SLEEPING PLENTY, BUT STILL SLEEPY: TIME FOR A SLEEP STUDY?
I get between eight and nine hours of sleep most nights but still feel groggy in the morning. Would a sleep study help me figure out why I'm never rested?
A sleep test may be beneficial. However, before you seek medical attention, consider several things about sleepiness. The most common cause of sleepiness is not sleeping long enough. Getting enough restful sleep is crucial for maintaining good health. Research over the past decade has shown that healthy sleep is just as important as exercising regularly and eating a healthy diet. Most adults need between seven and nine hours of quality sleep to reap the health benefits.
When you don't get enough sleep, over time it can have serious health consequences. For example, a consistent lack of healthy sleep can raise your risk for high blood pressure and heart disease. People who don't get enough sleep have more difficulty staying at a healthy weight than those who do sleep well. Not getting adequate sleep also may increase a person's risk of depression, anxiety and substance abuse.
An interesting website put together by the Centers for Disease Control and Prevention website shows by city the proportion of adults who do not get at least seven hours of sleep. To learn more and to see if your city is listed, go to cdc.gov/500cities and choose the category "unhealthy behaviors" and the measure "sleep."
While getting enough sleep is important, a regular sleep and wake pattern also is key. Recent studies show that an irregular schedule, such as when you go to bed and wake up later on weekends than weekdays, is associated with poorer health, worse mood and increased sleepiness and fatigue. Some studies show that this pattern of sleep, sometimes called "social jet lag," is associated with increased likelihood for heart disease. Keeping a regular sleep and wake schedule, along with sleeping at least seven hours per night, helps improve sleep quality and effectiveness.
In a situation like yours, where you feel like you're getting plenty of sleep but don't feel well-rested in the morning, it's possible that your morning grogginess could be a symptom of a treatable sleep disorder. Make an appointment to see a health care provider who specializes in sleep medicine. He or she can provide you with a comprehensive assessment of your situation that includes a discussion of your symptoms, a review of your medical history and a thorough physical exam.
Based on that evaluation, specific tests might be helpful. Those tests may or may not include a sleep study. If a sleep study is recommended, it may be conducted in a lab where you are monitored throughout the study. This type of sleep test is called a polysomnogram. It involves monitoring brain waves, muscle tone, airflow, blood oxygen level, heart rate and breathing during sleep. At other times, a home sleep apnea test can provide the needed information.
Seek care from a sleep center accredited by the American Academy of Sleep Medicine. Your health care provider will be able to help decide the best test for you and, then, based on the test results, establish your diagnosis. If you do need treatment for a sleep disorder, your health care provider can help you choose a treatment plan that will work best to accomplish your goals. Health care providers who are board-certified in sleep medicine are specially prepared to help you get the treatment you need and help you start feeling better.
Timothy Morgenthaler, M.D., Center for Sleep Medicine, Mayo Clinic, Rochester, Minn.
SOME HEAD LICE ARE HARDER TO KILL THAN OTHERS
Are some types of lice resistant to over-the-counter treatments? Is there a prescription medicine that eliminates head lice?
Over-the-counter treatments for head lice are often effective, but they don't work in all cases. Some strains of lice can be resistant to over-the-counter treatments. If head lice persist despite treatment at home, contact your health care provider to discuss prescription medication alternatives.
Head lice are tiny, wingless, parasitic insects that live and feed on blood from a person's scalp. Head lice cause a lot of fear and anxiety. Fortunately, although they are a nuisance, head lice don't carry any transmissible diseases that are dangerous.
Unfortunately, head lice can spread easily. They may go from one person to another through direct contact, or they may be passed through shared items, such as combs, brushes and towels. Head lice tend to stay within about 1 inch of the scalp, anchoring onto a hair shaft. If you suspect that you or a family member has head lice, first look behind the ears and along the back of the neck, near the scalp. Lice are small — about the size of a strawberry seed. Their eggs, or nits, resemble tiny pussy willow buds. Nits can be mistaken for dandruff, but, unlike dandruff, nits can't be brushed out of hair easily.
Because head lice move rapidly through groups that have close contact, schoolchildren often are affected. Prompt treatment is important to minimize spread within these groups. There are a variety of over-the-counter treatments for head lice. The most common are shampoos containing medications such as pyrethrin or permethrin to kill lice.
To catch the full life cycle of head lice, treat more than once. Treating only once will not affect head lice still in eggs. For best effect, repeat treatment seven or eight days after the first application.
Some lice strains, however, have become resistant to these medications. If over-the-counter treatments don't work, consider prescription treatments.
Malathion is a prescription medication for head lice that you apply to the hair and rub into the hair and scalp. Another prescription treatment for head lice is benzyl alcohol lotion. You apply it to the scalp and hair for 10 minutes and then rinse it off. Seven days later, you repeat the treatment. This medication is not recommended for children younger than 6 months.
Sometimes, the prescription shampoo lindane is prescribed for head lice. However, due to increasing resistance of lice to this medication and the possibility of serious side effects, lindane typically is used only when other measures fail.
If you don't want to use medications that kill head lice, try using a fine-toothed comb or nit comb to physically remove lice from wet hair. For this method to be effective, however, it must be repeated every three to four days for at least two weeks. It can be difficult to remove all lice and nits this way.
Home remedies often include attempting to suffocate head lice by applying products such as mayonnaise or petroleum jelly to the scalp. This approach is rarely effective. Some people try to kill head lice with heat, using an extra-hot hair dryer. Putting kerosene on the hair also is used sometimes in an attempt to kill lice. These techniques can lead to severe burns. Do not use them.
If nonprescription treatment hasn't eliminated head lice, talk to your health care provider. Prescription treatments often can eliminate the problem effectively.
Dawn Davis, M.D., Dermatology, Mayo Clinic, Rochester, Minn.
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