Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

Neurodevelopmental disorders refer to any impairment and disorder of the brain and nervous system growth and development. Disorder in the brain and nervous system can affect the emotional, physiological, psychological ability and overall timely development of a child. With advanced technology and continuous study in the medical field, one can now assess the neurodevelopment of his/her children. Neurodevelopmental Assessment concentrates on the overall growth and development of a child including his/her weaknesses and strengths. A complete developmental profile is generated with the help of various tests and examinations. This assessment is used to analyse the various developmental factors including social and communication skills, functional and motor skills, cognition and learning abilities, and language and speech development. Neurodevelopmental Assessment involves a team of child s close people including parents, guardians, and family members who help to understand the medical history if any. It helps doctors to provide appropriate ways to assist the child in his/ her growth and development.

Tests and Examinations

Tests for the Neurodevelopmental Assessment may vary from child to child depending upon their condition. But, there are usually some tests that are done to understand the overall development of the child. These tests may include speech tests, hearing tests, blood tests, physical examinations, and questionnaires, which may be given before or during the assessment process.

Assessment

The assessment processes and sessions may vary depending upon the need of the child. However, usually, there are three major sessions that help the pediatrician understand the concerns of the family and parents. These sessions include consulting about the detailed medical history of the child, understanding the problem and its possible cause, and providing proper ways and treatment options for the patient. 

In the first session, parents and guardians are asked about any medical concern they have and the medical examination of the child is carried out accordingly. A standardized assessment with the child will be carried out by a clinical psychologist and the parents and guardians are asked to complete a questionnaire for the assessment. Depending upon the age, questionnaire may be sent to school for teacher/s to complete.

The next session is usually led by language and speech therapist to discuss and understand the current language and speech concerns of the child. Previous assessments and medical examinations are taken into account to carry out further assessments. An occupational therapist will assess the child s ability to perform self-care activities and other tasks according to his/her age. The session may include the assessment of a child s motor skills and abilities and reflection on any probable sensory-based problems that may be affecting the child s occupational performance.

The last session mainly includes the discussion with the parents and guardians to help them understand the problem, its causes, and treatment options. If the child requires any further assessment or/and recommendations, then the parents are told about that too.

Takeaway
Neurodevelopmental Assessment of children is often performed on kids who do not show the developmental signs according to their age. Parents and guardians should not hesitate to consult their children to clinical psychologist and therapist as the early intervention and assessment can help in the timely growth and development of the children.

Neurodevelopmental Assessment (0-5 Years)  - What Should You Know?

With age, most body organs begin to deteriorate in their function. This happens to the brain also, thereby reducing the overall speed of functioning of most organs. While slowing of bodily movement is visible, the internal organs functioning also slows down, which is not that obvious. Memory loss or dementia is one of the main manifestations of this degeneration of the brain.

Alzheimer s is the most common form of dementia, and the associated symptoms includes reduced reasoning abilities and cognitive defects. Though it is seen only in the elderly, not all elderly people will have Alzheimer s. The overall quality of life of the affected person is reduced with difficulty remembering things that were recently learned. It is a progressive disease and as it gets more severe, a full-time caretaker may be required.

Causes: The brain cells are affected by protein masses known as plaques and tangles. These hamper the way communication between the brain cells happens as well as affect nutrition from reaching all parts of the brain. This leads to shrinking of the brain, eventually leading to memory loss and other problems. There is also a strong genetic linkage, as most people with Alzheimer s have the lipoprotein A gene.

Symptoms: Though memory loss is the most common symptom, there are other symptoms:

Being confused about places, people, and times
Inability to find the right words during conversations
Regular objects are misplaced
Becoming irritable, (in someone who was not so previously)
Mood swings
Personality changes
Inability to organise thoughts
Not able to make the right decisions
Repetitive talks and actions
Forgetfulness (not something the person always does)
Difficulty with numbers (again, not something calculations
Difficulty managing everyday tasks and minor problems
Suspicion of others (like immediate family members and friends)
Risk factors: While age is definitely a risk factor, the fact that not all aged people develop Alzheimer s is to be borne in mind. Other risk factors include the history of stroke, high cholesterol, high blood pressure, diabetes, smoking, obesity, and poor lifestyle choices.

Diagnosis: While there is no definitive way to diagnose Alzheimer s, symptoms along with brain scans and neuropsychological function testing are useful ways to confirm the diagnosis.

Treatment: This is aimed at two things reducing the rate of disease progression and treat (or reverse) symptoms if possible.

Cholinesterase inhibitors improve cellular communication in the brain and also manage depression and agitation. Memantine is used to slow the pace of disease progression.
In people with the disease, small changes are useful to help them with the symptoms. These include keeping essential things like keys and wallet in the same place, keep a daily diary to help them remember things, keep pictures of friends and family within visible distance.

Alzheimer's - An Overview!

We're all guilty of making fun of snorers, but sometimes this snoring can be a symptom of sleep apnea. Sleep apnea is a condition where breathing is not continuous and may start and stop many times while asleep. This affects the quality of your sleep and in turn can affect many aspects of your health including your cardiovascular health. Here's how:

High blood pressure
When a sleep apnea patient's breathing stops, the oxygen levels in the blood also suddenly fall. This can increase your blood pressure. High blood pressure means that the heart muscles need to work harder to pump blood through the body.

Cardiomyopathy
As a result of high blood pressure, the heart walls may become thicker and the heart muscles become stiffer. This is known as cardiomyopathy. As this condition worsens, the heart becomes weaker and is unable to maintain a regular rhythm. This can eventually lead to heart failure.

Arrhythmia
An irregular heartbeat is also known as arrhythmia. This may also be related to the changes in the heart's structure that follow the drop in blood oxygen levels. In many cases, arrhythmia has no visible symptoms and can often go undiagnosed. This can result in the formation of blood clots in the atria which can lead to a stroke.

Sleep apnea is easy to diagnose. If the doctor feels that you show symptoms of sleep apnea, you may be asked to stay on the hospital overnight and undergo a sleep evaluation. This tests a variety of body functions including brain activity, eye movements, heart rate, breathing patterns and blood oxygen levels.

Treatment for sleep apnea depends on the causes for this condition. If you are overweight, regular exercise and a change in diet can help you lose the excess weight and cure sleep apnea. Similarly, if your sleep apnea is triggered by an allergy, treating the allergy can help cure the sleep apnea. Other forms of treatment for sleep apnea may include:

Continuous positive airway pressure (cpap)
This is a machine which pumps air into the body through a nasal mask. By keeping the pressure in the machine higher than normal air pressure the upper airway passages are kept open and hence the quality of your sleep is improved. An auto cpap machine can modulate the air pressure such that it is higher when you inhale and lower when you exhale.;

Oral devices
Your doctor may suggest oral devices that allow you to keep your mouth open while you sleep. This is easier to use than cpap machine but less effective. Surgery is the last resort when it comes to treatment for sleep apnea.

Sleep Apnea and Its Link to Heart Failure

Dementia refers to the progressive loss of memory in a human being. It does not refer to any particular disease. It is rather a cumulative representation of symptoms which signify that the person is losing his or her memory. Dementia occurs in seven stages. Read on to read more about them:

In the first stage, there is no cognitive decline and the person is mentally sound. There is no memory loss as well.
In the second stage, there is a very mild cognitive decline leading to normal forgetfulness that is often associated with progressing age.
In the third stage, there is a mild cognitive decline. The person has an increased forgetfulness and may find it difficult to concentrate on things.
In the fourth stage, there is moderate cognitive decline and the person starts forgetting even the most recent events. They cannot even travel alone or manage their own finances.
In the fifth stage, there is moderately severe cognitive decline. The person going through this stage often requires help even with their daily activities. People tend to forget even the most common things like phone and email passwords.
In the sixth stage, there is severe cognitive decline. This stage is also called middle dementia and there is prominent memory loss. People cannot even count from 1 to 10. Their speech becomes slurry. They also start having delusions.
In the seventh stage, there is very severe cognitive decline. This stage is also called late dementia. The psychomotor skills are also lost at this stage and the person may not even be able to walk properly.
Some of the early signs of dementia are listed below:

In the initial days of dementia, the person usually tends to get confused when it comes to choosing the right words. This makes them take much longer time to conclude their speech.
There might also be a change in the mood of the person.
Depression is also one of the early signs.

The person will have a tendency to forget even the most recent events that took place in his or her life. This means that they might remember what happened ten years before but they might not remember what they did in the morning.
Early signs also include failure to sense directions. People often tend to forget their addresses and the landmarks and thus become lost when they travel alone.
Confusion is also one of the common signs and this is directly correlated to the loss of memory because when a person cannot remember familiar faces, it leads to a lot of confusion within his own mind.
So, if you suspect that someone in your house is suffering from dementia, then you must look out for these early signs and seek medical help immediately. Early treatment can keep the condition from worsening.

Dementia - Stages and Early Signs!

Epilepsy is a form of chronic disorder and it is characterized by recurrent seizures. The episodes of epileptic seizures may differ from person to person. These seizures could be a result of genetic disorder or a result of trauma or stroke. During a seizure, a patient may also experience symptoms of neurological disorders and sometimes lose consciousness.

Medical help for epilepsy
Epilepsy itself cannot be cured using medication, but proper medicines help in eliminating recurrent seizures. These medicines stabilize the electrical activity within the brain preventing seizures.

How effective is the medication for epilepsy?
The success of controlling seizures using medicines depends on the type and severity of epilepsy. Medicines for epilepsy are usually very effective and may fully keep seizures under control. However, controlling seizures caused due to brain problems may be more difficult. Usually, epilepsy medicines can control seizures for a long period of time when they are taken regularly.

When is medical help needed?
The decision about when to start medicines for epilepsy is a tricky one. This is because a first seizure cannot confirm whether a person has an on-going epilepsy problem. A second seizure may occur after many years or may not happen at all. Prediction of seizures is also quite difficult.

The severity of seizures also indicates when to start medicines for treatment. In case a first seizure is quite severe, medication should be started at once. Some people have very mild seizures even though they may be recurring in nature, and medication can be avoided in this situation. After first seizure MRI and EEG may help to know whether you have the risk of second seizure or not.

All the pros and cons must be thought over before starting medications for the treatment of epilepsy. It is advisable to wait for a second seizure and then start medications for treatment. In most cases, medication is started after a second seizure occurs, twelve months within the first seizure. You should always consult a doctor to know when you need to start taking medicines to treat the condition.

For making the most out of the medicines to control seizures, you should follow certain steps:

You must take medications exactly as your doctor has prescribed.
Before switching to generic versions of your medicines or before taking other prescribed medicines, you must consult your doctor.
You should never stop taking the medicines.
In case you experience enhanced depression, mood swings and suicidal thoughts, you should talk to your doctor immediately.
In case you have migraine, you should let your doctor know so that he can prescribe you anti-epileptic medicines, which also prevent migraines.
Medicines cannot treat the underlying cause of epilepsy, but these help in controlling seizures and this is the most common symptom of epilepsy. Medication should be started at a proper time and must be continued without stopping.

When to Seek Medical Help for Epilepsy

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