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Thoracic Medicine

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Sleep Medicine

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New research confirms that sleep disturbances are linked to pain and depression, but not disability, among patients with osteoarthritis (OA).  Results from a new study found that poor sleep increases depression and disability, but does not worsen pain over time.

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Older women with disordered breathing during sleep were found to be at greater risk of decline in the ability to perform daily activities, such as grocery shopping and meal preparation, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.

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People with moderate to severe obstructive sleep apnoea may have an intrinsic inability to burn high amounts of oxygen during strenuous aerobic exercise, according to a new study led by researchers at University of California, San Diego School of Medicine.

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This webinar will be a clinical presentation in assessing a child who presents with snoring. Snoring is a very common presentation in childhood with some studies suggesting that up to 30% of children will snore at some point in their life. Within those that snore, there will be some who have obstructive sleep apnoea.

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Sleep apnoea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.

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Researchers believe that disrupted circadian clocks are the reason that shift workers experience higher incidences of type 2 diabetes, obesity and cancer. The body's primary circadian clock, which regulates sleep and eating, is in the brain. But other body tissues also have circadian clocks, including the liver, which regulates blood glucose levels.

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Asthma and Athletes

What is Asthma?

Asthma is a disorder of the airways that causes them to constrict (narrow and tighten) on exposure to certain stimulants. The airway constriction is caused by inflammation and swelling of the lining of the airways, tightening of the muscles in the airway and excess mucous production. Asthma affects over 2 million Australians and as of yet the cause is unknown.

Asthma and Athletes

Asthma and athletes

Many athletes struggle with competition due to having asthma. Exercise is in fact one of the most common triggers of an asthma attack.

There are different ways however, to manage asthma that is triggered by exercise and having your asthma under control can will allow to continue to play and breathe easily.

Things to know about Asthma and Exercising:

  • Your lungs will work better if you’re in good shape
  • The better your lungs work, the fewer problems you should have with your asthma
  • If you learn to control your asthma, you’ll feel better and be able to do more
  • Having an Asthma Action Plan takes all the mystery out of treating your asthma. Make sure your coaches have a copy, and know what to do if you need help.
  • If you are a professional Athlete, you can apply for a Therapeutic Use Exemption for your medication.

What is a Therapeutic Use Exemption (TUE)?

A TUE grants an athlete permission to use, for therapeutic purposes, a substance or method that would otherwise be prohibited.

How do you apply for a TUE?

Obtain a therapeutic use exemption form through your sports International Federation (IF) or National Anti-Doping Organisation (NADO).

Have your physician fill in the form and return it to either your IF or NADO with supporting documents.

The supporting documents will need to include a complete medical history (including hospital admissions for asthma and reports from a clinical examination of the respiratory system),spirometry results and results from one of the breathing tests to diagnose asthma (as below).

The TUE should be submitted at least 21 days before participating in an event.

Non-prohibited alternative treatment options:

  1. Leukotriene- receptor agonists (Singulair)
  2. Anticholinergics (Atrovent)
  3. Cromones (Intal Forte, Tilade)
  4. Theophyllines (Nuelin)
  5. Anti- IgE agents (Xolair)

Applying for a Therapeutic Use Exemption

Bronchial Provocation Tests

Respiratory symptoms cannot be relied on to make a diagnosis of asthma and/or airways hyperresponsiveness (AHR) in elite athletes.

For this reason, the diagnosis should be confirmed with bronchial provocation tests.

Asthma Management for Elite Athletes

Asthma management in elite athletes should follow established treatment guidelines (eg, Global Initiative for Asthma) and should include:

  • education
  • an individually tailored treatment plan
  • minimization of aggravating environmental factors
  • drug therapy that must meet the requirements of theWorld Anti-Doping Agency.

Long-term intense endurance training, particularly in unfavourable environmental conditions, appears to be associated with an increased risk of developing asthma and AHR in elite athletes.

Globally, the prevalence of asthma, exercise-induced bronchoconstriction, and AHR in elite athletes reflects the known prevalence of asthma symptoms in each country.

Top 10 tips for Asthma Management

  1. ALWAYS carry your reliever puffer with you.
  2. Have an “asthma plan” with your family and friends and your workplace or school.
  3. Remember that asthma need not stop you from achieving your goals in life, whatever these might be. You just need to plan effectively.
  4. Know your triggers and avoid these where possible (eg: particular foods, medications, chemicals and pollutants).
  5. Remember that whilst exercise can be a trigger for an attack, with the right approach it can be managed effectively and can limit the impact of asthma in your life (remember that many elite athletes are asthmatic).
  6. Always warm up and cool down before and after exercise with 10 to 20 minutes of light exercise and stretches.
  7. Check with your doctor as to which puffer you should use before engaging in exercise and use this 5 to 10 minutes prior to your warm up.
  8. Visit your doctor at least every 6 months to review your asthma and general management of asthma.
  9. Be familiar with first aid procedures for managing emergencies and ensure that family and friends are also familiar with these.
  10. Remember that your thoughts play a crucial role in how you manage your asthma. Worrying thoughts and the stress associated with these can severely impact on your quality of life. An asthma management program can help you in identifying and challenging any self-limiting or other unhelpful thought processes.

Ref: www.makingchanges.com.au

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