睡眠障礙引頭痛 自律神經失調元凶

「一覺到天亮，一暝大一吋」，但是，如果有失眠入睡困難、半夜醒來不易再睡等情況，恐罹患睡眠障礙，根據台灣睡眠醫學會一項「國人睡眠大調查」結果發現，台灣15至59歲的人口中，平均每5人就有1人深受失眠之苦。尤其值得注意的是，睡眠障礙會會引發偏頭痛。要揪出睡眠障礙造成頭痛的元凶，醫師建議必需兼顧生理與心理健康，尤其是要調整自自律神經失調的困擾。

睡眠障礙元凶　自律神經失調惹禍

為什麼睡眠障礙會引起頭痛？精神科醫師楊聰財表示，其實睡眠障礙只是冰山一角，冰山下的狀況要特別關注，睡眠障礙要從生理因素與心理因素去解決。其中生理因素主要來自自律神經失調，一旦自律神經不穩定，交感神經與副交感神經不協調，交感神經會過盛，引起血壓升高、肌肉緊繃、呼吸心跳加快，在交互影響下，便容易引起頭痛。

至於心理因素引起睡眠障礙，則常見出現慢性焦慮、憂鬱，或慢性壓力感如怒氣。焦慮、憂鬱與怒氣此三種統稱為「情緒障礙」，容易造成頭痛不適。臨床發現，10個有睡眠障礙問題的民眾，約有7、8個與情緒障礙有關。

自律神經失調　女多於男

楊聰財醫師表示，門診曾經收治許多因為出現頭暈、頭重、頭痛的患者求診，主訴特別的是頭痛位置有移動情況，有時頭頂痛，有時單側痛，有時兩邊同時痛，甚至疼痛會往下發展，合併肌肉緊繃、眼睛乾澀、呼吸不順、腹痛等不適症狀，但是進行腦波、心電圖、X光等檢查，卻發現都正常，一時找不到病因，經過進一步診斷才發現是慢性自律神經失調。

自律神經失調該怎麼改善？建議要兼顧生理與心理，照顧身心四個大支柱：即「能睡、能笑、能動、能吃」：

【調整自律神經失調方法】：

1.「能睡」：是指每天最好晚上11點睡覺，早上6點起床，維持正常睡眠。

2.「能笑」：指常保笑容能使腦內啡分泌，有益健康避免頭痛。

3.「能動」：指每周維持333規律運動，每週運動至少3天、每次30分鐘、心跳達到130下。 

4.「能吃」：指睡覺前適度食用包括鮮奶、香蕉與深海魚油等食物，有助於自律神經安定。

此外，平時要養成「說唱做寫」紓壓好方法4要訣，例如每天做深呼吸吐氣、睡前寫快樂日記等。

【醫師小叮嚀】：

楊聰財醫師表示，自律神經失調調整好，睡眠障礙即可降低，但是如果出現睡眠障礙，例如一周中有3天以上睡眠時間不到6小時，或是有入睡困擾，且情況連續兩周以上，影響日常生活，就可能是與情緒障礙影響到睡眠有關，建議可至精神科就醫檢查。

若是明明睡眠超過9小時以上，卻怎麼睡都覺得睡不夠，上班仍容易打瞌睡、精神不濟，則可能與生理有關，例如有睡眠呼吸中止症、打鼾等呼吸道問題，建議到睡眠中心進行睡眠檢查。

资料来源：

https://tw.news.yahoo.com/睡眠障礙引頭痛　自律神經失調元凶

10 Ways to Make Memory Rehab Work

Physical exercise can rehabilitate bodies that have grown soft and flabby. Can mental exercise rehabilitate brains that have deteriorated because of disease or age? Maybe.

A published scholarly review has examined the research literature on this issue and arrived at several useful conclusions: 

1. Focus, Reduce Distractions. The two common causes of forgetting, in both normal people and those with impaired memory, are a) failure to register new information effectively, and b) interference from conflicting sensations and thoughts.
2. Customize the Rehabilitation Needed. Rehab need to take into account the type of memory therapy and the cause and severity of the impaired memory capability.
3. Learn in Small, Frequently Repeated Chunks. New information has to be re-packaged for memory-impaired people so that it is in simple, concrete form, in small chunks, and repeated frequently — with patients required to re-state the information and make explicit associations with what they already know. (Notice how this sounds like the way one needs to teach young children).
4. Practice Attentiveness. Attentiveness to new information can be enhanced by self-cueing, wherein patients remind themselves to be more attentive at crucial moments. This can even be done by creating a conditioned reflex in which a cue signal conditions greater attentiveness. (Notice how this sounds like how you “clicker” train dogs).
5. Uses Mnemonics. Mnemonic tips and tricks can help. This includes using acronyms, rhymes, stories, and constructing mental images.
6. Find Ways to Compensate. Even in patients with severe impairments, some aspects of memory, such as subliminal or implicit memory, may have been spared and can be exploited to compensate for the lost ability.
7. Spread Rehearsals Over Time. Memory rehearsal is more effective if it is spread out over time rather than bunched into a few closely spaced sessions.
8. Manipulate the Cues. Be more aware of cues you are using. A “vanishing clues” approach can help. For example, in a rehearsal session, cued retrieval might begin with cueing the first three letters of a target word, then repeating later with two, then  one, and eventually no letter cues.
9. Minimize Error, Lest you Learn the Errors. Trial-and-error learning is generally less effective than learning conditions that minimize error, because error responses can get stored as memories that compete with the right answers. In short, it is better to not know than to generate wrong answers.
10. Use Memory Crutches. Using external memory aids (sticky notes, wall charts, notebooks, etc.) should help, bearing in mind, however, that using such aids may themselves be a memory task. It is like having a schedule calendar and forgetting to check the calendar. Smart phones and radio paging devices (“NeuroPage”) can be especially helpful because they remind the patient when to check on the stored information. In some patients, repeated use of such aids develops a habit for target tasks and these may even generalize to certain non-target tasks.

These ten approaches are some of the same approaches that work especially well in people with normal memory capabilities. To make them work in patients with impaired memory just takes more effort, patience, and time.

Source: Ptak, R., Van der Linden, M., and Schneider, A. 2010. Cognitive rehabilitation of episodic memory disorders: from theory to practice. Frontiers in Human Research. 4 (57): 1-11. doi: 10.3389/fnhum.2010.00057.

All retrieved from https://www.psychologytoday.com/blog/memory-medic/201305/10-ways-make-memory-rehab-work

The Health Benefits of Dreams

Dreams, memories, and emotions

The dream -- likely a means of coping with a major life stress --helped Kern, explains researcher Rosalind Cartwright, PhD, professor emeritus of psychology at Rush University in Chicago. “It’s almost like having an internal therapist, because you associate [through dreams] to previous similar feelings, and you work through the emotion related to it so that it is reduced by morning.”

Although some researchers believe dreams are just a byproduct of sleep, others think dreams are important for memory consolidation or conflict resolution. Cartwright has found clues to suggest that dreams may help with mood regulation.

Dreams occur during both REM (rapid-eye-movement) and non-REM sleep, but sleep studies show that brain activity is heightened during REM periods. When sleep-study participants are wakened during the first non-REM period, those who recall their dreams tend to report thinking about a piece of emotional unfinished business. The dreamer may then restate or reshape the problem in a different form during the next REM cycle, and so on, through the night.

Dreaming may help depression

Sleep is without a doubt beneficial. According to the National Sleep Foundation, humans spend more than two hours dreaming each night (with the most vivid dreams occurring during REM sleep). Rats deprived of that precious REM sleep for four days produce fewer nerve cells in the hippocampus, the brain’s memory center.

Among humans, dreaming may also help alleviate depression. In sleep studies of recently divorced women with untreated clinical depression, Cartwright and colleagues found that patients who recalled dreams and incorporated the ex-spouse or relationship into their dreams scored better on tests of mood in the morning. And they were much more likely to recover from depression than others who either did not dream about the marriage or could not recall their dreams.

“It really shows that there was an ongoing working through the night in the dream material, and eventually that the depression lifted in those people,” Cartwright says.

Looking back now, Kern says she was highly stressed at the time and the dream helped her realize how much the boy had been controlling her life. “It didn’t solve the problem,” she says, “but it helped put it in perspective.”

All retrieved from http://www.webmd.com/mental-health/features/the-health-benefits-of-dreams?page=2