Tip 1: Exercise

Regular physical exercise helps maintain mental health and boost our mood. In fact, regular moderate physical exercise has been studied and included in our psychiatry guidelines as an approach to help treat depression.

Tip 2: Sleep

Good sleep habits can help improve our mood and prevent mental illness. One third of our lives is spent sleeping, so learning good sleep habits is definitely worthwhile.

Tip 3: Balanced Thinking

We can change our mood by changing how we think. If we notice we are having all or nothing thinking (for example,  “nothing goes my way”, or, “no one likes me”), practice making those thoughts more balanced by seeing the other side of things (“some things don’t work out for me but other things do”, or, “some people like me while others don’t like me”).

This is a key component of cognitive behavioural therapy and can actually help us start to change our moods to become less depressed or anxious and more positive and balanced.

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For those who are unable to naturally maintain this rhythm—or those who have difficulties breathing, resting, or staying asleep—there are a growing number of new technologies that aim to make the process of resting well more accessible.

Sunnybrook is home to a state-of-the-art research, education, and sleep laboratory that combines brain science-based clinical abilities, teaching, and research, as part of the Clinical Neurophysiology program.

At the most recent edition of our Speaker Series community education session, “A Good Night’s Sleep,” Sunnybrook experts Dr. Andrew Lim (highlighting circadian rhythms), Dr. Mark Boulos (focusing on restless legs syndrome), and Dr. Anu Tandon (sharing about sleep apnea) presented to community members about a range of sleep-related health issues and also had the opportunity to provide real-time feedback and information to participants in the live webinar moderated by Dr. Brian Murray.

A common topic and point of interest: the use and benefits of positive airway pressure therapy.

CPAP, APAP & BIPAP

There are three main types of positive airway pressure therapy:

• CPAP: Continuous Positive Airway Pressure delivers consistent pressure maintained throughout the respiratory cycle to improve oxygenation.
• APAP: Automative Positive Airway Pressure automatically adjusts to meet each person’s specific needs, changing throughout the night to constantly measure resistance.
• BIPAP: Bilevel of variable Positive Airway Pressure is low-range pressure, that delivers higher air pressure when you breathe in.

In addition to these familiar therapies, there are also dental and nasal options, surgical alternatives (nasal or jaw), and nerve stimulation.

Technological sleep innovations

Sleep technologies that collect information while resting in a natural environment and recording information over an extended period of time can also include various pedometers and related trackers. Fitbit® (for example), or similar devices can measure metrics like heart rate, temperature, oxygen levels, and assesses quality of sleep and physical activity.

To assist in discovering sleep abnormalities, Sunnybrook’s Dr. Lim highlighted a few innovative wearable technologies, including:

• MUSE is a brain sensing headband that uses real-time biofeedback to help refocus during the day and recover overnight; it determines when psychology and physical problems arise within the body, with guidance for combatting stress and overcoming fatigue.
• The ANNE^TM ONE system, for the diagnosis of obstructive sleep apneas in adults, is worn over multiple nights in a row, monitoring and predicting when breathing stops during sleep.
• WRIST ACTIGRAPHY devices are wrist-worn monitors that record movement and sleeping or talking patterns over an extended period.

How is your sleep hygiene?

“Healthy sleep is paramount to a healthy lifestyle.” Dr. Mark Boulos, Sunnybrook Neurologist

Here are a few things to consider when monitoring and improving your sleep hygiene:

1. Establishing a fixed wake up time
2. Prioritizing your sleep over other activities
3. Making gradual adjustments to your routines
4. Limiting the amount of naps taken during the day
5. Winding down before going to sleep
6. Dimming lights for a quiet and relaxing sleep environment
7. Unplugging from electronics before bedtime
8. Getting as much daylight exposure as you can
9. Optimizing your bedroom (limiting use for sleep and sex only)
10. Refraining from eating or drinking before going to sleep

Sunnybrook’s Sleep Disorder Clinic

For those who would like to visit Sunnybrook’s Sleep Disorder Clinic, ask your family doctor for a referral if you are experiencing symptoms of concern, including:

• Sleepiness or features of narcolepsy
• Loud snoring or stopping of breathing in sleep
• Restless legs syndrome
• Abnormal sleep behaviours

Have your family doctor fax a brief request to “assess sleep” to 416-480-6092, to arrange clinical assessments and necessary sleep studies: click here for our Outpatient Sleep Assessment Request Form.

Coming soon from the Hurvitz Brain Science program

Sunnybrook’s Hurvitz Brain Science program is growing, with a new Circadian Rhythm Lab on the horizon. To learn more about sleep research taking place within the Hurvitz program, or if you are interested in supporting fundraising efforts, please visit link here for more information.

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All of the things that the brain is responsible for – physical and mental – are part of brain health. While often spoken about separately, mental health is a central part of brain health – they are not separate or distinct.

Mental health is brain health.

Understanding this can help to reduce the stigma that continues to be associated with mental illness, which, like any physical disorder or disease, is a health problem and requires appropriate treatment.

One of most important things that people don’t often realize is that the three major brain conditions of our lifetime; stroke, dementia, and depression, are all inter-related. They are all happening in the same organ, and if person has been diagnosed with one of those three conditions, their risk of the other two conditions increases.

That is to say: if an individual has a stroke, it increases their risk of having post-stroke depression and developing dementia; if someone has dementia, there is an increased risk of developing depression and having a stroke; and having clinical depression, increases the risk of going on to have stroke and/or dementia.

What affects brain health

Any disruptions to the brain can affect the way it works. The brain is an incredibly vascular organ – there are a rich supply of arteries and veins that help with the delivery of nutrients to the brain, as well as the removal of toxins and by-products of metabolism, to keep it healthy.

When that blood flow is interrupted, it affects brain function and that results in changes in the way information travels along the brain’s pathways. This can impact how we move, how we sense things like hearing or touch, the way we think about the world and people around us, how we perceive a situation, and how we behave.

It is important that brain conditions are understood and treated from multiple perspectives at the same time. Traditionally, the various medical specialties that deal with brain conditions would treat disorders individually; for example, if a person has a stroke and needs a blood clot removed, they will be seen by a neurosurgeon or neurologist. If a person has depression, they will be treated by a psychiatrist. If a person has dementia, they might see a neurologist or a psychiatrist.

But the new way of understanding and treating brain conditions involves a broader and more collaborative approach.

A multi-disciplinary approach to brain health

Sunnybrook’s Garry Hurvitz Brain Sciences Centre will connect brain health experts from across medical disciplines in the same building.

Bringing brain specialists together to collaborate with one another will help enhance a patient’s treatment, education, and will pave the way for possible new discoveries of the causes and potential treatments of brain conditions.

For stroke, depression, dementia, and other brain conditions, including sleep disturbances, anxiety, Amyotrophic Lateral Sclerosis (ALS), tremor, and others – having a broad range of the brain specialities and disciplines, including neurology, neurosurgery, psychiatry, psychology, and more, working together for improved patient care, is really the way of the future.

For more information about brain health:

• Learn more about Sunnybrook’s Garry Hurvitz Brain Sciences Centre
• Q & A with Dr. Levitt about Sunnybrook’s Garry Hurvitz Brain Sciences Centre
• Learn more about the Hurvitz Brain Sciences Program at Sunnybrook

If you need help in an emergency, please call 911 or visit your local emergency department.

If you’re feeling like you’re in crisis or need somebody to talk to, please know that help is also available through community resources:

• Find a local crisis resource at sunnybrook.ca/gethelp
• Crisis Services Canada
  • Phone: 24-hour, toll-free 1-833-456-4566
  • Text: 45645 (4:00 p.m. – midnight Eastern Time)
• Kids Help Phone
  • Phone: 24-hour, toll-free, 1-800-668-6868
  • Text: 686868 (24 hours, 7 days a week)

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What causes fatigue?

There are many causes of cancer-related fatigue and often a person will have more than one reason for being fatigued at any given time. There are treatments and things you can do to help with fatigue.  Talk to your health care team  about some of the causes of fatigue.

• It is important to remember that your body is fighting against your cancer.  This is very hard work and can result in the feeling of fatigue.
• Cancer treatments can cause fatigue. It is very common for a person who is getting chemotherapy or having radiation treatments to feel fatigued.
• Another common and treatable cause of cancer-related fatigue is anemia.  When a person is anemic, it means they have fewer red blood cells in their bloodstream than what they would normally have.  Anemia can be caused by cancer itself or can be a side effect of treatments. Sometimes anemia can be treated with medications that increase the body’s production of red blood cells. If you have anemia, your health care team might suggest that you receive a blood transfusion.
• When a person has been told they have cancer or is having treatment for their cancer, it is very common for this to be an emotional or distressing experience.  This can make a person feel fatigued.
• It is very common for a person with cancer to have trouble with sleeping.  Waking up often during the night and not getting enough sleep can make fatigue worse.
• Other symptoms like pain, trouble breathing and nausea (feeling sick to your stomach) can result in fatigue.

What’s important for me to know about fatigue?

Just like pain or nausea (feeling sick to your stomach), fatigue is a real symptom and it can have a big impact on your life.  You might think you are expected to feel fatigue when you have cancer.  You might also think it is not something you need to tell your health care team about. . There are things that can help you feel less tired and it is important for you to talk to your health care team about your fatigue as different suggestions can be made depending on the underlying cause.

Sometimes a person is worried their fatigue might mean their cancer treatment is not working. If you are worried about this, please discuss this with your health care team.

It is important for you to know what you can do about cancer-related fatigue:

• Exercise regularly (this is the most effective thing you can do to improve your fatigue)
• Keep a journal or diary of how you feel each day. This can help plan daily activities
• Let others help with tasks that need to get done (for example laundry or cleaning)
• Save your energy for the things you enjoy doing
• Don’t be afraid to ask for help. Friends and family might be willing to help, but may not know what to do.
• Try to balance activities with rest.
• Take one short nap not longer than one hour during the day.  If you find you need to sleep more than this please speak to your health care team as this may mean that there are issues other than fatigue that need to be looked at and explored further.

When should I speak to someone about the fatigue I’m feeling? When should I be concerned?

One way to think about whether you should speak to someone about the fatigue you are feeling is to think about how it is affecting your life.  If you are worried or distressed about the fatigue you are experiencing, speak to your health care team.  Also, you can ask yourself these three questions:

1. Am I more tired in general than before I had cancer?
2. Am I too tired to do things like go grocery shopping or go out for dinner with friends?
3. Am I too tired to get out of bed in the morning or get dressed?

If your answer is “Yes” to the first two questions, be sure to discuss fatigue with your health care team during your next visit.  If you also answer, “Yes” to the third question, you or someone you know should contact your health care team right away.  It is concerning if your fatigue is bad enough that it impacts your ability to do things like get out of bed or get dressed.

Fatigue is very common for a person living with cancer.  Many of the underlying causes of fatigue have treatments and ones that you can do yourself without the use of medication however just to be sure that you are following the right path and that there is no other reason for your fatigue it is important to to tell those caring for you at the place you are getting treatment so they can determine what the cause is and to jointly develop a plan to help you.

The post Cancer-related fatigue 101 appeared first on Your Health Matters.

Managing cancer fatigue through sleep: tips, and ways to tackle sleep-related issues.

Sleep reference »

The post Dr. Mike’s sleep reference appeared first on Your Health Matters.

Canadian Association of Psychosocial Oncology;

Harvard Sleep Patterns;

Mayo Clinic Napping;

BYO Sleep Hygiene;

Mayo Clinic 7 Tips;

CancerBridges Sleeping Myths;

Healthlink BC

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