Common HPA/ Stress Conditions Flashcards
What is Insomnia?
Repeated difficulty with sleep onset, maintenance, duration or quality
despite adequate opportunity & results in daytime impairment.
What causes Insomnia?
- Prevalence 7.9% in UK (2012)
-
Many different models proposed for its cause, as it can present very differently - some struggle to get to sleep, some to stay asleep.
However the following may cause it: - Hyperarousal – physiological & cognitive
- Genetics - link to brain function and arounsal function
- Molecular mechanisms - histamine is sleep surpressing for example, melatonin is the opposite (and is a popular supplement)
- Specific brain regions - lesions and reduced grey matter can be associated
- NREM sleep instability - non rapid eye movement sleep instability can result in arousal rather than sleepiness
- Behavioural & cognitive
Risk factors
* Increase with age, FH, sex, lifestyle, stress, pre-existing conditions, mental health disorders, social factors. Women more likely to have it than men plus people in urban areas with lots of street lights.
Impact
* Depression, cognitive function, heart disease, ↑risk of accidents, ↑mortality, affects relationships, affects work “
What are conventional methods to diagnose and treat Insomnia?
Diagnosis - Thorough history, diagnostics to rule out other disorders eg pain or snoring. Mental and social health history too eg drugs or tobacco use
Treatment - Cognitive behavioural therapy (CBT) (sleep hygine therapy) and sedatives which can provide relief
How can herbs help with Insomnia?
- Support to make lifestyles changes & implement sleep hygiene - similar time for bed, no use of screens etc, excercise, room temp etc
- Herbal management focuses on supporting nervous system with nervines & support sleep with a evening sleep support mix with
nervines & sedatives - Encourage to seek other therapies – CBT
Example tincture mix, 5ml before bed or increase to 15ml:
* Anemone pulsatilla 5ml - (is this pasqueflower?)
* Avena sativa 30ml - oat
* Eschscholzia californica 20ml - california poppy
* Passiflora incarnata 25ml - passionflower
* Matricaria recutita 25ml - chamomile
What is chronic fatigue syndrome?
- Unexplained, profound fatigue worsened by exertion
- Cognitive dysfunction
- Impairment of daily function that lasts for more than 6 months
They may also have other symptoms such as stomach upset. It was originally called ME but this is now considered inaccurate.
What causes chronic fatigue syndrome?
Pathogenesis unknown but it has been linked to:
* Immune dysfunction
* Hormone regulation
* Metabolism
* Oxidative stress response
- Estimated minimum prevalence 0.2% (UK, 2011)
Risk factors
* Age, sex
* Environmental factors
Impact
* Affects education & work, day to day activities, relationships & mental health
What are conventional methods to diagnose and treat chronic fatigue syndrome?
Diagnosis
* Presence of following 3 symptoms > 6 months with moderate or severe intensity at least 50% of the time, fatigue, post-exertional malaise, unrefreshing sleep
* Plus presence of either cognitive impairment or orthostatic intolerance
* Test to rule out other causes of fatigue
Treatment
* There is some research supporting graded exercise therapy but is not in NICE guidelines due to potentially harmful effects
* CBT is encouraged as an adjunct but is not curative
How can herbs help in the treatment of chronic fatigue?
In depth history taking – can any associated or
triggering factors be identified? Then:
* Lifestyle management - excercise, nutrition can help a struggling system
* Symptom relief
* Support key systems
* Gut function, sleep quality, immune function, hormone regulation, detoxification pathways
What is Fibromyalgia?
Neurosensory disorder characterized in part by abnormalities in pain processing by CNS. People likely have a lower threshold of pain & other stimuli which could be related to psychlogical factors.
What causes Fibromyalgia?
- Research shows there are biochemical, metabolic & immunoregulatory abnormalities -
Risk factors
* Female health, sex, stress, age -
Impact
* Affects education & work, systemic inflammatory conditions - sometimes comes with RA and lupus.
What is conventional diagnosis and treatment for Fibromyalgia?
Diagnosis
* History taking, physical exam, tests to rule out other pathology - some may use a scoring tool (widespread pain index) as a support for diagnosis.
Treatment
* Exercise (moderation), psychological & behavioural approaches
* For significant pain antidepressants, anticonvulsants, muscle relaxants
What are the signs and symptoms of fibromyalgia?
Signs & symptoms
* Persistent (>3 month) wide spread pain
* Stiffness
* Fatigue
* Cognitive impairments
* Sleep disturbance
* Mood disorders
* IBS
* Also anxiety etc
* Prevalence of 5.4% in UK (2016)”
How can herbs help with Fibromyalgia?
In depth history taking – can any associated or tiggering factors be identified?
* Lifestyle advice
* Symptom management
* Support key systems - Gut function, sleep quality, immune function, hormone regulation, detoxification pathways, anti-inflammatory
- Consider a long term herbal approach coupled with a PRN mix for more acute symptoms
- Referral to other therapies eg acupuncture
