Showing posts with label memory. Show all posts
Showing posts with label memory. Show all posts

Wednesday, September 7, 2016

WHY IS SILENCE GOOD FOR YOUR BRAIN?


WHY IS SILENCE GOOD FOR YOUR BRAIN?

Brain is, without any argument, the most important organ of our body. We depend on brain to ensure better performance of all useful activities, be it related to our jobs or household chores. Some of the important functions of brain include memory, reasoning, judgment, language, calculation, etc. Having understood the importance of brain and its functions, it is equally important to understand the measures needed to take good care of the brain.

Nutritious diet, regular physical activity, freedom from stress and anxiety, sound & adequate sleep, regular brain “exercises” (solving crossword puzzles, Sudoku, etc), preventing head injury and avoiding smoking, are important measures that ensure good brain health.

The purpose of this article is to emphasize the important role played by silence in the wellbeing of brain. Who has not heard this- “If speech is silver, silence is gold”!

In our daily lives, we are surrounded by different kinds of noise and sounds most of the time. These include sound of vehicles, loud music, ringing of smartphones, and so on. This “noise pollution” has a detrimental effect on our brain and body. Various research studies have shown that exposure to noise leads to higher incidence of elevated blood pressure, which is an important risk factor for heart attacks and brain strokes. Noise pollution also causes impairment of hearing; sleep disturbances, and problems with memory and concentration. Studies have concluded that children exposed to households or classrooms near airplane flight paths, railways or highways have lower reading scores and are slower in their development of cognitive and language skills.  

If noise has so much of adverse effects on brain, silence should have just the opposite effect- and it is indeed so.
1. Silence leads to lowering of heart rate and blood pressure. This effect on BP lowering is seen with as little as two minutes of silence. Lowering the BP would lead to a lesser incidence of brain strokes.
2. Silence is relaxing and rejuvenating. In this 24X7 work environment with exposure to various sounds, our brain gets muddled and then, we cannot focus and concentrate. Therefore, we need periods of quiet and calm to allow our brains to recharge. Some people use music to relax. While music does relax the brain, it is interesting to note that silence has far greater effects on brain relaxation than music.
3. Silence promotes better sleep. We have all experienced the difficulties in falling or maintaining good sleep, when exposed to sounds or noise. In silent environment, on the other hand, sleep is sound and relaxing. Better sleep translates into better functioning of brain. Growth hormone is secreted in brain during sleep. Consolidation of memory and learning also occurs during sleep. Good sleep is also a stress buster and lowers BP.
4. Silence may improve memory. In an interesting experiment conducted on mice, it was found that exposing them to two hours of silence per day led to development of new neurons in the hippocampus area of the brain. Hippocampus is mainly involved in memory, emotion and learning. So, there is a high possibility that these brain functions would improve, if one is exposed to even short periods of silence on daily basis.
5. Silence is a stress buster. When a person is stressed and anxious, one of the best and easiest quick fixes is to take rest (sit or lie down) in complete silence. While it may be tempting to get a counseling done by a family member or a psychologist for stress, it is equally important to have periods of silence to overcome stress.
6. Silence improves our ability to concentrate and focus. In our daily lives, we are constantly exposed to stimuli- sounds as well as sights. This makes our brains foggy and inattentive, leading to difficulty in concentrating. In this situation, the ability to solve problems or to come up with new ideas is greatly hampered. Silence, even for short periods, comes to our rescue in this condition. Silence makes the brain fresh and energetic. One can solve complex problems and come up with bright new ideas after a brief period of silence.
7. Silence helps us tap the hidden talents and strengths in our own brain. Brain has immense capacity and resources, which largely remain untapped. This is because one cannot look deep inside his brain, when exposed to distractions of sounds/noise. On the other hand, in a silent environment, one can daydream, fantasise or think and be more creative. As Herman Melville once wrote, "All profound things and emotions of things are preceded and attended by silence."
8. Silence reduces the risk of heart attacks and brain strokes by reducing plaque formation in the arteries. 
All these beneficial effects of silence on brain should prompt us to seek silence everyday in our busy lives, even if it is for a brief period. Moreover, sitting in silence is free, easily accessible, and has no side effects.





This article was modified and published in September 2016  issue of B POSITIVE magazine, a heath and wellness magazine.

DR SUDHIR KUMAR MD DM (NEUROLOGY)
CONSULTANT NEUROLOGIST
APOLLO HOSPITALS, HYDERABAD
PH-04023607777
Email: drushirkumar@yahoo.com

Friday, March 18, 2016

TIPS FOR GOOD AND RELAXING SLEEP (on WORLD SLEEP DAY)

TIPS FOR GOOD AND RELAXING SLEEP

Today is World Sleep Day (celebrated on Friday of second full week in March).  You must be wondering why should we celebrate World sleep day. This is because about 45% of population suffers from one form of sleep disorder or other or are sleep deprived. Sleep problems are not only associated with un-refreshed feeling, but are also associated with major health hazards. So, the World sleep day is aimed at raising awareness about benefits of good sleep and ways to ensuring a good sleep. This year’s slogan for World sleep day is “Good sleep is a reachable dream”.

Normal Sleep
     1. Normal sleep duration is 7-9 hours in adults (10-11 hours in 6-12 year olds; 9 hours in teenagers)
     2. Natural sleep occurs at nights, as melatonin (sleep hormone) is released during nights (when there is no light)
     3. Adults need to sleep only once (at nights). This is called monophasic sleep. People older than 60 may have biphasic sleep (in addition to nights, they may sleep in afternoons too). Newborn babies and infants may have polyphasic sleep (they sleep and get up multiple times).
     4. The best time to go to bed is between 9 PM to 11 PM and the best time to get up is between 5 AM to 7 AM. It should be made a habit to go to sleep and awaken at the same time everyday to avoid sleep problems.
     5. People who work until late evenings may benefit from a short post-noon sleep, called as siesta or power nap. Typically, it should not last more than 15-20 minutes. Siesta energizes the individual improving their work efficiency.

Functions of Normal Sleep
1. Sleep is restorative in nature and makes us fresh and energised to do the day’s work,
2. Growth hormone (GH) is released at nights during sleep. GH secretion may get affected in nights shift workers (and day sleepers). (Prolactin and testosterone are also maximally secreted at nights)
3. Consolidation of memory occurs during sleep. So, it is a better habit to have a good nights’ sleep for better memory, rather than burning midnight oil! The best long term memory is achieved when learning is followed by sleep within three hours.

Risks and Hazards of Sleeping Less
1. Attention and concentration are impaired the day after less sleep. This could result in driving errors, poor efficiency at school or work, as the case may be,
2. Some people complain of general tiredness or heaviness of head/headache after sleeping less,
3. Memory impairment may occur in people sleeping less,
4. Increased irritability and behavioral problems are seen in sleep deprived people,
5. Less sleep may make you fat and lead to obesity,
6. Increased incidence of diabetes mellitus, hypertension, cancer, stroke and coronary artery disease is seen in people sleeping less,
7. Lack of sleep kills sex drive,
8. Less sleep may lead to depression and anxiety; also, people with depression and anxiety sleep less,
9. Lack of sleep leads to skin ageing, and makes it lackluster. Dark circles may form under the eyes.
10. There is also an association between less sleep and higher death rates. Reducing sleep duration from 7 to 5 hours on a regular basis may double the risk of death, mostly from cardiovascular causes.

Tips for Ensuring Good and Sound Sleep
1. Have a light dinner and avoid heavy meals at nights. Eat at least two to three hours before sleeping time. A full stomach may cause sleep disturbance. Late dinners may cause acid reflux in the stomach,
2. Avoid tea, coffee other stimulant drinks at nights, as it may cause less sleep,
3. Avoid smoking at all times, especially at nights,
4. Maintain a good sleep hygiene (try to sleep and wake up at the same time every day)
5. Avoid night shift duties and doing duties in changing shifts (occasional night duty is alright),
6. Avoid frequent travels to places with different time zones (this can lead to jet lag and impaired sleep),
7. Avoid arguments and heated discussions just before sleep,
8. Avoid watching negative news on TV about various crimes, etc at nights. Instead it may be better to listen to some soothing music or read a relaxing novel.
9. Exercise in the evenings improve night’s sleep quality,
10. A glass of milk would also improve sleep,
11. The bedroom should be used only for sleep (and sex) and office work should not be brought to bedroom.
12. It is better to keep the phones and other gadgets away during sleep, and keep them in silent mode
13. Sleep is better in dark, so, ensuring that would improve sleep quality.
14. Also, maintain a good ambient room temperature. Too hot or too much cold temperature may hamper good sleep.
15. Avoid taking sleeping pills, as they can lead to addiction or dependence on them. After that, you would not get sleep without them and over a period of time, much higher doses of sleeping pills would be needed.

DR SUDHIR KUMAR MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist
Apollo Health City, Hyderabad
Phone- 0091-40-23607777/60601066
Online consultation:  http://bit.ly/Dr-Sudhir-kumar


Friday, August 12, 2011

TAKING CARE OF A PATIENT AFTER BRAIN STROKE (PART 2)

TAKING CARE OF A STROKE SURVIVOR (PART 2)

NON-DRUG ASPECTS OF PATIENT CARE

In my previous article posted on 11th August 2011, I had discussed about the various medications that are required to be taken by a stroke patient. However, there are several other aspects of post-stroke care that are equally important to make the life of a stroke survivor better & more comfortable.

1. Assessment of swallowing

Eating food is probably the most important function and a normal swallowing ensures that the patient can take liquids and solid food. Swallowing can be impaired in a stroke of medulla oblongata (brain stem or posterior circulation) and also in bilateral hemispheric strokes. Sometimes, the patient may be too drowsy to swallow. In a person who is awake and conscious, the adequacy of swallowing can be assessed by a swallow test. The patient is made to sit up and asked to swallow a glass of clear water. If he can drink it within half a minute without coughing or choking, then the swallowing seems to be adequate and the patient may be started on oral feeding.

2. Feeding

Feeding and good nutrition is an important aspect of ensuring a good post-stroke recovery. For patients who can swallow, normal food can be given by mouth as early as possible. For people who can not swallow, there are two options. In the first option, a tube (Ryles tube or naso-gastric tube) is inserted from nose upto the stomach and is kept secured by an adhesive near the nose. Then, liquid diet (milk, juice, etc) can be given at 2-hourly intervals through the tube. Ensure that the patient is not lying down while feeding, and the patient head end should be elevated by 30-45 degrees and left so for at least half an hour after feeding. The other option is PEG (percutaneous endoscopic gastrostomy), where a tube is inserted directly into the stomach by a minor surgical procedure by the gastroenterologist. The advantage of PEG (over the naso-gastric tube) are two-fold: i) It can be kept for much longer periods. Ryle's tube needs to be changed every 2-4 weeks. ii) Different types of food can be given via PEG.

3. Physiotherapy

Physiotherapy is the only method by which the strength and balance of the person can be improved upon. Many patients have significant residual weakness and imbalance after brain attack (stroke). They may be unable to stand or walk without support. They may also be unable to use their hands for any meaningful work. This is where physiotherapy is very important. Physiotherapy should be done under guidance of qualified physiotherapists. It should be done on a regular basis. Many patients ask for medicines or operations to improve the muscle weakness; unfortunately there are none, but good & regular physiotherapy can definitely make the muscle power & strength better.

4. Speech therapy

Many stroke survivors have language dysfunction. This can range from difficulty in understanding spoken words, inability to read or write, speaking or repeating the spoken words. In right-handed individuals, language area is located in the left side of brain. Therefore, language problems are more common after strokes on the left side of brain (which causes right sided weakness also). Additionally, patients with stroke in cerebellum (posterior circulation) may have slurred speech, but they are able to understand and speak. Patients with speech problems benefit from speech therapy. This can be taken under the guidance of trained speech therapists/rehab experts.

5. Nursing care

Good nursing care is very important in the post-stroke recovery. This includes feeding, bladder & bowel care, frequent position changing, and bathing. A stroke survivor may be dependent on others for activities of daily living and this is where nursing care is important. If a person lies on the same position for long, bed sores may develop, so, the position of the patient should be changed every two hours. Patient may have urinary and fecal incontinence (lack of control leading to voiding of uring and stool in clothes). This can be overcome with the help of adult diapers or changing clothes/bedsheets as per the needs.

6. Prevention of deep vein thrombosis

Blood clots may develop in the leg veins of people who are immobile. Therefore, in stroke survivors with paralysis of legs, there is a higher chance of clots forming in the leg veins (deep vein thrombosis or DVT). This can be minimised by frequent passive movements of the paralsed leg by the care-giver. There are compression stockings available in the market, which can be worn by the stroke patient to prevent DVT.

7. Cognitive stimulation and counseling:

Patients with stroke are prone to develop dementia (memory loss and other cognitive dysfunction) and depression. The risk can be minimised by various measures. Firstly, the patient should be kept in a well-lit room where abundant natural light comes in. Some stroke survivors may have reversal of sleep rhythm (they may sleep during the day and keep awake at nights). This rhythm may delay the recovery from stroke. Therefore, the patient should be kept busy/engaged during the day and not allowed to sleep. If the patient finds it difficult to sleep during nights, a small dose of sleeping pill may be used. Patients may be encouraged to listen to songs/music (through head phones, etc); allowed to meet with various friends or relatives; talk as often as possible (if patients can not talk, even listening is important for brain stimulation, so the visitors should be encouraged to talk even if the patient does not respond).

Depression after stroke is also common. So, proper counseling and psychotherapy is important. Sometimes, antidepressant medications may also be required.

8. Sexual functions

There is no restriction as such, and sexual functions can be resumed as per the patients' ability. Sexual drive may diminish after stroke, and sometimes, there may be linmitations due to physical handicap. These can be overcome to a great extent with the halp of an understanding partner.

9. Diet
  • A good diet is essential for proper recovery.
  • A diabetic should follow the diabetic diet.
  • Generally, the diet should be low in fat and cholesterol content.
  • As constipation is common in post-stroke patient, the diet should be rich in fibre content.
10. Physical activity

Physical activity is encouraged in stroke survivors. They should be encouraged to stand and walk inside home or be taken for an evening or morning walk with an attendant. If these is a risk of fall, use of a walking stick or walker is encouraged. Prolonged sick leave or bed rest is not advised, and the patient should return to normal life activites as early as possible.


DR SUDHIR KUMAR MD (MEDICINE) DM (NEUROLOGY)
SENIOR CONSULTANT NEUROLOGIST
APOLLO HOSPITALS, JUBILEE HILLS, HYDERABAD
Phone: 040-23607777/040-60601066