The Problem With Problem Sleepiness

ADC - problem sleepiness

Everyone feels sleepy at times. However, when sleepiness interferes with daily routines and activities or reduces the ability to function, it is called “problem sleepiness.” A person can be sleepy without realizing it. For example, a person may not feel sleepy during activities such as talking and listening to music at a party, but the same person can fall asleep while driving home afterward. You may have problem sleepiness if you:

  • Consistenlty do not get enough sleep or get poor quality sleep
  • Fall asleep while driving
  • Struggle to stay awake when inactive such as when watching televison or reading
  • Have difficulty paying attention or concentrating at work, school or home.
  • Have performance problems at work or school
  • Are often told by others that you are sleepy
  • Have difficulty remembering
  • Have slowed responses
  • Have difficulty controlling your emotions
  • Must take naps on most days

What Causes Problem Sleepiness?

Sleepiness can be due to the body’s natural daily sleep-wake cycles, inadequate sleep, sleep disorders or certain drugs.

Sleep-Wake Cycle

Each day there are two periods when the body experiences a natural tendency toward sleepiness: during the late night hours (generally between midnight and 7 a.m.) and gain during the midafternoon (generally between 1 p.m. and 4 p.m.). If people are awake during these times, they ahve a higher risk of falling asleep unintentionally, especially if they havent been getting enough sleep.

Inadequate Sleep

The amount of sleep needed each night varis among people. Each person needs a particular amount of sleep in order to be fully alert throughout the day. Research has shown that when healthy adults are allowed to sleep unrestricted, the average time slept is 8 to 8.5 hours. Some people need more than that to avoid problem sleepiness; others need less.

If a person does not get enough sleep, even on one night, a “sleep debt” begins to build and increases until enough sleep is obtained. Problem sleepiness occurs as the debt accumulates. Many people do not get enough sleep during the work week and then sleep longer on the weekends or days off to reduce their sleep debt. If too much sleep has been lost, sleeping in on the weekend may not completely reverse the effects of not getting enough sleep during the work week.

 

What Can Help?

Many people simply do not allow enough time for sleep on a regular basis. A first step may be to evaluate daily activites and sleep-wake patterns to determine how much sleep is obtained. If you are consistently getting less than 8 hours of sleep per night, moe sleep may be needed. A good approach is to gradually move to an earlier bed-time. For example, if an extra hour of sleep is needed, try going to bed 15 minutes earlier each night for four nights and then keep the last bedtime. This method will increase the amount of time in bed without causing a sudden change in schedule. However, if work or family schedules do not permit the earlier bedtime, a 30 – to 6o minute daily nap may help.

A person with problem sleepiness is limited in reaching their full potential, let us help you find a solution. Contact us for more information or to schedule an appointment.

Testing Information: Your Muscle and Nerve Function

ADC - Nerve and Muscle Testing

Electromyography (EMG) and nerve conduction studies (NCS) are tests that measure muscle and nerve function. In most cases, both tests are performed. NCS is most often done first.

During NSC, mild electrical currents are applied to the skin on some parts of your body. This is done to see how quickly impulses travel between nerves. EMG assesses muscle function. To do this, a fine needle is placed under your skin into the muscle being tested. This is repeated on other muscles. The needle allows the electrical activity in your muscles to be measured. No electrical currents are applied with the needle.

During each test, wavy lines (waveforms) appear on a screen or on paper. these lines show how well your nerves and muscles work. These waveforms help to determine your test results.

Before Your Test

Prepare for your test as instructed. Shower or bathe, but don’t use powder, oil, or lotion. your skin should be clean and free of excess oil. Wear loose clothes. Be aware that you may be asked to change into a hospital gown. the entire test will take about 1 hour. Be sure to allow extra time to check in.

During Your Test

You will be asked to lie on an exam table with a blanket over you. You may have one or both of the following:

Nerve Conduction Study (NCS)

Small metal disks (electrodes) will be attached to your skin on the area of your body being tested. This will be done using water based gel or paste. A doctor or technologist will apply mind electrical currents to your skin. Your muscles will twitch. But the test won’t harm you. Currents may again be applied to the same area. Or, the test may continue on other parts of your body.

Electromyography (EMG)

Most of the electrodes will be removed for EMG. The doctor will clean the area being tested with alcohol. A fine needle will be inserted into the muscle in this region. When the needle is inserted, you may feel as if your skin is being pinched. Try to relax and do as instructed.

After Your Test

Before you leave, all electrodes will be removed. You can then get right back to your normal routine. If you feel tired or have some discomfort, take it easy. If you were told to stop taking any for your test, ask when you can start taking them again. Your doctor will let you know when your test results are ready.

For the safety and for the success of your test, tell the technologist if you have any bleeding problems or if you take blood thinners. You may also be asked questions about your overall health. Contact us to answer any questions you may have or to schedule an appointment.

 

 

Stay Sharp: Test Your Brain Wave Activity

ADC - Electroencephalography

Electroencephalography (EEG) is a test that measures your brain wave activity (brain function). Your doctor may order this test to check for seizures or other brain problems. For this test, small metal disks (electrodes) are attached to the scalp with glue, or with water-based gel or paste. During the test, wavy lines (waveforms) appear on a screen or on paper. They will be studied to assess your brain function. In some people who are prone to seizures, parts of this test may slightly increase their chance of having a seizure. But the benefits of this test outweigh the risk.

Before Your Test

Prepare for your test as instructed. Wash and dry your hair. But don’t use any hair styling products. Your scalp and hair should be clean and free of excess oil. Take your routine medications, unless told not to. You may be asked to sleeping during the EEG. To help you do this, you may be told to stay up all or part of the night before the test. Or, you may be given medication to help you sleep during the test. If so, someone will need to drive you home after the test. Your test will take about 90 minutes. But allow extra time to check in. Don’t forget to let your technologist know:

  • What medications you take
  • About any seizures you may have had in the past

During Your Test

You will sit in a reclining chair or lie down on an exam table in a softly lighted room. The technologist will measure certain points on your head He or she will use a special pencil to mark the spots where electrodes will be placed on your scalp. Your scalp will be rubbed with a mild abrasive, and electrodes will be attached. You will then be asked to do any of the following:

  • Relax, and open and close your eyes.
  • Breathe rapidly and deeply for a few minutes.
  • Sense a flashing light through your closed eyes.
  • Relax and go to sleep.

After Your Test

When your test is done, all of the electrodes will be removed. At home, wash your hair to remove any remaining glue, gel or paste. You can get right back to your normal routine. If you stopped taking any medications before the test, ask your doctor when you can start taking them again. Your doctor will let you know when your test results are ready.

Remember to avoid caffeine, but eat meals as usual. Contact us if you have any questions or to schedule an appointment. 

Traveling Overseas? Don’t Forget Your Vaccinations.

ADC - traveling

Whether traveling for business or pleasure, most people do not think about the possibility of acquiring a travel-related illness. In fact, travel in undeveloped countries and many foreign or tropical countries outside of resort areas, does entail some risks for acquiring local or travel-related diseases. The Travel Clinic at Amarillo Diagnostic Clinic is available to assist you with problems in this regard. We have a full-service clinic with disease-prevention strategies, information, vaccinations and medications available for travel essentially anywhere in the world. The travel clinic at ADC is supervised by Dr. Taylor Carlisle, a board certified Infection Disease specialist trained in Tropical Medicine and Public Health.

If you are planning to take your family overseas for a vacation, or maybe you’re going on a mission trip with your church, Amarillo Diagnostic Clinic encourages you to take precautions prior to your trip. Our travel clinic not only provides immunizations, but also provides pre-travel counseling and post-travel health evaluations. It is recommended that you see your physician 6 to 8 weeks prior to your departure and then again; after your trip if you experience unusual health issues. Remember, it is easier to take precautions in preventing overseas illnesses than it is to treat them. Call Amarillo Diagnostic Clinic today and let our travel clinic staff assist you in planning for a healthy overseas adventure.

Vaccinations

  • You should get vaccinated against any diseases that may be endemic to the region where you’re headed at least four weeks before a trip out of the country.
  • Visit the Centers for Disease Control and Prevention site to learn more about diseases you may come in contact with during your trip.

People are basically the same no matter where you travel.
But the diseases and illnesses can be very different.

The bacteria and germs that live in one country can be very different from those of another region. That’s why lots of people get sick when they travel – they don’t have natural immunity to these germs (or put another way, their bodies haven’t yet learned how to defend themselves against these new, potentially health-threatening invaders). A common example of this is ” traveler’s diarrhea,” which often occur when visitors drink tap water while away. Ever notice how the locals don’t suffer from this malady? That’s because they have natural immunity to the bacteria that are present in their water and you don’t.

You should ask your healthcare provider if you think you will need vaccinations before traveling. Contact us to answer any questions or to schedule an appointment. 

 

 

The Connection Between Sleep And Heart Disease Explained

ADC - sleep and heart disease

Scientific studies have shown a direct connection among sleep, sleep disorders, and heart disease. There is an increased risk of sudden cardiac death (dying from heart stoppage) in the first several hours after waking up. It is known that in there is an increased work demand on the heart that occurs when you wake up. People with sleep-related breathing disorders are more likely to have high blood pressure and are at risk of heart disease and stroke. Treating certain sleep-related breathing disorders may actually decrease a person’s chances of developing certain heart diseases.

Effects of Heart Disease on Sleep

As outlined above, sleep-related breathing disorders can directly cause heart disease. Yet, there are side effects of heart disease on sleep that, though more subtle, are also important to address. For instance, patients with congestive heart failure often report difficulty falling asleep or staying asleep This may be due to shortness of breath that often accompanies heart failure. This shortness of breath is often worse when the patient lies down because blood in the legs flows back into the heart and can overwhelm its ability to pump.

Heart failure patients may have orthopnea (shortness of breath when lying down) or paroxysmal nocturnal dyspnea (waking up from sleep short of breath). Patients who experience these symptoms may feel like they have insomnia since their sleep is interrupted. In addition to experiencing these complications from heart disease, patients often worry about the long-term consequences of a heart attack or chronic heart disease. Anxiety by itself can lead to the development of chronic sleep problems.

There are many complex relationships between heart conditions and sleep-related breathing disorders. People with heart conditions need to take special care and seek medical attention in order to ensure their ability to sleep well.

Good Sleep and A Healthy Heart

Many things can be done to maintain a healthy heart: eat a nutritional diet, maintain a healthy weight, exercise regularly, get regular medical check-ups, and get adequate amounts of good quality sleep. If you have any kind of heart condition, it is especially important to watch for signs that you may have a sleep-related breathing disorder, such as OSA, which could stress your heart. People with OSA are often overweight and experience loud snoring, gasping or choking episodes while sleeping, as well as trouble staying awake during the daytime If you already have hypertension or cardiovascular disease, talk with your healthcare professional about whether or not you may have a sleep and breathing disorder, such as OSA or CSA.

It is also important that patients with congestive heart contrast to people with OSA, those with heart failure and CSA are commonly thin and may not snore at all. if your healthcare professional thinks that you have a sleep disorder, he or she may suggest you have a diagnostic test called a sleep study, or refer you to a sleep medicine specialist. Sleep studies are usually done in a sleep laboratory. Small sensors called electrodes are attached to your body to measure your sleep, be able to determine whether you have any abnormalities in the quality of your sleep. Your healthcare professional is then given the results and the two of you can decide on the best course of treatment. Sleep disorders are treatable, and treatment can lead to a more healthy heart.

How to Sleep Well

These guidelines can help most people sleep better, as well as helping many individuals with different types of sleep disorders. For more specific guidelines about your own sleep problem, consult your healthcare professional.

  • Get up at the same time every day.
  • Go to bed only when sleepy.
  • Establish relaxing pre-sleep rituals such as a warm bath, light bedtime snack, or 10 minutes of reading.
  • Exercise regularly.
  • Maintain a regular schedule.
  • Avoid caffeine within six hours of bedtime.
  • Try to nap at the same time every day; mid-afternoon is best for most people.
  • If sleeping pills are prescribed, they should be used conservatively. Most doctors avoid prescribing sleeping pills for periods longer than three weeks
  • Never combine sleeping pills and alcohol.

There are many complex relationships between heart conditions and sleep-related breathing disorders. People with heart conditions need to take special care and seek medical attention in order to ensure their ability to sleep well. Contact us to answer any questions or to set up an appointment.

The Ultimate Guide: Pulmonary Function Testing

ADC Pulmonary testing

Some information provided by Johns Hopkins Medicine

Pulmonary function tests measure how well the lungs take in and exhale air.  It also helps to determine how efficiently the lungs transfer oxygen into the bloodstream.  This test is helpful in diagnosing certain types of lung disorders such as asthma and/or chronic obstructive pulmonary disease (COPD). There are 2 types of disorders that cause problems with air moving in and out of the lungs:

  • Obstructive. This is when air has trouble flowing out of the lungs due to resistance. This causes a decreased flow of air.
  • Restrictive. This is when the chest muscles can’t expand enough. This creates problems with air flow.

There are many different reasons why pulmonary function tests (PFTs) may be done. They are sometimes done in healthy people as part of a routine physical. Or you may have PFTs if your healthcare provider needs help to diagnose you with a health problem such as:

  • Asthma
  • Allergies
  • Chronic Bronchitis
  • Respiratory Infections
  • Lung Fibrosis
  • Bronchiectasis  (a condition in which the airways in the lungs stretch and widen)
  • Chronic Obstructive Pulmonary Disease (COPD) (formerly known as“emphysema”)
  • Asbestosis (a condition caused by exposure to asbestos)
  • Sarcoidosis (an inflammation of your lungs, liver, lymph nodes, eyes, skin, or other tissues)
  • Scleroderma (a disease that affects your connective tissue)
  • Pulmonary Tumor
  • Lung Cancer

PFTs are usually safe for most people. However, because the test may require you to breathe in and out quickly, you may feel dizzy and there’s a risk that you might faint. If you feel lightheaded, tell your doctor. The test may cause you to have an asthma attack if you have asthma. In extremely rare cases, PFTs may be responsible for a collapsed lung.

A few pieces of advice are to avoid eating a large meal before testing. A full stomach can prevent lungs from inhaling fully. A person should also avoid food and drinks that contain caffeine, such as chocolate, coffee, and tea, before the test. Caffeine can cause airways to open. Lastly, a person should also avoid smoking and strenuous exercise before the test.

Contact us for any questions or to set up an appointment.

 

Key Benefits of Radiology That You Should Know

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Information provided by the RadiologyInfo.org

At ADC, our Diagnostic Imaging Department is equipped to provide a wide range of radiology services. These services include CT Scans, General and Vascular Ultrasonography, Bone Density testing and EKG’s. All studies are interpreted by independent radiologists who are board-certified by the American Board of Radiology. Listed below are the key benefits of each test and what it can do for the body.

CT Scans

A computed tomography (CT) of the body uses special x-ray equipment to help detect a variety of diseases and conditions. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.

Benefits of CT include:

  • Determining when surgeries are necessary
  • Reducing the need for exploratory surgeries
  • Improving cancer diagnosis and treatment
  • Reducing the length of hospitalizations
  • Guiding treatment of common conditions such as injury, cardiac disease and stroke

General/Vascular Ultrasonography

Vascular ultrasounds use sound waves to test the body’s circulatory system to help identify blockages and detect blood clots. A Doppler ultrasound study is a technique that evaluates blood flow through a blood vessel. An ultrasound does not use ionizing radiation, has no known harmful effects, and provides a clear picture of soft tissues that don’t show up well on x-ray images.

Benefits of a ultrasonography include:

  • Most ultrasound scanning is noninvasive (no needles or injections).
  • Occasionally, an ultrasound exam may be temporarily uncomfortable, but it is almost never painful.
  • Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
  • Ultrasound imaging is extremely safe and does not use any ionizing radiation.
  • Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.

Bone Density

Bone densitometry uses a very small dose of ionizing radiation to produce pictures of the inside of the body (usually the lower spine and hips) to measure bone loss. It is commonly used to diagnose osteoporosis and to estimate an individual’s risk for developing fractures. It’s simple, quick and noninvasive. Additionally, it’s the most accurate method for diagnosing osteoporosis.

Benefits of a bone density test include:

  • DXA bone densitometry is a simple, quick and non-invasive procedure.
  • No anesthesia is required.
  • The amount of radiation used is extremely small—less than one-tenth the dose of a standard chest x-ray, and less than a day’s exposure to natural radiation.
  • Bone density testing is the most accurate method available for the diagnosis of osteoporosis and is also considered an accurate estimator of fracture risk.
  • The equipment is widely available making bone densitometry testing convenient for patients and physicians alike.
  • No radiation remains in a patient’s body after an x-ray examination.
  • X-rays usually have no side effects in the typical diagnostic range for this exam.

EKG

Screening tests may include laboratory tests to check blood and other fluids, genetic tests that look for inherited genetic markers linked to disease, and imaging tests that produce pictures of the inside of the body. These tests are typically available to the general population; however, an individual’s needs for a specific screening test are based on factors such as age, gender and family history. An EKG measures the electrical activity of the heart and reveals information on heart rate and rhythm.

The benefits on an EKG may include:

  • Cardiac CT for calcium scoring is a convenient and noninvasive way of evaluating whether you may be at increased risk for a heart attack.
  • The exam takes a small amount of time, causes no pain and does not require injection of contrast material.
  • No radiation remains in a patient’s body after a CT examination.
  • X-rays used in standard CT scans have no immediate side effects.

Staying healthy is one of the most important things that a person can do for themselves. Contact us to answer any questions or to schedule an appointment.

Shift Work and Problem Sleepiness

Daytime sleepiness

About 20 million Americans (20 to 25 percent of workers) perform shift work. Most shift workers get less sleep over 24 hours than conventionally-scheduled day workers. Additionally, sleep loss is greatest for night shift workers, those who work early morning shifts and female shift workers with children at home. As a result, roughly 60 to 70 percent of shift workers have difficulty sleeping and/or problem sleepiness.

Roughly 60 to 70 percent of shift workers have difficulty sleeping and/or problem sleepiness.

The human sleep-wake system is designed to prepare the body and mind for sleep at night and wakefulness during the day. These natural rhythms make it difficult to sleep during daylight hours and to stay awake during the night hours, even in people who are well rested. It is possible that the human body completely adjusts to nighttime activity and daytime sleep, even in those who work permanent night shifts.

In addition to the sleep-wake system, environmental factors can influence sleepiness in shift workers. Because our society is strongly day-oriented, shift workers who try to sleep during the day are often interrupted by noise, light, telephones, family members and other distractions. In contrast, the nighttime sleep of day workers is largely protected by social customs that keep noises and interruptions to a minimum.

Problem sleepiness in shift workers may result in:

  • Increased risk for automobile crashes, especially while driving home after the night shift
  • Decreased quality of life
  • Decreased productivity (night work performance may be slower and less accurate than day performance
  • Increased risk of accidents  and injuries at work

What Can Help?

Sleep-there’s no substitute! Many people simply do not allow enough time for sleep on a regular basis. A first step may be to evaluate daily activities and sleep-wake patterns to determine how much sleep is obtained. If you are consistently getting less than 8 hours of sleep per night, more sleep may be needed. A good approach is to gradually move to an earlier bedtime. For example, if an extra hour is needed, try going to bed 15 minutes earlier each night for four nights and then keep the last bedtime. This method will increase the amount of time in bed without causing a sudden change in schedule. However, if work or family schedules do not permit the earlier bedtime, a 30-60 minute daily nap may help.

Medications/Drugs

In general, medications do not help problem sleepiness, and some make it worse. Caffeine can reduce sleepiness and increase alertness, but only temporarily. It can also cause problem sleepiness to become worse by interrupting sleep. While alcohol may shorten the time it takes to fall asleep, it can disrupt sleep later in the night, and therefore add to the problem sleepiness. Medications may be prescribed for patients in certain situations. For example, the short-term use of sleeping pills has been shown to be helpful in patients diagnosed with acute insomnia. Long-term use of sleep medication is recommended only for the treatment of specific sleep disorders.

If you think you are getting enough sleep but still feel sleepy during the day, contact us or schedule an appointment to be sure your sleepiness is not a symptom of an undiagnosed sleep disorder.

 

What To Expect When Visiting a Sleep Specialist

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According to the National Commission on Sleep Disorders, millions of Americans are needlessly suffering from undiagnosed or misdiagnosed sleep disorders. While poor sleep can have a negative effect on performance, alertness, memory, concentration and reaction times, it is also being linked to other health issues such as heart disease and depression.

Sleep disorders are a serious health concern. It is especially important for persons suffering from hypertension diabetes, obesity and heart failure to see a sleep specialist for the detection and treatment of sleep apnea as it may prevent heart attacks and strokes as well as minimize underlying symptoms of other diseases. Left untreated, sleep disorders can lead to increased health risks and an overall lower quality of life.

Symptoms of a sleep disorder can include:

  • Insomnia
  • Daytime sleepiness
  • Morning headaches
  • Constant leg movement
  • Gasping episodes at night
  • Overweight/obesity
  • Hypertension
  • Loud snoring
  • Dry mouth, sore throat
  • Forgetfulness
  • Loss of energy

What To Expect?

The first step will be an initial visit with our sleep specialist who will review your medical and sleep history. You will then schedule an appointment for an overnight visit. To help determine if a sleep disorder exists, your physicians will need to know what physiologic changes occur during your typical night of sleep. We do this by recording your brainwave pattern (known as the EEG) as well as your eye movements and degree of muscle tone. Using an EKG monitor, we will measure your heart rate and check for irregular heart beats during the night. Other measurements will include oxygen saturation, snoring, leg movements or jerking and respiratory effort. An intercom in the room will allow communication with the technician should you have any questions or require assistance. Studies will usually begin between 8:00pm and 9:00pm  and will conclude at about 6am. you will then follow up with your physician who will make recommendations for treatment of the disorder.

How To Prepare

 

In order to feel more comfortable with your stay, feel free to bring your toiletries and usual sleepwear and if you prefer, your own pillow. (It is helpful to avoid using hair products or skin lotions on the night of the study). It is recommended that you eat a meal prior to your study and continue to take medications as prescribed (unless your physician specifies otherwise). It is also preferred that you not consume foods or beverages containing caffeine after 5pm.

Finally…

Amarillo Diagnostic Clinic, P.A. is a distinguished group practice of physicians specializing in internal medicine and its major subspecialties and provides a wider range of diagnostic services on site. Each of the physicians at Amarillo Diagnostic Clinic has built their practices around their commitment to superior methods of diagnosis and treatment for their patients. Contact us if you have any questions or to set up an appointment.

Key Benefits Of ADC’s Patient Portal

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Ever walk out of your doctor’s office feeling overwhelmed or anxious? And please don’t even mention the painful wait times. That’s why we’ve given our patients the option to streamline their visits. Our Patient Portal is your safe and easy way to take care of many of your medical tasks associated with doctor visits.

Our portal is powered by FollowMyHealth, and it works as a universal health record. FollowMyHealth is a secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an internet connection. It’s also used by numerous health care organizations and thousands of physicians across the country. It is the driving force behind their hospital or clinic’s specific patient portal. While portals may have a different name, the technology is the same. Using a secure username and password, patients can view health information such as appointments, clinical summaries, medications, immunization, allergies, and lab results.

With FollowMyHealth, you can:

  • Review your medical records online in a safe, secure environment
  • Communicate privately with physicians via secure messaging
  • View test and lab results, read medical notes from your doctor
  • Update your health information (allergies, medications, conditions, etc.)
  • Request Rx refills
  • Schedule or change appointments
  • Fill out and submit forms prior to appointments
  • Share information with other doctors/clinics
  • Fax, print or email records for external use

Best of all, it’s available online anytime via any computer, tablet, or smart phone. With people bypassing the doctor’s office every chance they get, we believe that it’s important for medical offices to adopt these service improvements so patients can have the best experience overall.

Take the stress out of staying healthy. Sign up or log in now.

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