WHY DO WE NEED A SLEEP STUDY?

Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted and why.
The normal process of falling asleep begins with a sleep stage called non-rapid eye movement (NREM) sleep. During this stage, your brain waves, as recorded by electroencephalography (EEG), slow down considerably. Your eyes don’t move back and forth rapidly during NREM, in contrast to later stages of sleep. After an hour or two of NREM sleep, your brain activity picks up again, and rapid eye movement (REM) sleep begins. Most dreaming occurs during REM sleep.

You normally go through four to six sleep cycles a night, cycling between NREM and REM sleep in about 90 minutes. Your REM stage usually lengthens with each cycle as the night progresses. Sleep disorders can disturb this sleep process. Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted.
Your doctor may recommend polysomnography if he or she suspects you have:
-Sleep apnea or another sleep-related breathing disorder — your breathing repeatedly stops and starts during sleep.
-Periodic limb movement disorder — you involuntarily flex and extend your legs while sleeping. This sleep disorder is sometimes associated with restless legs syndrome.
-Narcolepsy — you experience overwhelming daytime drowsiness and sudden attacks of sleep.
-REM sleep behavior disorder — you act out dreams as you sleep.
-Unusual behaviors during sleep — you do unusual activities during sleep, such as walking, moving around a lot or rhythmic movements.
Unexplained chronic insomnia — you consistently have trouble falling asleep or staying asleep.






What Does Stress Testing Show?

Stress testing shows how your heart works during physical stress (exercise) and how healthy your heart is.
A standard exercise stress test uses an EKG (electrocardiogram) to monitor changes in your heart’s electrical activity. Imaging stress tests take pictures of blood flow throughout your heart. They also show your heart valves and the movement of your heart muscle.
Doctors use both types of stress tests to look for signs that your heart isn’t getting enough blood flow during exercise. Abnormal test results may be due to coronary heart disease (CHD) or other factors, such as poor physical fitness.
If you have a standard exercise stress test and the results are normal, you may not need further testing or treatment. But if your test results are abnormal, or if you’re physically unable to exercise, your doctor may want you to have an imaging stress test or other tests.
Even if your standard exercise stress test results are normal, your doctor may want you to have an imaging stress test if you continue having symptoms (such as shortness of breath or chest pain).
Imaging stress tests are more accurate than standard exercise stress tests, but they’re much more expensive.
Imaging stress tests show how well blood is flowing in the heart muscle and reveal parts of the heart that aren’t contracting strongly. They also can show the parts of the heart that aren’t getting enough blood, as well as dead tissue in the heart, where no blood flows. (A heart attack can cause heart tissue to die.)
If your imaging stress test suggests significant CHD, your doctor may want you to have more testing and treatment.






The Super Heart-Healthy Diet!

Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt. The diet is rich in fruits, vegetables, whole grains and low-fat dairy products, which can help protect your heart. Beans, other low-fat sources of protein and certain types of fish also can reduce your risk of heart disease.

Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels.
Major sources of saturated fat include:
Red meat
Dairy products
Coconut and palm oils

Sources of trans fat include:
Deep-fried fast foods
Bakery products
Packaged snack foods
Margarines
Crackers

Heart-healthy eating isn’t all about cutting back, though. Most people need to add more fruits and vegetables to their diet — with a goal of five to 10 servings a day. Eating that many fruits and vegetables can not only help prevent heart disease, but also may help prevent cancer.
Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish, such as salmon and mackerel, are a good natural source of omega-3s. Omega-3s are present in smaller amounts in flaxseed oil, walnut oil, soybean oil and canola oil, and they can also be found in supplements.
Following a heart-healthy diet also means drinking alcohol only in moderation — no more than two drinks a day for men, and one a day for women. At that moderate level, alcohol can have a protective effect on your heart.






Angina and Coronary Artery Disease

Angina is pain or discomfort that comes when your heart does not get enough oxygen. Angina is usually a symptom of a heart problem known as coronary heart disease (CHD), also called coronary artery disease (CAD)
Your heart is a muscle. It pumps oxygen-rich blood to your whole body. Your heart also needs oxygen to work. Blood vessels called coronary arteries carry blood with oxygen to your heart.
In healthy coronary arteries, blood flows freely to bring oxygen to the heart. In coronary heart disease, these arteries become stiff and narrow. This lowers blood flow and the amount of oxygen that gets to the heart.

With exercise or emotional stress, the heart works harder and needs more oxygen. Lower blood flow can lead to angina. You could feel discomfort or pain in the chest, arm, shoulder, back, neck, or jaw. When angina has been present for months or years without much change, it is called chronic stable angina. It most often goes away with rest or nitroglycerin.
If a clot forms in a coronary artery, it can further block blood flow. This can lead to chest pain known as unstable angina. It often occurs at rest. Unstable angina is a medical emergency and requires medical help right away.






Alternative Medicine for Coronary Artery Disease

Coronary artery disease develops when your coronary arteries — the major blood vessels that supply your heart with blood, oxygen and nutrients — become damaged or diseased. Cholesterol-containing deposits (plaque) on your arteries are usually to blame for coronary artery disease.
Omega-3 fatty acids are a type of unsaturated fatty acid that’s thought to reduce inflammation throughout the body, a contributing factor to coronary artery disease.
Fish and fish oil are the most effective sources of omega-3 fatty acids. Fatty fish, such as salmon, herring and to a lesser extent tuna, contain the most omega-3 fatty acids and therefore the most benefit. Fish oil supplements may offer benefit, but the evidence is strongest for eating fish.
Flax and flaxseed oil also contain beneficial omega-3 fatty acids, though studies have not found these sources to be as effective as fish. The shell on raw flaxseeds also contains soluble fiber, which can help lower blood cholesterol.
Other dietary sources of omega-3 fatty acids include walnuts, canola oil, soybeans and soybean oil. These foods contain smaller amounts of omega-3 fatty acids than do fish and fish oil, and evidence for their benefit to heart health isn’t as strong.






Symptoms of a Heart Attack

A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. The medical term for this is myocardial infarction. A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number quickly.
-DO NOT try to drive yourself to the hospital.
-DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack.
Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back.
The pain can be severe or mild. It can feel like:
-A tight band around the chest
-Bad indigestion
-Something heavy sitting on your chest
-Squeezing or heavy pressure
The pain usually lasts longer than 20 minutes. Rest and a medicine called nitroglycerin may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.
Other symptoms of a heart attack can include: anxiety, cough, cainting, light-headedness, dizziness, nausea or vomiting, palpitations, shortness of breath or profuse sweating.
After a heart attack you may need Holter Monitoring






Heart Diseases similar in women and men

An analysis of data from an international multicenter study of coronary computed tomography angiography (CCTA) reveals that men and women with mild coronary artery disease and similar cardiovascular risk profiles share similar prognoses. Results of the study were presented this month at the annual meeting of the Radiological Society of North America (RSNA).

“We conducted this study because we wanted to understand whether men and women with the same extent of coronary artery disease and similar risk profiles have similar or dissimilar prognoses,” said Jonathon Leipsic, M.D., FRCPC, director of medical imaging at St. Paul’s Hospital in Vancouver, British Columbia. “There is a tendency to think women’s heart disease is very different than men’s heart disease. Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women.”

Coronary artery disease occurs when the coronary arteries—the major blood vessels that supply the oxygen-rich blood to the heart muscle—begin to accumulate a buildup of fatty deposits called plaque. Over time, plaque may damage or narrow the arteries. CCTA is a noninvasive imaging test that uses computed tomography (CT) to image the amount of plaque present in the coronary arteries.






Heavy Drinking can lead to Heart Disease

Drinking more than the daily unit guidelines regularly and over a long period of time can increase your risk of developing heart disease. This is because, drinking at this level can:
-Increase the risk of high blood pressure. Drinking excessive amounts of alcohol causes raised blood pressure which is one of the most important risk factors for having a heart attack or a stroke. Alcohol is thought to do this through its effects on the kidneys and the blood vessels. Increases in your blood pressure can also be caused by weight gain from excessive drinking.
-Weaken the heart muscle. This means the heart can’t pump blood as efficiently. It’s known as cardiomyopathy and can cause premature death, usually through heart failure.
-Lead to an enlarged heart. This is a sign that the heart is unable to effectively pump blood around the body, and is known as heart failure.
Video: Coronary Artery Disease






Risk Factors for Coronary Artery Disease

Risk factors for coronary artery disease include:
Age. Simply getting older increases your risk of damaged and narrowed arteries.
Sex. Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.
Family history. Especially if a close relative developed heart disease at an early age. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55, or your mother or a sister developed it before age 65.
Smoking. Nicotine constricts your blood vessels, and carbon monoxide can damage their inner lining, making them more susceptible to atherosclerosis.
High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of your arteries.
High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaques and atherosclerosis.
Diabetes. Diabetes is associated with an increased risk of coronary artery disease.
Obesity. Excess weight typically worsens other risk factors.
Physical inactivity. Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well.
High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.






Causes of Coronary Artery Disease

In CAD, narrowed coronary arteries limit the supply of blood to the heart muscle. If narrowing is not extensive, difficulties may occur only during physical exertion, when the narrowed arteries are unable to meet the increased oxygen requirements of the heart. However, as the disease worsens, the narrowed arteries may starve the heart muscle of oxygen during periods of normal activity, or even at rest.
-Smoking promotes the development of plaque in the arteries. Also, by increasing the amount of carbon monoxide in the bloodstream and decreasing the amount of oxygen available to the heart, smoking increases the likelihood of angina.
-High blood cholesterol levels lead to coronary artery disease.
-High blood pressure predisposes one to CAD.
-People with diabetes mellitus are at greater risk for atherosclerosis.
-Obesity may promote atherosclerosis.
-Lack of exercise (a sedentary lifestyle) may encourage atherosclerosis.
-Men are at greater risk than women for coronary artery disease, although the risk for postmenopausal women approaches that of men as estrogen production decreases with menopause.
-Women over age 35 who take oral contraceptives and smoke cigarettes have a higher risk of atherosclerosis.
-A family history of premature heart attacks is associated with greater CAD risk.
-A spasm of the muscular layer of the arterial walls may cause an artery to contract and produce angina. Spasms may be induced by smoking, extreme emotional stress or exposure to cold air.