Insomnia

Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep. It also can cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can drain your energy level and affect your mood. It also can affect your health, work performance and quality of life.

How much sleep is enough varies from person to person. But most adults need 7 to 9 hours a night.

At some point, many adults have short-term insomnia. This can last for days or weeks. Short-term insomnia is usually due to stress or a distressing event. But some people have long-term insomnia, also called chronic insomnia. This lasts for three months or more. Insomnia may be the main problem, or it may be related to other medical conditions or medicines.

You do not have to put up with sleepless nights. Simple changes in your daily habits often can help.

Symptoms

Insomnia symptoms may include:

• Having a hard time falling asleep at night.
• Waking up during the night.
• Waking up too early.
• Feeling tired or sleepy during the day.
• Feeling cranky, depressed or anxious.
• Having a hard time paying attention, focusing on tasks or remembering.
• Making more errors or having more accidents.
• Having ongoing worries about sleep.

When to see a doctor

If insomnia makes it hard for you to do daily activities, see your doctor or another primary care professional. Your doctor will search for the cause of your sleep problem and help treat it. If it’s thought that you could have a sleep disorder, your doctor might suggest going to a sleep center for special testing.

Causes

Insomnia may be the main problem or it may be related to other conditions.

Long-term insomnia is usually due to stress, life events or habits that disrupt sleep. While treating the cause of your sleep problem may stop your insomnia, sometimes it can last for years.

Common causes of long-term insomnia include:

• Stress. Concerns about work, school, health, money or family can keep your mind active at night, making it hard to sleep. Stressful life events, such as the death or illness of a loved one, divorce, or a job loss, also may lead to insomnia.
• Travel or work schedule. Your body’s “internal clock,” known as circadian rhythms, guides things such as your sleep-wake cycle, metabolism and body temperature. Disrupting these rhythms can lead to insomnia. Causes include feeling jet lag from traveling across multiple time zones, working a late or early shift, or changing shifts often.
• Poor sleep habits. Poor sleep habits include going to bed and waking up at different times each day, taking naps, being too active before bedtime and having a sleep area that is not comfortable. Other poor sleep habits include working, eating or watching TV while in bed. Using computers or smartphones, playing video games, or watching TV just before bed can disrupt your sleep cycle.
• Eating too much late in the evening. Having a light snack before bedtime is OK. But eating too much may cause you to feel uncomfortable while lying down. Many people also have heartburn. This is when stomach acid backs up into the tube that carries food from your mouth to your stomach. This tube is called the esophagus. Heartburn may keep you awake.
• Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Waking up too early can be a sign of depression. Insomnia often occurs with other mental health conditions.
• Medicines. Many prescription drugs can interfere with sleep, such as certain antidepressants and medicines for asthma or blood pressure. Many medicines available without a prescription, such as some pain medicines, allergy and cold medicines, and weight-loss products, contain caffeine and other stimulants that can disrupt sleep.
• Medical conditions. Examples of conditions linked with insomnia include ongoing pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson’s disease and Alzheimer’s disease.
• Sleep-related disorders. Sleep apnea causes you to stop breathing at times during the night, disrupting your sleep. Restless legs syndrome causes a strong uncomfortable urge to move your legs when trying to fall asleep. This may keep you from falling asleep or getting back to sleep.
• Caffeine, nicotine and alcohol. Coffee, tea, cola and other drinks that have caffeine are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can disrupt sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often results in waking up in the middle of the night.

Insomnia and aging

Insomnia becomes more common with age. As you get older, you may:

• Change your sleep patterns. Sleep often becomes less restful as you age, so noise or other changes in your surroundings are more likely to wake you. With age, your internal clock often moves forward in time, so you get tired earlier in the evening and wake up earlier in the morning. But older people typically still need the same amount of sleep as younger people.
• Change your level of activity. You may be less physically or socially active. A lack of activity can disrupt a good night’s sleep. Also, the less active you are, the more likely you may be to take a daily nap. Napping can disrupt sleep at night.
• Have changes in your health. Ongoing pain from conditions such as arthritis or back problems, as well as depression or anxiety, can disrupt sleep. Issues that make it more likely that you’ll need to urinate during the night, such as prostate or bladder problems, can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.
• Take more medicines. Older people typically use more prescription drugs than younger people do. This raises the chance of insomnia related to medicines.

Insomnia in children and teens

Sleep problems may be a concern for children and teenagers too. But some children and teens simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.

Risk factors

Nearly everyone has an occasional sleepless night. But you’re more likely to have insomnia if:

• You’re a woman. Changes in hormones during the menstrual cycle and in menopause may play a role. During menopause, night sweats and hot flashes often disrupt sleep. Insomnia also is common during pregnancy.
• You’re over 60. Because of changes in sleep patterns and health, it’s more likely you’ll have insomnia as you get older.
• You have a mental health or physical health condition. Many issues that affect your mental or physical health can disrupt sleep.
• You’re under a lot of stress. Being stressed can cause short-term insomnia. Major or long-lasting stress can lead to long-term insomnia.
• You do not have a regular schedule. For example, changing shifts at work or traveling can disrupt your sleep-wake cycle.

Complications

Sleep is as important to your health as a healthy diet and regular physical activity. Whatever is keeping you from sleeping, insomnia can affect you mentally and physically. People with insomnia report a lower quality of life compared with people who sleep well.

Complications of insomnia may include:

• Lower performance on the job or at school.
• Slowed reaction time while driving and a higher risk of accidents.
• Mental health conditions, such as depression, anxiety or substance misuse.
• Higher risk or worsening of long-term diseases or conditions, such as high blood pressure and heart disease.

Prevention

Good sleep habits like these can help prevent insomnia:

• Keep the time you go to bed and the time you wake up the same every day, including weekends.
• Stay active. Regular activity can lead to a good night’s sleep.
• Limit naps or do not nap at all.
• Limit or do not use caffeine, alcohol and nicotine.
• Do not eat large meals or drink a lot of fluids before bed.
• Make your bedroom comfortable for sleep and only use it for sex or sleep.
• Create a relaxing bedtime ritual, such as taking a warm bath, reading or listening to soft music.

Staying healthy involves a combination of medical care and a good diet. Here are some tips:

1)Regular Check-ups: Schedule routine check-ups with your healthcare provider to monitor your health and catch any issues early.

2)Stay Active: Engage in regular physical activity to maintain a healthy weight, improve cardiovascular health, and boost mood.

3)Eat a Balanced Diet: Consume a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. Limit processed foods, sugar, and sodium.

4)Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support bodily functions.

5)Get Adequate Sleep: Aim for 7-9 hours of quality sleep each night to support overall health and well-being.

6)Manage Stress: Practice stress-reducing techniques such as meditation, deep breathing, or hobbies you enjoy.

7)Limit Alcohol and Avoid Tobacco: Drink alcohol in moderation, if at all, and avoid smoking or using tobacco products.

8)Practice Good Hygiene: Wash your hands frequently, brush and floss your teeth regularly, and maintain good hygiene habits to prevent illness and infection.

9)Stay Informed: Stay informed about health recommendations and guidelines from reliable sources such as healthcare professionals or reputable organizations.

10)Listen to Your Body: Pay attention to your body’s signals and seek medical attention if you experience any concerning symptoms or changes in health.

Obesity is a medical condition characterized by an excess amount of body fat, which presents a risk to health. It is typically defined and measured by the Body Mass Index (BMI), which is a calculation based on height and weight. A BMI of 30 or higher is considered obese. Obesity increases the likelihood of developing various health issues, such as heart disease, type 2 diabetes, stroke, certain types of cancer, and osteoarthritis. It’s caused by a combination of factors, including genetics, dietary habits, physical activity levels, and environmental and psychological factors. Managing and preventing obesity involves a holistic approach, including dietary changes, increased physical activity, and sometimes medical intervention. 

Preventing obesity involves a multifaceted approach focusing on diet, physical activity, and behavioral changes. Here are some key strategies:

1. **Healthy Eating Habits:**

   – **Eat Balanced Meals:** Focus on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats.

   – **Control Portions:** Pay attention to portion sizes to avoid consuming too many calories.

   – **Limit Sugar and Processed Foods:** Reduce intake of foods high in added sugars and processed foods that are high in calories and low in nutrients.

2. **Regular Physical Activity:**

   – **Stay Active:** Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week, along with muscle-strengthening exercises on two or more days a week.

   – **Incorporate Activity into Daily Life:** Take the stairs, walk or bike instead of driving, and stand up regularly if you have a sedentary job.

3. **Behavioral Changes:**

   – **Mindful Eating:** Pay attention to what and when you eat. Try to eat slowly and only when you’re actually hungry.

   – **Sleep Well:** Ensure adequate sleep as lack of sleep can affect hormones that regulate hunger and appetite.

   – **Stress Management:** Find healthy ways to manage stress, such as through exercise, meditation, or hobbies, rather than eating.

4. **Preventive Healthcare:**

   – **Regular Check-ups:** Regular visits to a healthcare provider can help monitor your health status and prevent the onset of obesity-related conditions.

   – **Health Education:** Understanding the risks of obesity and being informed about healthy lifestyles can empower individuals to make healthier choices.

5. **Community and Environment:**

   – **Supportive Environments:** Advocate for environments that support healthy living, such as safe parks for physical activity and access to healthy foods.

   – **Policy and Public Health Initiatives:** Support policies that promote nutritional education, physical activity, and equitable access to healthy food options.

Combating obesity is not just about individual actions; it also requires support from communities and policymakers to create environments that facilitate healthy choices and lifestyles.

Listeriosis is a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes. An estimated 1,600 people get listeriosis each year, and about 260 die. The infection is most likely to sicken pregnant women and their newborns, adults aged 65 or older, and people with weakened immune systems.

Signs and symptoms of Listeria infection vary depending on the person infected and the part of the body affected.

The bacteria are most likely to sicken people who are pregnant and their newborns, adults aged 65 or older, and people with weakened immune systems. Other people can be infected with Listeria, but they rarely become seriously ill.

Invasive illness

Invasive means bacteria have spread beyond the intestines (gut). Invasive listeriosis happens when Listeria have spread beyond the intestines.

Symptoms of invasive illness usually start within 2 weeks after eating food contaminated with Listeria.

Symptoms of invasive illness

People who are pregnant

Symptoms typically include

• Fever
• Flu-like symptoms, such as muscle aches and fatigue

People who are not pregnant

Symptoms typically include

• Fever
• Flu-like symptoms, such as muscle aches and fatigue
• Headache
• Stiff neck
• Confusion
• Loss of balance
• Seizures

Severity of invasive illness

People who are pregnant

• Symptoms in pregnant people are usually mild. Some pregnant people never have symptoms.
• However, infection during pregnancy usually leads to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.

People who are not pregnant

• Symptoms in non-pregnant people can be severe.
• Almost 1 in 20 non-pregnant people with invasive listeriosis die.

Intestinal illness

Listeria can also cause an intestinal illness. This kind of illness is rarely diagnosed because laboratories do not regularly test patient stool (poop) samples for Listeria.

Symptoms of intestinal illness usually start within 24 hours after eating food contaminated with Listeria and usually last 1–3 days.

Symptoms of intestinal illness

Symptoms typically include

• Diarrhea
• Vomiting

Severity of intestinal illness

• Symptoms are usually mild.
• However, some people with intestinal illness develop invasive illness.

Diagnosis and Treatment

Listeriosis is usually diagnosed when a bacterial culture (a type of laboratory test) grows Listeria from a body tissue or fluid, such as blood, spinal fluid, or the placenta.

Treatment

Invasive illness: People with an invasive illness are treated with antibiotics. 

Intestinal illness: Most people recover from intestinal illness without antibiotic treatment. Antibiotics are needed only for patients who are very ill or at risk of becoming very ill. People who have an intestinal illness should drink extra fluids while they have diarrhea.

Prevent Listeria

Listeria is a harmful germ that can be in food. Find out which foods are more likely to be contaminated with Listeria and ways you can protect your health and the health of your loved ones.

Choose safer foods

Listeria is especially harmful for some people:

• Older adults (65 and older)
• People who have weakened immune systems (have health problems or take medicines that lower the body’s ability to fight germs and sickness)
• Pregnant people and newborns

If you are in any of these groups, choose safer foods to protect your health or your pregnancy:

Do not eat

Choose these instead

Eat this, not that

• Unpasteurized soft cheeses, such as queso fresco and brie •Unheated cheeses sliced at a deli	• Hard cheeses, such as cheddar and parmesan •Cottage cheese, cream cheese, string cheese, feta, and mozzarella •Pasteurized soft cheeses heated to an internal temperature of 165°F or until steaming hot •Deli-sliced cheeses heated to 165°F or until steaming hot
• Unheated deli meat, cold cuts, hot dogs, and fermented or dry sausages	• Deli meat, cold cuts, hot dogs, and fermented or dry sausages reheated to 165°F or until steaming hot
• Premade deli salads, such as coleslaw and potato, tuna, or chicken salad	• Homemade deli salads
• Refrigerated pâté or meat spreads	• Pâté or meat spreads in sealed, airtight containers that don’t need to be kept refrigerated before opening
• Refrigerated smoked fish	• Smoked fish in sealed, airtight packages or containers that don’t need to be kept refrigerated before opening •Smoked fish cooked in a casserole or other cooked dishes
• Raw or lightly cooked sprouts	• Sprouts cooked until steaming hot
• Cut melon left out for more than 2 hours (1 hour if it’s exposed to temperatures hotter than 90°F, such as a picnic or hot car) •Cut melon in refrigerator for more than a week	• Melon that has just been cut
• Raw (unpasteurized) milk, yogurt, and ice cream	• Pasteurized milk, yogurt, and ice cream

Because of recent outbreaks, CDC is currently working to understand the risk of Listeria infection from enoki mushrooms. While this work is happening, CDC advises people who are pregnant, aged 65 or older, or have a weakened immune system to not eat raw enoki mushrooms. Instead, cook enoki mushrooms thoroughly, and ask that restaurants cook them thoroughly.

Foods more likely to be contaminated with Listeria

Listeria is a hardy germ that can be difficult to fully remove from food processing facilities. If a facility has Listeria germs, the germs can spread to food that touches contaminated equipment or surfaces. Listeria can also spread from contaminated food to surfaces. It can even grow on foods kept in the refrigerator. The good news is that Listeria is easily killed by heating food to a high enough temperature.

Find out why some foods are more likely to be contaminated with Listeria and learn about recent outbreaks linked to these foods.

Soft cheeses, such as queso fresco and brie

Soft cheeses are more likely than hard cheeses to be contaminated with Listeria because of their high moisture, low salt content, and low acidity. These conditions support the growth of Listeria. Soft cheeses made with unpasteurized milk or made in facilities with unclean conditions are even more likely to be contaminated. Although pasteurizing milk kills germs, cheese made with pasteurized milk can still get contaminated during cheese-making.

Soft cheeses include queso fresco, queso blanco, queso panela, brie, camembert, and blue-veined.

Hard cheeses include asiago, cheddar, emmental, gruyere, parmesan, and swiss cheese.

Meats, cheeses, and salads from the deli

Products sold at the deli, especially those sliced or prepared at the deli, can be contaminated with Listeria. Listeria spreads easily among deli equipment, surfaces, hands, and food. Deli products are kept refrigerated, but refrigeration does not kill Listeria.

Examples of deli salads include coleslaw, potato salad, tuna salad, and chicken salad.

Deli meats, cold cuts, hot dogs, and fermented or dry sausages

Deli meats, cold cuts, hot dogs, and fermented or dry sausages can be contaminated with Listeria when they are made or prepared at facilities where Listeria persists. Although cooking, fermenting, or drying kills germs, these meats can get contaminated afterwards if they touch surfaces with Listeria. Refrigeration does not kill Listeria, but reheating before eating will kill any germs that may be on these meats.

Examples of fermented or dry sausages include chorizo, pepperoni, salami, and summer sausage.

Pâté or meat spreads

Refrigerated pâté or meat spreads can become contaminated with Listeria when they are made in a facility where Listeria persists. Refrigeration does not kill Listeria.

A safer choice is “shelf-stable

” pâté or meat spreads. These are heat-treated to kill any germs and sealed in airtight containers (such as cans, tins, or glass jars). They don’t need to be refrigerated before opening.

Cold-smoked fish

Cold-smoked fish can become contaminated with Listeria when it is made in a facility where Listeria persists. The cold-smoking process does not kill Listeria. Refrigeration also does not kill Listeria.

Safer choices are “shelf-stable

” smoked fish or cooked smoked fish. Shelf-stable smoked fish are heat-treated to kill any germs and sealed in airtight containers or packages that don’t need to be refrigerated before opening. Cooking smoked fish also kills any germs that may be in it.

Cold-smoked fish products are often labeled as “nova-style,” “lox,” “kippered,” “smoked,” or “jerky.”

Sprouts

Sprouts need warm and humid conditions to grow. These conditions are also ideal for the growth of Listeria and other harmful germs. Germs can grow on the inside and outside of sprouts, so washing them does not remove all germs. Homegrown sprouts can also have germs because they need the same conditions to grow.

Melons

Melons are more likely than many other fruits to be contaminated with Listeria. This is because they have low acidity and can be kept in the refrigerator for a long time. Both these conditions support the growth of Listeria.

Raw (unpasteurized) milk and raw milk products

Raw milk is milk that has not been pasteurized. Pasteurization heats milk to a high enough temperature for a long enough time to kill germs that can make you sick.

Raw milk and products made from it – including ice cream and yogurt – can contain Listeria and other harmful germs. These germs can get into raw milk in multiple ways, including unclean conditions at the dairy farm and contact with animal poop.

CDC recommends that everyone choose pasteurized milk and dairy products.

People at Risk

CDC estimates that Listeria is the third leading cause of death from foodborne illness, or food poisoning, in the United States. An estimated 1,600 people get sick from Listeria each year, and about 260 die.

Listeria is most likely to sicken pregnant women and their newborns, adults aged 65 or older, and people with weakened immune systems. Other people can be infected with Listeria, but they rarely become seriously ill.

Who has a greater chance of Listeria infection?

Pregnant Hispanic women are 24 times more likely than the general population to get Listeria infection.

Las mujeres hispanas embarazadas tienen 24 veces mayor que la población general de contraer la infección por Listeria.

The common cold is an illness affecting your nose and throat. Most often, it’s harmless, but it might not feel that way. Germs called viruses cause a common cold.

Often, adults may have two or three colds each year. Infants and young children may have colds more often.

Most people recover from a common cold in 7 to 10 days. Symptoms might last longer in people who smoke. Most often, you don’t need medical care for a common cold. If symptoms don’t get better or if they get worse, see your health care provider.

Illnesses of the nose and throat caused by germs are called upper respiratory tract infections.

Symptoms

Most often, common cold symptoms start 1 to 3 days after someone is exposed to a cold virus. Symptoms vary. They can include:

• Runny or stuffy nose.
• Sore or scratchy throat.
• Cough.
• Sneezing.
• Generally feeling unwell.
• Slight body aches or a mild headache.
• Low-grade fever.

The mucus from your nose may start out clear and become thicker and yellow or green. This change is normal. Most often, it doesn’t mean that you have a bacterial illness.

When to see a doctor

For adults. Most often, you don’t need medical care for a common cold. But see your health care provider if you have:

• Symptoms that get worse or do not get better.
• Fever greater than 101.3 degrees Fahrenheit (38.5 degrees Celsius) that lasts more than three days.
• Fever returning after a fever-free period.
• Shortness of breath.
• Wheezing.
• Intense sore throat, headache or sinus pain.

For children. Most children with a common cold don’t need to see a health care provider. Get medical care right away if your child has any of the following:

• Fever of 100.4 degrees Fahrenheit (38 degrees Celsius) in newborns up to 12 weeks.
• Rising fever or fever lasting more than two days in a child of any age.
• More-intense symptoms, such as headache, throat pain or cough.
• Trouble with breathing or wheezing.
• Ear pain.
• Fussiness or drowsiness that isn’t typical.
• No interest in eating.

Causes

Many viruses can cause a common cold. Rhinoviruses are the most common cause.

A cold virus enters the body through the mouth, eyes or nose. The virus can spread by:

• Droplets in the air when someone who is sick coughs, sneezes or talks.
• Hand-to-hand contact with someone who has a cold.
• Sharing objects with the virus on them, such as dishes, towels, toys or telephones.
• Touching your eyes, nose or mouth after contact with the virus.

Risk factors

These factors can increase the chances of getting a cold:

• Age. Infants and young children have a greater risk of colds than other people, especially if they spend time in child care settings.
• Weakened immune system. Having a long-term illness or weakened immune system increases your risk.
• Time of year. Both children and adults are more likely to get colds in fall and winter.
• Smoking. Smoking or being around secondhand smoke increases the risk of catching a cold.
• Exposure. Being in crowds, such as at school or on an airplane, increases the chance of getting a cold.

Complications

These conditions can occur along with your cold:

• Middle ear infection. This is the swelling and build-up of fluids in the space behind the eardrum. It may be caused by a virus or bacteria. Typical signs and symptoms include earaches or the return of a fever following a common cold.
• Asthma. A cold can trigger wheezing, even in people who don’t have asthma. For people with asthma, a cold can make it worse.
• Sinusitis. In adults or children, a common cold that lasts a while can lead to swelling and pain in the sinuses. These are air-filled spaces in the skull above the eyes and around the nose. A virus or bacteria may cause sinusitis.
• Other illnesses. A common cold can lead to illnesses of the lungs, such as pneumonia or bronchitis. People with asthma or weakened immune systems have an increased risk of these conditions.

Prevention

There’s no vaccine for the common cold. You can take these steps to slow the spread of the virus and prevent illness:

• Wash your hands. Wash your hands well and often with soap and water for at least 20 seconds. If soap and water aren’t available, use an alcohol-based hand sanitizer with at least 60% alcohol. Teach your children the importance of hand-washing. Try not to touch your eyes, nose or mouth with unwashed hands.
• Clean and disinfect. Clean and disinfect surfaces that are touched often. These include doorknobs, light switches, electronics, and kitchen and bathroom countertops. This is especially important when someone in your family has a cold. Wash children’s toys often.
• Cover your cough. Sneeze and cough into tissues. Throw away used tissues right away, and then wash your hands. If you don’t have a tissue, sneeze or cough into the bend of your elbow, and then wash your hands.
• Don’t share. Don’t share drinking glasses or silverware with other family members.
• Stay away from people with colds. Avoid close contact with anyone who has a cold. Stay out of crowds when possible. Try not to touch your eyes, nose and mouth when you’re in crowds.
• Review your child care center’s policies. Look for a child care setting with good hygiene practices and clear policies about keeping sick children at home.
• Take care of yourself. Eat well, exercise and get plenty of sleep to help you stay healthy.