Minnesota - Twin Cities

Excessive sleep in the elderly is quite common due to numerous conditions. Luckily, there are several ways to treat excessive sleepiness, whether through medications or by practicing good sleep hygiene. In this post, we will review what you need to know about sudden excessive sleepiness in the elderly.Causes of Excessive Sleepiness in the ElderlyWhat causes excessive sleepiness in the elderly? Excessive sleepiness can be caused by anything, from pre-existing conditions to medical treatments. Below are some causes for excessive sleeping in the elderly.Anxiety and/or depression. When emotions overwhelm an older adult, they can sometimes manifest as physical symptoms such as extreme fatigue.Dementia. Excessive sleepiness and sleep deprivation are common symptoms of older adults with dementia. Fatigue can aggravate dementia symptoms more, which is why one should seek treatment immediately upon experiencing excessive sleepiness or sleep deprivation.Sleep disorders. Sleep apnea, restless leg syndrome, and narcolepsy can impact overall health and quality of life.New medications. Many over-the-counter and prescription drugs such as antihistamines, sleep aids, anti-nausea meds, opioids, antidepressants, and others have fatigue as a common side effect, which can become more significant as one ages.Medical treatments. Recovering from surgery, chemotherapy, and other medical treatments can often leave older adults feeling worn out.Infections. Illnesses such as pneumonia, flu, or urinary tract infections can all result in feelings of fatigue and may often go undiagnosed in older adults.Nutrient deficiencies. When older adults have low nutrients such as iron or vitamin B12 and vitamin D in their bodies, it can often result in them feeling sluggish and weak.Chronic diseases. Fatigue can occur as a symptom for adults with autoimmune disorders, hormonal imbalances, heart problems, lung conditions, and cancer.Next, lets review some treatment methods for excessive sleeping in the elderly.Treatment for Excessive Sleepiness in the ElderlyMedications combined with other types of therapies, treatments, and behavior modifications are often recommended for older adults with excessive sleepiness. Below are some possible medications for excessive sleeping in the elderly.Armodafinil is a wake-promoting agent that can be used to treat narcolepsy and sleep apnea.Benzodiazepine receptor agonists are hypnotics that can assist with nighttime sleep.Melatonin is an over-the-counter supplement that helps one fall asleep and wake up on time.Methylphenidate encourages alertness.Modafinil can be used to treat narcolepsy and residual sleepiness.Sodium oxybate is used to treat narcolepsy and limit sleep interruptions at nighttime.DOWNLOAD OUR SLEEP HABITS GUIDELastly, lets take a look at ways to maintain sleep hygiene for excessive sleepiness in the elderly.Maintaining Sleep Hygiene for Excessive Sleepiness in the ElderlyElderly excessive sleeping can be maintained by practicing good sleep hygiene. Below are some ways to practice good sleep hygiene for excessive sleep in the elderly.Use the bed only for sleep.Go to bed at the same time each night and wake up at the same time each morning.Make sure the sleeping space is cool, dark, quiet, and relaxing.Avoid alcohol, caffeine, and large meals before bedtime.Get some exercise during the day to help you fall asleep more easily at night.

Chronic pain is a major health issue affecting millions of people globally. It can have a debilitating impact on lives, preventing people from enjoying activities they love and limiting the quality of their day-today life. Recent surveys indicate that approximately 50 million adults in the U.S.more than one in fivereport experiencing pain every day or most days, most commonly in their back, hips, knees, or feet. People with chronic pain say it limits their functioning, including social activities and activities of daily living.   Chronic pain is generally defined as pain persisting for longer than 12 weeks despite medication or treatment.  Clinicians may use various determinations, but a general rule of thumb is that the pain has lasted beyond the expected duration after an acute injury or illness or is present without any history of an injury or insult. Taking a Multimodal Approach to Treatment Treating chronic pain is not a one-size-fits-all endeavor. To optimize outcomes, it is critical to form a multimodal treatment strategy. A multidisciplinary approach has been shown to be one of the most effective ways to manage chronic pain. A combination of medications, physical and behavioral therapies, injections, neuromodulation and in rare cases, implantable pain pumps should be considered in order to provide patients with the best possible results. Physicians who specialize in interventional pain management typically offer a full range of such options and work with their patients to develop a course of treatment aimed at helping them manage their chronic pain to the best extent possible.Classifying PainFor all physicians considering the challenge of chronic pain management, it may be helpful to review the different types of pain classification: Somatic pain is felt in the muscles, bones or soft tissues. It is typically localized and can be intermittent or constant. It is often described as anaching, gnawing, throbbing, or cramping type of pain. Visceral pain comes from the internal organs and blood vessels and is typically more diffuse than localized. Visceral pain tends to be referred to other locations, and can be accompanied by symptoms such as nausea, vomiting, or tension in lower back muscles. It can be intermittent or constant, and is typically described as being dull, squeezing, or aching. Neuropathic pain occurs when the nervous system is damaged or not working properly. It can be experienced at the various levels of the nervous The Importance of Multimodal Therapy Tools for treating chronic pain system, from the peripheral nerves to the spinal cord and the brain. Nerve pain can be described as shooting, sharp, stabbing, lancinating, or burning.Tools in the Pain Management ToolboxA multimodal approach to managing chronic pain often involves layering options that range from conservative to highly interventional. Conservative management-The least invasive options for many patients include first-line therapies such as topical analgesics, physical therapy, acupuncture, chiropractic, transcutaneous electrical nerve stimulation (TENS) therapy and massage therapy. For some patients experiencing mild or temporary pain states, these interventions can be enough to manage the problem. For individuals who experience ongoing pain, these interventions can be helpful adjunctive therapies alongside other more intensive approaches.Medication management- Depending on the type of pain and its severity, doctors may opt for either short- or long term use of over-the-counter medications like nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, anticonvulsants, neuropathic agents and in severe cases, opioids. While these medications can provide short-term relief, they may not be sufficient to manage chronic pain.  Regarding the use of narcotic pain relievers (such as fentanyl, buprenorphine, oxycodone, hydrocodone, hydromorphone, morphine and methadone), and practitioner education in the last few years has been extensive.  Education has reduced the number of opioid prescriptions and underscored their use as a tool for management of acute pain, which is their primary indication. There is considerable research showing that the use of opioids for chronic pain does not provide substantial benefit beyond the acute care period. Most providers are increasingly aware of this, and educating their patients about opioid risks and benefits is an ongoing responsibility of all physicians.  There are several non-narcotic prescriptions which can be used to manage chronic pain. The group of gabapentinoids (gabapentin and pregabalin) can be particularly effective, especially for neuropathic pain. Another commonly used medication is duloxetine, a serotonin and norepinephrine reuptake inhibitor, often used for neuropathic pain in combination with gabapentin. For myofascial pain, muscle relaxers such as tizanidine, baclofen, and cyclobenzaprine can be helpful for certain patients.  Medical cannabis is increasingly understood to be useful for select patients, with about a 5060% reported success rate in reducing pain. Anecdotally, people who have previously used marijuana recreationally seem to respond well to it in a pain management context, because they understand what having cannabis in their system feels like. Other patients who have not used cannabis previously may not care for the side effects and therefore not report such positive results. In general, though, many physicians and patients agree that cannabis can be helpful to try in low doses and safely ingested in oral form. A comprehensive, multidisciplinary pain practice typically has physicians who can certify patients for medical cannabis.Interventional TherapiesThere are several interventional procedures that can be effective in addressing chronic pain, starting with local injections in the joint, spine or nerves. These can be trialed as part of a treatment plan for certain types of chronic pain, particularly in cases where the specific sources of pain have been identified. For example, injections can treat arthritis, nerve blocks can relieve neuropathic pain and epidural steroid injections can assuage radicular back and neck pain. When combined with physical therapy, these targeted treatments may help reduce inflammation and improve mobility. In cases where injection therapy does not prove adequate for ongoing pain relief, other advanced interventional  50 million adults in the U.S. more than one in five report experiencing pain every day or most days.  Therapies may be utilized. The technology and practice of implantable pain control devices is advancing rapidly, with life-changing outcomes for many more patients than ever before. These devices deliver very low doses of specifically targeted pain relief around the clock and present less risk of addiction and fewer side effects, removing concerns around either forgetting to take or taking too much medication. Peripheral nerve stimulation (PNS) therapy delivers an ongoing series of electrical pulses to a targeted area of a peripheral nerve, reducing the pain signals that are sent from the body to the brain.  For other cases, spinal cord stimulation (SCS) can be an effective solution. SCS therapy also uses electricity to modulate the way pain signals are sent from the body to the brain, with the modulation being done at the level of the spinal cord. One of the most common indications for SCS is failed back syndrome: people who have had surgery on their back but continue to have low back pain and possibly leg pain. SCS therapy can also be used for other indications, such as painful neuropathies including diabetic neuropathy and alcohol-induced neuropathy, as well as complex regional pain syndrome involving chronic arm or leg pain that develops after injury or illness. The data supporting use of spinal cord stimulation for chronic pain is favorable. The technology of today has greatly improved compared to even five or ten years ago, and results are getting better. Neuromodulation does not work for every patient, however, and we dont ever promise or expect 100% pain relief; the goal is typically a 5075% reduction in pain, enough to improve comfort, mobility and quality of life. In some cases where systemic medications, surgeries, interventional procedures and neuro-stimulation implants have failed, pain specialists may recommend an intrathecal drug delivery system, also known as a pain pump. The pain pump is surgically implanted in the abdomen or upper buttock and delivers a steady supply of medications directly into the intrathecal space where the spinal cord is located. The medicationstypically a combination of an opioid and a local anestheticcan be provided in very low doses, directly at the site of where those medications work on the spinal cord. Intrathecal drug delivery is sometimes referred to as a targeted drug delivery because it primarily targets spinal binding sites for pain relief, bypassing the blood brain barrier by infusing the therapeutic agents into the cerebrospinal fluid. Because of the targeted delivery, it reduces the mental side effects associated with systemic opioid management. Intrathecal drug delivery has flourished since its inception because it is uniquely effective. Many experienced pain physicians consider it to be the best therapy for the worst pain.Physical and Behavioral TherapyIn conjunction with other interventions, it is paramount for pain management physicians to utilize physical and behavioral therapy as part of the treatment plan for chronic pain patients when indicated. Physical therapists can teach patients exercises that focus on posture, mobility, balance and strength-building that can provide long-term relief from chronic conditions like arthritis, fibromyalgia and low back pain. Behavioral therapy can also help patients address underlying mental health issues that commonly go hand in hand with chronic pain. When patients have depression or anxiety that is not well controlled, their chronic pain is often quite challenging to treat effectively.Referring to a Pain SpecialistGaining control over a patients chronic pain can present a real challenge to primary care physicians and other general practitioners. Faced with a patient that proves refractory to usual treatments, doctors may consider referring the patient to a specialist in pain management. Primary care clinicians should be aware of their options for referring a patient suffering from chronic pain in order to provide them with the best hope for achieving long-term relief. An experienced specialist may be able to tailor treatments specifically targeted for their patients condition, which can be invaluable when handling complex cases such as chronic pain conditions.  Chronic pain is challenging to treat.  As opposed to acute pain, wherein physicians often know the etiology of a patients pain, chronic pain often requires a more extensive workup to identify the source or sources of a patients painful condition. This can be especially true when it comes to spinally mediated pain, which is the most common complaint chronic pain physicians encounter.  The spine is a complex anatomic structure. The task a pain specialist undertakes is to find out what may be causing the pain, utilizing advanced imaging, tests and interventional therapies, which are often diagnostic as well as therapeutic.  When a patient is initially seen by a pain specialist, the physician takes a full history, reviews the referring providers notes and any diagnostic results to date. As previously mentioned, physical therapy is often a first line intervention for patients. If psycho-social stressors are present, behavioral health consultation is warranted. Additional workup such as diagnostic tests and imaging will then be considered if indicated. Once this workup has been initiated, the pain physician can hopefully find the source of the chronic pain and begin interventions and allied therapies in a more targeted approach. This all happens concurrently with the patient working with physical therapy, seeing a behavioral health therapist, and optimizing a medication regimen along the way as indicated. A comprehensive pain clinic often has physical therapy and behavioral health specialists on site as a part of their practice and can offer a multidisciplinary approach to chronic pain under one roof. A Focused, Intensive ApproachMany pain specialty practices offer a chronic pain program an intensive, focused initiative designed for patients who may have exhausted their therapeutic options, are no longer seeking a specific diagnosis or additional interventions, and are simply living with chronic pain they are likely to have for the rest of their lives. Our program, and programs like it around the country, combine education with physical and behavioral therapy. Patients learn principles for self-management: quality nutrition, good sleep hygiene, smoking cessation, benefits of exercise in improving mental and physical healthbasically how all the components of their own behaviors are going to help them manage their pain better and improve their quality of life. These programs are usually quite intensive, with patients coming every day or several days a week for the duration of the program, which may be four to eight weeks in length. Educating Patients and Setting Expectations When we think of patients achieving relief from their chronic pain, we typically mean their pain has become minimal enough that it doesnt unduly affect their daily life. Chronic pain is challenging to treat; the longer the body experiences a hyper-excitable state while in pain, the more the brain remodels and adapts to the chronic pain state. This phenomenon is known as central sensitization and can present as a vicious cycle which can be hard to break. Breaking this cycle is what a pain specialists care team works toward. A key part of chronic pain management is educating patients about their health and their options, making sure they understand time to therapeutic effects, setting realistic expectations for each modality and helping them play a positive role in their pain relief journey.Today more than ever before, there are options that can help nearly every patient. Taking a multimodal, multidisciplinary approach gives us the greatest chance of achieving significant pain management and improved quality of life.Cody Foster, MD, practices at Nura Pain Management and is board certified in Anesthesiology and Pain Medicine

At some point, in life we all experience stress. Its not always a thing. Yet prolonged stress can lead to both emotional damage.  Different individuals experience stress in ways and understanding the triggers of your stress and effective methods to alleviate its symptoms can prevent the development of severe health problems down the line. Engaging in relaxation techniques may even proactively ward off stress before it escalates.  What signs indicate that someone is experiencing stress? Feeling stressed is your bodys way of responding to changes, in your life routine. Activities you're doing regularly. There are times when a little stress can push you to overcome fears or get things done; much stress can have negative effects on your well being.It's crucial to be aware of the signs of stress, on so that you can take steps to manage them right from the start.  Feeling queasy in the tummyExperiencing discomfort, in the chest area.Frequent head pain.Tightness, in the musclesFeeling tired or having trouble sleeping. Forgetting thingsFeeling easily annoyedSerious health issues could also lead to these symptoms appearing. It's crucial to discuss your symptoms with a healthcare provider at all times. If you experience symptoms such, as chest pains don't hesitate to seek medical help. What kinds of stress exist there? Sudden stress is normal and doesn't last long; it can feel exhilarating. Give us a boost to tackle moments such, as exams or work problems.  When someone experiences stress due, to specific situations it can lead to both mental and physical health issues arising from constantly feeling overwhelmed by rushing through tasks and taking on too much work while struggling with organizational challenges.  Long term stress is something that persists when we overlook or fail to address the sources of stress in our lives. If left unchecked and not dealt with stress could lead to serious health issues, like heart attacks or strokes and even prompt thoughts of suicide.Post traumatic stress disorder (PTSD) which arises from a event sometimes manifests, as flashbacks,nighmares or episodes of anger.  If one overlooks the signs of stress. They worsen to a level h it may progress into anxiety disorder where an individual experiences intense apprehension or dread concerning routine activities, in life even after the initial stressor is removed. Tips, for coping with stressOne effective approach, to handling stress involves identifying the factors that trigger stress in your life foremost.  If you find yourself overwhelmed by stressors talking to a healthcare about your symptoms is recommended.  Some basic strategies, for dealing with stress include; Engage in activity such, as a half hour walk or a yoga session to maintain your well being.Establish objectives. Ranking to determine the tasks that require attention and those that can be postponed.Engaging in calming practices such, as meditation and mindful breathing exercises.Let us assist you in managing and reducing stress.  It's hard to eliminate all the stress, in your life; however there are methods to deal with it effectively.   Blue Cross provides a range of health initiatives that can assist you in recognizing the sources of your stress and maintaining it at bay by opting for lifestyle options. Some individuals may also engage in an internet based behavioral health initiative such, as Learn to Live.* This course assists in recognizing issues and grasping the functioning of ones mind before teaching strategies to manage anxiety or stress effectively.  Visit your member portal to check if this program is part of your coverage or reach out to customer support using the contact number provided on the back of your Blue Cross ID card. If you need assistance, in locating a physician to help with your stress management needs please reach out to customer support. Search for a doctor online.  

Welcome to the Humana Neighborhood Center.Our Neighborhood Centers are a great place to join up with friends, take a class and more. You dont need to be a Humana member to participate! Start by watching online classes like cooking demos, crafts, meditation, etc. Then, check out our calendar to RSVP for upcoming events, browse our video library to see previous classes, and create an account to get a personalized experience of each one. To further help with rising costs, we are offering Humana members even more ways to save money on healthcare expensesgo here to find out more.See event calendar