New Year’s resolutions: How to boost success rates


Do we make New Year’s resolutions just to ignore them? Are they merely promises doomed to fail? In this feature, we ask whether, statistically speaking, these resolutions work, and what increases the chances of success.

New Year’s resolutions are an ancient tradition that continues to this day.

The Babylonians started each year with pledges to pay debts and return borrowed items.

The Romans began their year by promising the two faced god, Janus, that they would behave better.

In modern societies, many people still promise to make changes as the new year dawns; this desire, in many cases, is fueled by the excesses of the holiday period.

Most commonly, it would seem, New Year’s resolutions revolve around weight loss, quitting smoking, reducing drinking, and exercising more.

How effective are annual resolutions?

A study from 1989 tracked 200 people living in Pennsylvania as they attempted to make changes based on New Year’s resolutions.

On average, the participants made 1.8 resolutions, most commonly, to stop smoking or lose weight. Less frequently, people pledged to improve relationships, and a surprisingly low 2.5% were hoping to control their drinking habits.

An impressive 77% managed to hold to their pledges for 1 week, but the success rate dropped to 19% over 2 years. Although that is a substantial drop out rate, it means that 1 in 5 of those participants achieved their goal.

Of the 77% successful resolvers, more than half slipped at least once, and, on average, people slipped 14 times across the 2 years.

A study in the Journal of Consulting and Clinical Psychology in 1988 followed the efforts of 153 New Year’s resolvers who were determined to quit smoking.

At 1 month, 77% of participants had managed at least one 24-hour period of abstinence. Overall, though, the results seemed a little disappointing with the authors writing:

“Only 13% of the sample was abstinent at 1 year, and 19% reported abstinence at the 2-year follow-up.”

Another study, appearing in PLOS ONE, took a more general look at behavior. The research team tracked the food shopping habits of 207 households from July 2010 to March 2011.

Unsurprisingly, the researchers found that, during the holiday period, expenditure increased by 15%. Three-quarters of this increase went on less healthful items.

Also, as expected, when January rolled around, the sale of healthful items shot up by 29.4%.

However, the sale of less healthful items did not drop in tandem with this health drive — people were buying more nutritious items, but still purchasing the same amount of unhealthful food.

Overall, the number of calories they purchased in the New Year was higher than during the holiday period. The authors conclude:

“Despite resolutions to eat more healthfully after New Year’s, consumers may adjust to a new ‘status quo’ of increased less-health[ful] food purchasing during the holidays, and dubiously fulfill their New Year’s resolutions by spending more on health[ful] foods.”

The authors believe that the key to successful resolutions is to focus on replacing unhealthful items with healthful ones, rather than buying both.

That is sound advice, but not necessarily easy to implement.

Successes and failures of weight loss goals

In 2009, GlaxoSmithKline released Orlistat, which they hailed as “the first clinically proven over-the-counter weight loss aid” in Europe.

As part of their marketing push, the company also conducted an internet survey about weight loss that included questions about New Year’s resolutions.

Although the survey was not meant to be a scientific study, it generated a substantial pool of data with 12,410 females from six European countries responding.

A group of researchers took advantage of this dataset and published an analysis in the journal Obesity Facts.

They found that around half of the women had made a weight loss New Year’s resolution in the past 2 years.

As for success rates, they observed that women with a body mass index (BMI) of under 25, which health experts define as “normal,” were successful 20% of the time.

However, of thos with a BMI of 30 or above — which doctors class as overweight or obese — only 9% reported some success.

In the overweight group, three-quarters of the female respondents said that their primary reason for failing to lose weight was that it took too long to see results. Around one-third of those who were obese or overweight stated that they were not successful due to a lack of confidence.

What increases the chances of succeeding?

In the Pennsylvania study we mention above, the scientists found no link between success rate and participants’ sex or age; similarly, the type of resolution did not influence how likely they were to succeed.

The researchers contacted participants by telephone after 1 week, 1 month, 3 months, 6 months, and 2 years.

During these interviews, the researchers also asked participants what techniques they used to help them keep their resolutions, and how often they implemented each one.

They found that the most successful resolvers were applying stimulus control at all five checkpoints.

Stimulus control is the act of keeping things around you that remind you why you chose the resolution.

For instance, someone who is quitting smoking might keep a picture of their young child nearby to remind them why they decided to stop.

At the 6-month and 2-year mark, successful resolvers were using self-liberation (or willpower), and reinforcement management — rewarding themselves for being successful.

Conversely, individuals who did not keep their resolutions most commonly employed self-blame and wishful thinking.

The study we highlighted above that followed the fates of 153 smokers also looked at factors that made quitting more likely. The authors explain:

“The use of multiple strategies for cessation was associated with abstinence at the 2-year follow-up. A strong motivation to quit was found to be important for both initial success and long-term maintenance.”

Other studies that have investigated smoking cessation more generally have identified factors that increase the chance of quitting. These factors include staying away from smokey environments, abstaining from alcohol, stress management techniques, and will power.

Another paper took a different approach. Publishing their work in the Journal of Clinical Psychology, the authors set out to understand why some people succeeded where others failed.

To do this, they recruited two sets of participants: 159 New Year’s resolvers and 123 people who were interested in solving a problem at a later date. The researchers followed the participants for 6 months and charted their successes and failures.

In agreement with other studies, the most common reasons for New Year’s resolutions were losing weight, increasing exercise, and quitting smoking.

The authors found that the most successful resolvers used more willpower, stimulus control, reinforcement management, positive thinking, and avoidance strategies.

Conversely, those who were less successful tended to use more wishful thinking, blame and criticize themselves, and make light of the problem.

Ending on a high

Some of the results above might cast a shadow across ambitions to make a change in 2020, but they shouldn’t.

The authors of the study above made some overarching conclusions that should boost the confidence of any New Year’s resolver:

“Resolvers reported higher rates of success than nonresolvers; at 6 months, 46% of the resolvers were continuously successful compared to 4% of the nonresolvers.”

So, although the cards might be stacked against anyone who plans to make a New Year’s resolution, simply by making that resolution, you have boosted your odds of success.

According to this data, forming a New Year’s resolution increases your chances of generating change more than 10-fold.

The authors write that, “Contrary to widespread public opinion, a considerable proportion of New Year resolvers do, in fact, succeed, at least in the short run.”

In conclusion, New Year’s resolutions do not work for everyone. But, as the saying goes, “you’ve got to be in it to win it.”

If you are considering making a resolution for 2020, according to the findings of these studies, the best approach is to keep things around you to remind you why you want to make those changes.

Also, reward yourself for successes, and stay motivated. Throw a healthful dose of willpower into the seasonal mix, and you are likely to succeed. Good luck!

A new study identifies a link between vaping and depression.

A recent study concludes that people who smoke electronic cigarettes are twice as likely to report clinical depression as those who have never vaped. The correlation was particularly strong among younger people.

Known as vaping, battery-powered e-cigarettes use heat to deliver an aerosol cocktail of nicotine and flavors to the user. An e-cigarette produces a small cloud of vapor, whereas a cigarette releases smoke.

Many people believe that the vapor contains water. In fact, it contains varying amounts of toxic chemicals that have links to heart and respiratory diseases, as well as cancer.

The use of e-cigarettes in the United States has snowballed since their introduction a decade ago.

According to the Annals of Internal Medicine

in 2016, an estimated 10.8 million people in the U.S. used e-cigarettes. Of this number, 2.8 million (9.2%) were 18–24 years old.

Today, some experts consider vaping to be an epidemic among teenagers — the number of high school students who turned to vaping doubled in 2018.

Although links between traditional cigarettes and depression primarily prompted the study, the results of an earlier study that indicated that 9.1% of those with depression were e-cigarette users, compared with 4.5% among the general population was also a factor.

First author of the study, Dr. Olufunmilayo Obisesan of John Hopkins University in Baltimore, MD, told Medical News Today that “Combustible cigarette smoking has been linked with an increased risk of developing major depressive disorder and has also been shown to be highly predictive of future suicidal behavior among individuals with a history of depression.”

“In light of the similarities in some of the constituents of cigarettes and e-cigarettes, we decided to explore the existence of a similar association between e-cigarettes and depression.”

Concerns for youngsters who vape

The study looked at the responses of nearly 900,000 randomly sampled adults aged 18 and older in a cross-sectional study of 2016–2017 data gathered by the Behavioral Risk Factor Surveillance System (BRFSS)

The BRFSS is the largest national telephone survey carried out in the U.S.

“The researchers found that 34% of current e-cigarette users reported having experienced clinical depression, compared with 15% of those who had never vaped. Also, 27% of former users were more likely to report clinical depression, compared with 15% in those who had never used e-cigarettes.

College students aged 18–25 showed the most significant link between e-cigarette use and depression.

The scientists focused on this group in particular because, typically, young people are more likely to experiment with new products, such as e-cigarettes. Tobacco companies often target this demographic in marketing campaigns.

“This highlights the potential susceptibility of e-cigarette users in this group to depression at a particularly vulnerable time in their lives, but also warrants pause in what this kind of nicotine addiction may be doing to our children, high schoolers, and younger, who we know are using e-cigarettes in epidemic proportions,” says Dr. Mariell Jessup of the American Heart Association’s (AHA) Tobacco Center of Regulatory Science.

The AHA has launched a major initiative to tackle youth e-cigarette use and nicotine addiction.

“The main implication of our findings for the youth is that they need to know that there are potential mental health effects associated with the use of e-cigarettes.”

Dr. Olufunmilayo Obisesan

Depression risk rises with increased use

The study also found that the link between e-cigarette use and depression was stronger in people who vaped the most often.

“Clinically, our study provides information that physicians could consider when counseling patients seeking information about e-cigarettes, especially those with depression,” Dr. Obisesan told MNT.

He added that the study emphasized the need for doctors and health professionals to routinely collect information on e-cigarette from individuals during clinic visits, especially among those with mental health conditions. In conclusion, Dr. Obisesan told MNT:

“We hope that our study will provide a baseline for future longitudinal studies that can confirm our findings and establish the direction of association between e-cigarette use and depression, which we currently believe to be bi-directional.”

New evidence suggests that being physically active could help slash prostate cancer risk.

Researchers using a new method of assessing risk factors for prostate cancer have found an intriguing link between a lack of physical activity and an increased risk of this condition.

According to data from the National Cancer Institute (NCI), by the end of 2019, there will have been an estimated 174,650 new cases of prostate cancer in the U.S. alone.

Despite the number of people that this cancer affects every year, specialists still have insufficient knowledge about the risk factors that may play a role in its development.

The NCI cite a mix of modifiable and nonmodifiable factors, including age, a family history of prostate cancer, and the levels of vitamin E, folic acid, and calcium in the body.

Yet there may be other lifestyle-related factors at play, and investigators are hard at work to uncover them.

Recently, a team of researchers from the University of Bristol and Imperial College London in the United Kingdom — alongside colleagues from other academic institutions across the globe — have used a different approach to try to find out more about prostate cancer risk factors.

In their new study, the findings of which now appear in the International Journal of Epidemiology, the investigators used a method called “Mendelian randomization.”

Mendelian randomization

allows researchers to look at genetic variations to assess causal relationships between various potential risk factors and the development of certain outcomes — in this case, prostate cancer.

Physical activity may more than halve risk

In their study, the researchers identified potential risk factors for prostate cancer through the World Cancer Research Fund’s (WCRF) 2018 systematic review of the evidence.

They also had access to the medical information of 79,148 participants with prostate cancer, as well as 61,106 participants without cancer who acted as the controls.

The analysis revealed that individuals with a genetic variation that increased their likelihood of being physically active had a 51% lower risk of prostate cancer than people who did not have this genetic variation.

Moreover, the researchers explain that “physical activity,” in this case, refers to all forms of activity, not just exercise.

Following on from this, the study authors conclude that interventions encouraging males to ramp up their levels of physical activity may have a protective effect against this widespread form of cancer.

“This study is the largest-ever of its kind, which uses a relatively new method that complements current observational research to discover what causes prostate cancer,” notes study co-author Sarah Lewis, Ph.D.

“It suggests that there could be a larger effect of physical activity on prostate cancer than previously thought, so will hopefully encourage men to be more active.”

Sarah Lewis, Ph.D.

Anna Diaz Font, who is head of research funding at WCRF — which, alongside Cancer Research U.K., funded this study — emphasizes the importance of the current findings.

“Up till now, there has only been limited evidence of an effect of physical activity on prostate cancer. This new study looked at the effect of 22 risk factors on prostate cancer, but the results for physical activity were the most striking,” she says.

The study’s findings, Diaz Font believes, “will pave the way for even more research, where similar methods could be applied to other lifestyle factors, to help identify ways men can reduce their risk of prostate cancer.”

What is the difference between cold and flu?


Both flu (influenza) and cold are caused by viruses, and they can have similar symptoms. So how do we know if a person has the flu or a bad cold? In this article, we explain the differences.

Cold and influenza are the most common illnesses in humans.

. Every year, 5-20 percent of the population of America develop flu symptoms.

The main difference between cold and flu is that, generally, symptoms of the flu are usually a lot more severe.

Each year, more than 200,000 people are hospitalized because of flu complications; flu is responsible for around 23,600 deaths every year.

Fast facts on colds vs. flu:

  • Colds and flu share many of the same symptoms; the major difference being flu is often worse, and accompanied by a high fever.
  • According to the Centers for Disease Control and Prevention (CDC), the average adult will have 2-3 colds every year.
  • The rhinovirus is the most common cause of cold.

The difference between cold and flu

Cold and flu are caused by different viruses, and, in general, the symptoms of flu are worse. Also, there are less likely to be serious complications from cold, such as pneumonia and bacterial infections.

The main difference between cold and flu symptoms is that flu more commonly includes fever; the fever can be 100 degrees Fahrenheit or higher and last for 3-5 days.

The extreme fatigue associated with flu can persist for weeks. Cold symptoms are generally milder and last about 1 week.

Also, runny nose or nasal congestion is more common with cold than flu.

Vomiting is another key difference; vomiting is not normally associated with the common cold but can be present in flu.

Although the differences above are generally true, without conducting special tests, it is impossible to know for sure whether it is flu or cold. For instance, it is possible to have flu without fever.

What is a cold?

Almost everybody is familiar with the sensation of having a cold. Colds affect both warm and cool climates equally, and the average person will have had many colds from infancy all the way until later life.

Symptoms include a runny nose, sore throat, coughing and sneezing, watery eyes, a headache, and body aches. There is no cure, except for resting and drinking plenty of fluids, but the cold should pass within 7-10 days.

There is normally no need to visit a doctor, but a person with a weakened immune system is more prone to developing pneumonia as a complication

To avoid catching or spreading a cold, people should wash their hands regularly and make sure they sneeze into a tissue or handkerchief, or into their elbow. This is the most hygienic as it stops the spread of germs, which cannot live on clothing or surfaces like they can on skin.

What is flu?

There are three types of flu virus, influenza A, influenza B, and influenza C. Types A and B are the ones that cause seasonal epidemics. One of the key symptoms of flu is feeling feverish or having a temperature of 100 degrees Fahrenheit or above. However, not everyone with the flu will have a fever.

Other symptoms include:

  • headaches or body aches
  • vomiting, nausea, and possibly diarrhea, especially in children
  • a sore throat and a cough
  • fatigue
  • chills and shivering
  • a congested or runny nose

A common cold is less likely to cause a high fever. With a cold, symptoms such as a runny nose or throat irritation will normally improve within a few days.

How to treat flu

The CDC note that the majority of people who have the flu do not need medical attention. Most can remain at home and avoid contact with other people to prevent the disease from spreading. However, the following treatments are available:

  • Over-the-counter medications – these can reduce fever. Tylenol can help people with flu feel more comfortable while they recover. Tylenol is also available to purchase online.
  • Prescription antiviral flu drugs – these are also available from a physician. They are for people who are at high risk of serious complications and are not normally necessary for effective treatment. They can only be given within a certain amount of time from symptom onset.
  • Home remedies – to alleviate symptoms, home remedies such as steam inhalation, nourishing foods like chicken soup, keeping warm, and other comfort measures can be used.

A physician will be able to decide if antivirals are needed. People who tend to be at greater risk include infants under the age of 2, people aged 65 years and older, and pregnant women.

Emergency warning signs for flu

Patients should seek medical help if they notice any of the emergency warning signs.

Warning signs in infants include difficulty breathing, having no appetite, and not producing tears when they cry, or having fewer wet diapers than usual.

Severe symptoms in older children include:

  • breathing problems
  • bluish skin color
  • not drinking enough fluids
  • not waking up or interacting
  • being so irritable that they do not want to be held
  • fever with a rash

If flu-like symptoms improve but then return with fever and a worse cough, the parent should consult a physician.

Anti-flu vaccines and other types of protection

The best way to protect against the flu is by having an annual vaccination, as this helps the body to build up the immune system so that it can fight off the virus more quickly.

The flu vaccine is recommended during pregnancy as it has been proven safe. If flu occurs during pregnancy, it can have serious complications for the unborn child and the mother.

Vulvodynia: What you need to know


Vulvodynia and vestibulodynia refer to a chronic discomfort of the vulva, the part of a woman’s body that protects the genitals.

It includes the external female genitalia, including the mons pubis, the labia majora and minora, the clitoris, and the perineum.

Vulval pain can happen for a number of reasons, but vulvodynia and vestibulodynia are specifically linked to a hypersensitivity of the nerve endings in the skin.

Around 16 percent of women are estimated to have experienced pain or stinging in the vulval area at some time in their life.

Treatment

Treatment aims to alleviate symptoms. As the cause is unknown, finding a solution that works may take some trial and error.

Medications to block pain may include antidepressants, anticonvulsants, or serotonin-norepinephrine reuptake inhibitors (SNRIs).

Other solutions include creams, lotions, and anesthetic gel for applying to the vulval area.

Examples include topical hormone creams containing estrogen and testosterone, topical anesthetics, such as lidocaine, and products that contain an antidepressant or anticonvulsant ingredient. These can be applied 15 to 20 minutes before sexual activity, or when needed. Some of these products are available for purchase online, including lidocaine.

A nerve block is an anesthetic drug that is injected into the nerves that transmit pain signals, in this case, from the vulva to the spine. Interrupting the pain signals in this way can provide short-term relief.

If no other method is effective, surgery to remove the painful tissue may be appropriate.

Two techniques that are currently being investigated are neurostimulation and the spinal infusion pump.

Neurostimulation involves delivering low-voltage electrical stimulation to a specific nerve. This can replace pain with a tingling sensation.

A spinal infusion pump is an implanted device that can deliver low-dose medication to the spinal cord and nerve roots. This can dull pain.

However, there is limited evidence regarding the use of these measures for vulvodynia.

Some researchers have found that physical and psychosexual therapy can help improve sexual functioning, for example, by helping to reverse a fear of touch.

Symptoms

Vulvodynia features a burning, stinging, itching, irritating, or a raw feeling in the vulvar tissue, which may or may not appear inflamed. Patients may describe a feeling of throbbing, itching, aching, soreness, and swelling.

The pain can affect a particular spot, or it may be felt in a wider area, including the clitoris, the perineum, the mons pubis, and the inner thighs. It can also affect the area around the urethra and the top of the legs and inner thighs.

The pain involved in vulvodynia is neuropathic, which means it stems from abnormal signals from the nerve fibers in the vulval area. The nerve endings are hypersensitive.

It may be constant or intermittent. A constant pain that happens when there is no touch or pressure is known as unprovoked vulvodynia.

Vestibulodynia, previously known as vestibulitis, involves a pain that is triggered by light touch, or provoked pain.

Symptoms may be worse during or after sexual intercourse, walking, sitting, or exercising. It can happen when inserting a tampon, or when prolonged pressure is applied, for example, during horseback riding.

Vulvodynia is usually defined as lasting for at least 3 months. It often starts suddenly, and it may last for months or years. It is not life-threatening, but the pain can prevent the individual from carrying out some normal activities. This can also lead to upset or depression.

Complications

Relationship problems can result, because sexual intercourse is painful. One study suggests that 60 percent of women with vulvodynia are unable to engage in sex.

Studies suggest

that women who have vulvodynia can have a normal pregnancy, and that in some cases, pain levels fall during pregnancy. However, women with the condition are more likely to have a cesarean delivery.

Home remedies

Some measures can be taken that do not involve medications.

If vulvodynia occurs, the first step is to stop using any irritants, such as perfumed soaps. A change in menstrual products might help, for example, switching from synthetic to cotton-based items.

Cool gel packs may offer immediate, short-term pain relief. A range of cool gel packs is available for purchase online.

Pelvic floor muscle exercises may help by relaxing tissues in the pelvic floor and releasing tension in muscles and joints.

Biofeedback uses technology to increase an individual’s awareness of how they might be stressing their body. This information can help people change habits that lead to harm or discomfort. For women with vulvodynia, it can help strengthen the pelvic floor muscles, and this may reduce pain.

A trigger point is a specific area of discomfort. Trigger-point therapy involves massaging a small area of tightly contracted muscle to release tension and relieve pain. An anesthetic medication applied directly, for example, as a cream, can also be used to relieve pain in a trigger point.

Since stress can play a role in vulvodynia, either as a trigger or a consequence, stress management may help ease symptoms.

Acupuncture and cognitive behavior therapy are options currently being explored.

Diet

A change in diet may help. Cutting out one food at a time may help to pinpoint a trigger.

Items that commonly trigger a reaction include:

  • caffeine
  • high-sugar foods
  • acidic foods
  • processed foods

Causes

Vulvar pain can be caused by infections, neurological problems, inflammatory conditions, and neoplasms, such as squamous cell carcinoma.

Vulvodynia is not related to an underlying condition. The exact cause is unknown. It is not caused by a sexually transmitted or other infection, skin disease, or cancer, although these can also cause pain.

Factors that may raise the risk of vulvodynia include:

  • Damage to or irritation of the nerves around the vulva
  • A high density of pain-sensing nerve fibers in the vulval area
  • High levels of inflammatory substances in the vulval area, for example, because of inflammation
  • genetic susceptibility
  • pelvic floor muscles are weak or unstable
  • unusual or long-term reaction to infection, trauma, or another environmental factor
  • changes triggered by hormones

Other factors that increase susceptibility include:

  • frequent yeast infections
  • sexually transmitted infections (STIs)
  • chemical irritation of the external genitals, caused by soaps, feminine hygiene products or detergents in clothing
  • rashes on the genital area
  • previous laser treatments or surgery on the external genitals
  • nerve irritation, injury or muscle spasms in the pelvic area
  • diabetes
  • precancerous or cancerous conditions on the cervix

Provoked vestibulodynia could result from:

  • sexual intercourse
  • tampon insertion
  • a gynecologic examination
  • prolonged sitting
  • wearing tight underclothes or pants
  • activities such as cycling or horseback riding

Clitorodynia refers to pain in the clitoris.

Vulvodynia can be confused with other vulvovaginal problems, such as chronic tension or spasm of the muscles of the vulvar area called vaginismus.

Prevention

Measures that can reduce the risk of triggering pain include:

  • wearing cotton underwear and loose-fitting clothes around the genital area
  • avoiding scented toilet paper and perfumed creams and soaps
  • avoiding friction or sitting for prolonged periods
  • refraining from excessive genital washing
  • not douching or using vaginal wipes
  • using water-soluble lubricants during sexual intercourse
  • patting the area dry after rinsing or urinating

If a vaginal infection is suspected, it is important to have it diagnosed and treated promptly and to discuss with a physician if any treatments appear to make the condition worse.

Diagnosis

Diagnosis may involve a pelvic exam, to look for skin changes and assess the pain.

A cotton swab test is used to delineate the areas of pain and categorize their severity. The physician may press with swab on different areas while asking the patient to rate the level of pain.

The patient should be ready to describe the pain, including the type of pain and its severity, say when it started, and whether it began gradually or suddenly, where it hurts, and how often.

The doctor may use a special magnifying glass, to carry out a colposcopy.

Tests may be carried out to try to find the source of the pain and to eliminate other causes.

These include:

  • taking a culture for bacteria and yeast
  • blood tests to assess levels of estrogen, progesterone, and testosterone
  • a biopsy

In a biopsy, the doctor first numbs the genital area with a painkiller, and then a small piece of tissue is taken for examination under a microscope.

Insomnia: Everything you need to know


Insomnia is a sleep disorder that regularly affects millions of people worldwide. In short, individuals with insomnia find it difficult to fall asleep or stay asleep. The effects can be devastating.

Insomnia commonly leads to daytime sleepiness, lethargy, and a general feeling of being unwell, both mentally and physically. Mood swings, irritability, and anxiety are common associated symptoms.

Insomnia has also been associated with a higher risk of developing chronic diseases. According to the National Sleep Foundation, 30-40 percent of American adults report that they have had symptoms of insomnia within the last 12 months, and 10-15 percent of adults claim to have chronic insomnia.

Here, we will discuss what insomnia is, its causes, symptoms, diagnosis, and possible treatments.

Fast facts on insomnia:

  • There are many possible causes of insomnia.
  • An estimated 30-40 percent of Americans report experiencing insomnia each year.
  • Often, insomnia is due to a secondary cause, such as illness or lifestyle.
  • Causes of insomnia include psychological factors, medications, and hormone levels.
  • Treatments for insomnia can be medical or behavioral.

Causes

Insomnia can be caused by physical and psychological factors. There is sometimes an underlying medical condition that causes chronic insomnia, while transient insomnia may be due to a recent event or occurrence. Insomnia is commonly caused by:

  • Disruptions in circadian rhythm – jet lag, job shift changes, high altitudes, environmental noise, extreme heat or cold.
  • Psychological issues – bipolar disorder, depression, anxiety disorders, or psychotic disorders.
  • Medical conditions – chronic pain, chronic fatigue syndrome, congestive heart failure, angina, acid-reflux disease (GERD), chronic obstructive pulmonary disease, asthma, sleep apnea, Parkinson’s and Alzheimer’s diseases, hyperthyroidism, arthritis, brain lesions, tumors, stroke.
  • Hormones – estrogen, hormone shifts during menstruation.
  • Other factors – sleeping next to a snoring partner, parasites, genetic conditions, overactive mind, pregnancy.

Media technology in the bedroom

Several small studies in adults and children have suggested that an exposure to light from televisions and smartphones prior to going to sleep can affect natural melatonin levels and lead to increased time to sleep.

In addition, a study conducted by Rensselaer Polytechnic Institute found that backlit tablet computers can affect sleep patterns. These studies suggest that technology in the bedroom can worsen insomnia, leading to more complications.

Medications

According to the American Association of Retired Persons (AARP), the following medications can cause insomnia in some patients:

  • corticosteroids
  • statins
  • alpha blockers
  • beta blockers
  • SSRI antidepressants
  • ACE inhibitors
  • ARBs (angiotensin II-receptor blockers)
  • cholinesterase inhibitors
  • second generation (non-sedating) H1 agonists
  • glucosamine/chondroitin

Signs and symptoms

Insomnia itself may be a symptom of an underlying medical condition. However, there are many signs and symptoms that are associated with insomnia:

  • Difficulty falling asleep at night.
  • Waking during the night.
  • Waking earlier than desired.
  • Still feeling tired after a night’s sleep.
  • Daytime fatigue or sleepiness.
  • Irritability, depression, or anxiety.
  • Poor concentration and focus.
  • Being uncoordinated, an increase in errors or accidents.
  • Tension headaches (feels like a tight band around head).
  • Difficulty socializing.
  • Gastrointestinal symptoms.
  • Worrying about sleeping.

Sleep deprivation can cause other symptoms. The afflicted person may wake up not feeling fully awake and refreshed, and may have a sensation of tiredness and sleepiness throughout the day.

Having problems concentrating and focusing on tasks is common for people with insomnia. According to the National Heart, Lung, and Blood Institute, 20 percent

Types

Insomnia includes a wide range of sleeping disorders, from lack of sleep quality to lack of sleep quantity. Insomnia is commonly separated into three types:

  • Transient insomnia – occurs when symptoms last up to three nights.
  • Acute insomnia – also called short-term insomnia. Symptoms persist for several weeks.
  • Chronic insomnia – this type lasts for months, and sometimes years. According to the National Institutes of HealthTrusted Source
    , the majority of chronic insomnia cases are side effects resulting from another primary problem.

Treatment

Good sleep hygiene, including avoiding electronics before bed, can help treat insomnia.

Some types of insomnia resolve when the underlying cause is treated or wears off. In general, insomnia treatment focuses on determining the cause.

Once identified, this underlying cause can be properly treated or corrected.

In addition to treating the underlying cause of insomnia, both medical and non-pharmacological (behavioral) treatments may be used as therapies.

Non-pharmacological approaches include cognitive behaviorlal therapy (CBT) in one-on-one counseling sessions or group therapy:

Medical treatments for insomnia include:

  • prescription sleeping pills
  • antidepressants
  • sleep aids available online or over-the-counter
  • antihistamines
  • melatonin, which can be purchased online
  • ramelteon

Home remedies

Home remedies for insomnia include:

  • Improving “sleep hygiene”: Not sleeping too much or too little, exercising daily, not forcing sleep, maintaining a regular sleep schedule, avoiding caffeine at night, avoiding smoking, avoiding going to bed hungry, and ensuring a comfortable sleeping environment.
  • Using relaxation techniques: Examples include meditation and muscle relaxation.
  • Stimulus control therapy – only go to bed when sleepy. Avoid watching TV, reading, eating, or worrying in bed. Set an alarm for the same time every morning (even weekends) and avoid long daytime naps.
  • Sleep restriction: Decreasing the time spent in bed and partially depriving the body of sleep can increase tiredness, ready for the next night.

Diagnosis

A sleep specialist will start by asking questions about the individual’s medical history and sleep patterns.

A physical exam may be conducted to look for possible underlying conditions. The doctor might screen for psychiatric disorders and drug and alcohol use.

The Stanford Center for Sleep Sciences and Medicine explains that the term “insomnia” is often used to refer to “disturbed sleep.”

For a diagnosis of insomnia, the disturbed sleep should have lasted for more than 1 month. It should also negatively impact the patient’s wellbeing, either through the causing distress or disturbing mood or performance.

The patient may be asked to keep a sleep diary to help understand their sleeping patterns.

Other tests may include a polysomnograph. This is an overnight sleeping test that records sleep patterns. In addition, actigraphy may be conducted. This uses a small, wrist-worn device called an actigraph to measure movement and sleep-wake patterns.

Risk factors

Insomnia can affect people of any age; it is more common in adult females

than adult males. It can undermine school and work performance, as well as contributing to obesity, anxiety, depression, irritability, concentration problems, memory problems, poor immune system function, and reduced reaction time.

Some people are more likely to experience insomnia. These include:

  • travelers, particularly through multiple time zones
  • shift workers with frequent changes in shifts (day vs. night)
  • the elderly
  • users of illegal drugs
  • adolescent or young adult students
  • pregnant women
  • menopausal women
  • those with mental health disorders

Flu rash: Everything you need to know


The flu is a common respiratory infection, and its symptoms can range from mild to severe. Although a rash is not a common symptom of the flu, it can sometimes occur.

There is evidence to suggest that certain types of flu may lead to a rash forming in some people. In other cases, another condition may cause a rash to develop when a person has the flu.

In this article, learn more about a flu rash, including the symptoms, diagnosis, and treatment.

Can the flu cause a rash?

The flu causes many uncomfortable symptoms, but a rash is typically not one of them. There is some evidence, however, that the flu may sometimes cause a rash.

A small 2014 case study

of school-aged children found that a rash is a possible symptom of influenza type B.

The authors indicated that other factors, aside from the flu, might have contributed to the onset of the rash, such as a measles outbreak in a nearby area.

The authors of an older article

from 2011 stated that a rash occurs in about 2% of all influenza A cases. The researchers indicated that the rash could occur among children with or without accompanying viral or bacterial infections or environmental factors.

Other symptoms

The flu has several recognizable symptoms that a person will typically experience during the infection.

In most cases, the flu will clear on its own within a few days to 2 weeks

According to the Centers for Disease Control and Prevention (CDC)

, the typical symptoms of the flu include:

  • a cough
  • chills
  • a fever
  • body aches
  • a sore throat
  • fatigue
  • a stuffy or runny nose
  • headaches
  • vomiting or diarrhea

In some cases, a person may develop health complications as a result of the flu. Some of these, such as pneumonia, can be life threatening.

Other complications may include:

  • worsened asthma symptoms
  • swelling of heart, brain, or muscle tissues
  • heart or kidney failure
  • extreme inflammatory responses in the body

Other causes of a rash

Certain other viruses could potentially cause a rash. Some of these viruses may have symptoms similar to those of the flu and be easy to mistake for this illness at first.

For example, a person may develop flu-like symptoms prior to developing a measles rash.

Some common measles symptoms that may appear before the rash occurs include:

  • a runny nose
  • a fever
  • fatigue
  • a cough
  • body aches and pains

Some other common viral infections that may cause a rash include:

  • chickenpox
  • rubella
  • fifth disease
  • roseola
  • West Nile virus
  • dengue fever
  • hand, foot, and mouth disease
  • mononucleosis
  • Zika virus

In some cases, another condition may cause a rash in someone who already has the flu.

Diagnosis

If flu-like symptoms occur alongside a rash, it is best to speak to a doctor. During the appointment, the doctor will conduct a physical examination and ask about the person’s symptoms.

During times when the flu is widespread, the doctor may not need to test for the virus. However, when this is not the case, the doctor may test for the type of virus.

A doctor can also examine the rash and determine whether it may be due to a different condition.

Treatment

If a person has the flu, the typical treatment involves extra rest and fluids. However, people with severe infections and those at risk of developing complications may receive antiviral medications from a doctor.

These medications can help the person recover from their flu more quickly and prevent further complications. Some examples include:

  • peramivir (Rapivab)
  • oseltamivir (Tamiflu)
  • baloxavir (Xofluza)
  • zanamivir (Relenza)

If a person has the flu and a rash, a doctor may not treat the rash directly. Instead, the rash should clear when the body fights off the virus.

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When to see a doctor

Anyone can develop the flu, even otherwise healthy individuals. However, certain groups of people have a higher risk of developing complications. These individuals include:

  • older people
  • children under the age of 5 years
  • pregnant women
  • people with chronic illnesses, such as asthma, diabetes, or heart disease

Although most cases of the flu will resolve with plenty of rest and fluids, people who are at risk of complications should see a doctor.

In some cases, a person may need to seek immediate medical attention. People with the flu should seek emergency medical care if they experience any of the following:

  • persistent pain or pressure in the chest or abdomen
  • difficulty breathing
  • seizures
  • severe muscle pain
  • shortness of breath
  • a fever or cough that improves but then returns or worsens
  • persistent confusion or dizziness
  • worsening of chronic medical conditions
  • lack of urination
  • severe weakness or unsteadiness

Parents or caregivers should seek emergency care

for a child who has:

  • bluish lips or face
  • severe muscle pain
  • fast breathing or trouble breathing
  • seizures
  • ribs pulling in with each breath
  • chest pain
  • a fever or cough that improves before returning or worsening
  • dehydration, signs of which can include little urine, no tears, and a dry mouth
  • a lack of alertness
  • the inability to interact when awake
  • a fever above 104°F or any fever in infants under 12 weeks old
  • worsening symptoms of chronic medical conditions

Summary

A rash is a possible but uncommon symptom of the flu. If a rash appears due to the flu or another virus, it should clear when the virus is no longer active.

A person should see their doctor if they have an unexplained rash or severe flu symptoms. A doctor can also help determine whether the rash is due to the flu or another condition.

Rare diseases more common than we think

Rare diseases are by their very nature obscure and unknown, falling through the cracks when it comes to research budgets and treatment development. But now, a study has shown they are more common than we think.

The United States classifies a rare disease as one that affects fewer than 200,000 people. However, all together, rare diseases in the U.S. affect 25–30 million people.

While the diseases themselves may be rare, this significant figure highlights just how many people are living with diseases that get little attention due to their singularity.

Until the recent study, scientists had no real concept of the prevalence of rare diseases globally.

The few studies into the incidence of rare diseases have seldom looked at population registries, making it hard to establish prevalence with precision.

As in the U.S., most countries do not track rare diseases. In fact, they document very few even after diagnosis. This makes it tricky to work out the exact number of rare diseases or how many people are living with them.

Now an analysis of the Orphanet database, which is a comprehensive record of the incidence of rare disease, indicates that over 300 million people globally are living with a rare disease.

‘A low estimation of the reality’

“In all likelihood, our data represent a low estimation of the reality. The majority of rare diseases are not traceable in healthcare systems, and in many countries, there are no national registries,” says Ana Rath, the director of Inserm US14 in Paris, France.

The National Institute for Health and Medical Research (INSERM) in France established Orphanet in 1997 to improve knowledge of rare diseases and boost awareness, diagnosis, and treatment of people living with them.

Today, a consortium of 40 countries work together to pool data on rare diseases, making it the most comprehensive source of data on the topic.

Researchers hope that by highlighting the number of individuals impacted by a rare disease and showing that rare disease is “not so rare,” public health policies at a national and global level will begin to address the issue.

“Given that little is known about rare diseases, we could be forgiven for thinking that [those living with them] are thin on the ground,” says Rath. “But when taken together, they represent a large proportion of the population.”

According to the Genetic and Rare Diseases Information Center (GARD), there may be as many as 7,000 rare diseases. Experts often refer to these diseases as orphan diseases because drug companies have tended to neglect them by excluding them from their drug research and treatment development budgets.

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, which passed in the U.S. in 1983, offered pharmaceutical companies a financial incentive to develop drugs for rare diseases, such as polycythemia vera, Marfan syndrome, and systemic sclerosis.

However, there is still no available treatment for most rare diseases.

Many scientists have serious concerns about the impact that these rare diseases have on those living with them and their families around the world.

4% of the population have a rare disease

The researchers did not include some cancers or other rare conditions induced by infection or poisoning in their investigation. However, they analyzed 3,585 rare diseases to find out how many people globally have the disease at the same time. The results showed that 3.5­–5.9% of the world’s population have these conditions at any given time.

The study also found that 80% of those with a rare disease had one of only 149 illnesses.

In addition, 71.9% of the diseases on Orphanet had genetic causes, and 69.9% began in childhood.

The research concludes that rare diseases are not so rare, after all.

In the study abstract, the authors refer to rare diseases as “an emerging global public health priority.”

The researchers call for the findings to shine a light on research priorities, emphasize the societal impact of these conditions, and highlight the need for a comprehensive public health policy, both on a national and global level.

The focus going forward is on examining those diseases not included in the study and building knowledge on rare diseases to ensure that people receive better care.

“Making patients visible within their respective healthcare systems by implementing means to record their precise diagnoses would make it possible in the future not only to review our estimations but more fundamentally to improve the adaptation of support and reimbursement policies.”

Ana Rath

In the U.S., the Office of Orphan Products Development (OOPD)

runs a program to incentivize drug companies to develop treatments for rare diseases. The 10 years between 1973 and 1983 saw the approval of just 10 treatments for rare diseases. But since then, the OOPD have overseen the development of more than 400 drugs and products.

New technology better controls type 1 diabetes

Type 1 diabetes has no cure, and although there are several treatment options available, many people find managing the condition challenging. New technology could help reduce that burden.

Many people find managing type 1 diabetes inconvenient, but new research may change this.

More than 1 million children and adults in the United States have type 1 diabetes, according to the American Diabetes Association. 

The Centers for Disease Control and Prevention (CDC) note that about 5%

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of all people who have diabetes have type 1. 

Type 1 diabetes can significantly impact a person’s life, as people need to monitor their blood sugar levels regularly to ensure they do not become dangerously high or low.

Currently, people with type 1 diabetes measure their blood sugar levels by pricking a finger several times a day or wearing a glucose monitor. Depending on the measurements, they may have to administer insulin using an injection or insulin pump.

But a new form of technology trialed recently and showcased in the New England Journal of Medicine could replace these conventional methods.

Automatic insulin

The trial looked at a particular type of artificial pancreas, or closed-loop control. These devices continuously monitor and regulate blood glucose levels. When the monitor detects that a person needs insulin, a pump releases the hormone into the body. 

The trial involved the use of the Control-IQ system — a new type of artificial pancreas that uses algorithms to adjust insulin doses automatically throughout the day.

“By making management of type 1 diabetes easier and more precise, this technology could reduce the daily burden of this disease, while also potentially reducing diabetes complications, including eye, nerve, and kidney diseases,” says Dr. Griffin P. Rodgers, director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

The 6-month trial is part of a much larger research initiative known as the International Diabetes Closed-Loop (iDCL) Study, which involves the testing of several artificial pancreas systems to determine a variety of factors, such as safety, effectiveness, and user-friendliness.

The trial recruited 168 people with type 1 diabetes and with a minimum age of 14.

The researchers assigned over 100 people to use the Control-IQ system, while 56 people formed a control group that used sensor-augmented pump (SAP) therapy. This therapy does not alter insulin doses automatically.

Researchers wanted to replicate day-to-day life, so they did not monitor the systems remotely. Participants did, however, contact researchers every few weeks to check data from the device.

24-hour control

The researchers were interested in the amount of time that blood glucose levels reached a target range of 70 to 180 milligrams per deciliter (mg/dl).

The results showed that the blood sugar levels of the people who used the Control-IQ system were in the target range for an average of 2.6 hours per day longer than previously. Those using the SAP therapy saw no notable change throughout the trial.

Vitally, the system also improved the participants’ blood glucose control overnight as well as during the day. This is a crucial advancement for people whose levels drop significantly when asleep.

None of the groups experienced severe cases of hypoglycemia ⁠— when blood sugar levels become very low.

Reducing the burden

According to Dr. Guillermo Arreaza-Rubín, the study’s program scientist and director of NIDDK’s Diabetes Technology Program, these findings indicate that this system “has the potential to improve the health of people living with type 1 diabetes, while also potentially lifting much of the burden of care from those with the disease and their caregivers.”

Boris Kovatchev, Ph.D., director of the UVA Center for Diabetes Technology, says the technology’s glucose control is “beyond what is achievable using traditional methods.”

The team has submitted the results of the trial to the U.S. Food and Drug Administration (FDA). They are waiting to find out whether the device can go to market.

Doctors’ beliefs about treatment affect patients’ experience of pain


New research finds that the placebo effect may be socially contagious. In other words, a doctor’s beliefs about whether or not a pain treatment will work can exert a subtle influence on how much pain the patient will actually experience. 

A doctor’s display of confidence in a treatment may make it more effective.

The power of placebo may extend beyond what researchers previously believed.

At first, they only used placebos as controls in drug experiments.

With time, however, placebos proved to have value as potential treatments in their own right.

Pain, depression, anxiety, irritable bowel syndrome, Parkinson’s disease, and epilepsy are only some of the conditions that placebos have shown promise in treating.

A new study has looked into another fascinating aspect of the placebo: Does it transmit socially, from one person to another? If so, how? More specifically, how does a doctor’s belief about the effects of a medication affect their patient’s experience of pain?

Laboratory at Dartmouth College in Hanover, NH — is the corresponding author of the new study.

Chang and colleagues have published their findings in the journal Nature Human Behaviour

Testing placebo power in 3 experiments

To study the phenomenon of socially transmitted placebo, the researchers devised three experiments. All three involved two different creams that were meant to relieve heat-induced pain by targeting pain receptors on the participants’ skin.

One of the creams was called thermedol, and the other was a control cream. Although different in appearance, both creams were actually placebos — namely, petroleum jelly with no pain relieving properties at all.

The researchers asked undergraduate students to play the roles of “doctors” and “patients.” They informed the “doctors” of the creams’ benefits and conditioned them to believe that thermedol was better at relieving pain than the control cream.

The first experiment consisted of 24 “doctor-patient” pairs. In each pair, the “patient” did not know which cream was thermedol and which was the control. Only the “doctor” knew which was the “effective” cream.

The researchers then applied the creams to the participants’ arms, followed by pain-inducing heat, in order to evaluate the effects of the cream. All participants received the same amount of heat.

During the experiment, all participants wore cameras that recorded their facial expressions in the doctor-patient interactions.

Using a machine-learning algorithm trained on facial signals of pain, the researchers were able to examine the effect of cues such as raised eyebrows, raised upper lips, or nose wrinkling on the perceived effectiveness of the treatments.

In this experiment, the participants reported experiencing less pain with thermedol, and skin conductance tests suggested that they actually did experience less discomfort. Their facial expressions also reflected less pain with thermedol.

In the other two experiments, the researchers applied the creams in different orders, and they led the doctors to believe that they were using thermedol when they were using the control creams, and vice versa.

The experimenters themselves were also blind to the study, not knowing which cream was which. In these experiments, the results were the same.

How doctors’ beliefs affect clinical results

Overall, across all three experiments, the results revealed that when the “doctors” believed that a treatment was effective, the “patients” reported feeling less pain. Their facial expressions and skin conductance tests also revealed fewer signs of pain.

The reasons for this remain unclear. However, the researchers believe that social contagion via facial cues is the most likely explanation.

“When the doctor thought that the treatment was going to work, the patient reported feeling that the doctor was more empathetic,” says Chang.

“The doctor may have come across as warmer or more attentive. Yet, we don’t know exactly what the doctor was doing differently to convey these beliefs that a treatment works. That’s the next thing that we’re going to explore,” he adds.

“What we do know though is that these expectations are not being conveyed verbally but through subtle social cues,” explains Chang.

“These findings demonstrate how subtle social interactions can impact clinical outcomes. You can imagine that in a real clinical context, if the healthcare providers seemed competent, empathetic, and confident that a treatment may work, the impact on patient outcomes could be even stronger.”