Acute Reaction to Stress

Acute stress disorders. Extreme life events may produce individual patterns of reaction. Such events might be the death of a partner, war, experiences, separation, accidents, experience of violence, traumata or abuse. To some people this might be the case even with simple things like attendance of school, a move or likewise. Of course it is only natural for a person confronted with a stressful event to feel sad, shocked or unable to understand what is happening.

However, if this reaction takes too long or does not stop at all or the reaction in itself is inadequate to the event thus leading to an increased impairment of the person concerned, this person needs professional help. The reactions to life events can be manifold producing for instance restricted consciousness, decreased attention, disorientation, amnesia or depression, desperation, anxiety or aggression but also bodily symptoms like sweating, heart throbbing and blushing are common.

If the reaction occurs immediately after the event and disappears fairly rapidly, this is called acute reaction to stress. This is a normal reaction. However, depending on the severity of the symptoms professional help may be needed for a short time.

© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)

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Knowing from long years of experience that neurological or psychiatric illnesses are very often considered to be better not mentioned or talked about, we would nonetheless like to introduce you briefly to the world of neurology and psychiatry. There are no other medical sciences that have achieved more progress and improvement over the past decades than these. Especially the “Decade of the brain” led to a definite change for the better in diagnostics and therapies. Today we can offer a wide range of modern diagnostic and therapeutic possibilities for nearly all psychiatric and neurological disorders. Yet, when it comes to neurological deficits or mental illness there are still many prejudices and unnecessary fears prevalent.

Whereas usually everybody accepts the fact that illness is normal and happens to everyone from time to time, normal illnesses are most often considered to be solely physical such as a broken leg, colds, diarrhoea or similar. Diabetes mellitus is as normal an illness as is backache or headache.

Illnesses of the brain, the psyche or neurological deficiencies are also as normal as any other illnesses and moreover, they are not only very common but on the increase. Their patterns may sometimes be worrying or frightening but this is largely due to a huge lack of information in general public.

According to the study “The Global Burden of disease” carried out by the WHO (World Health Organization) depression for instance is the most important disease of all, more important even than diseases of the heart, asthma or cancer. And yet, the majority of people suffering from depression do not seek professional help or are not treated sufficiently. Therefore, we should not only like to contribute to health education, but we offer practical help and assistance to everyone suffering from or fearing psychiatric and/or neurological disorders with the help of our top Neurologists, Psychologists, Psychiatrists, and Psychotherapists in Dubai.

GNC, German Neuroscience Center (Neurology, Psychiatry, Psychology, Counseling in Dubai, UAE

ADHD - Attention Deficit Hyperactivity Disorder

Approximately 5 to 10% of children between the ages of 6 and 18 years are affected by ADHD. Boys are 3 to 4 times more affected than girls. For a long time people believed that ADHD occurs solely during childhood. But in 30% of the affected children the symptoms persist – possibly in a milder form -, frequently combined with additional psychiatric disorders as depressions, anxiety disorders or dependencies. Adults with ADHD are often not diagnosed until a diagnosis has been made for one of their children.

Attention-Deficit/Hyperactivity disorder is a neurobiological brain function disorder, which often causes significant implications for the affected person’s professional and private life. It is presumed that this condition is caused by an imbalance between individual neurotransmitters leading to disturbed information processing between different areas of the brain, which are responsible for concentration, conception, and impulse control. Hence new information can be less well filtered and the persons affected become constantly over-stimulated. They are struggling to distinguish what is important from what is unimportant and is hard for them to focus on main points. Due to the high rate of occurrence within families a genetic predisposition does probably exist, but birth asphyxia and other environmental influences are said to be contributing elements, too.

ADHD Symptoms:

Attention deficiencies and disorganisation: Lack of concentration while reading longer texts – work instructions! -, difficulty following longer conversations and lectures attentively. A person with ADHD becomes even more distracted while performing subjectively boring activities, for example routine activities. New tasks are continually being started with older tasks not being finished, preventing the formation of patterns, which would be required for establishing structures. This implies disorder and chaotic organisation: The persons affected are not able to multitask, they have problems to organise their daily life and they have poor time management skills. They frequently change jobs, interrupt their life career and generally even face financial difficulties. In their private lives they are often unhappy in relationships, break up with their partners more often, have unstable friendships and have difficulties parenting their own children, too. The consequences are reduced self-esteem and feelings of failure.

Hyperactivity: is generally less pronounced in adults, but can reflect in the inability to remain seated for longer periods (flights, cinema, lectures etc.). The affected persons often jiggle feet or tap the table with their fingers.

Impulsiveness and labile affect: Emotional liability and hyperexcitability with rapidly changing moods up to several times per day may occur spontaneously but can also be initialised from the outside. The affected persons react extremely emotionally to daily stress factors; they are impatient with others, interrupt their counterpart during a conversation, are increasingly irritable, have a low frustration tolerance and tend to risky driving behaviour. On the other hand: Adults with ADHD are often very creative and have associative thinking abilities. When they are occupied with tasks they are interested in, they can work extremely hard and persistently. They even become specialists on many occasions. They are very sensitive towards interpersonal vibrations, can be very empathetic, enthusiastic and impulsive.

ADHD Treatment

There are various therapeutic options, as for example concentration techniques, self-organisation techniques and conflict management training. The treatment should be customized for each individual according to their specific needs. Moreover, education of patients, families, and teachers regarding the diagnosis is an integral part of treatment. In more severe cases medication might be required.

The treatment is focused on improvements in daily life, education, job, career, personal and family life.

Adjustment Disorders

Adjustment Disorder means that a normal reaction to stress starts as late as a month after the event and will continue up to six months. This still would be considered a normal reaction although also in these cases therapeutic help might be necessary

© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)

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Knowing from long years of experience that neurological or psychiatric illnesses are very often considered to be better not mentioned or talked about, we would nonetheless like to introduce you briefly to the world of neurology and psychiatry. There are no other medical sciences that have achieved more progress and improvement over the past decades than these. Especially the “Decade of the brain” led to a definite change for the better in diagnostics and therapies. Today we can offer a wide range of modern diagnostic and therapeutic possibilities for nearly all psychiatric and neurological disorders. Yet, when it comes to neurological deficits or mental illness there are still many prejudices and unnecessary fears prevalent.

Whereas usually everybody accepts the fact that illness is normal and happens to everyone from time to time, normal illnesses are most often considered to be solely physical such as a broken leg, colds, diarrhoea or similar. Diabetes mellitus is as normal an illness as is backache or headache.

Illnesses of the brain, the psyche or neurological deficiencies are also as normal as any other illnesses and moreover, they are not only very common but on the increase. Their patterns may sometimes be worrying or frightening but this is largely due to a huge lack of information in general public.

According to the study “The Global Burden of disease” carried out by the WHO (World Health Organization) depression for instance is the most important disease of all, more important even than diseases of the heart, asthma or cancer. And yet, the majority of people suffering from depression do not seek professional help or are not treated sufficiently. Therefore, we should not only like to contribute to health education, but we offer practical help and assistance to everyone suffering from or fearing psychiatric and/or neurological disorders with the help of our top Neurologists, Psychologists, Psychiatrists, and Psychotherapists in Dubai.

GNC, German Neuroscience Center (Neurology, Psychiatry, Psychology, Counseling in Dubai, UAE

Dissociative Disorder (Conversions)

Definition of Dissociative Disorder

Traumatic events or seemingly unsolvable problems can lead to psychic reaction known as dissociative disorder. It is characterized by a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with a dissociative disorder experience their body or the world around them as unreal and they are uncertain about who they are. They could feel like having many different identities which often leads to problems with functioning in everyday life. They may escape reality in ways that are involuntary and unhealthy.

Symptoms

Signs and symptoms of dissociative disorder could include memory loss (amnesia) of certain time periods, events and people, an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness, a sense of being detached from yourself and a blurred sense of identity. Along with the dissociation and multiple or split personalities people may also experience depression, mood swings, sleep disorder, anxiety, panic attacks, eating disorders and more.

Dissociative disorder is separated into three major disorders:

1. Dissociative amnesia: People with this disorder are blocking out critical personal information, usually of a traumatic or stressful nature. They can't recall information about themselves or events and people in their life, especially from a traumatic time. These gaps in memory are much more severe than normal forgetfulness, and are not the result of an underlying medical condition.

2. Dissociative identity disorder: This disorder is characterized by alternate identities. People may feel the presence of one or more other people talking or living inside their head and a feeling as though they are possessed by other identities. This disorder was formerly known as multiple personality disorder and it is the most famous of the dissociative disorders. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.

3. Depersonalization-derealization disorder: People with this disorder experience a feeling of being outside themselves. They observe their actions, feelings and thoughts from a distance as though watching a movie. A person with depersonalization disorder has this experience so frequently and so severely that it interrupts his or her functioning and experience.

Causes

The main causes for dissociative disorder are traumatic events in the past such as physical, sexual or emotional abuse suffered during childhood, although some people 'dissociate' after experiencing war, kidnapping or even an invasive medical procedure. Switching off from reality is a normal defense mechanism to cope during a traumatic time but it becomes dysfunctional when the environment is no longer traumatic but the person still acts and lives as if it is.

Treatment

The primary treatment for dissociative disorder is psychotherapy. The psychotherapist consultation will help the patient to understand the cause of the condition and to form new ways of coping with stressful circumstances. A person with dissociative disorder might also benefit from drugs such as antidepressants or antianxiety medication. These medications can help to control the mental health symptoms associated with dissociative disorders.

© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)

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Knowing from long years of experience that neurological or psychiatric illnesses are very often considered to be better not mentioned or talked about, we would nonetheless like to introduce you briefly to the world of neurology and psychiatry. There are no other medical sciences that have achieved more progress and improvement over the past decades than these. Especially the “Decade of the brain” led to a definite change for the better in diagnostics and therapies. Today we can offer a wide range of modern diagnostic and therapeutic possibilities for nearly all psychiatric and neurological disorders. Yet, when it comes to neurological deficits or mental illness there are still many prejudices and unnecessary fears prevalent.

Whereas usually everybody accepts the fact that illness is normal and happens to everyone from time to time, normal illnesses are most often considered to be solely physical such as a broken leg, colds, diarrhoea or similar. Diabetes mellitus is as normal an illness as is backache or headache.

Illnesses of the brain, the psyche or neurological deficiencies are also as normal as any other illnesses and moreover, they are not only very common but on the increase. Their patterns may sometimes be worrying or frightening but this is largely due to a huge lack of information in general public.

According to the study “The Global Burden of disease” carried out by the WHO (World Health Organization) depression for instance is the most important disease of all, more important even than diseases of the heart, asthma or cancer. And yet, the majority of people suffering from depression do not seek professional help or are not treated sufficiently. We should therefore not only like to contribute to health education but we offer practical help and assistance to everyone suffering from or fearing psychiatric and/or neurological disorders with the help of the best psychologist and psychiatrist in Dubai.

GNC, German Neuroscience Center (Neurology, Psychiatry, Psychology, Counseling in Dubai, UAE

Eating Disorders, Bulimia nervosa, Anorexia nervosa

What are Eating Disorders?

Eating Disorders are conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health. Bulimia nervosa, anorexia nervosa and binge-eating disorder are the most common specific forms of eating disorders.

Eating disorders can cause serious physical problems and they can even be life-threatening. Most commonly they appear during the teen years or young adulthood but may also develop during childhood or later in life.

Types and Symptoms

Anorexia nervosa

Anorexia nervosa is characterized by abnormal eating behavior, an obsession with food and being thin, sometimes to the point of deadly self-starvation. A person with Anorexia has an intense fear of gaining weight, a distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight. Even if a patient is underweight he sees himself as overweight. Moreover, the disease is characterized by a refusal to eat and denial of hunger, excessive exercise and a fear of eating in public.

Physical consequences of Anorexia nervosa could include the thinning of the bones (osteopenia or osteoporosis), brittle hair and nails, dry and yellowish skin, growth of fine hair all over the body (lanugo), low blood pressure, slowed breathing and pulse, damage to the structure and function of the heart, brain damage, multiorgan failure and infertility.

Bulimia nervosa

Bulimia nervosa is characterized by episodes of eating large amounts of food in a short duration followed by forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with this disease may be at a normal weight or even a bit overweight, although they often fear gaining weight, desperately want to lose weight and intensely are unhappy with their body size and shape.

Physical consequences of Bulimia nervosa could include a chronically inflamed and sore throat, swollen salivary glands in the neck and jaw area, abnormal bowel functioning, damaged teeth and gums, irregular heartbeat, menstrual irregularities or loss of menstruation and an electrolyte imbalance which can lead to heart attack.

Binge-eating disorder

People with Binge-eating disorder lose control over eating. They eat excessive amounts of food (binge), but unlike Anorexia and Bulimia they don't try to compensate for this behavior with exercise, fasting or purging. Binge-eating disorder is characterized by eating to the point of discomfort or pain, eating faster and frequently eating alone.

 As a result, people with binge-eating disorder often are over-weight or obese. They are at a higher risk for developing cardiovascular disease and high blood pressure. Moreover, people with this disease often feel depressed, disgusted or upset over the amount eaten. They experience guilt, shame, and distress about their binge-eating, which can lead to more binge-eating.

Causes

The causes for eating disorders are manifold. Possible causes include biological reasons, psychological and mental health and society. There may be genes that make certain people more vulnerable to developing eating disorders. People with these disorders may have psychological and emotional problems such as a low self-esteem that contribute to the disorder. Moreover, society often cultivates a desire for thinness, especially in the modern Western culture.

Treatment

Psychotherapy, nutrition education and medication are effective treatment methods for eating disorders. An individual, group or family psychotherapy helps the patient to learn how to exchange unhealthy habits for healthy ones. The main focus of the treatment is to restore the person to healthy weight, treating the psychological issues related to the eating disorder and to reduce or eliminate behaviors or thoughts that lead to insufficient eating and preventing relapse. Cognitive behavioral therapy is commonly used in eating disorder treatment, especially for bulimia nervosa and binge-eating disorder.

Eating disorders can’t be cured by medications but they may help to control urges to binge or purge or to manage excessive preoccupations with food and diet. Since eating disorders often occur along with depression and anxiety medications such as antidepressants, anti-anxiety and mood stabilizers may also help with these symptoms.

© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)

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Knowing from long years of experience that neurological or psychiatric illnesses are very often considered to be better not mentioned or talked about, we would nonetheless like to introduce you briefly to the world of neurology and psychiatry. There are no other medical sciences that have achieved more progress and improvement over the past decades than these. Especially the “Decade of the brain” led to a definite change for the better in diagnostics and therapies. Today we can offer a wide range of modern diagnostic and therapeutic possibilities for nearly all psychiatric and neurological disorders. Yet, when it comes to neurological deficits or mental illness there are still many prejudices and unnecessary fears prevalent.

Whereas usually everybody accepts the fact that illness is normal and happens to everyone from time to time, normal illnesses are most often considered to be solely physical such as a broken leg, colds, diarrhoea or similar. Diabetes mellitus is as normal an illness as is backache or headache.

Illnesses of the brain, the psyche or neurological deficiencies are also as normal as any other illnesses and moreover, they are not only very common but on the increase. Their patterns may sometimes be worrying or frightening but this is largely due to a huge lack of information in general public.

According to the study “The Global Burden of disease” carried out by the WHO (World Health Organization) depression for instance is the most important disease of all, more important even than diseases of the heart, asthma or cancer. And yet, the majority of people suffering from depression do not seek professional help or are not treated sufficiently. We should therefore not only like to contribute to health education but we offer practical help and assistance to everyone suffering from or fearing psychiatric and/or neurological disorders with the help of best psychiatrists in Dubai.
If you're unable to know what your mental health concern is, we can help you with that using our top Neurologists, psychologists, psychiatrists & psychotherapists help.

GNC, German Neuroscience Center (Neurology, Psychiatry, Psychology, Counseling in Dubai, UAE

PTSD: Post Traumatic Stress Disorder Symptoms, Treatment & More

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What is Post traumatic stress disorder (PTSD)?

Post-traumatic stress disorder - PTSD - is a serious mental health condition that occurs after a traumatic event. PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror. It could remain for month or even years. It could start directly after the event or delayed by months. After experiencing or witnessing a terrifying event a person may have difficulties coping and adjusting it. The person may feel stressed or frightened even when he is no longer in danger. These feelings continue and even increase, becoming so strong that they keep the person from living a normal life.

Symptoms

Post-traumatic stress disorder (PTSD) could include many symptoms. Most often they begin within three month of the traumatic event. There are three main categories of PTSD Symptoms:

1. Reliving: The person with post-traumatic stress disorder repeatedly relives the traumatic event as if it were happening again. This may include flashbacks, nightmares and hallucinations. He or she also may feel severe emotional distress or physical reactions to something that reminds him of the event.

2. Avoiding: The person avoids thinking or talking about the traumatic event. He or she may also avoid places, events or objects that reminds him or her of the trauma which can lead to feelings of detachment and isolation. A strong guilty feeling and depression may occur.

3. Increased arousal: The person may feel tense, frightened and easily startled. He or she may experience troubles of sleeping and concentrating as well as irritability or outbursts of anger. Physical symptoms, such as increased blood pressure and heart rate, rapid breathing, muscle tension, nausea, and diarrhea also may occur.

Moreover the person could feel depressed or emotional numb. Sometimes the patients block the event completely from their memory.

Causes

A person suffering from PTSD can develop a post-traumatic stress disorder when he or she goes through or witnesses a traumatic event, such as sexual violation, torture, child abuse, car accidents, sudden death of a loved one or a natural disaster. PTSD can occur in anyone who has experienced a traumatic event but it is assumed that it is caused by a mix of the brain regulation of stress chemicals and hormones and inherited mental health risks, such as an increased risk of anxiety and depression. Moreover, life experiences and inherited aspects of the personality do play a big role.

If you're unable to know what your mental health concern is, we can help you with that using our top Neurology Doctor, Psychiatry Doctor, and Psychology doctor's help.

Treatment

The treatment of PTSD is very effective. The goal is to support the coping skills of the patient to be able to deal with the traumatic event. The main treatments for people with post-traumatic stress disorder are psychotherapy or medications, sometimes both. The patient will learn certain skills to address the symptoms and thus improve the symptoms. The Psychologist helps in coping if any symptoms arise again.

Cognitive behavioral therapy (CBT) is a very helpful therapy when suffering from PTSD. There are several parts to CBT, including:

• Exposure therapy: It helps facing and controlling the fear by mental imagery, writing, or visiting the place where the event happened.
• Cognitive restructuring: It helps recognizing the way of thinking such as negative or inaccurate ways of perceiving normal situations. Sometimes people remember the event differently than how it happened. The Psychologist helps looking at things in a realistic way.
• Stress inoculation training: It helps reducing the symptoms by reducing anxiety. It helps looking at the memories in a healthy and realistic way.

All these approaches can help reducing fear after a traumatic event. The best type of treatment should be discussed individually with the Psychologist. Moreover, certain medications, such as Antidepressants and Anti-anxiety medications, can improve the feelings of anxiety and stress. Sometimes a combination of psychotherapy and medications is recommended by the Specialist.

Furthermore the PTSD patient will learn relaxation techniques such as PMR or autogenic training. It is recommended that the patient visits a support group as well to learn from other sufferers how they managed the situation.

© GNC, German Neuroscience Center Dubai (Neurology, Psychiatry, Psychology, Counseling, Dubai, UAE)

Sleep disorder: Insomnia Treatment, Symptoms, Causes & More

Living in Dubai and suffering from insomnia or sleep disorders? We show you how to have a better sleep. But be aware, its actual work!

Every third person in the UAE has at least once suffered from sleep disorders. A healthy sleep is essential for our physical and mental well being. It allows to regenerate the body and to deal with events and emotions endured during the day. But how long does a person need to sleep? Indeed there is no general valid sleep time. Each organism has a biological rhythm thus some are ‘early sleeper’ or ‘late sleeper’. The need of sleep differs according to the person, its age and sleep behavior. However, generally speaking, a person requires 7 to 8 hours of uninterrupted sleep to feel rested.

Definition

Insomnia / sleep disorders are one of the most common complaints in in the world. More than 60 million adults suffer from insomnia just in the U.S. 30% to 50% of the population is affected by insomnia or other sleep problems. Especially in Dubai – a high productive work environment – insomnia is a very common complaint.

Insomnia / sleep disorders are characterized by difficulty falling asleep and/or staying asleep, waking up often during the night, waking up too early in the morning and feeling tired upon waking. It could take a toll on the ability to function during the day and cause an irritability, depression or anxiety. For patients with sleep disorders it is often difficult to pay attention, to focus on tasks or to remember. Insomnia also could cause tension headaches and due to the reduced attention it could increase errors and accidents. Insomnia may be an independent disorder or secondary to a medical condition.

Forms

One distinguishes two forms of insomnia: The primary and the secondary Insomnia. Primary Insomnia is sleeplessness that is not directly associated with any other health condition or problem, like medical, psychiatric, or environmental causes. Secondary insomnia is a result of other causes like illness (Depression, Asthma, Arthritis, Cancer), drugs, excessive worrying, pain. Depression is a leading cause of secondary insomnia.

Moreover one distinguishes between acute and chronic Insomnia. It varies in how long it lasts and how often it occurs. It can come and go and there might be times when a patient has no sleep problems. It varies in how long it lasts and how often it occurs. It can come and go and there might be times when a patient has no sleep problems.

Types

Insomnia: A person suffers from insomnia if he/she has difficulty to falling asleep (sleep-onset insomnia); if the quality and duration of sleep is interrupted during the night or by early waking in the morning and the person is not able to get back to sleep (terminal insomnia).
Disorders of the sleep-wake-cycle: It occurs when the internal hour clock of a person to sleep at dark time and to wake up at light time is confused (e.g. due to time zone change, to shift work)
Parasomnia: It is characterized by abnormal actions or events that occur during sleep (e.g. sleep walking, sleep terrors)
Narcolepsy: It is a neurological disorder expressed by excessive daytime sleepiness.

Causes

Causes of secondary Insomnia are mentioned above. Causes of acute primary Insomnia can be emotional or physical complaint, Stress (occupational or private), Illness, Environmental factors like noise, light, or extreme temperatures that impair the quality of sleep, Medications, Interferences in a normal sleep schedule. Causes of chronic primary Insomnia can be Depression or/and Anxiety, Chronic Stress, Pain or discomfort at night.

Often the feeling of tension can cause sleeplessness. Stressful events that have been occurred during the day and not been able to be broken down until the evening can prevent our sleep. A vicious circle starts as the person desires to sleep better on the next day and enforce his/her sleeps but achieves the contrary: a lack of sleep.

Another reason is the type of sleep. Indeed the profundity and length of a sleep characterizes its quality. Our sleep cycle distinguishes two main phases: The NREM (Non rapid eye movement) phase that has 4 stages going from light sleep to deep sleep and lasts for 90 minutes. This phase helps the body to regenerate. The REM (Rapid eye movement) phase, also known as the dream sleep, that helps to deal with events and emotions endured during the day. A person does not feel rested even if he/she slept 8 hours because the cycle was interrupted: When the person wakes up in the moment of the NREM deep sleep phase, he/she can feel not having got a good night’s rest. Also the regeneration of the body can be affected if the person is not able to reach the deep phase after going to sleep and instead wakes constantly up. The ideal cycle for a reposed sleep is shown in the diagram below:

Finally sleep disorders can also be caused by external disruptive factors: Too low room temperature, too flat/high or too soft/hard pillow, too hard/soft mattress, a ‘low breathable’ duvet are factors of sleep discomfort. Here are some recommendations: It is recommended to air the room before going to sleep. It is important to choose a Pillow that allows the spine to be perfectly aligned. You should use a medium-firm mattress to avoid muscles pressure and offer support to back, neck and legs. If possible, choose duvets made from natural materials (feather, silk, cotton) as they are more breathable and avoid the person to perspire, wake up and have the sleep disturbed.

Diagnostics

Polysomnography is a powerful tool to diagnose sleep disorders. Polysomnography is a comprehensive recording of physiological changes that occur during sleep such as brain waves, oxygen level in the blood, heart rate and breathing rate as well as eye and leg movement. It is used to diagnose or rule out many types of sleep disorders, including Narcolepsy, Restless legs movements, REM behavior, Parasomnias, somnambulism, epilepsy related disease, snoring and sleep apnoea. On the other hand, stress related or other psychiatric disturbances may cause sleep disorders or vice versa, just as inappropriate bedding.

For all these reasons it is of the utmost importance to analyse sleep and sleeping customs thoroughly in order to determine by aid of the neurologist the individually correct diagnosis and ensuing possibilities of treatment for sleep disorders. The sole application of sleeping drugs does not represent an ideal solution but may even be dangerous because it could lead to dependencies as unwanted side-effect.

How to Prepare for the Sleep Disorder Test

There are no major preparations necessary. The patient is advised not to take any sleep medicine or drink alcohol or caffeinated beverages prior to this test.

Risk factors of the Sleep Disorder Test

Polysomnography is a non invasive procedure. There is no risk, except maybe some skin irritation caused by the adhesive used to attach the sensors to the skin. It is therefore a fabulous procedure for children too.

Mechanism of the Sleep Disorder Test

Physiologic sensor leads are placed on the patient in order to record the following:

1. EEG (Electroencephalogram)
2. EOG (Electro-Occulogram)
3. EMG (Electromyogram)
4. ECG (Electrocardiogram)
5. Airflow (thermistor or thermocouple sensor)
6. Respiratory Effort (piezo crystal effort sensor)
7. Oxygen saturation (Pulse oximeter)

Procedure of the Sleep Disorder Test

1. AT A SLEEP LABORATORY OR HOSPITAL

For the standard test, the patient - suffering from sleep disorders - comes to a sleep lab in the early evening, and over the next 1–2 hours is introduced to the setting and “wiring up” so that multiple channels of data can be recorded when he/she falls asleep. The sleep lab may be in a hospital, or in a center. A sleep technician should always be in attendance and is responsible for attaching the electrodes to the patient and monitoring the patient during the study. She must explain to the patient about the procedure to keep the patient relaxed throughout the night.
The sleep laboratory should be equipped with video cameras in the patient’s room, so that the patient can be recorded while sleeping. This allows the technician to review the tape at any time during the test and verify whether strange looking waveforms were caused by an actual arousal, a period of wake, or normal patient movements in bed.

2. AT HOME

Nowadays, neurologists may carry out home studies to enhance patient comfort and reduce expenses, which is in the best interest of any patient. The patient is given thorough instructions as to how the screening tool is used. He will then use the equipment at home in his usual sleep surroundings and return it the next day. Most screening tools consist of an airflow measuring device (thermistor) and a blood oxygen monitoring device (pulse oximeter). They are small and easy to handle and produce excellent graphs and other results. At the German Neuroscience Center our neurologists follow this new path and provide patients  - suffering from sleep disorders - with a tool they can easily apply at home rather than putting the patient into an awkward situation at the clinic because they realize that especially in Arabic countries with prayer times and similar rules to follow, it might be difficult for the patient to carry out a sleep study outside their homes.

The patient will sleep with the screening device for one to three nights, and then return the device to the neurologist. The neurologist will retrieve data from the device and can make assumptions based on the information given, for example, a series of drastic blood oxygen desaturations during night periods may indicate some form of respiratory event (apnea). At a minimum, the equipment will monitor the oxygen saturation.

Sleep Disorder Test Summary

Polysomnography (PSG) has proved to be a convincing tool for enhancing our understanding of sleep and sleep disorders. It is an essential diagnostic procedure to clarify the causes of sleep disorders thus enabling the neurologist to determine an appropriate form of treatment.
Ideally, and in accordance with international guidelines, sleep studies will be carried out by neurologists in close cooperation with an ENT specialist in such cases where first results point at a serious disease, as is standard at the German Neuroscience Center GNC.

Evaluation of sleep disorders must be made more readily available to the hundreds of thousands of patients with sleep disorders who still lack diagnosis and treatment. Lack of sleep or permanently disturbed sleep will lead to reduced concentration and failing personal efficiency. This will not only gravely affect the patients’ private lives but also their daily working capacity. Sleep disorders, if not analyzed and left untreated, may lead to dangerous, even fatal, situations and social decline by, for instance, losing one’s job. Today, thanks to Polysomnography, nobody has to take such risks, since our neurologists, psychiatrists, and psychologists at the German Neuroscience Center know of many ways how to treat sleep disorders adequately after having analyzed and diagnosed the causes thoroughly.

Sleep Disorders, Treatment

There are very effective ways of treatment for sleep disorders these days. The problem is rather that patients are hesitant to search professional help. Thus a vicious circle could start where the sufferer is already afraid of going to bed. Obviously then it will be very difficult to fall asleep. If you are suffering from sleep disorders, you know what we are talking about. Specialists are using a combination of these scientifically proven treatment options for insomnia: Sleep hygiene, stimulus control, relaxation techniques, sleep restriction therapy, cognitive behavioural therapy and medications.

We would like to deliver one of these techniques to your doorstep or rather in your bedroom. Stimulus control therapy. It’s very effective and successfully used since more than 30 years. It sounds easy but it’s not. The pivotal point is your willpower to maintain these rules. It is actual work. If you don’t manage it alone, a psychologist might help you.

Rules of stimulus control therapy (Bootzin, 1980)

1. Only go to bed when sleepy. Bear in mind being sleepy is not the same thing as being tired. It is important to be aware of this difference.
2. Use the bed only for sleep and sexual activity. Do not engage in sleep-incompatible activity in bed such as eating snacks, watching TV or working.
3. If after about 10 minutes you are unable to fall asleep or awaken, leave the bed and go to another room. Then return to bed and repeat as often as necessary until you do fall asleep. It is important to not watch the clock while doing this. It is your subjective estimate of time that is important.
4. Keep a regular morning rise time no matter how much sleep you got the night before. This will help regularize the circadian (24 hour) schedule and if you don't sleep well one night, the drive to sleep will be higher the following night.
5. Avoid napping. This prevents reducing sleep drive earlier in the day that can make it harder to fall asleep at night.

Why is it working? Psychologists call it conditioning. Conditioning is a type of learning that had a major influence on the school of thought in psychology known as behaviourism. Wrong conditioning is a major problem that occurs in chronic insomnia. If you repeatedly toss and turn in your bed for hours on end, your body will eventually learn to associate your bed with stress and being awake. As a result, your bedroom will actually cause you to stay awake. The points above are trying to address this problem and to re-teach your body to associate your bed with healthy sleep. Keep in mind that it takes time and effort to make it work. Like any other form of learning. However, if this is not sufficient a combination therapy might be the right thing for you. This could include sleep hygiene, relaxation techniques, sleep restriction therapy, cognitive behavioural therapy and medication.