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DIFFICULTY FALLING OR STAYING ASLEEP: BREATHING DISORDERS – SLEEP APNEA MAY ALSO LEAD TO A DIMS PROBLEM AND MANAGEMENT OF CSA

admin — Tue, 26 Apr 2011 14:51:22 +0000

Obstructive sleep apnea may also lead to a DIMS problem, especially if patients become aware that they suffer from the disorder. This often happens if they remember that they have awakened frequently, or if their bed partners have told them about their snoring. If these patients begin to worry about their impaired breathing, they may develop a fear of falling asleep and thus induce a kind of secondary insomnia by forcing themselves to stay awake as long as possible. Therapy for such a problem must be twofold: the cause of the obstructed breathing needs to be discovered and managed, and the psychophysiologic pattern of behavior must be thwarted before it becomes entrenched.

Management of CSA usually involves the use of drugs, such as protriptyline, imipramine, or aminophylline, which are known to stimulate the breathing drive. Weight loss is also necessary in obese individuals. Sometimes an electric pacemaker designed to stimulate the diaphragm works in cases where the disordered breathing poses a threat to life. Unfortunately, such pacing cannot be timed to synchronize with the natural breathing rhythm; consequently obstructive apnea may develop, requiring separate treatment. For those patients in whom Cheyne-Stokes breathing produces severely lowered oxygen levels, a drug called acetazol-amide sodium has some benefits. The rate of success with all of these therapies, however, is somewhat low.

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IMPORTANCE OF SECOND STAGE OF STRESS BREAKDOWN:

admin — Tue, 21 Dec 2010 12:47:03 +0000

It is very important that people in stressful situations recognize the symptoms of stage two stress breakdown as serious enough to force a change in lifestyle, or relief of the stress. Thankfully, many stress breakdowns do not progress past stage two. This is probably because, as I indicated before, most people recognize the symptoms of stage two as serious and will be moved to try to ‘rescue’ the person displaying these symptoms. In the majority of cases this rescue operation succeeds in removing the person from the stress, or the stress from the person, sufficient to prevent a further progression of stress breakdown.

As we will see a little later, the threshold between stage two and stage three is very important, because while people generally can identify the symptoms of stage one and stage two as associated with stress, the symptoms of stage three are not easily recognized as stress related. Therefore, people tend to make wrong assumptions about the causes of the unusual behaviour observed in stage three stress breakdown, and sometimes the treatment based on these wrong assumptions can make the situation worse.

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IMPORTANCE OF SECOND STAGE OF STRESS BREAKDOWN:
It is very important that people in stressful situations recognize the symptoms of stage two stress breakdown as serious enough to force a change in lifestyle, or relief of the stress. Thankfully, many stress breakdowns do not progress past stage two. This is probably because, as I indicated before, most people recognize the symptoms of stage two as serious and will be moved to try to ‘rescue’ the person displaying these symptoms. In the majority of cases this rescue operation succeeds in removing the person from the stress, or the stress from the person, sufficient to prevent a further progression of stress breakdown.As we will see a little later, the threshold between stage two and stage three is very important, because while people generally can identify the symptoms of stage one and stage two as associated with stress, the symptoms of stage three are not easily recognized as stress related. Therefore, people tend to make wrong assumptions about the causes of the unusual behaviour observed in stage three stress breakdown, and sometimes the treatment based on these wrong assumptions can make the situation worse.
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TRANSITIONAL HYPNOTIC STATE – THS

admin — Fri, 08 May 2009 09:41:23 +0000

Pseudo insomniacs are healthy, and normal in all other aspects. They have just lost the confidence to sleep. Pseudo insomniacs are unable to operate the natural in-built mechanism inside their brains and so cannot switch off at night and fall asleep.

Chronic insomniacs are people who cannot shift from the waking mode to the THS. The cerebral cortex of the brain is too involved with uncontrolled thoughts and this prevents entry to the THS mode; hence the sleep centre cannot trigger sleep onset.

The THS was discussed in the previous chapter, and is the transitional state between waking and sleeping. This is an observed state in anyone falling asleep. However, this state can be artificially induced in ourselves when we are ready to fall asleep.

To enter the THS we must limit and control thought stimulation in the cerebral cortex. This is like making an imaginary surgical cut between the cerebral cortex and the sleep centre. Once we are in the THS, the level of arousal in the cerebral cortex will be minimal and the sleep centre will take over and trigger off natural sleep. This imaginary surgical cut involves the technique of thought control.

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OUR SENSITIVITY TO PAIN: PAIN IN MAN AND ANIMALS

admin — Wed, 29 Apr 2009 10:30:48 +0000

We humans are inclined to regard ourselves as sensitive in a way that animals are not because our brain has developed above the level of that of animals. We feel that we are sensitive, that we are highly strung. This gives us the ability to appreciate the subtlety and diversity of our sensations in a way which would not otherwise be possible. We feel that this sensitivity in itself makes us more vulnerable to pain. I think that this is only partially true. Many very sensitive people, by developing a quiet philosophy and understanding, have a great capacity for the

self-management of pain; and on the other hand, many very insensitive people allow distress and fear to overtake them, and so withstand pain very badly.

My own experience with patients is that the more sensitive persons learn the technique of the self-management of pain rather better than their less sensitive fellows. One reason for this is that some degree of sensitivity helps the patient to let himself go along with me with these ideas.

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BACKGROUND PROBLEMS AT HOME CAUSING STRESS

admin — Thu, 23 Apr 2009 08:21:30 +0000

Too late for a baby

« It’s never too late. What a silly saying! It is too late for me to have a family. And now I regret it. I suppose they mean it is never too late to repent. But no sin. I just put it off”. Felt good at the time. Put it off. Now it haunts me. I shall remain unfulfilled until the day I die. I don’t talk about it. He does not know how I feel. Really think he is quite happy as it is. Strange how one does not understand the other. I can accept it. But the thought of it is there. Worrying me. Perhaps I don’t accept it. I don’t know. Punishment for having had a good time. Must you be punished for having a good time? Is a good time bad? It’s just that I put it off. »

What’s done cannot be undone. But the rumination about it can be brought to an end.

Life goes on. One stage moves to the next. She has moved into a phase of life of accepted childlessness. When in transition from one stage to another, the increased activity of our brain leaves us more vulnerable to stress.

Regrets

«It may seem silly, but I have regrets. It’s not that the regrets are silly. It’s the way they keep worrying me. Wish I had spent more time with the children when they were young. I did as much as most people, but feel I could have done more. And Aunt Mary. She had been good to me in the early days. We drifted apart. Wish I could have reconciled things with her before she died. Just silly things. I know them to be silly. But the thought of them keeps stirring my brain. There is no quiet within me, although people comment that I seem so relaxed. ÓÓ

We are human. The human state is full of shortcomings. We can strive towards perfection. But to set God-like standards for what we do is to exalt ourselves beyond our human condition. We are what we are. Improve ourselves within our limits. But let us accept what we are. We forgive others for their shortcomings. The least we can do is to consider ourselves with equal forgiveness. And just if you wish it, seek forgiveness from God.

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