Sleep DisordersSleepandLungCare

What is CPAP and how does CPAP work?

What is CPAP and how does CPAP work?

CPAP treatment Continuous positive airway pressure therapy (CPAP) uses a machine to help a person who has obstructive sleep apnea (OSA) breathe more easily during sleep. A CPAP machine increases air pressure in your throat so that your airway does not collapse when you breathe in.

Types of CPAP masks:

The CPAP machine will have one of the following attached to it:
  • A mask that covers your nose and mouth known as a full face CPAP mask
  • A mask that covers your nose only-called a nasal CPAP mask
  • A mask that fits directly into the base of your nose, with pillow type cushions that seal around your nostrils, known as a nasal pillows CPAP mask

Types of CPAP machines:

There are 2 types of CPAP machines, ones that offer fixed air pressure and ones that offer automatically adjusted air pressure, often known as Auto or APAP machines.
There is no difference in treatment success between both types of machines (CPAP and APAP). The APAP machines are generally more expensive than CPAP. Paying the extra cost for an APAP machine is generally not needed or recommended except in some selected cases.

How Does CPAP Work?

To understand how a CPAP machine works, you should know how obstructive sleep apnea works. Obstructive sleep apnea occurs when the throat muscles and tongue collapse into the airways during sleep, blocking airflow. This airway blockage sends a message to the brain that the body needs to breathe, awakening it from sleep to take a loud, gasping breath. Individuals with mild obstructive sleep apnea experience 5-15 of these episodes per hour of sleep, while individuals with severe obstructive sleep apnea experience more than 30. A CPAP machine works by continuously blowing gentle, pressurized air through the airway. The increased air pressure prevents the airway from collapsing when you breathe. CPAP Machine Effectiveness When used as directed, CPAP therapy can immediately improve the quality of life for individuals who suffer from obstructive sleep apnea. You’ll likely notice less snoring, fewer breathing obstructions and a decrease in daytime sleepiness—among other health benefits. Research has shown that using a CPAP machine can reduce the risk of health problems linked with obstructive sleep apnea, such as high blood pressure, depression and cardiovascular issues.

Difficulties with CPAP

Problems that may occur with CPAP include:
  • Dry nose and sore throat.
  • Nightmares and excessive dreaming during early use.
  • Nasal congestion, runny nose, and sneezing.
  • Irritation of the eyes and the skin on the face.
  • Abdominal bloating.
  • Leaks around the mask because it does not fit properly.
You can expect mild discomfort in the morning when you first start using CPAP. This usually disappear after few nights of using the CPAP machine. All the above mentioned issues can be managed by adjusting the machine pressure and implementing some of the comfort features that are built into all modern CPAP/APAP machines.
Respiratory DisordersSleepandLungCare

Cough in adults

Cough in adults

What is a cough?

— A cough is an important reflex that helps clear out the body’s airways (the trachea and bronchi, which are the tubes that carry air within the lungs). Coughing helps keep people from breathing things into the airways and lungs that could cause problems. It is normal for people to cough once in a while. But sometimes, a cough is a symptom of an illness or condition. Some coughs are called “dry” coughs, because they don’t bring up mucus (phlegm). Other coughs are called “wet” or “productive” coughs, because they do bring up mucus. Some coughs are mild and don’t cause serious problems. Other coughs are severe and can cause trouble breathing.

What causes a cough?

 — In adults, common causes of a cough include:
  • An infection of the airways or lungs (such as the common cold)
  • Postnasal drip – Postnasal drip is when mucus from the nose drips down or flows along the back of the throat. Postnasal drip can happen when people have:
  • A cold
  • Allergies
  • A sinus infection – The sinuses are hollow areas in the bones of the face that open into the nose .
  • Lung conditions, like asthma and chronic obstructive pulmonary disease (COPD) – Both of these conditions can make it hard to breathe. COPD is usually caused by smoking.
  • Acid reflux – Acid reflux is when the acid that is normally in your stomach backs up into your esophagus (the tube that carries food from your mouth to your stomach).
  • A side effect from blood pressure medicines called “ACE inhibitors”
  • Smoking cigarettes

Should I call my doctor or nurse?

— Call your doctor or nurse right away if:
  • You have trouble breathing or noisy breathing (wheezing).
  • You have a fever or chest pain.
  • You cough up blood, or yellow or green mucus.
  • You cough so hard that it makes you vomit.
  • Your cough gets worse or lasts longer than 10 days.
  • You have a cough and have lost weight without trying.

Will I need tests?

— Maybe. To figure out the cause of your cough, your doctor or nurse will talk with you and do an exam. Based on your symptoms and other factors, he or she might decide that you need tests. These might include:
  • A chest X-ray
  • Breathing tests – Breathing tests involve breathing hard into a tube. These tests show how the lungs are working.
  • Allergy skin tests to find out what you’re allergic to – For a skin test, the doctor puts a drop of the substance you might be allergic to on your skin and makes a tiny prick in the skin. Then he or she will watch your skin to see if it gets red and bumpy.
  • A CT scan of your chest or sinuses – A CT scan is an imaging test that creates pictures of the inside of the body.
  • Lab tests on a sample of the mucus you cough up
  • Using a “scope” to look inside your nose, sinuses, airway, or lungs
  • Tests to check for acid reflux – These usually involve having a thin tube put in your mouth and down into your esophagus.

Is there anything I can do on my own to get rid of my cough?

— Yes. To help get rid of your cough, you can:
  • Use a humidifier in your bedroom
  • Use an over-the-counter cough medicine, or suck on cough drops or hard candy
  • Stop smoking, if you smoke
  • If you have allergies, avoid the things you are allergic to (like pollen, dust, animals, or mold)
If you have acid reflux, your doctor or nurse will tell you which lifestyle changes can help reduce symptoms.

How is a cough treated?

 — Treatment depends on the cause of your cough. For example:
  • Some infections are treated with antibiotic medicines. If an infection is caused by bacteria, doctors can treat it with antibiotics. If an infection is caused by the flu virus, a different medicine might help. If the infection is caused by another virus (such as the common cold), antibiotics will not help.
  • Postnasal drip is treated with different kinds of medicines that can come as a pill or nose spray.
  • Asthma and COPD are usually treated with medicines that people breathe into their lungs (called “inhaler medicines”).
  • Acid reflux can be treated with medicine to reduce or block stomach acid.
  • If you have a cough as a side effect from an ACE inhibitor, your doctor can switch your medicine.
If the cause of your cough is not clear, your doctor might prescribe medicine to make your cough less severe. But these medicines have side effects, and doctors usually recommend them only if nothing else has worked.
Respiratory DisordersSleepandLungCare

Chronic obstructive pulmonary disease (COPD), including emphysema

Chronic obstructive pulmonary disease (COPD), including emphysema

What is COPD?

— COPD is a lung disease that makes it hard to breathe. In people with COPD, the airways (the branching tubes that carry air within the lungs) become narrow and damaged . This makes people feel out of breath and tired. COPD can be a serious illness. It cannot be cured and it usually gets worse over time. But there are treatments that can help. You might have heard COPD referred to as “chronic bronchitis” or “emphysema.” These are types of COPD.

Why did I get COPD?

— The most common cause of COPD is smoking. Smoke can damage the lungs forever and cause COPD. People can also get COPD from breathing in toxic fumes or gases. In rare cases, COPD is caused by a genetic problem. A blood test can check for this.

What are the symptoms of COPD?

— At first, COPD often causes no symptoms. As it gets worse it can make you:
  • Feel short of breath, especially when you are moving around
  • Wheeze (make a whistling or squeaking noise as you breathe)
  • Cough and spit up phlegm (mucus)
People who have COPD are also at increased risk for:
  • Infections, such as pneumonia
  • Lung cancer
  • Heart problems

Is there a test for COPD?

— Yes. Your doctor or nurse can give you a test called “spirometry” to check for COPD. During spirometry, you take a deep breath and then blow out as fast and hard as you can into a tube. A machine connected to the tube measures how much air you can blow out of your lungs and how fast you can blow. If the results of your spirometry are not normal, you will get a medicine in an inhaler to see if your breathing gets better. Then after a few minutes, you will repeat the spirometry. This will help the doctor or nurse find out if your problem is caused by COPD or another lung problem, such as asthma. People with asthma usually get normal results after they use an inhaler. People with COPD do not.

Will I need other tests?

— Your doctor might order other tests, too. These can check to see if other problems besides COPD might be causing your symptoms. They can also look for some of the problems that COPD can lead to. Tests you might get include:
  • A blood test for a genetic problem called “antitrypsin deficiency” that can cause COPD.
  • A chest X-ray
  • An electrocardiogram (also called an “ECG”) – This test measures the electrical activity in your heart.
  • A low-dose CT scan – This is an imaging test used to screen for lung cancer. (Imaging tests create pictures of the inside of the body.) Your doctor or nurse might suggest lung cancer screening depending on your age, how much you have smoked in the past, and whether you still smoke.

Is there anything I can do to feel better?

— Yes. Here are 2 important things you should do:
  • STOP SMOKING! If you smoke, the most important thing you can do for your COPD is to stop smoking. It does not matter how long you have smoked or how much you smoke. Quitting will slow your disease and help you feel better.
  • Get the flu shot every fall, and the pneumonia vaccine at least once.Infections like the flu and pneumonia can be very hard on your lungs. It’s important to try to prevent them.

How is COPD treated?

— There are 4 main types of treatment for COPD:
  • Medicines– There are a lot of medicines to treat COPD. Most people use inhalers that help open up their airways or decrease swelling in the airways. Often people need more than one inhaler at a time. You might need to take a steroid medicine in a pill for a flare of COPD. This steroid medicine is not the kind that athletes take to build up muscle.
  • Oxygen– If the disease gets worse, you might need to use oxygen. Your doctor or nurse can test your blood oxygen to see if you need this.
  • Pulmonary rehab– In pulmonary rehab, you learn to improve your symptoms in new ways. You learn exercises and ways to breathe that can help ease symptoms. Even if you don’t do a pulmonary rehab program, staying active can help your breathing.
  • Surgery and endobronchial valves– Rarely, people with the emphysema type of severe COPD will need surgery. Surgery removes the most damaged parts of the lung. This surgery can reduce symptoms, but it does not always work.
Also rarely, doctors will place small “endobronchial valves” in the damaged airways. This can help the healthier parts of the lungs work better. The valves are placed using a thin tube that goes down your throat, called a “bronchoscope.”
Respiratory DisordersSleepandLungCare

The common cold

The common cold

What causes cough, runny nose, and other symptoms of the common cold?

 — These symptoms are usually caused by a viral infection. Lots of viruses can take hold inside your nose, mouth, throat, or lungs, and cause cold symptoms. Most people get over a cold without lasting problems. Even so, having a cold can be uncomfortable. And if your child has a cold, it can be hard to know when the symptoms call for a trip to the doctor.

What are the symptoms of the common cold?

 — The symptoms include:
  • Sneezing
  • Coughing
  • Sniffling and runny nose
  • Sore throat
  • Chest congestion
In children, the common cold can also cause a fever. But adults do not usually get a fever when they have a cold.

How can I tell if I have a cold or the flu?

 — The common cold and the flu both cause many of the same symptoms. But they also have some important differences. This table can help you tell the difference between a cold and the flu.

When should I call the doctor or nurse?

 — Most people who have a cold do not need to see the doctor or nurse. But you should call your doctor or nurse if you have:
  • A fever of more than 100.4º F (38º C) that comes with shaking chills, loss of appetite, or trouble breathing
  • A fever and also have lung disease, such as emphysema or asthma
  • A cough that lasts longer than 10 days
  • Chest pain when you cough, trouble breathing, or coughing up blood
If you are older than 75, you should also call your doctor or nurse any time you get a long-lasting cough. Take your child to the emergency room if he or she:
  • Becomes confused or stops responding to you
  • Has trouble breathing or has to work hard to breathe
Call your child’s doctor or nurse if he or she:
  • Refuses to drink anything for a long time
  • Is younger than 4 months
  • Has a fever and is not acting like him- or herself
  • Has a cough that lasts for more than 2 weeks and is not getting any better
  • Has a stuffed or runny nose that gets worse or does not get better after 2 weeks
  • Has red eyes or yellow goop coming out of his or her eyes
  • Has ear pain, pulls at his or her ears, or shows other signs of having an ear infection

What can I do to feel better?

 — If you are a teenager or an adult, you can try cough and cold medicines that you can get without a prescription. These medicines might help with your symptoms. But they won’t cure your cold, or help you get well faster. If you decide to try nonprescription cold medicines, be sure to follow the directions on the label. Do not combine 2 or more medicines that have Paracetamol in them. If you take too much acetaminophen, the drug can damage your liver. Also, if you have a heart condition, or you take prescription medicines, ask your pharmacist if it is safe to take the cold medicine you have in mind.

What should I know if my child has a cold?

 — In children, the common cold is often more severe than it is in adults. It also lasts longer. Plus, children often get a fever during the first 3 days of a cold.

Are cough and cold medicines safe for children?

 — If your child is younger than 6, you should not give him or her any cold medicines. These medicines are not safe for young children. Even if your child is older than 6, cough and cold medicines are unlikely to help. Never give Aspiring to any child younger than 18 years old. In children, aspirin can cause a life-threatening condition called Reye syndrome. When giving your child Paracetamol or other nonprescription medicines, never give more than the recommended dose.

How long will I be sick?

 — Colds usually last 3 to 7 days in adults and 10 days in children, but some people have symptoms for up to 2 weeks.

Can the common cold lead to more serious problems?

 — In some cases, yes. In some people having a cold can lead to:
  • Pneumonia or bronchitis (infections of the lungs)
  • Ear infections
  • Worsening of asthma symptoms
  • Sinus infections

How can I keep from getting another cold?

 — The most important thing you can do is to wash your hands often with soap and water. Alcohol hand rubs work well, too. The germs that cause the common cold can live on tables, door handles, and other surfaces for at least 2 hours. You never know when you might be touching germs. That’s why it’s so important to clean your hands often.
Respiratory DisordersSleepandLungCare

Chronic bronchitis

Chronic bronchitis

What is chronic bronchitis?

 — Bronchitis is an irritation in the bronchi, the tubes that carry air in and out of the lungs. It causes a cough that brings up mucus (phlegm). In people with chronic bronchitis, this cough lasts for 3 months or longer for 2 or more years in a row. Chronic bronchitis is 1 of the 2 main types of a serious lung disease called “COPD.” The other main form of COPD is called “emphysema.” COPD can make it hard to breathe. Both types of COPD are usually caused by smoking.

Why did I get chronic bronchitis?

 — The most common cause of chronic bronchitis is smoking, which can damage the lungs forever. People can also get chronic bronchitis from breathing in toxic fumes or gases.

What are the symptoms of chronic bronchitis?

 — The symptoms include:
  • Having a cough on most days for at least 3 months, for 2 years in a row
  • Coughing or spitting up clear or white mucus
  • Feeling very tired
  • Feeling short of breath
  • Chest discomfort or tightness

Will I need tests?

 — Yes. Your doctor might do several tests, including:
  • A chest X-ray – This can show other conditions that might be causing your cough, such as pneumonia.
  • Spirometry – During this test, you take a deep breath and then blow out as fast and hard as you can into a tube. A machine connected to the tube measures how much air you can blow out of your lungs and how fast you can blow.
If the results of your spirometry are not normal, your doctor or nurse will give you medicine in an inhaler. Then he or she will test you again. This will help the doctor or nurse find out if your problem is caused by chronic bronchitis or another lung problem, such as asthma. People with asthma usually have normal results after they use an inhaler. People with chronic bronchitis usually do not.

Is there anything I can do on my own to feel better?

 — Yes. If you smoke, stop. This is the most important thing you can do for your chronic bronchitis. It does not matter how long you have smoked or how much you smoke. Quitting will slow your disease and help you feel better. You should also get the flu shot every fall and the pneumonia vaccine at least once. Infections like the flu and pneumonia can hurt your lungs. It’s important to try to prevent them.

How is chronic bronchitis treated?

 — There are 3 main types of treatment for chronic bronchitis:
  • Medicines – There are a lot of prescription medicines to treat chronic bronchitis. Most people use inhalers that help open up their airways or that reduce swelling in the airways. Often people need more than 1 inhaler at a time. Sometimes, people need a medicine called prednisolone that comes in pills when their symptoms get worse than normal.
  • Oxygen – If the disease gets worse, some people need to use oxygen for breathing.
  • Pulmonary rehab – In pulmonary rehab, people learn things they can do to improve their symptoms. They learn exercises and ways to breathe that can help ease symptoms.
Respiratory DisordersSleepandLungCare

Bronchiectasis in adults

Bronchiectasis in adults

What is bronchiectasis?

— Bronchiectasis is a lung condition that causes a cough (often with mucus), shortness of breath, and other symptoms. In people with this condition, the airways (the branching tubes that carry air within the lungs) are wider than normal. This leads to an increase in mucus, which can be hard to cough up. When mucus stays in the lungs, it makes people with bronchiectasis more likely to get lung infections or bronchitis. Bronchiectasis has many different causes. These include certain infections or problems with the body’s infection-fighting system (called the “immune system”). Other diseases that can cause bronchiectasis include cystic fibrosis and pneumonia.

What are the symptoms of bronchiectasis in adults?

— Symptoms of bronchiectasis can include:
  • A long-lasting cough – The cough usually brings up thick, sticky mucus. It can last weeks or even months.
  • Shortness of breath or breathing that sounds like whistling (wheezing).
  • Frequent bronchitis or other lung infections.
  • A cough that brings up blood – This sometimes happens with bronchiectasis.
  • Sharp chest pain – The pain tends to get worse when you take a breath.
Some patients with bronchiectasis also have chronic sinusitis. This condition can cause a stuffy nose, pain in the cheeks or forehead, and yellow or green mucus from the nose.

Should I see a doctor or nurse?

— Yes. Call your doctor or nurse if:
  • You are coughing more than usual or your cough bothers you during sleep or other activities
  • You have shortness of breath or noisy breathing (wheezing)
  • You have new chest pain
  • You cough up dark yellow or green mucus, or thick, sticky mucus every day
  • You cough up blood
  • You have a fever

Will I need tests?

— Your doctor or nurse will learn about your symptoms and do an exam. You might have some or all of these tests:
  • Blood tests – These can help find the cause of the bronchiectasis, if it is not already known.
  • Tests on a sample of mucus you cough up (called a “sputum culture”)
  • Chest X-ray
  • CT scan of your chest – A CT scan is an imaging test that creates pictures of the inside of the body. It can show a detailed picture of your lungs and airways. A CT scan is usually needed to know if you have bronchiectasis, and to see which parts of the lungs are involved.
  • Tests to learn how well your lungs are working (“pulmonary function tests”)
  • A test called a “bronchoscopy” – You might have this test if you are coughing up blood. During this procedure, a doctor uses a thin tube (called a “bronchoscope”) to look at the airways inside the lungs.

How is bronchiectasis in adults treated?

— Doctors can give several different treatments to help with symptoms and prevent further problems. These can include:
  • Medicines to treat and prevent lung infections, reduce airway inflammation, and help thin out mucus in the lungs.
  • Airway clearance therapy – This involves loosening the mucus in the lungs so you can cough it up more easily. It is sometimes called “chest physiotherapy.” There is more than 1 way to do this. A doctor, nurse, or therapist can show you the different ways.
  • Treatment to stop bleeding in the airways – Coughing up a lot of blood can be life threatening. Doctors can do a procedure called “bronchial artery embolization” to help stop the bleeding. During this procedure, the doctor puts a thin tube into an artery in the leg and moves it up to the lungs. Then he or she uses tiny tools to block the artery in the bleeding area.
  • Pulmonary rehabilitation – This is called “pulmonary rehab” for short. In pulmonary rehab, you can learn about other ways to improve your symptoms. This includes getting information about your lung disease, learning ways to save energy, and exercising with a therapist.
  • Surgery – If part of a lung is damaged or keeps getting infected, doctors might do surgery to remove the most involved areas.
  • Lung transplant – This is done at a transplantation center. A surgeon replaces a person’s diseased lungs with healthy lungs. A lung transplant is done only in people who have severe disease and meet certain conditions.
If the bronchiectasis is caused by another medical condition, doctors will treat that condition. This could help the bronchiectasis.

Is there anything I can do on my own for bronchiectasis?

— If you smoke, the most important thing you can do is to stop smoking. It does not matter how long you have smoked or how much you smoke. Quitting can slow your disease and help you feel better. Get the flu shot every year (usually in the fall) and the pneumonia vaccine at least once. Infections like the flu and pneumonia can be very hard on your lungs.
Respiratory DisordersSleepandLungCare

Pulmonary embolism (blood clot in the lungs)

Pulmonary embolism (blood clot in the lungs)

What is a pulmonary embolism?

— Pulmonary embolism (or “PE”) is a blockage in 1 or more of the blood vessels that supply blood to the lungs. Most often these blockages are caused by blood clots that form elsewhere and then travel to the lungs. In rare cases, blockages can also be caused by air bubbles, tiny globs of fat, or pieces of tumor that travel to the lungs.

Why are blood clots dangerous?

— If a blood clot forms or gets stuck inside a blood vessel, it can clog the vessel and keep blood from getting where it needs to go. When that happens in the lungs, the lungs can get damaged. Having blocked arteries in the lung can also make it hard to breathe and can even lead to death. Most blood clots in the lungs actually form in the legs or pelvic area (where the legs connect to the body) and then travel to the lungs. Anyone who has had a blood clot in the lungs or who is at risk of a clot should know the symptoms of clots in these areas.

What are the symptoms of blood clots in the lungs?

— Common symptoms include:
  • Panting, shortness of breath, or trouble breathing
  • Sharp, knife-like chest pain when you breathe in or strain
  • Coughing or coughing up blood
  • A rapid heartbeat
If you get any of these symptoms, especially if they happen over a short period of time (hours or days) or get worse quickly, call for an ambulance (in the US and Canada, dial 9-1-1). At the hospital, doctors can run tests to find out if you do have a clot. Blood clots in the lungs can lead to death. That’s why it’s important to act fast and find out if there is a clot.

What are the symptoms of blood clots in the legs?

— Blood clots in the legs cause different symptoms depending on whether the clots form in veins deep in the leg or in the veins near the surface of the skin. Blood clots in the deep veins of the legs (also called “DVT”) are the most dangerous. Clots in the deep veins can cause:
  • Swelling
  • Pain
  • Warmth and redness in the involved leg
Blood clots in the veins near the surface of the skin (called “superficial veins”) are more painful, and can cause redness or infection. These clots sometimes also cause the veins to harden and bulge into ridges that look like cords. This is most common with the veins below the knee. If you think you have a blood clot in your leg, call your doctor or nurse right away. Blood clots in the veins near the surface of the skin are less dangerous. But blood clots in the deep veins of the leg are more serious and are more likely to travel to the lungs. Your doctor or nurse can do tests to find out if you do have a clot and where it is.

Is there a test to find blood clots in the lungs?

— Yes. There are several tests doctors can use to find out if a person has a blood clot in a lung. The most common tests include:
  • D-dimer blood test – D-dimer is a substance in the blood. The amount of D-dimer often goes up in people with a blood clot in a lung. This blood test is often done together with other tests.
  • CT pulmonary angiogram (also called a CT-PA) – A CT pulmonary angiogram is a special kind of X-ray that involves the use of computers. During this test, a dye is injected into 1 of your veins. The dye shows up on X-rays and can show if any blood vessels are blocked.
  • A ventilation/perfusion lung scan (also called a V/Q scan) – For this test, you breathe in a small amount of a radioactive substance. You also have a radioactive dye injected into 1 of your veins. Then doctors look at how the different substances look on the scan. The scan can show if 1 of the arteries in the lung is blocked.
  • Pulmonary angiography – For this test, you have a small tube called a “catheter” inserted into 1 of the large veins in your body, usually 1 in your leg. Then doctors gently push this tube up into the chest to where the major blood vessels of the lung are found. When the tube is in place, the doctors inject a dye that shows up on an X-ray.

How are blood clots in the lungs treated?

— Blood clots in the lungs are treated with medicines that dissolve clots or that keep clots from getting bigger. Some of these medicines are injected directly into a vein, while others come in shots or pills. Most people being treated for a blood clot in the lung are treated first in the hospital. After being released from the hospital, people who have had clots are usually put on medicines to prevent future blood clots. These medicines are called “anticoagulants,” “blood thinners,” or “anti-clotting medicines.” Almost everyone is put on an anti-clotting medicine that comes in a pill for at least 3 months (and usually longer). Some people are put on an anti-clotting medicine that is injected under the skin, called heparin. This might be for the first few days they are home, or longer if for some reason they can’t take pills. Anti-clotting medicines do not dissolve existing blood clots, but they do keep them from getting bigger. They also help keep new blood clots from forming. Being on an anti-clotting medicine for a few months is important because it gives the body time to dissolve the old clot. It’s also important because people who have a clot are at risk of developing another clot, especially in the first few months. There are a few different anti-clotting medicines that come in pill form. If your doctor puts you on an anti-clotting medicine, take it exactly as directed. If you forget or miss a dose, call your doctor to find out what to do. When you start taking an anti-clotting medicine, you will need to have your blood tested. If you are taking warfarin, you will need regular blood tests to check how your blood is clotting. If there are changes in your medical condition or test results, your doctor might need to adjust your dose. At the wrong dose, the drug can either stop working or lead to serious bleeding. In fact, bleeding is a risk with all the anti-clotting medicines, so you and your doctor should also always watch out for signs of bleeding. People who cannot take medicines to treat clots, or who do not get enough benefit from the medicines, can get a different treatment. This is called an “inferior vena cava filter” (also called an IVC filter). The inferior vena cava is the large vein that carries blood from your legs and the lower half of your body back up to your heart. IVC filters go inside the inferior vena cava. They filter and trap any large clots that form below the location of the filter. Your doctor might suggest 1 of these filters for you if:
  • You cannot safely take  anti-clotting medicine
  • You form clots even while on anti-clotting medicine
  • You have a dangerous bleeding problem while on anti-clotting medicine
  • You are so sick that another pulmonary embolism could kill you
In some cases, a person has a clot that is severe enough to cause low blood pressure and even shock. (Shock is when blood pressure gets too low, and not enough blood can get to the body’s organs and tissues.) If this happens, doctors can give medicine to dissolve the clot. This is sometimes called “clot-busting” medicine, and is given through a catheter (a small tube inserted into the vein). In some cases, doctors will do surgery to remove the clot.

Can I do anything on my own to prevent blood clots?

— Yes. People sometimes form clots because they have been sitting still for too long. People who travel on long airplane flights, for example, are at increased risk of blood clots. Here are some things you can do to help prevent a clot during a long flight:
  • Stand up and walk around every 1 to 2 hours
  • Do not smoke just before your trip
  • Wear loose, comfortable clothes
  • Shift your position while seated, and move your legs and feet often
  • Drink plenty of fluids
  • Wear knee-high compression stockings
  • Avoid alcohol and medicines that make you sleepy, because they can impair your ability to move around
Respiratory DisordersSleepandLungCare

Acute bronchitis

Acute bronchitis

What is bronchitis?

— Bronchitis is an infection that causes a cough. It happens when the tubes that carry air into the lungs, called the “bronchi,” get infected. Usually, bronchitis happens after a person gets a cold or the flu. The viruses that cause the cold or flu infect the bronchi and irritate them. People often wonder if taking antibiotics will help with their bronchitis. But the answer is no, because it is usually caused by a virus. Antibiotics kill bacteria, not viruses. Bronchitis can also happen when a person gets an infection called “whooping cough,” but this is much less common. Whooping cough is caused by bacteria that can infect the bronchi. Most people get vaccines that prevent whooping cough, but the vaccine doesn’t always work. Your doctor will be able to tell if you have whooping cough by doing an exam and listening to way your cough sounds. This article is about “acute” bronchitis. This is different from “chronic” bronchitis, which is an illness in smokers who have a long-lasting cough.

What are the symptoms of bronchitis?

— The most common symptoms of bronchitis are:
  • A nagging cough that can last up to a few weeks
  • Coughing up mucus that is clear, yellow, or green – Some people think green mucus means you have a bacterial infection. But this is not always true.
  • You might also have normal cold or flu symptoms, like a stuffy nose, sore throat, or headache. People with bronchitis do not usually get a fever.

When should I call the doctor or nurse?

— Most people who have a cough that lasts longer than their other cold or flu symptoms do not need to see a doctor. The cough can take up to 3 weeks to get better, sometimes even longer. But you should call your doctor or nurse if you have:
  • A fever higher than 100.4°F (38°C)
  • Chest pain when you cough, trouble breathing, or coughing up blood
  • A barking cough that makes it hard to talk
  • A cough and weight loss that you cannot explain
  • Symptoms that are not getting better after 3 weeks

Is there a test for bronchitis?

— People do not usually need a test. But your doctor or nurse might do a test, such as a chest X-ray, if the cause of your cough isn’t clear.

How is bronchitis treated?

— Bronchitis almost always goes away on its own, although it can take a few weeks. Doctors do not usually treat bronchitis with antibiotic medicines. That’s because bronchitis is usually caused by a virus, and antibiotics kill bacteria, not viruses. Antibiotics will not help your bronchitis go away faster, and they can actually cause other problems. So it’s not a good idea to take them if you don’t really need them. To feel better, you can treat your cold and flu symptoms. Different treatments you can try include:
  • Getting lots of rest and drinking plenty of liquids
  • Drinking hot tea
  • Sucking on cough drops or hard candy
  • Taking over-the-counter cough and cold medicines
  • Breathing in warm, moist air, such as in the shower, over a kettle, or from a humidifier
  • Taking a pain-relieving medicine if you have cold or flu symptoms like headache, muscle aches, or joint pain
It’s also important to avoid smoking or being around others who smoke. This can make your cough worse.

How can I keep from getting bronchitis again?

— You can reduce your chance of getting bronchitis again by keeping the germs that cause bronchitis out of your body. One of the best ways to do this is to wash your hands often with soap and water. If there is no sink nearby, you can use a hand gel with alcohol in it to clean your hands.

How can I keep from spreading my germs?

— In addition to washing your hands often, you should cover your mouth with your elbow when you sneeze or cough. Using your elbow keeps you from getting germs on your hands. If you use a tissue, throw the tissue away and wash your hands.
Respiratory DisordersSleepandLungCare

Sarcoidosis

Sarcoidosis

What is sarcoidosis?

— Sarcoidosis is a disorder that causes clusters of abnormal tissue to form in the body. These clusters are called “granulomas.” If many granulomas form in an organ, they can keep the organ from working normally. For example, granulomas can form in the lungs and cause breathing problems. Sarcoidosis can affect many different organs. Often it affects the lungs, but it can also affect the skin, eyes, nose, and lots of other body parts.

What are the symptoms of sarcoidosis?

— Sarcoidosis causes different symptoms depending on which body part it affects. Often the symptoms are mild and go away on their own. When it affects the lungs, sarcoidosis can cause:
  • Cough
  • Trouble breathing
  • Chest pain
  • Tiredness or weakness
  • Fever
  • Weight loss
When it affects the skin, sarcoidosis can cause a mild rash or painful bumps called Erythema Nodosum. Sometimes the rash and bumps go away completely. Other times, they leave a scar. Sometimes, sarcoidosis causes no symptoms even though it is damaging certain organs. For this reason, people with sarcoidosis might need to have tests to check for organ damage.

How do I know if I have sarcoidosis?

— There is no single “test” that can tell if you have sarcoidosis. To diagnose it, doctors and nurses look at:
  • Your symptoms and your physical exam
  • X-rays (or special X-rays called CT scans)
  • Lab work on tissue taken from your body (called a biopsy)
  • Tests that can rule out other causes of your condition

How is sarcoidosis treated?

— Doctors and nurses do not know what causes sarcoidosis, so they do not have a treatment to cure it. Luckily, they do have ways to treat its symptoms. Even so, if your symptoms are mild, you might not need treatment. Medicines called steroids can relieve the symptoms of sarcoidosis and prevent some of the damage it can cause. These steroid medicines are not the kind that athletes take to build up muscle. These steroids reduce swelling and shrink the granulomas caused by sarcoidosis. Sometimes, people can use skin creams, eye drops, and inhalers that have steroids in them. Other times, if their symptoms are severe, they take steroid pills. Even though steroid pills can help with the problems caused by sarcoidosis, they can also cause problems of their own. For instance, steroids can cause weight gain and mood swings, and make diabetes worse. For this reason, doctors and nurses try to take people off steroids as soon as possible. Medicines besides steroids can also help with sarcoidosis. Doctors and nurses usually use these medicines only in people who cannot take steroids or who do not get better with steroids.

How will sarcoidosis affect my life?

— Sarcoidosis usually goes away on its own or does not get worse. Sometimes it does get worse and can spread to many organs. Even so, people do not usually die from sarcoidosis.
Respiratory DisordersSleepandLungCare

Quitting smoking

Quitting smoking

What are the benefits of quitting smoking?

— Quitting smoking can lower your chances of getting or dying from heart disease, lung disease, kidney failure, infection, or cancer. It can also lower your chances of getting osteoporosis, a condition that makes your bones weak. Plus, quitting smoking can help your skin look younger and reduce the chances that you will have problems with sex. Quitting smoking will improve your health no matter how old you are, and no matter how long or how much you have smoked.

What should I do if I want to quit smoking?

— The letters in the word “START” can help you remember the steps to take: S = Set a quit date. T = Tell family, friends, and the people around you that you plan to quit. A = Anticipate or plan ahead for the tough times you’ll face while quitting. R = Remove cigarettes and other tobacco products from your home, car, and work. T = Talk to your doctor about getting help to quit.

How can my doctor or nurse help?

— Your doctor or nurse can give you advice on the best way to quit. He or she can also put you in touch with counselors or other people you can call for support. Plus, your doctor or nurse can give you medicines to:
  • Reduce your craving for cigarettes
  • Reduce the unpleasant symptoms that happen when you stop smoking (called “withdrawal symptoms”).
You can also get help from a free phone support line ( Quitline 13 7848.) or go online to www.quitnow.gov.au/.

What are the symptoms of withdrawal?

— The symptoms include:
  • Trouble sleeping
  • Being irritable, anxious or restless
  • Getting frustrated or angry
  • Having trouble thinking clearly
Some people who stop smoking become temporarily depressed. Some people need treatment for depression, such as counseling or antidepressant medicines. Depressed people might:
  • No longer enjoy or care about doing the things they used to like to do
  • Feel sad, down, hopeless, nervous, or cranky most of the day, almost every day
  • Lose or gain weight
  • Sleep too much or too little
  • Feel tired or like they have no energy
  • Feel guilty or like they are worth nothing
  • Forget things or feel confused
  • Move and speak more slowly than usual
  • Act restless or have trouble staying still
  • Think about death or suicide
If you think you might be depressed, see your doctor or nurse. Only someone trained in mental health can tell for sure if you are depressed. If you ever feel like you might hurt yourself, go straight to the nearest emergency department. Or you can call for an ambulance (000) or call your doctor or nurse right away and tell them it is an emergency.

How do medicines help you stop smoking?

— Different medicines work in different ways:
  • Nicotinereplacement therapy eases withdrawal and reduces your body’s craving for nicotine, the main drug found in cigarettes. There are different forms of nicotine replacement, including skin patches, lozenges, gum, nasal sprays, and “puffers” or inhalers. Many can be bought without a prescription, while others might require one.
  • Varenicline (brand name Champix) is a prescription medicine that reduces withdrawal symptoms and cigarette cravings. If you think you’d like to take varenicline and you have a history of depression, anxiety, or heart disease, discuss this with your doctor or nurse before taking the medicine. Varenicline can also increase the effects of alcohol in some people. It’s a good idea to limit drinking while you’re taking it, at least until you know how it affects you.

How does counseling work?

— Counseling can happen during formal office visits or just over the phone. A counselor can help you:
  • Figure out what triggers your smoking and what to do instead
  • Overcome cravings
  • Figure out what went wrong when you tried to quit before

What works best?

— Studies show that people have the best luck at quitting if they take medicines to help them quit and work with a counselor. It might also be helpful to combine nicotine replacement with one of the prescription medicines that help people quit.

What about e-cigarettes?

— Sometimes people wonder if using electronic cigarettes, or “e-cigarettes,” might help them quit smoking. Using e-cigarettes is also called “vaping.” Doctors do not recommend e-cigarettes in place of medicines and counseling. That’s because e-cigarettes still contain nicotine as well as other substances that might be harmful. It’s not clear how they can affect a person’s health in the long term.

Will I gain weight if I quit?

— Yes, you might gain a few pounds. But quitting smoking will have a much more positive effect on your health than weighing a few pounds more. Plus, you can help prevent some weight gain by being more active and eating less.

What else can I do to improve my chances of quitting?

— You can:
  • Start exercising.
  • Stay away from smokers and places that you associate with smoking. If people close to you smoke, ask them to quit with you.
  • Keep gum, hard candy, or something to put in your mouth handy. If you get a craving for a cigarette, try one of these instead.
  • Don’t give up, even if you start smoking again. It takes most people a few tries before they succeed.

What if I am pregnant and I smoke?

— If you are pregnant, it’s really important for the health of your baby that you quit. Ask your doctor what options you have, and what is safest for your baby.
Respiratory DisordersSleepandLungCare

Pulmonary nodule (A spot on the lung)

Pulmonary nodule (A spot on the lung)

What is a pulmonary nodule?

— A pulmonary nodule, also called a lung nodule, is a “spot” on the lungs that is seen on a chest X-ray or CT scan. A CT scan is an imaging test that creates pictures of the inside of the body. If there is only 1 spot, it’s called a “single” (or “solitary”) pulmonary nodule. A single pulmonary nodule usually causes no symptoms. People find out they have it after they have a chest X-ray or CT scan done for another reason.

What causes a pulmonary nodule?

— A pulmonary nodule is caused by either:
  • A condition that is not cancer – In most cases, a pulmonary nodule is not cancer. It is a growth, small area of infection, or old scar in the lungs. Some medical terms for these things include “granuloma,” which is an area of inflammation, and “hamartoma,” which is a non-cancerous growth.
  • Cancer – A pulmonary nodule can be lung cancer, which is when normal cells in the lungs change into abnormal cells and grow out of control. It can also be cancer that started in another part of the body and then spread to the lungs.

How will my doctor know whether my pulmonary nodule is cancer or not?

— To help figure this out, your doctor will use the following information:
  • Your age
  • Whether you have other symptoms or other known cancers
  • Whether you smoke or used to smoke
  • Whether you have family members with lung cancer
  • Whether you have worked with or around a material called asbestos
  • The spot’s size and shape on the X-ray or CT scan
  • Whether the spot has changed over time – To know this, your doctor will look at any old chest X-rays and CT scans you have.
Based on this information, your doctor will know whether there is a high, medium, or low chance that your pulmonary nodule is cancer.

What if there is a high chance my pulmonary nodule is cancer?

— If there is a high chance that your pulmonary nodule is cancer, your doctor will most likely do surgery to remove it. Before surgery, your doctor will order an imaging test called a PET scan. For this test, a doctor puts a substance in your vein through a thin tube, called an “IV.” Then a special camera takes pictures of your lungs, liver, brain, and bones. A PET scan can show whether the cancer has spread outside of your lungs. Also before surgery, you will have breathing tests to make sure it is safe to have part of your lung removed. After surgery, a doctor will look at the nodule under a microscope to see whether it was cancer. If it was cancer, your doctor will discuss possible further tests or treatment. If it wasn’t cancer, you will probably not need any further treatment.

What if there is a medium chance my pulmonary nodule is cancer?

— If there is a medium chance that your pulmonary nodule is cancer, your doctor will get more information about the nodule. If the nodule is 1/3 of an inch or bigger, your doctor will either order a PET scan or do a biopsy. A biopsy is a test in which your doctor will get a sample of tissue from the nodule. Depending on where the nodule is in the lung, your doctor can put a needle through your chest and into the nodule. Or he or she can put a thin tube with a camera and light on the end (called a “bronchoscope”) in your mouth or nose and down into your lungs to get a sample. After your doctor gets some tissue from the nodule, another doctor will look at the sample under a microscope to see whether cancer is present. If the PET scan or biopsy shows cancer, your doctor will likely recommend surgery to remove the nodule. If the nodule is smaller than 1/3 of an inch, or if the PET scan shows that the nodule is unlikely to be cancer, your doctor will probably recommend monitoring your nodule. He or she will repeat a CT scan in 3 to 6 months. Your doctor will also get other information by doing an exam and ordering some blood tests. Further tests are based on these results. For example, if you have a large lymph node (bean-shaped organ under your skin) on exam, you might need other tests.

What if there is a low chance my pulmonary nodule is cancer?

— If there is a low chance that your pulmonary nodule is cancer, your doctor will monitor it. He or she will order repeat CT scans. How often the scans are done depends on your individual situation. Most people have repeat CT scans done once or twice a year for up to 5 years. If your pulmonary nodule does not get bigger over time on repeat CT scans, it is most likely not cancer. Your doctor will then stop ordering repeat CT scans. If your pulmonary nodule does get bigger over time, your doctor will probably recommend surgery to remove it. Before the surgery, you will probably have a PET scan and breathing tests.
Respiratory DisordersSleepandLungCare

Pneumothorax (collapsed lung)

Pneumothorax (collapsed lung)

What is a pneumothorax?

 — A pneumothorax happens when air leaks out of the lung and collects in the space between the lung and the chest wall. This makes the lung collapse.

Other conditions can also cause a collapsed lung. But this article discusses a collapsed lung caused by air leaking out.

A pneumothorax can be mild (a small collection of air) or severe (a large collection of air). A severe pneumothorax is a medical emergency and can be life-threatening.

What causes a pneumothorax?

 — A lung injury, such as from an accident or surgery, can cause a pneumothorax.

A pneumothorax can also happen in people who do not have a lung injury. Some lung conditions and behaviors make a pneumothorax more likely to happen. These include:

  • Chronic obstructive pulmonary disease – This is a lung condition caused by smoking that makes it hard to breathe. It is also called “emphysema.”
  • Certain lung infections
  • Cystic fibrosis – This is a condition that some children are born with. It causes lung damage and lung infections.
  • Smoking

Sometimes, a pneumothorax happens in people who have no known lung condition or injury.

What are the symptoms of a pneumothorax?

 — People with a small pneumothorax might not have any symptoms. They might find out that they have it when they have a chest X-ray for another reason.

When people do have symptoms, the symptoms usually start suddenly and include:

  • Chest pain that can be sharp or stabbing
  • Trouble breathing

Should I call the doctor or nurse?

 — Yes. The symptoms listed above can also be caused by other conditions. But if you have these symptoms, call your doctor or nurse right away.

Is there a test for a pneumothorax?

 — Yes. Your doctor or nurse will ask about your symptoms, do an exam, and do a chest X-ray.

He or she might also do a CT scan. A CT scan is an imaging test that can create pictures of the inside of the body.

How is a pneumothorax treated?

 — Your treatment will depend on your symptoms and how small or big your pneumothorax is.

If your pneumothorax is small, your doctor might treat you by giving you oxygen and following your condition. That’s because a small pneumothorax sometimes gets better on its own. To follow your condition, your doctor might do a few chest X-rays over time.

If your pneumothorax is large or causing symptoms, your doctor will remove the air that has collected outside of your lung. He or she can do this in different ways:

  • Sometimes, the doctor can put a needle through your ribs, then suck out the air using a syringe.
  • Other times, your doctor will make a small hole in between your ribs. He or she will put a tube through the hole and into the collection of air. The tube will stay in your chest for a few days.

If your doctor uses a large tube (called a “chest tube”), you will need to stay in the hospital while it is in your chest. If your doctor uses a small tube, you might be able to go home during this time.

If this procedure doesn’t work, your doctor might need to do lung surgery to close off the air leak. This surgery is called “thoracoscopy.” During thoracoscopy, the doctor will give you medicine to make you sleep. Then he or she will make 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do the surgery.

If you need thoracoscopy to treat your pneumothorax, your doctor might do another surgical procedure during thoracoscopy to help prevent a future pneumothorax. He or she might also do this procedure if you have had more than one pneumothorax, even if the air leak stopped quickly.

Another way to help prevent a future pneumothorax is for your doctor to put a substance in your chest tube. This substance goes into the space where the air collected and helps the lung stick to the chest wall. This helps prevent air from collecting again.

What else should I do after treatment?

 — If you smoke, you should stop smoking. This can help lower your chance of getting another pneumothorax.

You should also ask your doctor when you can fly in an airplane or go scuba diving. Some people need to wait a certain amount of time after treatment before it’s safe for them to fly or go scuba diving.

 

Respiratory DisordersSleepandLungCare

Pneumonia in adults (Bacterial chest infection)

Pneumonia in adults (Bacterial chest infection)

What is pneumonia?

 — Pneumonia is an infection of the lungs that causes coughing, fever, and trouble breathing. It is a serious illness, especially in young children, people older than 65, and people with other health problems. Pneumonia is usually caused by bacteria but can also be caused by viruses or other germs.

What are the symptoms of pneumonia?

 — Common symptoms include:

  • Cough
  • Fever (temperature higher than 100.4°F or 38°C)
  • Trouble breathing
  • Pain when you take a deep breath
  • A fast heartbeat
  • Shaking chills

When people with pneumonia cough, they often cough up phlegm or mucus.

Should I see a doctor or nurse if I think I have pneumonia?

 — Yes, see a doctor or nurse as soon as possible. Pneumonia can be mild. But it can also be very serious, especially if you do not get it treated quickly. It’s especially important to see your doctor or nurse right away if:

  • Your cough keeps getting worse
  • You start having trouble breathing when doing everyday tasks or when resting
  • You have chest pain when you breathe in
  • You feel suddenly worse after getting better from a cold or the flu
  • You have a weakened immune system, for example because you have an HIV infection, had an organ transplant or stem cell (bone marrow) transplant, or take medicines that suppress the immune system
  • You already have a serious lung disease, such as chronic obstructive pulmonary disease or emphysema
  • You are 65 years of age or older

If your doctor or nurse thinks you might have pneumonia, he or she will probably take an X-ray of your chest. Taking a chest X-ray is the best way to tell if you have pneumonia.

How is pneumonia treated?

 — Pneumonia that is caused by bacteria is treated with antibiotics. These medicines kill the germs that cause pneumonia. Most people can take antibiotic pills at home, but some people need to be treated in the hospital. Make sure to take all of your antibiotics, even if you feel better before you finish them.

Pneumonia caused by influenza (or “the flu”) is treated with an antiviral medicine.

How soon will I feel better?

 — You should start to feel better 3 to 5 days after you start taking antibiotics. Most people can get back to their normal routine within a week of starting treatment. Even so, you might feel tired or have a cough for a month or longer after you get treated. Although this cough can take a while to go away, it is usually milder than when you first got sick.

How should I take care of myself until I recover?

 — Get lots of rest and drink lots of fluids.

If you don’t need to stay in the hospital, your doctor or nurse will probably want to see you or talk to you a few days after you begin treatment. This is to make sure your pneumonia is getting better. He or she should also see you after you get better to make sure everything is back to normal.

If your symptoms do not improve or get worse after starting treatment, tell your doctor or nurse.

What can I do to keep from getting pneumonia again?

 — You can wash your hands often with soap and water, or use alcohol hand rubs. Doing so will help protect you from germs.

There is also a vaccine against the most common type of bacterial pneumonia. But the pneumonia vaccine is not recommended for everyone. Ask your doctor if you should have it. You should get a flu vaccine every year.

 

Respiratory DisordersSleepandLungCare

Pleural effusion (Fluid in the pleural space)

Pleural effusion (Fluid in the pleural space)

What is pleural effusion?

 — Pleural effusion is a build up of fluid around (but not inside) the lungs. Heart failure is the most common cause of this problem. Pleural effusion can also be caused by an infection, cancer, or other health problems.

What are the symptoms of pleural effusion?

 — The symptoms include:

  • Chest pain – This pain can be sharp and get worse when you cough or take a deep breath. Sometimes the pain is a dull ache.
  • Breathing problems – You might breathe faster than normal or feel short of breath.
  • Cough
  • Fever
  • Hiccups

Will I need tests for pleural effusion?

 — Yes. Tests for pleural effusion include:

  • An X-ray of your chest
  • A CT scan of your chest – This is a special type of X-ray.
  • Ultrasound – This test uses sound waves to take pictures of the fluid around your lungs. Your doctor might do this test if you need to have some fluid taken out.
  • Thoracentesis – This is the name for a test in which a doctor takes a sample of fluid from around your lung. This is done using a needle that goes through the skin on your chest. Another doctor then checks the sample under a microscope.

How is pleural effusion treated?

 — The treatment depends on your symptoms and the cause of the problem. If you are having trouble breathing, your doctor will remove the fluid from around your lungs with a needle or plastic tube.

If heart failure caused the fluid around your lungs, your doctor will prescribe medicines called “diuretics.” These help pull fluid out of your lungs.

If an infection caused the fluid around your lungs, your doctor will prescribe antibiotics. Your doctor might put a flexible plastic tube into the fluid to drain the infection. This tube might stay in for a few days.

If you have cancer and get fluid around your lungs, your doctor might put a flexible plastic tube in the side of your chest to drain away the extra fluid. Your doctor might leave the tube in for a few weeks and you will drain the fluid at home. You might also need chemotherapy to treat the cancer and prevent the fluid from coming back.

You also might need surgery to remove a small sample of tissue from around your lungs. This is called a “biopsy.” Tests on this tissue can help explain why you have the effusion. At the time of surgery, the doctor might use a powdery substance called “talc” to close the space and keep the fluid from returning.

 

Respiratory DisordersSleepandLungCare

Pleural Mesothelioma (Pleural cancer)

Pleural Mesothelioma (Pleural cancer)

What is pleural mesothelioma?

 — Pleural mesothelioma is a rare type of cancer that happens in the thin layer of tissue around the lungs. This tissue is called the “pleura”.

Pleural mesothelioma is a very serious illness that gets worse over time.

People who get pleural mesothelioma are usually older than 50. It is almost always caused by being around a mineral called “asbestos.” Asbestos used to be common in insulation, ceiling tiles, car brakes, and many other materials. It is made up of very small fibers. If these fibers get into the lungs, they can cause serious health problems.

Since the 1970s, people have mostly stopped using asbestos. That’s because scientists learned that being around asbestos (“asbestos exposure”) can cause problems, including pleural mesothelioma. These problems might not happen until many years after a person is around asbestos. If you were around asbestos in the past, you could be at risk for pleural mesothelioma.

What are the symptoms of pleural mesothelioma?

 — The main symptoms include:

  • Shortness of breath – You might feel like you can’t get enough air or have to work harder than usual to breathe.
  • Chest pain

Having these symptoms does not mean you have pleural mesothelioma. Many common conditions cause shortness of breath and chest pain. Most of these conditions are much more common than pleural mesothelioma.

Should I see a doctor or nurse?

 — Yes. If you have shortness of breath, see your doctor or nurse. If you have chest pain or a lot of trouble breathing, you need to go to the hospital. Those symptoms could mean that your condition is serious.

Will I need tests?

 — Yes. Your doctor or nurse will do an exam and learn about your symptoms. You might have some or all of these tests:

  • Chest X-ray and other imaging tests – These might include a CT scan, PET scan, or MRI. All these tests create pictures of your lungs and the area around them.
  • Breathing tests – In these tests, you breathe hard into a tube. The tests show how well your lungs are working.
  • Bronchoscopy – A doctor uses a thin tube (called a “bronchoscope”) to look inside your airways.
  • Biopsy – A doctor takes a small sample of tissue from the pleura or the space between your lungs. Another doctor looks at the sample under a microscope to check for mesothelioma.

How is pleural mesothelioma treated?

 — Doctors cannot always get rid of pleural mesothelioma. But they can give treatments that might help you breathe better or have less pain. These include:

  • Surgery – Many people with pleural mesothelioma are not healthy enough for surgery, but a few people are. During surgery, doctors might:
  • Take out some (or all) of the tissue that has mesothelioma.
  • Drain fluid from around the lung
  • Put a powdery substance called “talc” in the space around the lung. This can help keep fluid from building up there.
  • Radiation therapy – Radiation kills cancer cells.
  • Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

Some people have a combination of treatments. For example, you might have radiation treatment or chemotherapy after surgery. The best treatment for you will depend on your age, health, and other symptoms. Your doctor or nurse will talk with you about the best treatment.

 

Respiratory DisordersSleepandLungCare

Lung cancer (The Basics)

Lung cancer (The Basics)

What is lung cancer?

— Lung cancer happens when normal cells in the lungs change into abnormal cells and grow out of control. There are different types of lung cancer. Some types grow much faster than others.

What are the symptoms of lung cancer?

— Common symptoms of lung cancer can include:
  • Cough
  • Trouble breathing, or wheezing
  • Spitting or coughing up blood
  • Chest pain that can be dull, sharp, or stabbing
  • Hoarse voice
  • Headache and swelling of the face, arms, or neck
If the cancer is growing in the top part of the lungs, it can also cause:
  • Pain in the arm, shoulder, or neck
  • Droopy eyelid or blurred vision
  • Weakness of the hand muscles
All of these symptoms can also be caused by conditions that are not lung cancer. But if you have these symptoms, you should let your doctor or nurse know.

Is there a test for lung cancer?

— Yes. If your doctor suspects that you have lung cancer, she or she will do an exam and a chest X-ray. If the chest X-ray shows a spot that looks like it could be cancer, he or she will probably follow up with other tests. These can include:
  • Blood tests
  • CT or PET scan – These imaging tests create pictures of the inside of your body. They can show abnormal growths.
  • Biopsy – A doctor will remove a small sample of tissue from the lung. He or she will look at the sample under a microscope to see if it has cancer.

What is lung cancer staging?

— Cancer staging is a way in which doctors find out how far a cancer has spread. The right treatment for you will depend, in part, on the stage of your lung cancer. Your treatment will also depend on the type of lung cancer you have, your age, and your other health problems.

How is lung cancer treated?

— Most people with lung cancer have 1 or more of the following treatments:
  • Surgery– Lung cancer can sometimes be treated with surgery to remove the cancer.
  • Radiation therapy– Radiation kills cancer cells.
  • Chemotherapy– Chemotherapy is the medical term for medicines that kills cancer cells or stop them from growing.
  • Targeted therapy– Some medicines work only for cancers that have certain characteristics. Your doctor might test your tumor to see if you have a kind of lung cancer that would respond to these medicines.
  • Immunotherapy– This is the term doctors use for medicines that work with the body’s infection-fighting system (the “immune system”) to stop cancer growth.
People with lung cancer also receive treatment for any symptoms they have. For example, if you have trouble breathing because fluid has collected around your lungs, your doctor can drain the fluid to help you breathe more easily.

What happens after treatment?

— For some cancers, treatment lasts a certain amount of time. For others, treatment is ongoing. You will be checked regularly to see if your lung cancer comes back after you finish treatment, or is growing even with treatment. Follow up tests usually include exams, chest X-rays, or CT scans. You should also watch for the symptoms listed above, because having those symptoms could mean the cancer has come back or grown. Tell your doctor or nurse if you have any symptoms.

What happens if the lung cancer comes back or starts to grow?

— If the lung cancer comes back or starts to grow, you might have more treatment, using 1 or more of the options above.

Can lung cancer be prevented?

— Maybe. The best way to avoid getting lung cancer is to not smoke. People who smoke have a much higher chance than those who don’t smoke of getting lung cancer. If you smoke, you can reduce your chance of getting lung cancer by quitting smoking.

What else should I do?

— It is important to follow all your doctors’ instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment. Getting treated for lung cancer involves making many choices, such as what treatment to have and when. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
  • What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
  • What are the downsides to this treatment?
  • Are there other options besides this treatment?
  • What happens if I do not have this treatment?
Respiratory DisordersSleepandLungCare

Idiopathic pulmonary fibrosis (Lung scarring)

Idiopathic pulmonary fibrosis (Lung scarring)

What is idiopathic pulmonary fibrosis?

 — Idiopathic pulmonary fibrosis (also called “IPF”) is a lung disease that makes it hard to breathe. It damages the air sacs in your lungs that send oxygen to the blood. This damage causes the lungs to be stiff. It also makes it hard for oxygen to reach the blood. This makes people with IPF cough and get short of breath.

People who get IPF are usually older than 50. It is a very serious illness that cannot be cured and gets worse over time. In some people, IPF can stay stable for several years before getting worse, or get worse gradually. But in others it gets worse more quickly.

Why did I get idiopathic pulmonary fibrosis?

 — Doctors do not know exactly how IPF starts. The risk of IPF is greater for people who:

  • Smoke or used to smoke
  • Have breathed in a lot of toxic chemicals or pollution
  • Have breathed in certain types of dust at work, over a long time
  • Have family members with pulmonary fibrosis

What are the symptoms of idiopathic pulmonary fibrosis?

 — IPF can start very slowly, so it might not cause any symptoms at first. When it does, symptoms can include:

  • Shortness of breath during exercise or other physical activity
  • Dry cough

Are there tests for idiopathic pulmonary fibrosis?

 — Yes. Doctors can do:

  • Blood tests to make sure you don’t have a different type of lung disease – There is no blood test for IPF.
  • Breathing tests to see how well your lungs are working – Breathing tests can show if your shortness of breath is caused by IPF or another disease such as emphysema.
  • An imaging test called a “CT scan” – This test uses a special X-ray to create pictures of the inside of the body. It can show lung damage caused by IPF.
  • If the doctor is not sure you have IPF after the CT scan, he or she might do a lung biopsy. In this test, a doctor does surgery to take a small sample of tissue from your lung. Another doctor looks at the sample under a microscope for signs of IPF.

How is idiopathic pulmonary fibrosis treated?

 — There is no treatment to cure IPF. It usually gets worse slowly. But doctors can treat some of the symptoms. These treatments can include:

  • Quitting smoking – If you smoke cigarettes, the most important thing you can do is stop smoking.
  • Flu and pneumonia vaccines – You should get the flu shot every fall and the pneumonia vaccine at least once. Infections like the flu and pneumonia can hurt your lungs. It’s important to try to prevent them.
  • Oxygen – As IPF gets worse, some people need to breathe oxygen from a tank they carry with them.
  • Pulmonary rehab – In pulmonary rehab, people learn exercises and ways to breathe that can help with IPF symptoms.
  • Medicine – Two medicines, have been shown to slow lung damage. But they do not cure IPF.
  • Treatment for acid reflux – Acid reflux is when the acid that is normally in your stomach backs up into your esophagus. The esophagus is the tube that carries food from your mouth to your stomach. People who have acid reflux might need medicine to stop the acid reflux from making IPF worse.
  • Lung transplant – This is surgery to replace 1 or both diseased lungs with healthy lungs. It is done only if a person with IPF meets certain conditions.

IPF sometimes gets worse very quickly, over a few days to weeks. If this happens, you should tell your doctor. Doctors can try to treat it with antibiotics and steroid medicines. (These are not the same as the steroids some athletes take illegally.)

 

Respiratory DisordersSleepandLungCare

Coughing up blood (Hemoptysis)

Coughing up blood (Hemoptysis)

What is coughing up blood?

 — Coughing up blood is when a person coughs up blood, either by itself or mixed with mucus. When mucus has blood in it, it can have streaks of blood, or the mucus can turn red or pink. The term doctors use for coughing up blood is “hemoptysis.” Coughing up blood can happen in adults and older children, but it is uncommon in young children.

When a person coughs up blood, it usually means the blood is coming from their airways or lungs. In other cases, blood from the nose, mouth, or stomach can drip into the throat and be coughed up. People can often feel where the blood is coming from, but not always.

If a person coughs up a lot of blood, doctors call it “massive hemoptysis.” This can be a medical emergency. This article discusses coughing up blood that is not a medical emergency.

What causes people to cough up blood?

 — In adults, there are many causes of coughing up blood, but the most common causes are:

  • Bronchitis – Bronchitis means inflammation of the bronchi. The bronchi are the tubes that carry air into the lungs . There are 2 types of bronchitis. “Acute” bronchitis is an infection of the bronchi. “Chronic” bronchitis is a condition in which the bronchi get damaged, for example by cigarette smoking.
  • Infections of the lungs, such as pneumonia
  • Bronchiectasis – This is a condition in which the airways are damaged and get infected easily. It has different causes.
  • Cancer that affects the bronchi or airways

In children, the most common causes of coughing up blood are:

  • An infection of the bronchi or lungs
  • Having an object or piece of food stuck in the airway. The object might be stuck for days or weeks before a child starts coughing up blood.
  • Bronchiectasis – In children, this is usually caused by “cystic fibrosis,” a condition some children are born with. Cystic fibrosis causes thick mucus to build up in the lungs, which leads to frequent lung infections.

Should I call a doctor or nurse?

 — Yes. Any time you or your child coughs up blood or mucus mixed with blood, call the doctor or nurse right away.

Let the doctor or nurse know if you remember seeing your child choke on something, even if it was days or weeks ago.

If you cough up a very large amount of blood (about 1 cup or more), or have trouble breathing, call for an ambulance.

Will I need tests?

 — Maybe. Your doctor or nurse will ask about your symptoms and do an exam. Based on your symptoms and other factors, he or she might do tests. These tests can help your doctor or nurse find out why you’re bleeding and where the bleeding is coming from.

Tests can include:

  • A chest X-ray
  • Lab tests – These might include tests of your blood or a sample of the mucus you cough up.
  • Bronchoscopy – This is a procedure in which a doctor uses a thin tube (called a “bronchoscope”) to look inside your airways.
  • A CT scan – This is an imaging test that creates pictures of the inside of your body.

Is there anything I can do on my own to stop coughing up blood?

 — Yes. If you smoke cigarettes, the most helpful thing you can do is stop smoking. If you take a medicine that keeps blood clots from forming (a “blood thinning” or “anti-clotting” medicine), let your doctor or nurse know. He or she might change your dose.

For teenagers and adults who have small streaks of blood in their mucus, a doctor might suggest trying an over-the-counter cough medicine to control the cough. But do not give any cough or cold medicines to young children. These medicines are unlikely to help and can have serious side effects in young children.

How is coughing up blood treated?

 — If your symptoms are mild and you have had a normal chest X-ray, you might not need treatment.

If you do need treatment, your doctor will treat the condition that’s causing you to cough up blood. He or she can also help stop the bleeding by:

  • Prescribing a cough medicine to keep you from coughing
  • Prescribing an antibiotic if you have bronchiectasis or an infection
  • Doing a procedure during bronchoscopy to stop the bleeding

 

Sleep DisordersSleepandLungCare

Sleep insufficiency

Sleep insufficiency

What is sleep insufficiency?

This is the term doctors use when a person does not get enough restful sleep. Sleep insufficiency is different from insomnia, which is when a person has trouble falling or staying asleep. In both cases, the person might sleep less than they should, and have trouble staying alert during the day. But in general, people with sleep insufficiency would be able to sleep if they had the chance. Usually, there are things outside their control keeping them from getting restful sleep.

Why is sleep important?

You need sleep in order to feel awake during the day, to be alert enough to do your normal activities, and to keep your body healthy. If you do not get enough sleep, or do not get restful sleep, it can lead to problems. Lots of different things can get in the way of sleeping. For example, you might work long hours, care for family members, or have health problems that make it hard to fall or stay asleep. Or you might get enough total hours of sleep, but wake up often and not feel rested afterwards.

How much sleep do I need?

It is different for every person. Most adults need about 7 to 9 hours of sleep each night inorder to feel awake enough during the day. But some people feel rested after a shorter sleep, and others need more sleep to feel alert the next day.

What are the symptoms of not getting enough sleep?

If you are not getting enough sleep, you might:
  • Have trouble staying awake to do your normal activities
  • Have trouble thinking clearly or focusing
  • Feel sad, anxious, or irritable
  • Fall asleep at inappropriate times, such as at work or while driving

Can not getting enough sleep lead to problems?

Yes. If you do not get enough sleep, or if you do not feel rested after sleeping, this can lead to problems like:
  • Accidents – If you fall asleep while driving, you could be seriously hurt or killed. You could also accidentally hurt or kill another person. Accidents can also happen if you are too tired or fall asleep while you are caring for a baby or child.
  • Work problems – If you are too tired at work, you can make mistakes. As a result, you could get into trouble or lose your job. Depending on the work you do, it could also be dangerous for you or for others.
  • Health problems – Not getting enough restful sleep over time can affect your health. Your immune system might have trouble doing its job to protect your body from infections. You might also be at higher risk for obesity and heart disease.
  • Stress – If you feel tired all the time, you might stop doing activities you used to enjoy, like spending time with friends or your partner. It can also be stressful and embarrassing to fall asleep at inappropriate times.

Should I see a doctor?

Yes. If you are not able to get enough sleep, or if you feel tired every day even after sleeping, talk to your doctor or nurse. They can help you figure out ways to improve your sleeping.

Will I need tests?

Probably not. Your doctor or nurse will probably be able to tell if you have sleep insufficiency just by talking to you. He or she might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night. If your doctor wants to learn more about your sleeping patterns, he or she might suggest something called “actigraphy.” This involves recording activity and movement with a monitor, usually worn on your wrist. The test is done at home, over 1 to 2 weeks. It will record how much you actually sleep and when.

Are there treatments that can help?

The main treatment is to improve your habits to try to get more and better sleep. Doctors call this following good “sleep hygiene.” That means that you:
  • Sleep only long enough to feel rested and then get out of bed
  • Go to bed and get up at the same time every day
  • Do not try to force yourself to sleep. If you can’t sleep, get out of bed and try again later.
  • Have coffee, tea, and other foods that have caffeine only in the morning
  • Avoid alcohol in the late afternoon, evening, and bedtime
  • Avoid smoking, especially in the evening
  • Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress
  • Solve problems you have before you go to bed
  • Exercise several days a week, but not right before bed
  • Avoid looking at phones or reading devices (“e-books”) that give off light before bed. This can make it harder to fall asleep.
  • Avoid long naps if you have trouble sleeping at night, especially in the late afternoon. Short naps (about 20 minutes) can be helpful, especially if your work schedule changes day to day and you need to be alert at different times.

Other things that can improve sleep include:

  • Relaxation therapy, in which you focus on relaxing all the muscles in your body 1 by 1
  • Working with a counselor or psychologist to deal with the problems that might be causing poor sleep
Sleep DisordersSleepandLungCare

Jet lag

Jet lag

What is jet lag?

Jet lag is a condition that causes sleep problems, tiredness, and other symptoms. It happens in people who fly across several time zones, especially when they fly east. The more time zones a person crosses, the more likely he or she is to get jet lag.

Jet lag gets better on its own as a person adjusts to the new time zone. But this can take several days. The farther from home a person is, the longer it takes to get over jet lag.

What are the symptoms of jet lag?

The symptoms include:

  • Sleep problems, such as problems falling or staying asleep
  • Feeling tired or sleepy in the daytime
  • Having trouble thinking, concentrating, or doing normal activities
  • Stomach problems, such as constipation
  • Feeling sick or having less energy than normal

Should I see a doctor or nurse?

If you think you had jet lag in the past, talk to your doctor or nurse before going on a long airline flight. He or she can help you figure out ways to avoid jet lag.

How can I prevent jet lag?

Here are a few things you can try:

  • Stay awake and sleep at certain times. This can help your body adjust to the new time zone. For example, you can:
  • Stay up until it’s dark if you fly west – Only go to sleep when it gets dark. If you go sightseeing, try to do it during the day.
  • Avoid bright morning light if you fly east – Go outside as much as possible in the afternoon. If you go sightseeing outdoors, try to do it in the afternoon until your body adjusts to the new time zone.
  • Eat meals at mealtime in the new time zone – For example, if you normally eat lunch at noon, eat at noon in the new time zone (not noon at home).
  • Get some exercise, but not right before you are supposed to go to sleep.

Can supplements or medicines help with jet lag?

Yes. A supplement called “melatonin” can help with sleep problems from jet lag when you fly east. Melatonin is a hormone that is naturally made by a gland in the brain. Taking extra melatonin can help your body adjust to a new time zone. You can buy melatonin pills in a store or pharmacy without a prescription. The usual dose is 5 milligrams after dark each night, about half an hour before you want to go to sleep.

If you want to try melatonin, tell your doctor or nurse. He or she can tell you if it is safe for you.

You should start taking melatonin the night you arrive, at bedtime. You can take melatonin for up to 5 nights in the new time zone. After that, you are not likely to need it.

Only adults should take melatonin. Doctors don’t know if it helps with jet lag in children. Avoid drinking alcohol while you are taking melatonin.

Does melatonin cause side effects?

 — Some people have side effects from melatonin. These can include:

  • Feeling sleepy in the daytime
  • Dizziness or confusion
  • Headache
  • Loss of appetite, nausea, and other stomach problems

But these side effects are very similar to jet lag. So doctors are not sure if they are really side effects of melatonin or just jet lag symptoms.

 

Sleep DisordersSleepandLungCare

Restless legs syndrome

Restless legs syndrome

What is restless legs syndrome?

Restless legs syndrome, or RLS for short, is a condition that causes strange sensations in your legs. RLS is also sometimes called “Willis-Ekbom disease.” If you have RLS, you probably have the urge to move your legs at night. This can make it hard to get comfortable and fall asleep.

In some cases, RLS happens on its own and seems to be passed on in families. In other cases, the condition seems to be linked to other medical problems. For instance, a condition called “anemia,” in which there is too little iron in the blood, seems to increase the risk of RLS. Other conditions that increase the risk of RLS include kidney disease, diabetes, and multiple sclerosis. Pregnancy seems to increase a woman’s risk of developing RLS, too.

What are the symptoms of RLS?

People who have RLS get an uncomfortable urge to move their legs when they are at rest. They describe the feeling as crawling, creeping, pulling, or itching. And they say the feeling is deep in the legs – not on the skin – usually below the knees. These symptoms usually get worse as the day moves on, and they are worst at night. The symptoms can be especially bad when trying to stay still to read a book, watch television, or fall asleep. But people can make the feeling go away temporarily if they walk around or move their legs. Some people with RLS find that their legs move on their own while they are asleep.

In short, the symptoms:

  • Happen when you are at rest
  • Go away if you move your legs on purpose
  • Are worst at night
  • Sometimes include the legs moving on their own during sleep

Together, the symptoms of RLS can make it hard to get a good night’s sleep. People with the condition often feel tired during the day.

Is there a test for RLS?

There is a test, but it is not usually necessary. Your doctor or nurse should be able to tell if you have it by asking about your symptoms and doing an exam. Still, it is possible that your doctor or nurse will decide to send you for a “sleep study,” to be sure of what is happening.

For a sleep study, you spend the night in a lab, and you are hooked up to different machines that monitor your movements, heart rate, breathing, and other body functions.

Is there anything I can do on my own to feel better?

Yes. You might feel better if you:

  • Do activities that keep your mind alert during the day, such as crossword puzzles
  • Get moderate regular exercise
  • Massage your legs (or have someone massage them)
  • Apply heat to your legs with heating pads or by taking a warm bath
  • Avoid taking medicines that can make RLS worse – These include antihistamines

Should I see a doctor?

See your doctor or nurse if your condition bothers you, or if it keeps you from getting a good night’s sleep.

How is RLS treated?

Some people with RLS do not need medicine for it because they have mild symptoms that don’t bother them very often. If treatment is needed, there are several medicines doctors can suggest.

In people with RLS who also have a severe form of kidney disease called kidney failure, the RLS might improve with a treatment called hemodialysis (also known as just dialysis).

What if I am pregnant?

If you are pregnant, you can take iron supplements and try the other tips that do not involve taking prescription medicines. Most of the medicines used to treat RLS are not proven to be safe to take during pregnancy. If your symptoms are bad, there are some medicines that might be OK to take. But keep in mind that the condition usually goes away or gets much better after you give birth.

 

Sleep DisordersSleepandLungCare

Dream enactment (REM behaviour disorder)

Dream enactment (REM behaviour disorder)

What is REM sleep behaviour disorder?

REM sleep behaviour disorder is a condition in which a person acts out their dreams. This can involve sudden movements and outbursts of talking or yelling. In some cases, it can lead to injury.

Each night, your body goes through 2 different types of sleep. These are called “rapid eye movement” (REM) sleep and “non-REM” sleep. You cycle through each type several times during the night. During REM sleep, your eyes often twitch but your body normally does not move. REM sleep is when most dreaming happens. In people with REM sleep behaviour disorder, the body does not stay still the way it normally does during REM sleep.

REM sleep behaviour disorder is different from sleepwalking, which is when a person walks or talks in their sleep. Sleepwalking is more common in children than adults, and most people grow out of it. People with REM sleep behaviour disorder usually start having symptoms when they are older, often in their 60s or 70s. The disorder starts gradually and gets worse over time. It is often related to other medical conditions.

What are the symptoms of REM sleep behaviour disorder?

The main symptom is acting out your dreams. For example, if you dream that you are in a fight, you might make punching or kicking motions in your bed. Most of these episodes last for less than a minute. You might also talk or yell in your sleep. Very active episodes might wake you up, but you might sleep through milder ones.

People with REM sleep behaviour disorder tend to have the most symptoms during the second half of the night. That’s because your body goes through more REM sleep during that time. The dreams people act out are often scary or unpleasant. Acting out your dreams can cause injury, for example, if you fall out of bed or hit something. It can also be dangerous for your partner if you make rough or violent movements.

What causes REM sleep behaviour disorder?

REM sleep behaviour disorder is caused by changes in the brain. These changes can be related to:

  • Parkinson disease, which is a brain disorder that affects movement, learning, and memory
  • Dementia with Lewy bodies, another brain disorder that causes memory problems
  • Other medical conditions that affect the brain, such as a stroke or tumour
  • Narcolepsy, which is a sleep disorder that makes you feel sleepy all the time and fall asleep suddenly
  • Certain medicines, such as those used to treat depression

In people who do end up having Parkinson disease or another brain disorder, it can take months or years to show other symptoms. If your doctor thinks you are at risk for one of these disorders, he or she will talk to you about what this means. In many cases, there are treatments that can help.

Should I see a doctor?

Yes. If you or your partner notice that you are acting out your dreams, see your doctor or nurse. He or she will ask about your sleep episodes as well as any other symptoms you have.

Will I need tests?

Yes. If your doctor or nurse suspects you have REM sleep behaviour disorder, he or she will send you for a “sleep study.” For this test, you spend the night in a sleep lab at a hospital or doctor’s office. You are hooked up to different machines that monitor your heart rate, breathing, and other body functions. The results of the test can tell your doctor or nurse if you have REM sleep behaviour disorder or another sleep disorder.

How is REM sleep behaviour disorder treated?

If you have frequent, bothersome, or dangerous episodes during sleep, your doctor might suggest medicine. Medicines used to treat REM sleep behaviour disorder include:

  • Melatonin : Melatonin is a hormone that is naturally made by a gland in the brain. Taking extra melatonin at bedtime can help your body to stay still during REM sleep. You can buy melatonin pills in a store or pharmacy without a prescription. But it’s important to work with your doctor to figure out the right dose for you. This might involve starting at a low dose and then increasing it slowly until your symptoms improve.
  • Clonazepam : Clonazepam is a drug used to treat anxiety. It can help treat REM sleep behavior disorder in some cases. Most doctors prefer to try treatment with melatonin first, since it has fewer side effects than clonazepam.

If your doctor thinks an antidepressant medicine is causing your sleep symptoms, stopping or switching the medicine can fix the problem.

Is there anything I can do on my own?

Yes. There are things you can do help protect yourself and your partner. You can:

  • Move any breakable items, such as lamps, away from your bed
  • If you have any weapons in your home, like guns, make sure they are stored safely away from where you sleep

If you have frequent violent episodes, it might be safest for you and your partner to sleep separately. If you often fall or jump out of your bed, you might try using a sleeping bag on the floor or a padded bed rail.

 

Sleep DisordersSleepandLungCare

What is a sleep study?

What is a sleep study?

A sleep study is a test that measures how well you sleep and checks for sleep problems. For some sleep studies, you stay overnight in a sleep lab at a hospital or sleep centre.

In other cases, your doctor can give you a portable sleep monitor to use at home, so you don’t have to spend the night in the sleep lab. But you should use a portable monitor only if:

  • Your doctor thinks you have a condition that makes you stop breathing for short periods while you are asleep, called “sleep apnoea.”
  • You do not have other serious medical problems, such as heart disease or lung disease.

What happens during a sleep study?

Before you go to sleep, a technician attaches small, sticky patches called “electrodes” to your head, chest, and legs. He or she will also place a small tube beneath your nose and might wrap 1 or 2 belts around your chest.

Each of these items has wires that connect to monitors. The monitors record your movement, brain activity, breathing, and other body functions while you sleep.

If you have a history of trouble falling asleep, your doctor might prescribe a medicine to help you fall asleep in the lab. If you have never taken the medicine before, your doctor might ask you take it on a night before your sleep study to see how it affects you.

Why might my doctor order a sleep study?

Your doctor will order a sleep study if he or she thinks you have sleep apnoea or a different condition. Examples of other sleep-related conditions include those that make you:

  • Have an uncomfortable feeling in your legs when you try to fall asleep, or sudden jerking leg movements while you sleep
  • Feel very sleepy during the day and fall asleep suddenly
  • Do odd things while you sleep, such as moving your arms and legs, shouting, or walking

How should I prepare for a sleep study?

On the day of your sleep study, you should:

  • Avoid alcohol
  • Avoid drinking coffee, tea, sodas, and other drinks that have caffeine in the afternoon and evening
  • Take all your regular medicines, unless your doctor tells you not to

 

Sleep DisordersSleepandLungCare

Insomnia

Insomnia

What is insomnia?

Insomnia is a problem with sleep. People with insomnia have trouble falling or staying asleep, or they do not feel rested when they wake up. Insomnia is not about the number of hours of sleep a person gets. Everyone needs a different amount of sleep.

What are the symptoms of insomnia?

People with insomnia often:
  • Have trouble falling or staying asleep
  • Feel tired or sleepy during the day
  • Forget things or have trouble thinking clearly
  • Get cranky, anxious, irritable, or depressed
  • Have less energy or interest in doing things
  • Make mistakes or get into accidents more often than normal
  • Worry about their lack of sleep
These symptoms can be so bad that they affect a person’s relationships or work life. Plus, they can happen even in people who seem to be sleeping enough hours.

Are there tests I should have?

Probably not. Most people with insomnia need no tests. Your doctor or nurse will probably be able to tell what is wrong just by talking to you. He or she might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night. In some cases, people do need special sleep tests, such as “polysomnography” or “actigraphy.”
  • Polysomnography : is a test that usually lasts all night and that is done in a sleep lab. During the test, monitors are attached to your body to record movement, brain activity, breathing, and other body functions.
  • Actigraphy : is a device that records activity and movement with a monitor or motion detector that is usually worn on the wrist. The test is done at home, over several days and nights. It will record how much you sleep and when.

What can I do to improve my insomnia?

You can follow good “sleep hygiene.” That means that you:
  • Sleep only long enough to feel rested and then get out of bed
  • Go to bed and get up at the same time every day
  • Do not try to force yourself to sleep. If you can’t sleep, get out of bed and try again later.
  • Have coffee, tea, and other foods that have caffeine only in the morning
  • Avoid alcohol in the late afternoon, evening, and bedtime
  • Avoid smoking, especially in the evening
  • Keep your bedroom dark, cool, quiet, and free of reminders of work or other things that cause you stress
  • Solve problems you have before you go to bed
  • Exercise several days a week, but not right before bed
  • Avoid looking at phones or reading devices (“e-books”) that give off light before bed. This can make it harder to fall asleep.
Other things that can improve sleep include:
  • Relaxation therapy, in which you focus on relaxing all the muscles in your body 1 by 1
  • Working with a counselor or psychologist to deal with the problems that might be causing poor sleep

Should I see a doctor?

Yes. If you have insomnia, and it is troubling you, see your doctor. He or she might have suggestions on how to fix the problem.

Are there medicines to help me sleep?

Yes, there are medicines to help with sleep. But you should try them only after you try the techniques described above. You also should not use sleep medicines every night for long periods of time. Otherwise, you can become dependent on them for sleep. Insomnia is sometimes caused by mental health problems, such as depression or anxiety. If that’s the case for you, you might benefit from an antidepressant rather than a sleep aid. Antidepressants often improve sleep and can help with other worries, too.

Can I use alcohol to help me sleep?

No, do not use alcohol as a sleep aid. Even though alcohol makes you sleepy at first, it disrupts sleep later in the night.
Sleep DisordersSleepandLungCare

Daytime Sleepiness

Daytime Sleepiness

What is daytime sleepiness?

Daytime sleepiness is feeling sleepy during the daylight hours, when most people are awake and alert.

What causes daytime sleepiness?

Daytime sleepiness can be caused by:

  • Not having good sleep habits – For example, not having enough time to sleep at night or not having a regular sleep schedule.
  • A sleep disorder, such as:
  • Sleep apnea – People with this condition stop breathing for short periods during sleep.
  • Narcolepsy – People with this condition are very sleepy in the daytime and sometimes fall asleep suddenly during normal activities.
  • Insomnia – People with this condition have trouble falling or staying asleep.
  • Things that disturb your sleep, such as:
  • Sounds – For example, if you have a new baby, he or she might cry and wake you up at night.
  • Health conditions, such as restless legs syndrome or nighttime leg cramps.
  • Schedule changes that affect sleep – This might include working a night shift or traveling to another time zone.
  • Medicines – Certain medicines can cause daytime sleepiness.

Is there anything I can do on my own to feel better?

That depends on the cause of your daytime sleepiness. But you can try having good sleep habits. This means that you:

  • Go to bed and get up at the same time every day.
  • Have drinks with caffeine in them only in the morning (these include coffee and tea).
  • Avoid alcohol.
  • Avoid smoking, especially in the evening.
  • Lose weight if you are overweight.
  • Exercise several days a week, but not right before bed.
  • Stay off your back when sleeping. (This is not always possible and does not always work.)
  • Avoid looking at a phone or reading device (“e-book”) that gives off light before bed. This can make it harder to fall asleep.

Should I see a doctor?

See a doctor if:

  • You are often very sleepy in the daytime.
  • You fall asleep in the middle of normal activities.
  • You fall asleep in a dangerous situation, such as while driving.
  • You see or hear things that are not really there.
  • When you wake up, you can’t move right away.
  • Your muscles feel weak if you laugh or get excited or angry.

Will I need tests?

Your doctor will decide which tests you should have. There are many different tests, but you might not need any. It depends on your age, other symptoms, and individual situation.

A “sleep study” is the most common test doctors use to find the cause of daytime sleepiness. For this test, you spend the night in a sleep lab at a hospital or doctor’s office. You are hooked up to different machines that monitor your heart rate, breathing, and other body functions. The results of the test tell your doctor or nurse if you have a sleep disorder.

Your doctor might also ask you to keep a daily log for 1 to 2 weeks, where you keep track of how you sleep each night.

How is daytime sleepiness treated?

That depends on what is causing your daytime sleepiness. Treatments can include:

  • Lifestyle changes – These can include changing your work schedule, taking naps, losing weight, or avoiding caffeine and alcohol.
  • Devices you wear at night – These can help people with sleep apnea.
  • Medicines – These can help you stay awake in the daytime or sleep better at night.
  • Surgery – A few people with sleep apnea have surgery to treat it. But most people don’t need surgery for daytime sleepiness.

Can daytime sleepiness be prevented?

 — You can reduce your chances of daytime sleepiness by having good sleep habits. If your doctor or nurse prescribes medicine or a device to wear, use it exactly how he or she tells you.

 

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