Why Do My Hands Shake?

Essential Tremor is a common neurologic disorder affecting millions of people. It is not a dangerous condition, however, while it is not life-threatening, those who have tremors may feel self-conscious, and the tremors may make it difficult to perform everyday activities. It generally affects adults over the age of 65, but there are cases of Essential Tremor in youth.

Symptoms may include any of the following:

1. Parts of your upper body, (such as the head, hands, voice, eyelids, and arms) shake uncontrollably, and worsen when performing tasks such as holding a glass, talking, eating, writing.
2. Shaking worsens with stress and caffeine intake.
3. Shaking diminishes while resting, and disappears during sleep.
4. Family members may have a history of tremor.

There is currently no test to pinpoint Essential Tremor. MRIs and other scans usually are normal. Your neurologist can rule out other possible causes of tremors, such as side effects of certain medications you may be taking or other underlying medical conditions.

Currently there is no cure, but if you find that your tremors are making your everyday tasks difficult, medications are available to alleviate the tremors. There are also techniques you can use to reduce stress – which may help lessen the severity of symptoms. Surgery is also an option for severe cases. However, if you experience other symptoms in addition to the tremors, you should contact your physician immediately.

Sleep and Menopause, An Imperfect Match

If you’re among the 40-50 million women in America going through menopause, your sleep quality may not be what it once was. At least 40% of women suffer sleep problems resulting from menopausal-related symptoms. Here are some interesting statistics that may affect you. According to the National Sleep Foundation, as many as 61% of menopausal and post-menopausal women polled reported frequent insomnia. Most women also find that the time between turning out the lights and actually falling asleep is increased during menopause. About 20% of women in menopause sleep less than 6 hours a night. These issues, along with frequent arousals throughout the night, can cause fatigue.

Why does sleep quality lessen with menopause?

Decreased production of estrogen is the culprit for many symptoms of menopause, including hot flashes. Menopausal women often have difficulty with sleep efficiency because hot flashes cause frequent awakenings during the night. Most women may experience hot flashes for about a year, but 25% can experience them for up to 5 years.

Snoring, which can lead to Obstructive Sleep Apnea (OSA), is also more prevalent and severe in post-menopausal women. With OSA, breaks occur in your breathing while you are asleep. It’s a very serious but treatable sleep disorder and one which you should speak to your physician about right away.

How can you sleep better?

There are solutions your physician can recommend to help you sleep better. Hormone Replacement Therapy (HRT) at low doses can help minimize symptoms of menopause and therefore lessen the effects on poor sleep. However, there are associated risks, and your doctor can decide if this treatment is right for you. There are other medications and supplements he/she can prescribe as well.

The best things you can do on your own to help you sleep better during menopause are:

1. exercise regularly, but never within a few hours of bedtime,
2. avoid heavy, spicy or acidic meals, alcohol, nicotine, and caffeine before bedtime,
3. wear lightweight clothes to bed, and
4. control your nighttime environment with comfortable temperatures. For example, use a fan to help circulate the air.

If your symptoms become uncomfortable, you cannot find ways to help yourself sleep better, or if you start to have feelings of depression or anxiety, contact your physician to map out a plan.

Recognize the Risk Factors for Stroke and Stroke Symptoms

There are many risk factors for stroke, including high blood pressure, cigarette smoking, age, family history of stroke, and gender. Unfortunately, strokes affect men and women at any age, not just the elderly. Although more men get strokes than women, the death rate for women is much higher than for men. Women, especially under the age of 55 can have additional risk factors for stroke that may include:

- Having migraines accompanied by flashing spots or blind spots,
- Having diabetes, lupus or other autoimmune diseases,
- Having had a miscarriage or some other clotting disorder,
- Taking birth control pills, even if the pills are low in estrogen, and
- Using hormone replacement therapy.

What symptoms do you need to recognize if you believe that a loved one may be having a stroke? To easily identify common symptoms in both men and women, ask the person to:

1. Smile. Look to see if one side of the face droops.
2. Raise both arms. Does one arm hang downward?
3. Repeat a simple sentence. Are they slurring words? Can they repeat the whole sentence?
4. Do they experience difficulty seeing in one or both of their eyes?
5. Do they experience a severe headache and not know why?
6. Do they have trouble walking or keeping their balance?

Sometimes women may have additional possible stroke symptoms which can include:
- Hiccups
- Nausea
- Face and limb pain
- Chest pain
- Shortness of breath
- Palpitations
- General overall weakness

If you suspect you or your loved one is having a stroke, call 9-1-1 immediately. Time is a critical factor. The longer you wait, the more serious the consequences.

For Women, Getting a Good Night’s Sleep is Not Just a Dream

If you’re a woman, getting a poor night’s sleep is more common than you think, and you are not alone. According to the National Sleep Foundation’s 2007 Sleep in America survey, 60% of women say they only get a good night’s sleep a few nights per week or less. Sixty-seven percent of women experienced sleep problems at least a few nights each week, while 46% experience sleep problems every night.

As a woman, you need to realize that a bad night’s sleep doesn’t “just go with the territory” in a busy daily schedule. Getting a good night’s sleep is vital to your health and taking care of your responsibilities. Women with poor sleep habits may experience daytime sleepiness and other risks such as:

• High stress levels
• Increased health issues and weight gain
• Drowsy driving (which can lead to motor vehicle accidents)
• Decreased ability to concentrate
• Poor job/school performance

Rather than relying on caffeine, sugar or nicotine to get you through the waking hours, create a healthy sleeping pattern in your life by:

• Maintaining a regular bedtime and wake time throughout the week (including weekends).
• Exercising regularly (never within a few hours of bedtime).
• Staying away from long naps (those longer than 30 minutes).
• Considering the bed only for sleeping and sexual intercourse.
• Avoiding heavy or spicy meals, alcohol, nicotine and caffeine at bedtime.
• Developing a routine in getting ready for bed – including relaxation time and soothing activities.
• Getting adequate exposure to bright light during the day.
• Wearing comfortable clothes to bed.
• Controlling your nighttime environment with comfortable temperatures, noise and light levels and a comfortable bed/mattress.

Sleep problems for women tend to increase with age. Factors such as PMS, pregnancy, motherhood, pain and menopause also contribute to poor sleep habits.

Working the Night Shift Can Affect Sleep Patterns

Do you work the night shift? If so, it could be disrupting your sleep habits and patterns. But, don’t worry – help is available! For the purposes of this post, we’ll define shift work as anything performed outside the hours of 9:00 am and 6:00 pm.

The underlying problem with shift work is that our bodies are designed to sleep at night. Shift workers “sleeping at the wrong time” often have less hours of sleep at a lower quality. This can lead to serious health problems, accidents on the job, and traffic accidents. Sleepy drivers take higher risks and have slower reaction time. If you work the night shift, be aware of these judgment errors that often occur:
· Overestimated performance
· Slower reaction time
· Decreased peripheral vision
· Poor multitasking
· Decreased vigilance
· Decline in motor dexterity

Here are some hygiene tips to help you regulate your sleep:
· Nap before coming to work, or immediately after work prior to driving home.
· Expose yourself to bright light prior to starting work.
· Limit your exposure to light upon returning home in the morning.
· Continue this schedule on your nights “off” if possible.
· Develop a relaxing sleep ritual before bed.
· Sleep in a cool, dark, quiet environment.
· Protect your sleep time.
· Get adequate sleep prior to your shift.

If you still find you have problems staying awake/focusing during your shift and/or falling asleep when you get home, talk to your physician. Sleep disorders are treatable and controllable.

Neuro Tip: Over-the-Counter Headache Remedies May Actually Aggravate Your Headaches

If you find yourself constantly taking over-the-counter remedies to relieve headaches, you may want to reconsider. Not all headaches are alike, and not all can be controlled with these medications. Some can even cause you to have what are called “rebound” or recurring headaches. While television commercials and magazine ads continue to tout that these medications can relieve your pain, most only temporarily mask the symptoms. You should check with your physician before you take them. Many of these medications contain caffeine, which can cause your headache to worsen because of its stimulant side effects.

Here’s a quick lesson in headaches. They can be classified into categories and are often treated differently:
· Migraine
· Tension
· Cluster
· Hormone-related
· Rebound

Migraine headaches can be debilitating and often occur more often in women. They can be caused by stress, hormone fluctuation and changes in barometric pressure. Tension headaches can affect anyone, can occur often and regularly and may be caused by fatigue, stress and certain medical conditions. Cluster headaches occur in groups, so patients may suffer from multiple headaches in a day. Men are more susceptible to these headaches than women.

Hormone-related headaches are caused by fluctuation in the body’s hormones and are more common in women. Men, however, can suffer from these as well. These are often precipitated by women’s menstrual cycles, use of birth control pills, and pregnancy. Rebound headaches can occur from taking the wrong type of medication – often those purchased over-the-counter. Not only can these medications cause rebound headaches, they can cause other health problems down the road.

The lessen here is to understand which type of headache you have before you take medication. Headaches can be controlled but you need to seek appropriate treatment by a healthcare professional. Think of this comparison: You wouldn’t treat the stomach flu with over-the-counter sinus medication. Headaches are no exception. Different headaches require different treatments. Talk to your physician if you suffer from headaches.

Memory Loss

We had many people visit our booth at the Senior Fair in Indianapolis to get “mini memory assessments” conducted by our JWM Neurology physician and nurse practitioner.

Several people that stopped by were somewhat reluctant to find out “if they had memory issues or problems”. While we certainly understand the anxiety that accompanies this, we encourage people to proactively take charge of their health.

Just because you have a memory issue does not mean that you have Alzheimer’s disease. It’s a misconception that many people believe. Issues with memory can be due to a number of factors – many of which can be controlled. Here are just a few things that can cause temporary memory issues:

· Sleep disorders
· Taking various types of medications
· Alcohol consumption
· Migraine headaches
· Depression
· Parkinson’s disease
· Other health conditions/diseases

If you are having memory problems, you should contact your physician for a consultation. Have a family member accompany you to the appointment to function as your eyes and ears.