Video: Understanding Different Types of Back Pain

Are you having trouble treating your back pain? This video explains why back pain can be so difficult to diagnose and treat.

sam-burriss-363710-unsplash.jpg

When you learn about your body, you are in control of how to support it well & correctly.

Click the photo to watch a short educational video!

Why Does Your Body Twitch As You're Falling Asleep?

If you’ve ever found yourself drifting off to sleep only to be woken by a vigorous, full-body twitch or jerk, then do not feel alarmed. You’re among the estimated 60 - 70 % of Americans who regularly experience a phenomenon known as a hypnic jerk—also known as a hypnagogic jerk, or sleep start—which strikes as a person falls into a deep sleep. Here’s what to know about it.

What do sleep jerks feel like?

Hypnic jerks—involuntary twitches or jolts which occur during the night—can affect people in different ways. Many people will sleep right through them, but for others, they are vigorous enough to wake them up.

Although there is no definite explanation for what causes hypnic jerks, people are more likely to suffer from them when they’re sleep deprived or anxious, or when they do sleep-impairing habits before going to bed, like drinking caffeine or doing exercise close to bedtime, says James Wilson, a U.K.-based sleep behavior and sleep environment expert. “For people who suffer from hypnic jerks, it’s awful,” he adds. “They worry about it before they go to bed, which makes it worse.”

Jacqui Paterson, who is 44 and lives in the U.K., says she has experienced these kinds of twitches on an almost-nightly basis for about three years.

“When I was about 41, I started getting insomnia, which I’d never had in my life before,” she says. “Initially, I was staying awake all night, but I now get these annoying jerks which wake me up exactly an hour after I fall asleep, like someone has set an alarm in my head. I seem to have replaced one evil with another.”

Paterson says the jerks come more regularly when she feels concerned or preoccupied. If she worries about them happening before she goes to bed, then it “almost guarantees” that she will suffer from them that night.

The jerks feel like a jolt or an electric shock, Paterson says. “I’ve heard people talk about getting a falling sensation when they drop off to sleep,” she says. “To me, the feeling is like that but on steroids. It’s like someone has come and slapped me. It’s a really shocking feeling, like jumping into freezing cold water. I always wake up feeling totally alert.”

What causes hypnic jerks?

Put simply, hypnic jerks are caused when one part of the brain tries to go to sleep more quickly than other parts of the brain.

“The complexity of going to sleep and waking up is incredible, and sometimes—particularly when we are sleep deprived—our brain doesn’t shut down normally, which means we get this sort of jerking movement when we’re in a light sleep,” says Wilson. Often, he adds, the brain tries to make sense of it, “which is when we imagine ourselves falling off the sidewalk, a cliff or in a hole.”

The reason why some people experience the twitches at such a predictable time is due to their circadian rhythm, or body clock, Wilson says. “Normally when we go to sleep, about half an hour later we go into a deep stage of sleep during which we wouldn’t get these hypnic jerks,” he says. “If someone is sleep deprived, as they go through the process of falling asleep, the brain will get stuck at the same point in time. Usually if we can help people address their sleep deprivation, the instances decrease or disappear altogether.”

How can you prevent sleep jerks from happening?

There are ways to limit the effects, particularly by making a conscious effort to sleep better. “Try and get in a good routine around sleep,” Wilson says. “Wake up at the same time every day, and wind down properly before going to bed, making sure the activities you do in the hour before going to sleep are relaxing to you. Like most issues surrounding sleep, preventing hypnic jerks is all about trying to solve that sleep deprivation.”

Wilson also suggests that if a person suffers from them at the same time every night, they could ask a housemate or family member to disturb their sleep about five minutes before the jerks tend to occur, either by encouraging them to turn over in bed or rustling something near them. Often, that will help stop the twitches from happening, he says.

 

This article originally appeared on time.com and was written by Kate Samuelson

Feeling Sleepy? Have a Nap. It's Good For you!

Here's a very valid case to have a power nap. Experts say an after-lunch snooze is good for you and your productivity.

If you’ve ever felt the need to rest your head on your work desk to secretly get a few minutes of post-lunch shut-eye while the boss wasn’t watching, it turns out you’re not lazy or disinterested. In fact, you are very normal.

According to Moira Junge, sleep psychologist and member of the Sleep Health Foundation, we were designed to require an afternoon kip to get through the day.

“We are all pre-programmed to need a little nap in the afternoon, explains Junge. “What happens with our body’s sleep mechanisms is that we have a post-lunch dip in our system and have a propensity to sleep.”

Junge explains the ‘post-lunch dip’ in our 24-hour circadian rhythm is like a sleepy switch that just flicks on in the afternoon. It’s independent of what we eat and of the amount we’ve slept the night before. This dip also gets repeated at night around 11pm and is the reason why some of us ‘crash out’ around that time.

“We are all pre-programmed to need a little nap in the afternoon. What happens with our body’s sleep mechanisms is that we have a post-lunch dip in our system and have a propensity to sleep.”

But, says Junge, what’s unique about this afternoon napping signal is that it’s temporary. It lasts 30 minutes to 1.5 hours before we go back to feeling alert again.

“If you don’t get an opportunity for sleep, say if you are at work, you can cycle through this dip quickly as your body’s systems will rise again, with or without a sleep if you can just manage to stay awake through it.”

Professor Leon Lack from the School of Psychology at Flinders University is pro-power napping and says if we can, we should. He reminds me that our need to nap in the afternoon is the reason why siestas are an accepted practice in many countries and explains that napping is a natural human habit dating back hundreds of years.

“We’ve become so fixed in our cultural habits of having a single nighttime sleep,” Prof Lack tells SBS. “This idea is a reasonably recent cultural adaptation from the industrial revolution and because of the advent of electric lights.

“Over 300 years ago, when most people were rural farmers, you probably had naps in the middle of the day and stayed up a little later at night but only so long as the fires burned in your house.”

So let’s say one day, our workplaces radically changed to become pro-napping zones. How long a kip should we have on our desk before the alarm rings? Junge says the trick is for the nap to be very short: 20 minutes is ideal, with time dedicated for you to fall asleep.

“If you sleep more than 20 minutes, you get into that deep slow wave of sleep where you can’t hear anything or wake up and don’t know where you are,” says Junge.

“That’s because the first 20 minutes of sleep are very light, stage one and two of sleep, and if you sleep for longer, you are more likely to have sleep inertia, where you wake up and feel worse or take a long time to ‘wake up’ and get going. Longer naps might also affect your sleepiness and ability to sleep at night. So short, sharp naps are recommended.”

Prof Lack goes even further to suggest that the average adult should be having 10 minute power naps in the afternoon, as needed, with a few minutes added to fall asleep.

He co-conducted research in 2006 comparing no naps with naps of five, 10, 20 and 30 minute durations. The 10-minute adult nap gave participants the biggest rise in alertness with the minimal amount of post-nap grogginess.

“With the 20 and 30 minutes sleeps, performance was impaired a little bit immediately after waking up for the first half hour or so,” says Prof Lack. “But the 10 minute naps produced significant benefits in cognitive performance.”

"Stop the struggle and have a quick kip so you can be more productive at work for the rest of the day.”

The moral of this dreamy story, Prof Lack suggests, is that if someone is really struggling with sleepiness in the afternoon, it’s likely they will continue on struggling for up to 90 minutes until they come out of ‘that dip’.

“So managers should find out what’s better for the worker. Is it better for them to be below par at work for 1.5 hours [during their afternoon dip] and potentially make mistakes? Or allow them 15 minutes – five minutes to relax and fall asleep and 10 minutes of napping – to increase the productivity for the remainder of that 1.5 hours?

“Napping could be considered beneficial if you are struggling with sleepiness in the day, commonly in afternoon and have a decline in alertness. Stop the struggle and have a quick kip so you can be more productive at work for the rest of the day.”

Both experts stress that this advice is general and that sleep needs vary according to individual needs and circumstances. They recommend that people with sleep disorders consult a GP and, if needed, see a sleep specialist.

This article originally appeared on sbs.com.au and was written by Yasmin Noone

 

A Probiotic That Lasts?

The bacteria in yogurts have largely failed to live up to their hyped health benefits, but there are other microbes that might.

Imagine that you take some North American mice, breed them in captivity for many generations, and then release them in small numbers into a South American jungle. Smart money says that these house-trained creatures wouldn’t last very long. And yet, this is effectively what we’re doing whenever we buy and consume probiotics.

These products — yogurts, drinks, capsules, and more — contain bacteria that supposedly confer all kinds of health benefits. But most of the bacterial strains in probiotics were chosen for historical reasons, because they were easy to grow and manufacture. They aren’t A-listers of the human gut, and they aren’t well-adapted to life inside us.

To make things worse, they’ve been effectively domesticated, having been reared in industrial cultures for countless generations. And they’re delivered at very low concentrations, outnumbered by the bacteria that already live inside us by hundreds or thousands of time.

A sound concept that doesn’t stick

That’s why studies have repeatedly shown that the bacteria in probiotics are more like tourists than tenants — they pass through without settling down. “You’re trying to establish organisms in an ecosystem to which they haven’t evolved,” says Jens Walter, from the University of Alberta. “They don’t possess the adaptations to be successful.”

That’s why probiotics don’t seem to have any effect on the make-up of the microbiome — the community of microbes that lives within us. It’s also why these products have been so medically underwhelming. The most discerning reviews suggest that they are useful for treating some kinds of infectious diarrhea, but little else.

And over the last decade, European Union regulators have been so unimpressed by the evidence behind probiotics that they banned every single health claim that appeared on these products’ packaging — including the word “probiotic” itself.

The concept is sound, though. We know that the bacteria in our microbiome are important for our health, and that changes in the microbiome have been linked to many conditions including inflammatory bowel disease, colorectal cancer, diabetes, and more. So it should be possible to improve our health by taking the right microbes. The problem is that we do so in a crude and naïve way. These are living things and we are ecosystems. You can’t just introduce the former into the latter and assume they’ll take hold. You need to know why they might succeed or fail. 

Unexpected results

That’s what Walter and his team have started to do. They focused on a specific strain of Bifidobacterium longum, which is a common, stable, and dominant part of the human gut. María Maldonado-Gómez, from the University of Nebraska, asked 23 volunteers to take daily doses of either B. longum or a placebo pill, and checked their stool for signs of the strain’s DNA.

In most of the volunteers, the bacterium disappeared within the first month or even the first week.  But in a third of them, it persisted, and for more than half a year in some cases. Unlike normal probiotics, this strain seemed to establish a permanent foothold.

“I never expected that,” says Walter. “Even with part of our core microbiome, I thought that our resident strains would outcompete the new one.”

In a way, they did. By comparing the volunteers’ microbiomes, Maldonado- Gómez showed that his B. longum strain was less likely to settle down if its new hosts already had B. longum strains of their own. That makes sense: Closely related microbes should be more similar, and thus more likely to compete for the same nutrients, resources, or living spaces. If many kinds of B. longum are already present, there are few niches for an incoming strain to fill.

Maldonado-Gomez also found that the ingested strain was more likely to wash out if a volunteers’ microbiome carried a few dozen particular bacterial genes, the vast majority of which are involved in breaking down carbohydrates and other nutrients. Again, this makes sense: If the native microbes are using these genes to digest whatever food is available, there’s nothing for an immigrant strain to eat.

These results show that it is possible to turn a swallowed microbe into a permanent part of the gut, and they hint at the type of factors that make for successful colonisation.

“I’m excited,” says Walter. “I think it really does show that we might be able to modulate gut ecosystems, by going in and establishing certain microbes. We didn’t look at health, and we’re still trying to identify what microbiome configurations are associated with disease. But if an individual misses or loses strains that are important for their health, it could be possible to redress that.” 

Ecosystem first

“The smart way to administer probiotics is to look at a person’s existing microbial ecosystem first,” says Emma Allen-Vercoe, from the University of Guelph. “Are all the engine parts present and running as they should?  If not, can we provide a missing part by giving a probiotic that possesses it? Can we predict how this newly introduced part will integrate into the engine?”

That’s a savvy and personalised approach to probiotics, with ecology at its heart — very different to the blundering, one-size-fits-all approach that companies currently take.

The success of this personalised approach depends on working out, on an individual basis, what niches in the gut are vacant and which strains are best at filling them. “But what if you could create a niche that only your strain could access?” asks Sean Gibbons, from MIT. Several scientists, he notes, are creating cocktails that contain both a probiotic microbe and a food source that only that microbe can eat — a so-called prebiotic.

“As long as the prebiotic was consumed in the diet, the probiotic would stick around,” says Gibbons. “If the prebiotic were removed, the probiotic would be washed out of the gut.”

Such a strategy might help to address concerns about giving people microbes that are specifically meant to persist in the body. Current probiotics have a fantastic safety record, but perhaps that’s because of their transience. If we switch to strains that are better colonisers, it might lead to unintended consequences.

Then again, there was no evidence of that in Walter’s study. The newcomer strain didn’t displace any of the volunteers’ native microbes, in the way that invasive species like fire ants or cane toads do. It didn’t affect the volunteers’ health, either.

Still, Walter worries that the use of better-colonising strains would lead to inappropriately harsh regulatory hurdles. He feels that the risks of ingesting core members of the microbiome are very small. “We’re already doing that with fecal transplants, and we introduced bacteria into our bodies all the time from our surroundings,” he says.

For now, such talk is moot, because the era of precision microbiome medicine still seems a long way off. “The findings need to be replicated in larger studies,” says Nadja Kristensen, from the University of Copenhagen. And while the study reveals why bacteria might colonise healthy humans, it’s unclear if the same principles would apply to sick people with disturbed microbiomes.

Walter’s study also looked at just one strain of B. longum, which is being developed by the Irish company Alimentary Health as a probiotic. Many other strains exist and they behave very differently.

“The company has another B. longum on the market, and they know for a fact that it doesn’t persist,” he says. “I would hope and anticipate that we’d see more studies that are similar to ours, using core members of the microbiome. We’re really just at the beginning.” 

By Ed Yong

Source: The Atlantic