Falls

Falls can be dangerous at any age. Babies and young children can get hurt falling off furniture or down the stairs. Older children may fall off playground equipment. For older adults, falls can be especially serious. They are at higher risk of falling. They are also more likely to fracture (break) a bone when they fall, especially if they have osteoporosis. A broken bone, especially when it is in a hip, may even lead to disability and a loss of independence for older adults.

Some common causes of falls include:

• Balance problems
• Some medicines, which can make you feel dizzy, confused, or slow
• Vision problems
• Alcohol, which can affect your balance and reflexes
• Muscle weakness, especially in your legs, which can make it harder for you to get up from a chair or keep your balance when walking on an uneven surface.
• Certain illnesses, such as low blood pressure, diabetes, and neuropathy
• Slow reflexes, which make it hard to keep your balance or move out of the way of a hazard
• Tripping or slipping due to loss of footing or traction

At any age, people can make changes to lower their risk of falling. It important to take care of your health, including getting regular eye exams. Regular exercise may lower your risk of falls by strengthening your muscles, improving your balance, and keeping your bones strong. And you can look for ways to make your house safer. For example, you can get rid of tripping hazards and make sure that you have rails on the stairs and in the bath. To reduce the chances of breaking a bone if you do fall, make sure that you get enough calcium and vitamin D.

NIH: National Institute on Aging

Sleep Disorders

What is sleep?

Sleep is a complex biological process. While you are sleeping, you are unconscious, but your brain and body functions are still active. They are doing a number of important jobs that help you stay healthy and function at your best. So when you don't get enough quality sleep, it does more than just make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.

What are sleep disorders?

Sleep disorders are conditions that disturb your normal sleep patterns. There are more than 80 different sleep disorders. Some major types include:

• Insomnia - being unable to fall asleep and stay asleep. This is the most common sleep disorder.
• Sleep apnea - a breathing disorder in which you stop breathing for 10 seconds or more during sleep
• Restless leg syndrome (RLS) - a tingling or prickly sensation in your legs, along with a powerful urge to move them
• Hypersomnia - being unable to stay awake during the day. This includes narcolepsy, which causes extreme daytime sleepiness.
• Circadian rhythm disorders - problems with the sleep-wake cycle. They make you unable to sleep and wake at the right times.
• Parasomnia - acting in unusual ways while falling asleep, sleeping, or waking from sleep, such as walking, talking, or eating

Some people who feel tired during the day have a true sleep disorder. But for others, the real problem is not allowing enough time for sleep. It's important to get enough sleep every night. The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. Most adults need about 7-8 hours each night.

What causes sleep disorders?

There are different causes for different sleep disorders, including:

• Other conditions, such as heart disease, lung disease, nerve disorders, and pain
• Mental illnesses, including depression and anxiety
• Medicines
• Genetics

Sometimes the cause is unknown.

There are also some factors that can contribute to sleep problems, including:

• Caffeine and alcohol
• An irregular schedule, such as working the night shift
• Aging. As people age, they often get less sleep or spend less time in the deep, restful stage of sleep. They are also more easily awakened.

What are the symptoms of sleep disorders?

The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that:

• You regularly take more than 30 minutes each night to fall asleep
• You regularly wake up several times each night and then have trouble falling back to sleep, or you wake up too early in the morning
• You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day
• Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods
• You have creeping, tingling, or crawling feelings in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep
• Your bed partner notices that your legs or arms jerk often during sleep
• You have vivid, dreamlike experiences while falling asleep or dozing
• You have episodes of sudden muscle weakness when you are angry or fearful, or when you laugh
• You feel as though you cannot move when you first wake up

How are sleep disorders diagnosed?

To make a diagnosis, your health care provider will use your medical history, your sleep history, and a physical exam. You may also have a sleep study (polysomnogram). The most common types of sleep studies monitor and record data about your body during a full night of sleep. The data includes:

• Brain wave changes
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate and electrical activity of the heart and other muscles

Other types of sleep studies may check how quickly you fall asleep during daytime naps or whether you are able to stay awake and alert during the day.

What are the treatments for sleep disorders?

Treatments for sleep disorders depend on which disorder you have. They may include:

• Good sleep habits and other lifestyle changes, such as a healthy diet and exercise
• Cognitive behavioral therapy or relaxation techniques to reduce anxiety about getting enough sleep
• CPAP (continuous positive airway pressure) machine for sleep apnea
• Bright light therapy (in the morning)
• Medicines, including sleeping pills. Usually, providers recommend that you use sleeping pills for a short period of time.
• Natural products, such as melatonin. These products may help some people but are generally for short-term use. Make sure to check with your health care provider before you take any of them.

Fractures

What is a fracture?

A fracture is a break in a bone. Fractures are usually caused by injuries. Since they can sometimes be serious, it's important to get medical care right away if you think you have a fracture.

What are the different types of fractures?

There are different ways to describe fractures. For example, there are different types of fractures based on:

• Whether the bone is partially or completely broken.
• Whether the bone breaks through the skin; if it does, it's called an open (or compound) fracture. If not, it's a closed fracture.
• The direction or shape of the break, for example if it's in a line across the bone or if it has some kind of pattern.
• The cause of the break. For example, a stress fracture is a small break in a bone that is often caused by overuse.
• Which bone is broken, for example facial fractures include nose and jaw fractures.

What causes fractures?

Fractures commonly happen because of car accidents, falls, or sports injuries. Overuse and repetitive motions can also cause fractures.

Low bone density and osteoporosis are conditions which cause weakening of your bones. Having one of these conditions makes you much more likely to break a bone.

What are the symptoms of a fracture?

The symptoms of a fracture can vary, depending on which bone you broke. But they may include:

• Intense pain
• Deformity, for example a limb that looks out of place
• Swelling, bruising, or tenderness around the injury
• Trouble moving the injured part

If you think that you may have broken a bone, get medical care right away.

How are fractures diagnosed?

To find out if you have a fracture, your health provider will do a physical exam and ask about your injury. They will also likely order an x-ray or other imaging test to see if your bone is broken.

What are the treatments for fractures?

The most common treatment for a fracture is for you to wear a cast or a splint. This will keep your bone from moving while it heals. How long you need to wear it will depend on the type of fracture and which bone is affected. But it's often for several weeks. Your provider will let you when you can get it off.

In some cases, you may need surgery to put in plates, pins, or screws to keep the bone in place.

Can fractures be prevented?

There are steps you can take to lower your risk of fractures:

• Keeping your bones strong by:
  • Getting enough calcium and vitamin D in your diet
  • Getting regular physical activity, including weight bearing exercises such as walking, tennis, and dancing
  • Getting treatment for low bone density or osteoporosis (if needed)
• Wearing protective equipment when you do sports
• Preventing falls by:
  • Getting rid of any tripping hazards in your home
  • Being careful when walking on wet or icy surfaces
  • Choosing the right footwear

Insomnia

What is insomnia?

Insomnia is a common sleep disorder. If you have it, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You may not feel refreshed when you wake up.

What are the types of insomnia?

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common. Common causes include stress at work, family pressures, or a traumatic event. It usually lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary. This means they are the symptom or side effect of some other problem, such as certain medical conditions, medicines, and other sleep disorders. Substances such as caffeine, tobacco, and alcohol can also be a cause.

Sometimes chronic insomnia is the primary problem. This means that it is not caused by something else. Its cause is not well understood, but long-lasting stress, emotional upset, travel and shift work can be factors. Primary insomnia usually lasts more than one month.

Who is at risk for insomnia?

Insomnia is common. It affects women more often than men. You can get it at any age, but older adults are more likely to have it. You are also at higher risk of insomnia if you:

• Have a lot of stress
• Are depressed or have other emotional distress, such as divorce or death of a spouse
• Have a lower income
• Work at night or have frequent major shifts in your work hours
• Travel long distances with time changes
• Have an inactive lifestyle
• Are African American; research shows that African Americans take longer to fall asleep, don't sleep as well, and have more sleep-related breathing problems than whites.

What are the symptoms of insomnia?

Symptoms of insomnia include:

• Lying awake for a long time before you fall asleep
• Sleeping for only short periods
• Being awake for much of the night
• Feeling as if you haven't slept at all
• Waking up too early

What other problems can insomnia cause?

Insomnia can cause daytime sleepiness and a lack of energy. It also can make you feel anxious, depressed, or irritable. You may have trouble focusing on tasks, paying attention, learning, and remembering. Insomnia also can cause other serious problems. For example, it could make you may feel drowsy while driving. This could cause you get into a car accident.

How is insomnia diagnosed?

To diagnose insomnia, your health care provider:

• Takes your medical history
• Asks for your sleep history. Your provider will ask you for details about your sleep habits.
• Does a physical exam, to rule out other medical problems that might cause insomnia
• May recommend a sleep study. A sleep study measures how well you sleep and how your body responds to sleep problems.

What are the treatments for insomnia?

Treatments include lifestyle changes, counseling, and medicines:

• Lifestyle changes, including good sleep habits, often help relieve acute (short-term) insomnia. These changes might make it easier for you to fall asleep and stay asleep.
• A type of counseling called cognitive-behavioral therapy (CBT) can help relieve the anxiety linked to chronic (ongoing) insomnia
• Several medicines also can help relieve your insomnia and allow you to re-establish a regular sleep schedule

If your insomnia is the symptom or side effect of another problem, it's important to treat that problem (if possible).

NIH: National Heart, Lung, and Blood Institute

Balance Problems

Have you ever felt dizzy, lightheaded, or as if the room is spinning around you? If the feeling happens often, it could be a sign of a balance problem. Balance problems can make you feel unsteady. You may also have blurred vision, confusion, and disorientation. They are one cause of falls and fall-related injuries, such as a hip fracture (broken hip).

Some balance problems are due to problems in the inner ear. Others may involve another part of the body, such as the brain or the heart. Aging, infections, head injury, certain medicines, or problems with blood circulation may also cause balance problems.

It is important to see your doctor about balance problems. They can be a sign of other health problems, such as an ear infection or a stroke. Your doctor may send you to a specialist for a diagnosis. You may need a hearing test, blood tests, or imaging studies of your head and brain. Other possible tests look at your eye movements, and how your body responds to movement.

In some cases, treating the illness that is causing the disorder will help with the balance problem. Exercises, a change in diet, and some medicines also can help.

NIH: National Institute on Deafness and Other Communication Disorders