Sleep & Snoring Archives - ENT Health

Understanding Balance and Maintaining Independence for Older Adults

John Trumbo — Wed, 15 May 2024 14:52:04 +0000

Understanding Balance and Maintaining Independence for Older Adults

Understanding balance is an important step toward maintaining health and independence as we age. One in four adults over the age of 65 will experience a fall each year.¹ Falls can often result in injuries such as broken bones but may also make older adults reluctant to participate in activities they once enjoyed. However, difficulty with balance is not necessarily inevitable and many changes in equilibrium can be caused by issues such as muscle weakness, arthritis, vision changes, low blood pressure, and taking multiple (more than four) medications at a time, also called polypharmacy. Identifying and limiting these situations, when possible, can help many older adults avoid loss of independence.

Physical fitness is one of the most important pillars of a long and healthy life. Walking, biking, and other aerobic activities approved by your doctor promote a healthy cardiovascular system. There is even some evidence that regular sauna use can mimic the benefits of aerobic activity and support cardiovascular health. Movement-based practices such as yoga and tai chi preserve balance and stability; classes can be found in many communities and organizations.

Strength training with weights or resistance bands is a great way to prevent loss of muscle mass and strength, known as sarcopenia, that accelerates after age 50. Strength training is also a good way to prevent osteoporosis, or bone disease. There is good evidence that with stronger bones and muscles, even if you do fall, you are less likely to have a serious injury.

Be sure to speak with your doctor before making any changes in your physical activity levels.

Three Helpful Daily Exercises

Here are three exercises that you can incorporate into your daily routine. Repeat these 10-15 times daily or as recommended by your doctor:

Single-leg Stance—Standing on one leg is a great way to test your stability. As you improve, try to increase the difficulty by doing it while brushing your teeth or adding hand weights.

Step 1: Stand behind a counter or sturdy chair with your back straight and your feet together.
Step 2: Slowly lift your right foot off the floor. If you need extra support, hold onto the back of the chair or counter with both hands as you lift your foot.
Step 3: Bend your right knee to a 90-degree angle.
Step 4: Hold the stance and maintain your balance for 10 seconds.
Step 5: Lower your right foot back to the floor.

Heel-toe Raises—Shuffling your feet when you walk can cause falls. Heel-toe raises can strengthen your shin and ankle muscles, helping you walk more safely and efficiently.

Step 1: Sit or stand upright with your back straight and your hands in your lap or on your hips. Keep your feet flat on the floor.
Step 2: Press into the balls of your feet to lift your heels and stand on your tiptoes. Hold for five to 10 seconds before lowering your feet flat on the floor.
Step 3: Press into your heels and lift your toes as high as you can, hinging at your ankles, raising slowly and with control. Hold for five to 10 seconds before placing your feet flat on the floor.

Sit-to-stand—This exercise mimics a key functional movement of daily living and can boost your core and leg strength.

Step 1: Scoot toward the front of your chair with your back straight and your feet hip-width apart. You can rest your hands on your lap or the armrests.
Step 2: Engage your core by contracting the muscles in your midsection; this helps strengthen and stabilize your body and support your spine and pelvis. Press your feet into the floor as you stand up from your seat.
Step 3: Pause for a breath while standing tall.
Step 4: Hinge at your hips and bend your knees to sit down, returning to the starting position.

Additional Steps to Help You Stay Healthy

Nutrition plays an important role in overall health. To get the most out of your physical fitness goals, make sure you are eating enough protein, in addition to a diet rich in vegetables, fruits, and whole grains. Lean meats such as fish and chicken, beans, lentils, and tofu are great sources of protein. Another way to help your bones stay healthy is with adequate dietary calcium found in yogurt, cottage cheese, beans, and spinach. Daily exposure to sunlight for about 20 minutes supports your body’s production of vitamin D. Also, pay attention to how much water you drink because dehydration can contribute to problems with balance.

As we age our sleep patterns may change, too—earlier to bed, earlier to rise, for instance. While this can be explained by natural changes in your “body clock,” make sure you are getting enough sleep to feel well rested. When you are overly tired your reaction time can be delayed. Be aware that many common medications can make you feel sleepy, so regularly reviewing your medication list with your doctor and removing any unnecessary items is a good idea. Medications for vertigo such as meclizine (brand name Antivert®) and diazepam (brand name Valium®) are generally not helpful for balance problems and are not recommended for those over 65-years-old due to risk of confusion and falls. Making some simple but important changes to your sleep hygiene can also improve the overall quality and duration of your sleep.

Preparation and planning are key. There are many additions to your living place that can be installed to provide extra options for stability. Keep regular appointments to check your hearing and vision, and make sure you have well-fitting shoes. Staying active physically and socially is one of the best ways to ensure a fulfilling life as we age.

¹ https://www.cdc.gov/falls/data/

Related Conditions

Falls Prevention for Older Adults

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

The Impact of Age-Related Hearing Loss

Improve Your Sleep Quality

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Understanding Balance and Maintaining Independence for Older Adults appeared first on ENT Health.

Sleep Awareness: Tips for Jet Lag

Brian Sprowl — Mon, 01 May 2023 19:25:49 +0000

Sleep Awareness: Tips for Jet Lag

Jet lag is a circadian rhythm sleep disorder that occurs when your internal clock’s schedule does not match the wake-sleep cycle where you are currently located. Your body’s clock runs a roughly 24-hour cycle and uses sunlight to regulate melatonin production and release. Melatonin levels rise sharply during the evening and decline to very low levels during daylight hours.

Jet lag typically occurs with long-distance air travel when you are crossing three or more time zones. With circadian rhythm misalignment, you may have trouble adjusting your sleep-wake cycle and other bodily rhythms to the new time zone. This may lead to feeling sleepy during the day, having difficulty functioning during the day, or not being able to fall sleep at an appropriate time.

The severity of jet lag depends on how many time zones you cross and in which direction. Often flying east is much more disruptive than flying west. A rough estimation for the duration of the adjustment is one day per time zone crossed. The ability to adjust to jet lag also varies among individuals.

Jet lag is a temporary condition and resolves when the internal clock adjusts to the new time zone. However, for certain populations, such as pilots and business travelers, the chronic state of an out-of-sync circadian rhythm can lead to other sleep disorders, such as insomnia. Common sleep disorder symptoms may include:

Trouble falling asleep at night—You may have difficulty falling asleep at night, or you may wake earlier than you desire in the morning. You may also have diminished quality of sleep.
Impaired cognitive function—You may have difficulty remembering or concentrating. You may feel disoriented.
Emotional stress—You may feel more irritable or stressed.
Stomach problems—You may have reduced appetite, nausea, or constipation.
Impaired physical function—Peak physical function can be affected, for example, for athletes.
Sensation of malaise—You may experience a vague or unfocused feeling of mental uneasiness, lethargy, or discomfort.

How Do I Know If I May Have Jet Lag?

According to the American Academy of Sleep Medicine, if you answer “yes” to the following questions, then you may have jet lag:¹

Have you traveled by air across at least two time zones?
Do you have trouble sleeping, or are you very sleepy during the day?
Do you have difficulty functioning normally or have a feeling of mild sickness or stomach problems within one to two days after travel?

How Do I Manage Jet Lag?

Plan ahead—Getting sufficient or additional sleep several nights before travel can help you by “banking” sleep. Apps are available to help you plan for your adjustment to a new time zone, such as Jet Lag Rooster by Sleepopolis. Just input your departure city/date/time and arrival city/date/time, and the app provides a schedule of sleep and wake adjustments prior to departure to minimize the effects of jet lag.

Melatonin—Melatonin is produced by the pineal gland and signals the brain to fall sleep. It can be used to phase shift your sleep earlier by taking a melatonin tablet in the late afternoon or early evening; however, taking it at the wrong time can further misalign your internal clock. In the U.S., melatonin is sold as a supplement and is not well regulated so the actual content of melatonin relative to the dose on the label can vary.

Sun exposure and bright light therapy—The sun is the most powerful regulator of the sleep-wake cycle and can be used to shift the internal clock. Sun exposure after landing in a new location can assist in adjusting your body to the new time zone. Alternatively, artificial light at certain times can help reinforce your body’s interval clock. Scheduling early morning light therapy could be beneficial, if traveling east. Light therapy can be supplied by special light boxes or dawn simulators.

Importantly, mistiming exposure to light therapy can be detrimental to circadian alignment. At certain times, light exposure can either advance or delay your internal clock. Avoiding direct light in the evening and wearing blue-light filtering glasses can also help.

Minimize caffeine and alcohol consumption—It is recommended to reduce caffeine and alcohol intake during travel because it can impact your sleep-wake cycle and cause dehydration. Remember to drink plenty of water during flights.

Exercise—Some research suggests that moderate exercise as approved by your physician can help adjust to a new time zone and provides light exposure when performed outdoors at the right time.

When circadian rhythm misalignment is too severe to gradually shift, for example, a 10-hour shift, it may be best to simply try to adjust the new zone by exposing oneself to daylight and exercising moderately. If the trip is short, some may prefer to stay at their home time zone’s schedule, if possible, and not shift.

References

Reeba Mathew, MD, and Virginia Skiba, MD. What is jet lag? Published August 2020. https://sleepeducation.org/sleep-disorders/jet-lag/

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The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Sleep Awareness: Tips for Jet Lag appeared first on ENT Health.

Improve Your Sleep Quality

John Trumbo — Thu, 07 Feb 2019 21:08:03 +0000

Improve Your Sleep Quality

Making some simple but important modifications to your sleep hygiene—your everyday behaviors and circumstances surrounding your sleep and bedtime patterns—can help improve the overall quality and duration of your sleep. Consider these tips for getting a better night’s sleep:

Make sure that your bedroom is dark and quiet, and that your pillows and bed are comfortable. The room temperature should be cool.
Go to bed at the same time every night and know how much sleep your body needs (seven to eight hours per night are recommended for most adults). Getting the same number of hours every night promotes a favorable, repeatable sleep cycle.
Limit television, cell phone, and computer activities an hour before bedtime. Pursue a bedtime sleep ritual that is more relaxing and less stimulating.
Create a routine that becomes familiar and relaxing. This prepares your brain for rest, and improves your quality of sleep.
Limit daytime napping to 30 minutes or less.
Any exercise, as approved by your physician, may be useful in improving sleep quality.
Do not eat late. Heavy, rich, fried, and fatty meals eaten late at night exacerbate gastroesophageal reflux disease (GERD) and may affect your sleep quality.
Limit stimulants and caffeinated beverages. Alcohol should only be consumed in moderation. While alcohol may induce sleep, it may also disrupt your sleep later in the night.
Exposure to daytime light, preferably outdoors as early as possible, and limited exposure to light in the evening help establish a healthy sleep-wake cycle and a good night’s rest.

You can also use this ENThealth Sleep Journal to help track your sleep patterns and be aware of daily situations that help—or hinder—a good night’s sleep. Print copies of this document to keep by your bedside for easy, effective journaling before you go to bed each night and when you wake up each morning. Or, you can fill it out electronically to share with your healthcare provider.

When you have taken steps to improve your sleep hygiene but you haven’t seen positive results, your sleep problem may be more complicated. An ENT (ear, nose, and throat) specialist, or otolaryngologist, or a sleep specialist can discuss additional tests and treatments for more complex sleep disorders, and which options might be best for you.

improve your sleep quality video

Here are some tips for improving the quality of your sleep.

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Learn More about Sleep Apnea through Our Partnership with AASM.

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Improve Your Sleep Quality appeared first on ENT Health.