Non-rapid-eye-movement (NREM) sleep This is subdivided into four stages, of which stage 1 is the lightest and stage 4 the deepest. The activity of the cerebral cortex (see BRAIN) is diminished and the body’s functions are mainly regulated by brain-stem activity. The metabolic rate is reduced; in keeping with this the temperature falls, respiration is reduced, cardiac output, heart rate, and blood pressure fall, and activity of the sympathetic nervous system is reduced. NREM sleep normally occurs at the onset of sleep except in neonates. During adult life, the duration – particularly of stages 3 and 4 – of NREM sleep becomes less, and very little of this deep sleep occurs after the age of 60 years.
NREM sleep has been thought to have several functions, such as energy conservation and growth. Growth hormone is produced in bursts during stages 3 and 4, and more cell division occurs during this type of sleep than during wakefulness. A controversial proposal has been that processing of information acquired during wakefulness occurs during NREM sleep.... sleep
Symptoms (SLE): Loss of appetite, fever. Weight loss, weakness. Thickened scaly red patches on face (butterfly rash). May invade scalp and cause loss of hair. Sunlight worsens. Anaemia. Joint pains. Enlarged spleen. Heart disorders. Kidney weakness, with protein in the urine. Symptoms worse on exposure to sunlight. Low white blood cell count. Many patients may also present with Raynaud’s phenomenon while some women with silicone breast implants may develop lupus.
Treatment. Anti-virals. Alteratives. Anti-inflammatories, anticoagulants. Alternatives. Teas: Lime flowers, Gotu Kola, Ginkgo, Aloe Vera, Boneset.
Decoctions: Burdock. Queen’s Delight. Helonias.
Tablets/capsules. Echinacea. Blue Flag root. Wild Yam. Ginkgo.
Formula. Dandelion 1; Black Haw 1; Wild Yam half; Poke root half. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.
Topical. Sunlight barrier creams: Aloe Vera, Comfrey. Horsetail poultice. Garlic ointment. Castor oil packs.
Diet. See: DIET – SKIN DISORDERS.
Supplements. Calcium pantothenate, Vitamin A, Vitamin E, Selenium.
Note: The disorder is frequently misdiagnosed as rheumatoid arthritis, multiple sclerosis or ME. Lupus antibodies have been linked with premature heart disease in women and transient strokes. ... lupus erythematosus
Treatment. Because of plastic surgery deformities are now seldom seen, yet herbalism may still have a case in the absence of conventional drugs.
Teas. Elecampane. Gotu Kola.
Red Clover compound.
Arthur Barker. Liquid Extract Echinacea 1oz; Liquid Extract Queen’s Delight half an ounce; Tincture Goldenseal 30 drops. Syr Senna 2oz. Distilled, or pure spring water to 8oz. Dose: 1 dessertspoon after meals.
Topical. Marshmallow and Slippery Elm poultices or ointment. Oil of Mullein. Aloe Vera. Castor oil packs. ... lupus vulgaris
Lupus vulgaris is a form of TUBERCULOSIS of the skin. It typically begins in childhood and may spread slowly for decades if untreated. The face and neck are the usual sites. In untreated disease, large, well-demarcated areas may be affected with redness, scaling and thickening. If the affected skin is blanched by pressure, yellow-brown foci may be observed – the so-called apple-jelly nodules. The disease causes extensive scarring as it spreads and may destroy cartilage in its path – for example, on the nose or ear – causing gross deformity. The disease was common in the UK up to 50 years ago, but is now rare. It is treated with a combination of tuberculostatic drugs.
Lupus erythematosus is an autoimmune disease which can affect skin or internal organs.
Discoid lupus erythematosus (DLE) In this disease, only the skin is affected. Sharply de?ned red, scaly and eventually atrophic patches appear on the face, especially on the nose and cheeks. ALOPECIA with scarring is seen if the scalp is affected. The condition is aggravated by sunlight. Topical CORTICOSTEROIDS are helpful.... lupus
People with sleep apnoea may not be aware of any problem during the night, but they may be sleepy during the day, with poor memory and concentration. Severe sleep apnoea is potentially serious and may lead to hypertension, heart failure, myocardial infarction, or stroke.
Obstructive sleep apnoea is the most common type and may affect anyone, but more often middle-aged men, especially those who are overweight. The most common cause is over-relaxation of the muscles of the soft palate in the pharynx, which obstructs the passage of air. Obstruction may also be caused by enlarged tonsils or adenoids. The obstruction causes snoring. If complete blockage occurs, breathing stops. This triggers the brain to restart breathing, and the person may gasp and wake briefly.
In central sleep apnoea, breathing stops because the chest and diaphragm muscles temporarily cease to work, probably due to a disturbance in the brain’s control of breathing. Causes include paralysis of the diaphragm and disorders of the brainstem. Snoring is not a main feature.People who are overweight may find losing weight helps.
Alcohol and sleeping drugs aggravate sleep apnoea.
In one treatment, air from a compressor is forced into the airway via a mask worn over the nose.
Night-time artificial ventilation may be needed.
Tonsillectomy, adenoidectomy, or surgery to shorten or stiffen the soft palate may be performed.... sleep apnoea
joints. The condition is 3 times as common in women and is most likely to appear between the age of 30 and 50.
The number and severity of symptoms varies. The most common symptom is Raynaud’s phenomenon. Also common are changes in the skin, especially of the face and fingers, which becomes shiny, tight, and thickened, leading to difficulty with movements. Other parts of the body may also be affected, leading to difficulty in swallowing, shortness of breath, palpitations, high blood pressure, joint pain, or muscle weakness. Progression of scleroderma is often rapid in the first few years and then slows down or even stops. In a minority of people, degeneration is rapid, and leads to death from heart failure, respiratory failure, or kidney failure.
There is no cure for scleroderma, but many of the symptoms can be relieved.... systemic sclerosis
Physiological changes, such as a fall in temperature and blood pressure, take place just before sleep and continue during the early stages of NREM sleep. There is an intrinsic rhythm of sleep which in most subjects has a periodicity of around 25 hours. This can be modi?ed by external factors to bring it into line with the 24-hour day. Two peaks of a tendency to sleep have been identi?ed, and these usually occur between around 14.00–18.00 hours, and 02.00–06.00 hours. There are, however, di?erences according to age, in that, for instance, infants sleep for most of the 24 hours; during adolescence there is also an increase in the duration of sleep. Sleep requirements fall later in life, but there are wide genetic di?erences in the amount of sleep that people require and also the time at which they fall asleep most readily.
The internal clock can be disturbed by a variety of external factors which include irregular sleeping habits due, for instance, to shift work or jet lag. Sleep is also more likely to occur after physical exertion, reading and social activity. The duration and intensity of exposure to light can also modify sleep profoundly. Light promotes wakefulness and is the main factor that adjusts the 25-hour internal rhythm to the 24hour daily cycle. Neural connections from the retina of the EYE act on an area in the brain called the supra-chiasmatic nucleus which stimulates the pineal gland which produces MELATONIN. This is thought to trigger the range of neurological and metabolic processes that characterise sleep.... rapid-eye-movement (rem) sleep
Irritability and a shortened attention span may occur after a short night’s sleep.
Longer periods without sleep leave a person increasingly unable to concentrate or perform normal tasks.
Three or more sleepless nights may lead to hallucinations and, in some cases, to paranoia.... sleep deprivation
Vigorous respiratory movements are made to overcome the obstruction during each apnoea. These are associated with snoring and snorting noises. The apnoea ends with a mini-arousal from sleep. As a result, sleep becomes fragmented and sleep deprivation, manifested as sleepiness during the day, is common. This may result in accidents – for instance, at work or while driving – and sleep apnoea is also linked with an increased risk of STROKE, heart attacks and HYPERTENSION.
The diagnosis of sleep apnoea has recently been facilitated by linking specially designed software with ELECTROCARDIOGRAPHY performed during sleep, with minimal disturbance of the subject.
Initial treatment is directed at correcting the cause (e.g. obesity), but if the apnoeas persist or are severe a nasal mask and pump which introduces air under slight pressure into the upper airway (continuous positive airway pressure, CPAP) is almost invariably e?ective.... sleep apnoeas
Parasomnias These include medical disorders such as ASTHMA, ANGINA PECTORIS or EPILEPSY which are made worse by sleep, and a range of behavioural alterations which are usually related to a speci?c sleep stage or to a change from one state of sleep to another. Sleepwalking, night terrors, and nightmares are examples.
Insomnia Insomnia is de?ned as a di?culty in initiating or maintaining sleep. It affects around 15 per cent of the population at any one time, and is often due to a poor pre-sleep routine (e.g. taking excessive stimulants such as ca?eine); unsatisfactory sleep due to poor environments such as an uncomfortable bed or a cold or noisy bedroom; anxiety and/or depression; or occasionally to a physical problem – for example, pain – or a medical disorder associated with sleep such as obstructive SLEEP APNOEAS or periodic limb movements.
Excessive daytime sleepiness This is usually due to sleep deprivation caused either by inadequate duration of sleep, or by poor quality of sleep. The individual’s lifestyle is often a cause and modi?cation of this may relieve the problem. Other common causes of excessive daytime sleepiness are depression, obstructive sleep apnoeas, periodic limb movements, excessive alcohol or other drug intake, and, less commonly, NARCOLEPSY.... sleep, disorders of
Symptoms: Joint pains with feverishness, loss of weight, anaemia and red raised patches of skin on nose and face (butterfly rash). Swelling of the joints resembles rheumatoid arthritis. Chest and kidney disease possible. Personality changes with depression followed by mania and possible convulsions.
Treatment. Standard orthodox treatments: aspirin, steroids. Alternatives: Echinacea (rash), Valerian (mental confusion), Lobelia (chest pains), Parsley Piert (kidney function).
Tablets/capsules. Echinacea. Poke root. Dandelion. Valerian. Wild Yam. Prickly Ash bark.
Powders. Echinacea 2; Dandelion 1; Wild Yam half; Poke root quarter; Devil’s Claw half; Fennel half. Mix. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily. In water or cup of Fenugreek tea. Tinctures. Dandelion 4; Valerian 1; Prickly Ash half; Poke root half; Peppermint quarter. Mix. Dose: 1 teaspoon thrice daily, in water or cup Fenugreek tea.
Tincture. Queen’s Delight BHP (1983) 1:5 in 45 per cent alcohol. Dose 1-4ml (15-60 drops).
Topical. Plantain Salvo. Castor oil. Oil Cajeput or Sassafras. Comfrey or Chickweed cream.
Diet. Young girls may require diet for anaemia.
Supplementation. Daily. Vitamins A, B6, B12, C, D. Dolomite (1500mg). Calcium Pantothenate (500mg). Iron: Men (10mg), women (18mg). ... arthritis, lupus
They include benzodiazepines, antihistamines, antidepressants, and chloral hydrate.
Sleeping drugs may cause drowsiness and impaired concentration on waking.
Long-term use may induce tolerance and dependence.... sleeping drugs
Sleepwalking is usually calm and aimless, although it is sometimes more frantic when it occurs with night terror.
Some people regularly sleepwalk.
Sleepwalking in children is not normally a cause for concern and tends to disappear with age.
In adults, it may be related to anxiety or the use of sleeping drugs.... sleepwalking