Western Michigan University Athletics

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Insomnia

 
What is Insomnia? 
Insomnia is difficulty falling asleep or staying asleep, even when given an appropriate chance to do so. The duration of insomnia is dependent on the type and cause and lasts a day or two in acute cases and up to months in chronic cases. People with insomnia can feel dissatisfied with their sleep and usually experience one or more of the following symptoms.


What are the signs and symptoms of insomnia?

• Difficulty falling asleep
• Difficult staying asleep
• Waking up too early in the morning
• Decreased performance
• Forgetfulness
• Unrefreshing sleep
• Fatigue or low energy
• Cognitive impairment
• Mood disturbance
• Behavior problems
• Difficulty concentrating at work or school
• Difficulty maintaining personal relationships

Acute vs. Chronic: 

• Acute insomnia is brief and often happens because of life circumstances (for example, when you can't fall asleep the night before an exam, or after receiving stressful or bad news). Many people may have experienced this type of passing sleep disruption, and it tends to resolve quickly and without formal treatment.
• Chronic insomnia is disrupted sleep that occurs at least three nights per week and lasts at least three months. Chronic insomnia disorders can have many causes. Changes in the environment, unhealthy sleep habits, shift work, other clinical disorders, and certain medications could lead to a long-term pattern of insufficient sleep. People with chronic insomnia may benefit from some form of treatment to help them get back to healthy sleep patterns. Chronic insomnia can be comorbid, meaning it is linked to another medical or mental health issue.

What causes Insomnia?
Insomnia can be attributed to mental health conditions (depression, anxiety), medical conditions or medications (pain disorders, sleep apnea), unhealthy sleep habits (sleep schedule, napping, exercise, eating, electronic stimuli, circadian rhythm), specific substances (alcohol, drug use, caffeine intake), and environmental conditions (light, noise, comfort). If you are believed to suffer from insomnia it is important to seek medical guidance in determining the cause and appropriate treatment options.

How do I get diagnosed with Insomnia?
There is no one definitive test which determines whether a person suffers from insomnia. Rather, physicians and allied healthcare professionals use a multitude of tools to assess an individual’s symptoms, life circumstances, and the potential for other medical or contributory conditions. Tests and tools used in diagnosing insomnia include:
 

• Sleep logs
• Sleep inventory
• Blood tests
• Mental Health Evaluations
• Screening Questionnaires

How do I get treated?
First, talk to your athletic trainer, doctor, or health care professional about your symptoms.
 

• Medications: Prescription and non-prescription medicine intended to target specific contributory symptoms and allow the user to sleep.
• Stimulus control: Encouraging REM sleep by removing or modifying the environment in which one sleeps.
• Relaxation training: Imagery, meditation, and breathing techniques aimed at clearing the mind and relaxing the body in preparation for, or return to sleep
• Lifestyle alterations: Making lifestyle changes to encourage rest. This includes but is not limited to managing food or caffeine intake, the timing of exercise, and the use of electronic devices before bed.
• Mental health therapy/counseling: Intended to address anxiety and depression that may have contributed to the development of insomnia

 
Free Online Resources

• National Sleep Foundation
  • www.sleepfoundation.org/insomnia/content/what-is-insomnia
  • www.sleep.org
• American Sleep Association
  • www.sleepassociation.org/patients-general-public/insomnia/insomnia/
• NCAA: Mind, Body, Sport
  • http://www.ncaa.org/sport-science-institute/introduction-mind-body-and-sport
• Sleep Research Society: http://www.sleepresearchsociety.org/
• American Academy of Sleep Medicine: https://aasm.org/

 
Informative YouTube Videos

• HowCast: Top 3 Causes of Insomnia: https://www.youtube.com/watch?v=f6GdBzYDzwc
• HowCast: How to Prevent Insomnia: https://www.youtube.com/watch?v=ucdGE9AJ_iI
• How to Sleep Better: https://www.youtube.com/watch?v=3eLfn7Ewx_s
• The Importance of Sleep for Studying: https://www.youtube.com/watch?v=tyaZuAI0YUw

Sleep Apnea

 

What is Sleep Apnea? 

A sleep disorder, which occurs when breathing is briefly and repeatedly interrupted during sleep. Two different types of sleep apnea exist:

Obstructive Sleep Apnea

• Muscles in the back of the throat fail to keep the airway open during sleep due to an upper airway obstruction
• Most common form of sleep apnea

Central Sleep Apnea

• The brain doesn’t send proper signals to the muscles that control breathing.
• Far less common form of Sleep Apnea

What are the risk factors?

• Age
  • Can occur at any age. However, there is an Increased risk as you age
  • This is due to age related changes in the brain as it pertains to respiratory control
• Race or Ethnicity
  • More common in African American, Hispanic, and Native Americans
• Family History and Genetics
  • Sleep apnea can be inherited
  • Associated with structural development of the face and skull, as well as respiratory control
• Lifestyle
  • Alcohol
    • Alcohol increases relaxation of the muscles in the mouth and throat
    • Affects how the brain controls sleep
  • Smoking
    • Causes inflammation in the upper airway, affecting breathing
    • Influences the brain, and the muscles that control breathing during sleep
  • Lack of physical activity

• Being overweight or obese increases risk of having sleep apnea

What causes Sleep Apnea?
Sleep apnea can be cause by a person’s physiological makeup or medical conditions

• Obesity
• Large Tonsils
• Endocrine Disorders
• Neuromuscular Conditions
• Heart or Kidney Failure
• Genetic Syndromes

What are the signs and symptoms of Sleep Apnea?

Signs

• Reduced or absent breathing
• Loud or frequent snoring
• Gasping for air during sleep

• Excessive daytime sleepiness or fatigue
• Decreases in attention, vigilance, concentration, motor skills, and verbal and visuospatial memory
• Dry mouth or headaches when waking up
• Frequent urination

How do I get diagnosed?
First, talk to your athletic trainer, doctor, or health care professional about your symptoms.

Diagnosing includes:

Medical history

• Information that you provide from what you are experiencing
• Indication of family history of sleep apnea or other sleep disorders
• Discuss risk factors for sleep apnea
• Other relevant medical history such as atrial fibrillation, type II diabetes, or high blood pressure

Physical exam

• Indicate other signs or conditions that can increase your risk for sleep apnea:
  • Obesity
  • Large tonsils
  • Narrowing of the upper airway
  • Large neck circumference
    • Greater than 17 Inches for men or 16 inches for women
  • Size of jaw and tongue
  • Positioning of tongue in mouth

• Used to diagnose sleep apnea or other sleep disorders by:
  • Detect apnea events, times in which your breathing slows, or stops during sleep
  • Detect low or high levels of activity in muscles that control breathing
  • Monitor blood oxygen levels during sleep
  • Monitor brain and heart activity during sleep
• Graded Mild, Moderate, or Severe
  • Mild: 5 to 14 apnea events in an hour
  • Moderate: 15 to 29 apnea events in an hour
  • Severe: 30 or more apnea events in an hour

How do I get treated?
First, talk to your athletic trainer, doctor, or health care professional about your symptoms.

Healthy lifestyle changes

• Healthy eating habits
  • Limiting alcohol intake, especially before bedtime
• Regular physical activity
• Healthy weight
  • Losing weight if you are overweight or obese
• Sleeping habits
  • Develop healthy sleeping habits
  • Getting the recommended amount of sleep based upon your age
• Quit Smoking

Breathing devices

• Continuous Positive Airway Pressure machine
  • Covers your nose, or nose and mouth
  • Motor provides continuous airway pressure to eliminate or reduce the number of apnea events
  • Should be used every time you sleep
• Side Effects
  • Congestion
  • Dry mouth
  • Runny nose
  • Nosebleeds
  • Most commonly prescribed treatment for those with sleep apnea

• Prescribed for mild cases of sleep apnea or for sleep apnea that occurs when you are lying on your back
• Two types of mouthpieces that may be prescribed
  • Mandibular repositioning mouthpieces
    • Covers the upper and lower teeth
    • Holds the jaw in a position that prevents it from blocking the upper airway
  • Tongue retaining device
    • Holds the tongue in forward position to prevent it from blocking the upper airway

• Requires surgery to implant the device within the body
• Senses breathing patterns and delivers a mild stimulation to muscles during an apnea event
• Nerve stimulator used to stimulate hypoglossal nerve, which helps position the tongue properly to keep the upper airway open

• Orofacial therapy
  • Helps to improve tongue positioning
  • Strengthens muscles that control the lips, tongue, soft palate, lateral pharyngeal wall, and face

• Surgery may be suggested if you have severe obstructive sleep apnea that does not respond well to conservative treatment

Living with Sleep Apnea

• After diagnosis, an individualized treatment plan will be developed
• Important to adopt or maintain healthy lifestyle and use prescribed treatment
• Your physician will monitor the use of the CPAP machine, and may want to modify pressure or prescription over time
• Physician may want to do repeat sleep studies to make sure you are having a positive response to treatment
• Follow up with your athletic trainer on symptoms or changes in symptoms

 

Links/Resources
https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
https://www.sleepapnea.org/

 
 

 

Attention-Deficit/Hyperactivity Disorder

 

What is ADHD/ADD? 
Attention-deficit/hyperactivity disorder (ADHD) and attention-deficit disorder (ADD) are brain disorders marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.


What are signs and symptoms of ADHD/ADD? 
It is normal to have some inattention, unfocused motor activity and impulsivity. Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity that:

• are more severe
• occur more often
• interfere with or reduce the quality of how they function socially, at school, or in a job

Hyperactivity-Impulsivity
People with symptoms of hyperactivity-impulsivity may often:

• Fidget and squirm in their seats
• Leave their seats in situations when staying seated is expected, such as in the classroom or in the office
• Often feel restless
• Be unable to engage in hobbies quietly
• Be constantly in motion or “on the go,” or act as if “driven by a motor”
• Talk nonstop
• Blurt out an answer before a question has been completed, finish other people’s sentences, or speak without waiting for a turn in conversation
• Have trouble waiting his or her turn

How do I get diagnosed?
First, talk to your athletic trainer, doctor, or health care professional about your symptoms.

Diagnosis of ADHD requires a comprehensive evaluation by a licensed clinician, such as a pediatrician, psychologist, or psychiatrist with expertise in ADHD. For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind normal development for his or her age. The doctor will also ensure that any ADHD symptoms are not due to another medical or psychiatric condition.


How do I get treated?
While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

Medication
Anyone taking medications must be monitored closely and carefully by their prescribing doctor. For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination. Sometimes several different medications or dosages must be tried before finding the right one that works for a particular person

Stimulants
The most common type of medication used for treating ADHD is called a “stimulant.” Although it may seem unusual to treat ADHD with a medication that is considered a stimulant, it works because it increases the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.

Under medical supervision, stimulant medications are considered safe. However, there are risks and side effects, especially when misused or taken in excess of the prescribed dose. For example, stimulants can raise blood pressure and heart rate and increase anxiety. Therefore, a person with other health problems, including high blood pressure, seizures, heart disease, glaucoma, liver or kidney disease, or an anxiety disorder should tell their doctor before taking a stimulant. 

Talk with a doctor if you see any of these side effects while taking stimulants:

• decreased appetite
• sleep problems
• tics (sudden, repetitive movements or sounds)
•  personality changes
• increased anxiety and irritability
• stomachaches
• headaches  

 

 
Links/Resources
http://www.ncaa.org/health-and-safety/sport-science-institute/adhd-and-student-athlete
http://www.ncaa.org/sport-science-institute/drug-testing-exceptions-procedures
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

 

  

Dyslexia

What is Dyslexia?
Dyslexia is a language-based learning disability. Dyslexia refers to a cluster of symptoms. It results in people having difficulties with specific language skills, particularly reading. People can have mild, moderate, or severe dyslexia. Dyslexia is referred to as a learning disability, because it can make it very difficult for a student to succeed academically in the typical educational environment.

 
What Causes Dyslexia?
The exact causes of dyslexia are still not completely clear. Brain imagery studies do show differences in the way the brain of a dyslexic person develops, functions and processes information. Dyslexia is not due to either a lack of intelligence, or a lack of desire to learn. With appropriate teaching methods dyslexics can learn successfully.


What are the symptoms?

• Reads slowly and painfully
• Experiences decoding errors, especially with the order of letters
• Shows wide disparity between listening comprehension and reading comprehension of some text
• Has trouble with spelling
• May have difficulty with handwriting
• Exhibits difficulty recalling known words
• Has difficulty with written language
• May experience difficulty with math computations
• Decoding real words is better than nonsense words
• Substitutes one small sight word for another: a, I, he, the, there, was

In addition to these symptoms, other issues may interfere with daily functioning. Other signs that may point to adult dyslexia include:

• Having difficulty focusing on one task
• Avoiding meetings that are about planning
• Becoming overwhelmed if asked to fill out a lengthy form
• Overreacting to your mistakes
• Imposing strict rules on yourself
• Learning better visually or through hands-on experience
• Being easily affected by stress
• Having low self-esteem

What are the types of Dyslexia?

• Primary dyslexia: This is the most common type of dyslexia, and is a dysfunction of, rather than damage to, the left side of the brain (cerebral cortex) and does not change with age. There is variability in the severity of the disability for Individuals with this type of dyslexia, and most who receive an appropriate educational intervention will be academically successful throughout their lives. Unfortunately, there are others who continue to struggle significantly with reading, writing, and spelling throughout their adult lives. Primary dyslexia is passed in family lines through genes (hereditary) or through new genetic mutations and it is found more often in boys than in girls.
• Secondary or developmental dyslexia: This type of dyslexia is caused by problems with brain development during the early stages of fetal development.
• Trauma dyslexia: This type of dyslexia usually occurs after some form of brain trauma or injury to the area of the brain that controls reading and writing. It is rarely seen in today's school-age population.

Other types of learning disability include:

• Visual dyslexia is sometimes used to refer to visual processing disorder, a condition in which the brain does not properly interpret visual signals.
• Auditory dyslexia has been used to refer to auditory processing disorder. Similar to visual processing disorder, there are problems with the brain's processing of sounds and speech.
• Dysgraphia refers to the individual’s difficulty holding and controlling a pencil so that the correct markings can be made on the paper.

How do I get diagnosed?
First, talk to your athletic trainer, doctor, or health care professional about your symptoms.

There are several types of tests your doctor may run to determine the level or severity of your dyslexia. These tests may include:

• Vision test
• Hearing test
• Reading test
• Psychological tests
• Questionnaires about your lifestyle or work life

 
Is there treatment for Dyslexia?
A treatment plan could include:

• Training or tutoring to help improve reading skills, which is crucial for dyslexia at any age
• Occupational therapy to help you learn ways to work around and manage issues your dyslexia causes in the workplace
• Requesting accommodations from your workplace that are reasonable under the Americans with Disabilities Act (ADA)
• Requesting instructions be spoken instead of written
• Finding methods to help you learn and remember
• Additional training in subjects or tasks that make you uncomfortable

 
Technology can also be an important part of managing dyslexia, especially for a working adult. Some things that may help include:

• Recording meetings or important conversations to listen to again later if you missed important information
• Using speech-to-text apps and software so you don’t have to write or type everything
• Using organization apps or electronic organizers to help keep you on track and minimize distractions

What are ways I can help myself?

• Provide a quiet area for activities like reading, answering comprehension questions
• Use books on tape
• Use books with large print and big spaces between lines
• Provide a copy of lecture notes
• Don’t count spelling on history, science or other similar tests
• Allow alternative forms for book reports
• Allow the use of a laptop or other computer for in-class essays
• Use multi-sensory teaching methods
• Teach students to use logic rather than rote memory
• Present material in small units

 

Links/Resources
https://www.mayoclinic.org/diseases-conditions/dyslexia/symptoms-causes/syc-20353552
https://www.dyslexia.com/