a cure, and medical emphasis must necessarily be on managing/avoiding possible short-term as well as long-term diabetes-related problems. There is an exceptionally important role for patient education, dietetic support, sensible exercise, self monitoring of blood glucose, with the goal of keeping both short-term blood glucose levels, and long term levels as well, within acceptable bounds. Careful control is needed to reduce the risk of long term complications. This is theoretically achievable with combinations of diet, exercise and weight loss (type 2), various oral diabetic drugs (type 2 only), and insulin use (type 1 and for type 2 not responding to oral medications, mostly those with extended duration diabetes). In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications should be undertaken to control blood pressure[38] and cholesterol by exercising more, smoking less or ideally not at all, consuming an appropriate diet, wearing diabetic socks, wearing diabetic shoes, and if necessary, taking any of several drugs to reduce blood pressure. Many Type 1 treatments include combination use of regular or NPH insulin, and/or synthetic insulin analogs (eg, Humalog, Novolog or Apidra) in combinations such as Lantus/Levemir and Humalog, Novolog or Apidra. Another Type 1 treatment option is the use of the insulin pump (eg, from Deltec Cozmo, Animas, Medtronic Minimed, Insulet Omnipod, or ACCU-CHEK). A blood lancet is used to pierce the skin (typically of a finger), in order to draw blood to test it for sugar levels.

In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care of a patient in a team approach. Optometrists, podiatrists/chiropodists, dietitians, physiotherapists, nursing specialists (eg, DSNs (Diabetic Specialist Nurse)), nurse practitioners, or Certified Diabetes Educators, may jointly provide multidisciplinary expertise. In countries where patients must provide their own health care (i.e., in the developed world, the US, and in much of the undeveloped world), the impact of out-of-pocket costs of adequate diabetic care can be very high. In addition to the medications and supplies needed, patients are often advised to receive regular consultation from a physician (e.g., at least every three to six months).

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Skin Aging

2008-12-22T17:47:00.000-08:00

Definition
Aging changes in the skin are a group of common conditions and developments that occur as people grow older.

Information

Skin changes are among the most visible signs of aging. Evidence of increasing age include wrinklesand sagging skin. Whitening or graying of the hair is another obvious sign of aging.

Your skin does many things. It protects you from the environment, helps regulate your body temperature, helps with fluid and electrolyte balance, and provides receptors for sensations such as touch, pain, and pressure.

Although skin has many layers, it can be generally divided into three main portions. The outer portion (epidermis) contains skin cells, pigment, and proteins. The middle portion (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.

The layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat. Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.

Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. This can be seen by comparing areas of your body that have regular sun exposure with areas that are protected from sunlight.

Natural pigments seem to provide some protection against sun-induced skin damage. Blue-eyed, fair-skinned people show more aging skin changes than people with darker, more heavily pigmented skin.

Causes of Aging Skin
Research shows that there are, in fact, two distinct types of aging. Aging caused by the genes we inherit is called intrinsic (internal) aging. The other type of aging is known as extrinsic (external) aging and is caused by environmental factors, such as exposure to the sun’s rays.

Intrinsic Aging
Intrinsic aging, also known as the natural aging process, is a continuous process that normally begins in our mid-20s. Within the skin, collagen production slows, and elastin, the substance that enables skin to snap back into place, has a bit less spring. Dead skin cells do not shed as quickly and turnover of new skin cells may decrease slightly. While these changes usually begin in our 20s, the signs of intrinsic aging are typically not visible for decades. The signs of intrinsic aging are:

• Fine wrinkles
• Thin and transparent skin
• Loss of underlying fat, leading to hollowed cheeks and eye sockets as well as noticeable loss of firmness on the hands and neck
• Bones shrink away from the skin due to bone loss, which causes sagging skin
• Dry skin that may itch
• Inability to sweat sufficiently to cool the skin
• Graying hair that eventually turns white
• Hair loss
• Unwanted hair
• Nail plate thins, the half moons disappear, and ridges develops

Genes control how quickly the normal aging process unfolds. Some notice those first gray hairs in their 20s; others do not see graying until their 40s. People with Werner’s syndrome, a rare inherited condition that rapidly accelerates the normal aging process, usually appear elderly in their 30s. Their hair can gray and thin considerably in their teens. Cataracts may appear in their 20s. The average life expectancy for people with Werner’s syndrome is 46 years of age.

Extrinsic Aging
A number of extrinsic, or external, factors often act together with the normal aging process to prematurely age our skin. Most premature aging is caused by sun exposure. Other external factors that prematurely age our skin are repetitive facial expressions, gravity, sleeping positions, and smoking.

The Sun. Without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick wart-like, rough, reddish patches of skin), and skin cancer can all be traced to sun exposure.
Facial Expressions. If you perform facial exercises to maintain a youthful-looking appearance, it is time to stop. Repetitive facial movements actually lead to fine lines and wrinkles. Each time we use a facial muscle, a groove forms beneath the surface of the skin, which is why we see lines form with each facial expression. As skin ages and loses its elasticity, the skin stops springing back to its line-free state, and these grooves become permanently etched on the face as fine lines and wrinkles.

Gravity. Gravity constantly pulls on our bodies. Changes related to gravity become more pronounced as we age. In our 50s, when the skin’s elasticity declines dramatically, the effects of gravity become evident. Gravity causes the tip of the nose to droop, the ears to elongate, the eyelids to fall, jowls to form, and the upper lip to disappear while the lower lip becomes more pronounced.

Sleeping Positions. Resting your face on the pillow in the same way every night for years on end also leads to wrinkles. Called sleep lines, these wrinkles eventually become etched on the surface of the skin and no longer disappear when the head is not resting on the pillow. Women, who tend to sleep on their sides, are most likely to see these lines appear on their chin and cheeks. Men tend to notice these lines on the forehead since they usually sleep with the face pressed face down on the pillow. People who sleep on their backs do not develop these wrinkles since their skin does not lie crumpled against the pillow.

Smoking. Cigarette smoking causes biochemical changes in our bodies that accelerate aging. Research shows that a person who smokes 10 or more cigarettes a day for a minimum of 10 years is statistically more likely to develop deeply wrinkled, leathery skin than a nonsmoker. It also has been shown that people who smoke for a number of years tend to develop an unhealthy yellowish hue to their complexion. Additionally, a study conducted in 2002 showed that facial wrinkling, while not yet visible, can be seen under a microscope in smokers as young as 20.

These signs can be greatly diminished, and in some cases avoided, by stopping smoking. Even people who have smoked for many years, or smoked heavily at a younger age, show less facial wrinkling and improved skin tone when they quit smoking.

For Healthier, Younger-Looking Skin
Prevention. While you cannot stop or even slow down the intrinsic aging process, you can prevent signs of premature aging by protecting your skin from the sun, quitting smoking, and eliminating facial exercises.

Dermatologists recommend comprehensive sun protection to prevent premature aging caused by the sun. Comprehensive sun protection includes:
• Avoiding deliberate tanning, including use of indoor tanning devices.
• Staying out of the sun between 10:00 a.m. and 4:00 p.m., when the sun’s rays are the strongest.
• Wearing protective clothing, such as a wide-brimmed hat and long sleeves, when outdoors during the day.
• Applying sunscreen year round. Sunscreen should be broad spectrum (offers UVA and UVB protection) and have a Sun Protection Factor (SPF) of 15 or higher. Sunscreen should be applied 20 minutes before going outdoors to all skin that will be exposed. It should be reapplied after sweating or being in water.

COMMON PROBLEMS
Skin disorders are so common among older people that it is often difficult to tell normal changes from those related to a disorder. More than 90% of all older people have some type of skin disorder.
Skin disorders can be caused by many diseases including diabetes, liver disease, heart disease and blood vessel diseases such as arteriosclerosis. Stress, reactions to medications, obesity and nutritional deficiencies can be other causes.
Climate, exposures to industrial and household chemicals, indoor heating, clothing, allergies to plants and other allergies and many other common exposures can also cause skin changes.
Sunlight can cause elastosis (loss of elasticity), keratoacanthomas (noncancerous skin growths), thickening of the skin, pigment changes such as liver spots, and other conditions.
Sun exposure has also been directly linked to skin cancers, including basal cell epithelioma, squamous cell carcinoma, and melanoma.

PREVENTION
Because most skin changes are related to sun exposure, prevention is a lifelong process.
• Prevent sunburn if at all possible.
• Use a good quality sunscreen when outdoors, even in the winter.
• Wear protective clothing and hats as necessary.
Good nutrition and adequate fluids are also helpful. Dehydration increases the risk of skin injury. Sometimes minor nutritional deficiencies can cause rashes, skin lesions, and other skin changes even if no other symptoms are present.
Keep skin moist with lotions and do not use soaps that are heavily perfumed. Bath oils are not recommended because they can cause you to slip and fall.
Moist skin is more comfortable and may heal better.

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Cancer

2008-12-21T05:04:00.000-08:00

What Is Cancer?

Cancer is the general name for a group of more than 100 diseases in which cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because abnormal cells grow out of control. Untreated cancers can cause serious illness and even death.

How a normal cell becomes cancer
Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more quickly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries.
Cancer cells develop because of damage to DNA. This substance is in every cell and directs all of the cell's activities. Most of the time when DNA becomes damaged, either the cell dies or is able to repair the DNA. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. Many times though, a person’s DNA gets damaged by things in the environment, like,chemicals, viruses, tobacco smoke or too much sunlight.

How cancers differ
Cancers can begin in many different parts of the body. But, different types of cancer can act very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That's why people with cancer need treatment that is aimed at their particular kind of cancer.

How cancer spreads (metastasis)
Because cancer cells keep growing and dividing, they are different from normal cells. Instead of dying, they outlive normal cells and continue to grow and make new abnormal cells.
Cancer usually forms as a tumor (a lump or mass.) Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs, and circulate through other tissues where they grow.
Cancer cells often travel through the bloodstream or through the lymph system to other parts of the body where they begin to grow and replace normal tissue. This spreading process is called metastasis.
Even when cancer has spread to a different part of the body it is still named for the place in the body where it started. For example, breast cancer that has spread to the liver is metastatic breast cancer, not liver cancer. Prostate cancer that has spread to the bone is called metastatic prostate cancer, not bone cancer.
Remember that not all tumors are cancerous. Benign (non-cancerous) tumors do not spread to other parts of the body (metastasize) and are very rarely life-threatening.

How common is cancer?
Half of all men and one-third of all women in the US will develop cancer during their lifetimes. Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking, limiting time in the sun, being physically active, and eating a better diet. The sooner a cancer is found and treated, the better the chances are for living for many years.

Allergy

2008-12-20T06:17:00.000-08:00

Also called: Hypersensitivity
An allergy is an immune system problem to a substance (allergen) that is normally harmless. An allergen can be inhaled, swallowed, or come in contact with the skin.
An allergy is a reaction of your immune system to something that does not bother most other people. People who have allergies often are sensitive to more than one thing. Substances that often cause reactions are

Pollen
Dust mites
Mold spores
Pet dander
Food
Insect stings
Medicines

Signs & Symptoms
For Common Allergies
Sneezing. Watery eyes. Cold symptoms that last longer than 10 days without a fever. Dark circles under the eyes.
Frequent throat clearing. Hoarseness. Coughing or wheezing.
Skin rash.
Loss of smell or taste.
Ear and sinus infections occur again and again.

Signs of a Severe Allergic Reaction
Shortness of breath. A hard time breathing or swallowing. Wheezing.
Severe swelling all over, or of the face, lips, tongue, and/or throat.
Feeling dizzy, weak, and/or numb.
Pale or bluish lips, skin, and/or fingernails.
Cool, moist skin or sudden onset of pale skin and sweating.
Fainting. Decreasing level of awareness.

How do you get allergies? Scientists think both genes and the environment have something to do with it. Normally, your immune system fights germs. It is your body's defense system. In most allergic reactions, however, it is responding to a false alarm.

Allergies can cause a runny nose, sneezing, itching, rashes, swelling or asthma. Symptoms vary. Although allergies can make you feel bad, they usually won't kill you. However, a severe reaction called anaphylaxis is life-threatening.

Self-Care / Prevention

For a Severe Allergic Reaction
Take prescribed medicine, such as an EpiPen, as advised. Then get emergency care!
Wear a medical ID alert tag for things that cause a severe allergic reaction.
Avoid things you are allergic to.

For Other Allergic Reactions
If mild symptoms occur after you take a medicine, call your doctor for advice.
For hives and itching, take an OTC antihistamine, such as Benadryl. Take it as prescribed by your doctor or as directed on the label.
Don't use hot water for baths, showers, or to wash rash areas. Heat worsens most rashes and makes them itch more.
For itching, use an oatmeal bath or calamine (not Caladryl) lotion. You can also use a paste made with 3 teaspoons of baking soda and 1 teaspoon of water.
Avoid things you are allergic to.
Read food labels. Don't eat foods that have things you are allergic to. When you eat out, find out if menu items have things you are allergic to before you order them.

Chest pain

2008-12-19T04:43:00.000-08:00

Definition

It's the middle of the night or maybe the beginning of a busy workday when you suddenly feel pain in your chest. You try to ignore it at first, but your chest pain has you scared and worried. Could you be having a heart attack? Should you go to the emergency room?
Chest pain is one of the most common reasons people call for emergency medical help. Every year emergency room doctors evaluate and treat millions of people for chest pain.

Fortunately, chest pain doesn't always signal a heart attack. Often chest pain is unrelated to any heart problem. But even if the chest pain you experience has nothing to do with your cardiovascular system, the problem may still be important — and worth the time spent in an emergency room to have your chest pain evaluated.
Symptoms

The characteristics of chest pain vary depending on what may be the cause. Chest pain symptoms may include:

Cardiac causes
• Heart attack. A heart attack can cause pressure, fullness or a crushing pain in your chest that lasts more than a few minutes. The pain may radiate to your back, neck, jaw, shoulders and arms, especially your left arm. Other signs and symptoms may include shortness of breath, sweating, dizziness and nausea. All, some or none of these may accompany your chest pain.
• Angina. Restricted blood flow to your heart can cause recurrent episodes of chest pain — angina pectoris, or angina. Angina (pronounced an-JI-nuh or AN-juh-nuh) is often described as a pressure or tightness in the chest. It's usually brought on by physical or emotional stress. The pain usually goes away within minutes after you stop the stressful activity.
• Pericarditis. Inflammation of the sac surrounding your heart (pericarditis) causes sharp, piercing and centralized chest pain. You may also have a fever and feel sick.
• Aortic dissection. In this condition, the inner layers of the main artery leading from your heart (aorta) separate, forcing blood between them. Symptoms are sudden and tearing chest and back pain.
• Coronary artery spasm. Coronary spasm can cause varying degrees of chest discomfort. In coronary spasm, arteries that supply blood to your heart go into spasm, temporarily closing down blood flow to your heart. It can occur with activity or at rest. A spasm may even wake you from sleep.

Noncardiac causes
• Heartburn. Heartburn is a painful, burning sensation behind your breastbone (sternum). Often this feeling is accompanied by a sour taste and the sensation of food re-entering your mouth (regurgitation). Heartburn-related chest pain usually follows a meal and may last for hours. Signs and symptoms occur more frequently when you bend forward at the waist or lie down. Pain can also occur when you swallow.
• Panic attack. Symptoms of a panic attack include intense fear accompanied by chest pain, rapid heartbeat, rapid breathing (hyperventilation), profuse sweating and shortness of breath.
• Pleurisy. Symptoms of pleurisy, an inflammation of the membrane that lines your chest cavity, include sharp, localized chest pain that's made worse when you inhale or cough.
• Costochondritis. In this condition, the cartilage of your rib cage becomes inflamed. The pain from costochondritis may occur suddenly and be intense, leading you to assume you're having a heart attack. Yet the location of the pain is different. Costochondritis causes your chest to hurt when you push on your sternum or on the ribs near your sternum. Heart attack pain is usually more widespread, and the chest wall usually isn't tender.
• Pulmonary embolism. This condition involves blockage of a lung artery. Symptoms can include sudden, sharp chest pain that begins or worsens with a deep breath or cough. Other symptoms can include shortness of breath, rapid heartbeat, anxiety and faintness.
• Sore muscles. Muscle-related chest pain tends to come on when you twist side to side or when you raise your arms, and can occur in conditions such as fibromyalgia.
• Injured ribs or pinched nerves. Symptoms of a bruised rib, broken rib or a pinched nerve can be chest pain that tends to be localized and sharp.
• Espophageal spasms. This disorder of the esophagus, the tube that runs from your throat to your stomach, can make swallowing difficult and even painful. The muscles that normally move food down the esophagus are uncoordinated, resulting in painful muscle spasms.
• Achalasia. In this swallowing disorder, the valve in the lower esophagus doesn't open properly to allow food to enter your stomach. Instead, food backs up into your esophagus, causing pain.
• Shingles. Symptoms of this reactivation of the same virus that causes chickenpox include pain and a band of blisters from your back around to your chest wall. The sharp, burning pain may begin several hours to a day or so before blisters appear.
• Gallbladder or pancreas problems. Symptoms can include acute abdominal pain that radiates to your chest.

If you or someone else may be having a heart attack:

* Dial 911 or call for emergency medical assistance. Don't "tough out" the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have someone such as a neighbor or friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens.

* Chew a regular-strength aspirin. Aspirin can inhibit blood clotting. However, you shouldn't take aspirin if you're allergic to aspirin, have bleeding problems or your doctor previously told you not to do so.

* Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin.

* Begin CPR. If the person suspected of having a heart attack is unconscious, a 911 dispatcher or another emergency medical specialist may advise you to begin cardiopulmonary resuscitation (CPR). Even if you're not trained, a dispatcher can instruct you in CPR until help arrives.

Acne

2008-12-18T19:33:00.000-08:00

Also called: Pimples, Zits
Acne is a common skin disease that causes pimples. Pimples form when hair follicles under your skin clog up. Most pimples form on the face, neck, back, chest and shoulders. Anyone can get acne, but it is common in teenagers and young adults. It is not serious, but it can cause scars.

No one knows exactly what causes acne. Hormone changes, such as those during the teenage years and pregnancy, probably play a role. There are many myths about what causes acne.

Some studies have shown that chocolate, cow's milk and refined carbohydrates, for example, will aggravate acne. Yet others have proved that these foods had no effect whatever. The results of various studies involving zinc supplementation have been equally inconsistent (M Murray & J Pizzorno, Encyclopaedia of Natural Medicine, Rocklin CA: Prima Publishing, 1990).

Another common myth is that dirty skin causes acne; however, blackheads and pimples are not caused by dirt. Stress doesn't cause acne, but stress can make it worse.

Many patients with stubborn acne get subjected to long term treatment with broad spectrum antibiotics, which often keeps the condition at bay by killing off the bacteria involved. However, the antibiotics often provoke a chronic intestinal yeast overgrowth which will actually make the acne worse. Consequently the first line of acne treatment is Candida albicans overgrowth. Proper care also requires the removal from the bowels of toxic bacteria preferably by the use of herbal remedies Hydrastis canadensis or Berberis vulgaris.

If you have acne
Clean your skin gently
Try not to touch your skin
Avoid the sun
Treatments for acne include medicines and creams.

7 Tips for Getting the Most Out of Your Acne Treatment

Good skin care plays an important role in treating acne. Following these skin care guidelines—unless your dermatologist instructs otherwise—can help improve treatment results:

1. Do NOT pop, squeeze or pick at acne.
This can make acne worse by spreading inflammation. With medical treatment, removing lesions is rarely necessary; however, when comedo removal is needed, it should be performed by an experienced healthcare professional.

2. Gently wash your face twice a day with a mild cleanser and pat dry.
Acne is not caused by poor hygiene, and vigorous washing and scrubbing will not clear your skin. In fact, all that scrubbing can irritate your skin and make acne worse. The way to clear acne is with appropriate acne products and good skin care.

3. Use “noncomedogenic” (does not clog pores) cosmetics and toiletries.
When buying cosmetics and other products that you will use on your skin or hair, be sure to look for ones labeled “noncomedogenic.” Makeup, sunscreen and toiletries that are not likely to cause acne state that they are “noncomedogenic” on the product.

4. Avoid aggravating your acne.
Oily hair, sporting equipment that rubs against your skin and airborne grease—all can irritate and make your acne worse. Ways you can avoid these situations include:
• If you have oily hair, keep it off your face and wash it daily.
• Avoid using hair care products that contain oil, such as pomades and gels.
• Wear cotton clothing or moleskin under sporting equipment to avoid skin-to-equipment contact.
5. Give acne products enough time to do their job.
Ask a dermatologist (or pharmacist) how much time is needed for each particular product to work. This way you’ll know when you can expect to see clearing and not stop using the product(s) before you see results. As a rule of thumb, it takes 6 to 8 weeks before you begin to see an improvement.

6. Use medications as directed.
Using more medication than directed will not improve results. In fact, it can make acne worse by aggravating the skin. Be sure to read all labels and use accordingly or as instructed by a dermatologist.

7. Avoid excess exposure to sunlight, and do not use tanning booths or sun lamps.
Contrary to popular belief, tanning does not clear acne; it simply masks acne. Tanning also increases one’s risk of developing melanoma and other skin cancers. Additionally, some acne treatments can increase the skin's sensitivity to sunlight and ultraviolet light from tanning booths and sun lamps. If you have acne, it is important to protect your skin by following sun-protection practices, such as wearing sunscreen and avoiding sunburns.

If after following these guidelines, you are not satisfied with the results from your acne treatment, be sure to see a dermatologist. Today, almost every case of acne can be cleared, especially with a dermatologist's help.

Menopause

2008-12-17T15:10:00.000-08:00

Also called: Change of life
Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovary stops producing the hormones estrogen and progesterone.

Menopause refers to a natural stop in a woman’s menstrual period and fertility. Menopause happens because the woman's ovary stops producing the hormones estrogen and progesterone.

All women go through menopause, usually between the ages of 40 and 55. A woman has reached menopause when she has gone 12 months without having a period.

A woman has reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier. They include

• A change in periods - shorter or longer, lighter or heavier, with more or less time in between
• Hot flashes and/or night sweats
• Trouble sleeping
• Vaginal dryness
• Mood swings
• Trouble focusing
• Less hair on head, more on face

Another health problem that can start during menopause is estrogen loss. This can lead to osteoporosis, a condition where bones become weak and break easily.
Also, women are at greater risk for heart disease after they go through menopause.

Treatments for menopause
In the past, some women would take hormones to replace the estrogen and progesterone their bodies were losing during menopause. Taking these hormones, known as hormone replacement therapy (HRT), might help with menopause symptoms and with bone loss.

But new research shows that, for some women, taking hormones has risks, including greater risk of heart disease, stroke, blood clots, and breast cancer. Therefore, for post-menopausal women, the U.S. Food and Drug Administration advises that HRT be used for the shortest time and at the lowest doses possible.

Some symptoms require treatment. Talk to your doctor about how to best manage menopause. Make sure the doctor knows your medical history and your family medical history. This includes whether you are at risk for heart disease, osteoporosis, or breast cancer.

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Insomnia

2008-12-16T15:34:00.000-08:00

Insomnia is a symptom of a sleeping disorder characterized by persistent difficulty falling asleep or staying asleep despite the opportunity. It is typically followed by functional impairment while awake. Insomniacs have been known to complain about being unable to close their eyes or "rest their mind" for more than a few minutes at a time. Both organic and non-organic insomnia constitute a sleep disorder.

Insomnia is the disturbance of a normal sleep pattern. For example, when you cannot get to sleep or wake up after only a few hours sleep.
Sleep is a state of consciousnesses, which gives your body time to rest and build up your strength. While you are asleep, your body goes through different stages at approximately 90 minute cycles. These include light sleep, deep sleep and dreaming, also known as rapid eye movement (REM) sleep.

Difficulties with sleep can appear in a variety of ways:
• Difficulty getting to sleep (sleep onset insomnia). This is most common in young people.
• Waking in the night (frequent nocturnal awakening). This is most common in older people.
• Waking early in the morning - the least common type of sleep disturbance.
• Not feeling refreshed after sleep. You may have trouble functioning normally during the day, feel irritable, tired, and find it difficult to concentrate.
• Waking when you have been disturbed from sleep by pain or noise.

Insomnia can last for days, months or even years and can be split into three categories:
• Transient insomnia lasts for 2-3 days.
• Short-term insomnia lasts for more than a few days, but less than three weeks.
• Chronic insomnia can be defined as insomnia most nights for three weeks or longer.

Chronic insomnia can lead to mental health problems such as depression, misuse of alcohol or other medicines in order to gain sleep.
Every individual is different so it is hard to define what normal sleep is for you. Other factors include your age, lifestyle, diet and environment.
Newborn babies can sleep for 16 hours a day, while children of school age need an average of 10 hours.

Adults usually need, on average, seven to nine hours sleep a night. As we get older, it's normal to need less sleep. Most people over 70 need less than six hours sleep per night; and they tend to be light sleepers.

Treatment for insomnia
In many cases, insomnia is caused by another disease, side effects from medications or a psychological problem. It is important to identify or rule out medical and psychological before deciding on the treatment for the insomnia. Attention to sleep hygiene is an important first line treatment strategy and should be tried before any pharmacological approach is considered.

Cognitive behavior therapy
A recent study found that cognitive behavior therapy is more effective than hypnotic medications in controlling insomnia. In this therapy, patients are taught improved sleep habits and relieved of counter-productive assumptions about sleep. Hypnotic medications are equally effective in the short term treatment of insomnia but their effects wear off over time due to tolerance. The effects of cognitive behavior therapy have sustained and lasting effects on treating insomnia long after therapy has been discontinued.

Medications
Many insomniacs rely on sleeping tablets and other sedatives to get rest. All sedative drugs have the potential of causing psychological dependence where the individual cannot psychologically accept that they can sleep without drugs. Certain classes of sedatives such as benzodiazepines and newer nonbenzodiazepine drugs can also cause physical dependence which manifests in withdrawal symptoms if the drug is not carefully titrated down. The benzodiazepine and nonbenzodiazepine hypnotic medications also have a number of side effects such as day time fatigue, motor vehicle crashes, cognitive impairments and falls and fractures. Elderly people are more sensitive to these side effects.
In comparing the options, a systematic review found that benzodiazepines and nonbenzodiazepines have similar efficacy which was not significantly more than for antidepressants. Benzodiazepines did not have a significant tendency for more adverse drug reactions. Chronic users of hypnotic medications for insomnia do not have better sleep than chronic insomniacs who do not take medications. In fact, chronic users of hypnotic medications actually have more regular nighttime awakenings than insomniacs who do not take hypnotic medications. Thus short term or occasional use of hypnotics can be benefitial but long term use may be detrimental to sleep.

Benzodiazepines
The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. Benzodiazepines bind unselectively to the GABAA receptor. These include drugs such as temazepam, flunitrazepam, triazolam, flurazepam, nitrazepam and midazolam. These drugs can lead to tolerance, physical dependence and the benzodiazepine withdrawal syndrome upon discontinuation, especially after consistent usage over long periods of time. Benzodiazepines while inducing unconciousness, actually worsen sleep as they promote light sleep whilst decreasing time spent in deep sleep such as REM sleep. A further problem is with regular use of short acting sleep aids for insomnia, day time rebound anxiety can emerge.

Non-benzodiazepines
Nonbenzodiazepine sedative-hypnotic drugs, such as Ambien (zolpidem), Sonata (zaleplon), Imovane (zopiclone) and Lunesta (eszopiclone), are a newer classification of hypnotic medications. They work on the benzodiazepine site on the GABAA receptor complex similarly to the benzodiazepine class of drugs. Some but not all of the nonbenzodiazepines are selective for the α1 subunit on GABAA receptors which is responsible for inducing sleep and may therefore have a cleaner side effect profile than the older benzodiazepines. Zopiclone and eszopiclone like benzodiazepine drugs bind unselectively to α1, α2, α3 and α5 GABAA benzodiazepine receptors. Zolpidem is more selective and zaleplon is highly selective for the α1 subunit thus giving them an advantage over benzodiazepines in terms of sleep architecture and a reduction in side effects. However, there are controversies over whether these non-benzodiazepine drugs are superior to benzodiazepines. These drugs appear to cause both psychological dependence and physical dependence though less than traditional benzodiazepines and can also cause the same memory and cognitive disturbances along with morning sedation.

Antidepressants
Some older antidepressants such as amitriptyline, doxepin, mirtazapine, and trazodone may have a sedative effect, and are prescribed off label to treat insomnia. The major drawback of these drugs is that they have antihistaminergic, anticholinergic and antiadrenergic properties which can lead to many side effects. Some also alter sleep architecture. As with many benzodiazepines, the use of antidepressants in the treatment of insomnia can lead to physical dependence; withdrawal may induce rebound insomnia and actually further complicate matters in the long-term.

Melatonin
The hormone and supplement melatonin is effective in several types of insomnia. Melatonin has demonstrated effectiveness equivalent to the prescription sleeping tablet zopiclone in inducing sleep and regulating the sleep/waking cycle. One particular benefit of melatonin is that it can treat insomnia without altering the sleep architecture which is altered by many prescription sleeping tablets. Another benefit is it does not impair performance related skills.Melatonin agonists, including Ramelteon (Rozerem), seem to lack the potential for abuse and dependence. This class of drugs has a relatively mild side effect profile and lower likelihood of causing morning sedation. Natural substances such as 5-HTP and L-Tryptophan have been said to fortify the serotonin-melatonin pathway and aid people with various sleep disorders including insomnia.

Antihistamines
The antihistamine Benadryl (diphenhydramine) is widely used in nonprescription sleep aids such as Tylenol PM, with a 50 mg recommended dose mandated by the FDA. In the United Kingdom, Australia, New Zealand, South Africa, and other countries, a 50 to 100 mg recommended dose is permitted. While it is available over the counter, the effectiveness of these agents may decrease over time and the incidence of next-day sedation is higher than for most of the newer prescription drugs. Dependence does not seem to be an issue with this class of drugs.
Periactin (Cyproheptadine) is a useful alternative to benzodiazepine hypnotics in the treatment of insomnia. Cyproheptadine may be superior to benzodiazepines in the treatment of insomnia because cyproheptadine enhances sleep quality and quantity whereas benzodiazepines tend to decrease sleep quality.

Atypical Antipsychotics
Low doses of certain atypical antipsychotics such as quetiapine (Seroquel) are also prescribed for their sedative effect but the danger of neurological and cognitive side effects make these drugs a poor choice to treat insomnia. Over time, Seroquel may lose its ability to produce sedation.
Other Substances
Some insomniacs use herbs such as valerian, chamomile, lavender, hops, and passion-flower. Valerian has undergone multiple studies and appears to be modestly effective.Cannabis has also been proven as an effective treatment for insomnia.

Middle-of-the-night awakenings due to polyuria or other effects from alcohol consumption are common, and hangovers can also lead to morning grogginess.
Insomnia may be a symptom of magnesium deficiency, or low magnesium levels, but this has not yet been proven. A healthy diet containing magnesium, can help to improve sleep in individuals without an adequate intake of magnesium.
Other reports cite the use of an elixir of cider vinegar and honey but the evidence for this is only anecdotal.

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