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Blog - Page 2 of 3 - Capitahealth

Blog - Page 2 of 3 - Capitahealth

Why do we sleep?


Sleep is a recurrent physiologic and fundamental process that every human being experiences, and it provides reparative and restorative bodily functions. The consensus is that sleep is needed to allow us to rest and recover from the stresses of everyday life. Additionally, researchers have shown that a good sleep is essential to maintaining mood, memory, cognitive performance and boosting body immune systems. During the waking hours, a chemical called adenosine builds up in the bloodstream eventually binds with brain cells (specifically in the basal forebrain) and inhibits their activities, which causes drowsiness. When we sleep the level of adenosine reduces, the brain cells are rejuvenated and are active again. Also, a recent study states that some tiny cavities are open up after about 6 hours of sleep, and they facilitates the drainage of some waste products from the brain.

Sleep has different phases; a deep slumber and one that is close to being awake. These phases are associated with changes in human body and health.

Sleep has two categories

  1. NREM
  2. REM

NREM or nor-rapid eye movement sleep has features like

  • Slow breathing and heart rate
  • Reduced physiological activity
  • Slower brain waves
  • Reduced blood pressure

It consists of four stages.

  1. In stage 1, transition from being awake to falling asleep takes place. Nervous system begins to slow down; muscle jerks and falling sensation are common.
  2. In stage 2, the brain waves further slow down with few rapid brain waves called sleep spindles. The heart rate and body temperature decrease. Eye movement stop and light sleep begins.
  3. In stage 3 and 4, the body goes into complete relaxation with a deeper sleep, reduced heart rate, blood pressure and body temperature. Slow brain waves (i.e. Delta waves) are present at these stages, which together refer to ‘slow wave sleep’. If a person wakes up in this phase, he feels disoriented for a while.

REM or rapid eye movement sleep is the sleep in which dreams occur. It has features like

  1. Intense brain activity
  2. Rapid and irregular breathing
  3. Continuous eye movements
  4. Temporary paralyzing of limb muscles
  5. Increased heart rate and blood pressure

A balance between NREM and REM sleep is necessary for a proper full-night sleep and promoting processes like memory, concentration and mood.

Sleep Architecture:

Research shows that REM and NREM sleep occur in alternate cycles of 90-110 minutes with 4-6 repetitions throughout the night.sleeping-child-812181_960_720

For infants, 50% of sleep time is in REM sleep. This figure is 20-25% for normal adults. With advancing age, stages 3 & 4 of NREM sleep decrease and REM dominates. The need of sleep is there, it’s only REM replacing NREM sleep stages in old age.

On an average, the adult sleep has 50% NREM stage 2 sleep, 20% REM sleep and the remaining in other stages; though this time is not constant over a night. At night, the first few cycles are short period REM sleep and longer periods of slow-wave sleep. As the night passes, REM increases and NREM stages decrease with REM sleep dominating by the time of dawn.

Adults need average 7 hours, a teenager about 9.5 hours and an infants 16 hours sleep per day. This pattern of sleep refers to ‘sleep architecture’.

Why sleep is important?

Everyone needs sleep for survival. According to experts, sleep triggers body’s repair process, production of proteins, biochemical and physiological processes.

Sleep loss directly affects functions like memory, reflex actions, complex thoughts and concentration. In addition to making us feel grumpy and groggy, sleep loss may harm endocrine and immune system; it may lead to chronic diseases like obesity, diabetes and hypertension.

Impact of sleep on performance and mood:

Studies show that less than seven hours of sleep a night for a week can seriously impair alertness. People, who are up for 19 hours, score badly in alertness tests. Thus, a sustained sleep deprivation is harmful to memory and motor performance.

Sleep loss adversely affects mood. A research of Pennsylvania University made people sleep for only 4.5 hours a night for a week. The result was a group of angry, sad, exhausted and mentally stressed people. Their mood scores declined as the test progressed. When they got proper sleep at night, there was a dramatic change in their mood scores, thus proving that sleep loss can influence mood.

Hormones and Metabolism

Sleep is immensely important for the body as it’s the time when hormones get secreted. For instance

  • Cortisol, a hormone promoting wakefulness
  • Growth hormone, contributing to childhood growth and muscle mass in adults
  • Follicle stimulating hormone and luteinizing hormone; both involved in reproduction
  • Hormones influencing appetite and weight

Obesity and Diabetes

Obesity is on a rise in America. According to the Centers for Disease Control and Prevention, 65% of Americans now are overweight. In addition to calorie intake, sleep deprivation has been linked to obesity.

  • Sleep deprivation means reduced production of growth hormone. As growth hormone controls the fat and muscle proportions in human body, a reduction in it means obesity.
  • A study correlates inadequate sleep and lesser levels of hormone Leptin needed for regulating the carbohydrate metabolism in body. This in turn causes the body to crave for carbohydrates despite the presence of already consumed fat.

1999 study at University of Chicago links sleep deprivation to impairment of sugar metabolism and hormone levels. Eleven young adults had little sleep for several nights resulting in a decline in their body’s ability to process blood glucose, to a pre-diabetic state, demanding the body for more insulin production.

Immune System

Sleep facilitates the body’s healing process. That’s why we automatically retire to bed when we are having cold or sore throat. Sleep enables the body to conserve energy and resources to boost immune system and fight diseases. Chemicals of immune system, Cytokines, are also sleep-inducers. On the other hand, deprivation of sleep may affect the way the immune system respond to diseases in the human body.

Cardiovascular Diseases

One of the consequential effects of sleep deprivation is cardiovascular disease. Inadequate sleep over a longer period results in a raised blood pressure and heart rate. This can lead to an increased risk of stroke. People are vulnerable to coronary heart disease when they are not having adequate sleep.


Different researches and studies show that sleep is an essential part of human life. On the contrary, sleep deprivation results can lead to different illnesses such as diabetes and heart problem. On an average, a person should get 7-9 hours of sleep to stay healthy and mentally active.

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Vocational Rehabilitation

electrostimulation-1230005_1920Vocational Rehabilitation (VR) is a process that enables people with health conditions and associated impairments/functional limitations/disabilities overcome barriers to accessing, maintaining or returning to employment. It helps rehabilitate the employees back to work after an injury or disorder has disrupted their work. It also enables individuals or participants with impairments or functional limitations to attain skill, resources and expectations required for a successful interview and job process.

According to “Vocational Rehabilitation: What Works, For Whom and When” by Waddell, Burton and Kendall 2008, VR needs emphasis through proper education and awareness. This way the public, companies and health professionals come to know about the value of work for health and recovery and their role in return to work process. VR requires knowledge and information from various sources like health care professionals such as physiotherapists and occupational therapists and other non-medical fields such as disability employment advisers and career counselors. VR sets out a programme, and the affected employees agree to it. This programme aids them in adjusting to somewhat new circumstances, after developing any disability, that would enable them to get back to work. This job is either their old one or a new position made solely for them. VR should intervene within two to four weeks of the person suffers from either temporary or permanent disability or any other health issue. As it is different from sick leave, VR aims at getting the employees to work with rehabilitation. In case, a company doesn’t have an HR specialist or any previous experience of VR, good communication between manager and employee can resolve such situation.

10246029_sMany cost studies have proved that VR is cost-effective too. Some benefits derived from it are reduced costs of litigation, sick pay, product & material damage, less absenteeism and staff turnover, improved productivity, corporate image, and morale. On the other hand, losing experienced employees and moving onto benefits like pension is quite expensive. Thus, disease intervention programs satisfy people primarily and help them in holding down their jobs.
Employment retention policy should promote equality between staff with disabilities and those without disabilities. Firstly, it should target those that have recently developed one form of medical condition or the other, as they are more work-oriented in their habits. Similarly, retaining expert staff offers business with the ability to respond more readily to rising customer demand, whereas recruitment creates a delay in work process. All these benefits to company depend on the skill level and status of an employee and the severity of their debility but not the type of their impairment. Adoption of employment retention is likely to emerge with passage of time. Some companies around the world are making amends like raising the retirement age which means there will be more physically challenged workers, since disability is correlated with advancing age.

Finally, economic recovery requires blurring the distinction between being jobless and having a job. Such policies that honor people’s need for treatment and adjustment to new circumstances while maintaining their link to work will be important in expanding both producers and consumers in the economy. To help the employers’ end, guides are present on many online forums.


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Vocational rehabilitation in Lagos and Abuja Nigeria

Ergonomics and Office Productivity

Ergonomics is a Greek work meaning ‘work science’; a science that enhances the work output of human beings through different factors and eliminates the man and pc unnecessary obstacles from their way. Ergonomics is of vital importance in every field of life. It deals with the methods and designs for the optimization of human well-being and overall system performance. It also tackles the understanding of interactions among humans and different systems. This field of science relies on researches carried out in scientific areas like engineering, physiology and psychology. Another name for ergonomics is ‘human factors’ as it deals with everything concerning welfare of human beings.

Ergonomists make sure that our life is free from unnecessary difficulty caused by poor designed tools and workstations. One way to achieve an increased work output is to prevent an occurrence of work-related injuries and stress. This will ultimately result in a reduction of worker’s compensation claims, employee turnover, insurance premium and health care costs for the company.Ergonomically designed equipment and workstations improve health, safety, performance and satisfaction. Good ergonomics encompasses some other factors like good posture, regular movement, work organization and software. It is also about creating an ambient environment where the temperature, lighting, space, noise, humidity, reflection and screen glare are appropriately managed to enhance the office productivity. Ergonomics is not limited to the design of equipment. It also involves the development of the policies, strategies, management, working hours, communication, telework, etc. of a company.
One of the issues hindering the work process is musculoskeletal disorders (MSDs). Most of the companies are switching to ergonomic solutions for cost-saving and preventing MSDs among the employees. Experts’ consensus is that every ergonomic intervention will positive impact on productivity. Whenever there is an elimination of unnecessary exertion and awkward postures from the work environment, time to complete the required task shortens. Thus, profit and productivity spike up.

According to a recent research Global Burden of Disease Study, the world most common work-related disability is lower back pain. It arises due to long and continuous faulty sitting posture. Now companies are trying to incorporate ergonomics into their system to reduce the cost of work-related injuries and improve employees’ health. This will result in increased efficiency. When companies provide suitable work environments to their workforce, they will find it easier to work. Their engagement and willingness to increase their output thus, benefitting the company in the longer run. According to a study by researchers at the Upjohn Institute, the University of Texas, Liberty Mutual, Health and Work Outcomes, and Steelcase Corporation, people with ergonomics equipment work more efficiently and develop less pain over the course of their duty hours. This study reveals that ergonomics can increase the production per unit of time worked. Studies also show that intervention to prevent MSDs, frequent rest breaks, better training, improvement in workstation equipment and multiple workplaces are some of the features that can directly affect productivity. An optimum solution to the several work-related issues requires a comprehensive ergonomic programme. Such a program must have elements like worker engagement, management commitment, training, sustainability and evaluation. All these work together to produce the desired result.


Relating Productivity to Ergonomics


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Ergonomics in Lagos and Abuja Nigeria

How to Manage Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

This is a condition of the hand affecting the nervous supply of the wrist. It comes about as a result of the median nerve getting squeezed or pinched before it supplies the palm. This affects sensation and wrist movements and may progressively get painful with time. It is the commonest cause of hand neuropathy and has to be ruled out wherever a patient comes with numbness and pain of the hand.


Symptoms start gradually and are progressive in nature. Early symptoms are mild and may be ignored for sometimes. Tingling and numbness in the thumb could be the first symptoms. The index and middle fingers may also be affected at this stage. Hand and wrist discomfort is also common. Other symptoms of carpal tunnel syndrome include:

  • Itchiness on the palm and especially on the thumb
  • Swollen hand and finger sensation although there is no visible swelling.
  • Numbness and tingling that is worse when constantly grasping an object.
  • Little finger spared from the symptoms affecting the rest of the palm
  • Hand weakness with a tendency to drop objects.
  • Muscle wasting.
  • Inability to differentiate temperature status of an object.
  • Can affect one or both hands.

Causes and risk factors

Carpal tunnel syndrome is caused by the compression of the median nerve as it enters the wrist from the forearm. This compression may be due to a number of factors but sometimes the exact cause cannot be pinpointed. However, there are risk factors that have been identified to increase chances of getting this condition. Some of these include:

  • Gender. Women are up to three times more likely to get the problem than men
  • Diabetic patients
  • People suffering from other metabolic disorders like hypothyroidism
  • Rheumatoid arthritis patients
  • Trauma and fractures of the wrist
  • Those working in repetitive work situations like assembly and packing lines.
  • People with anatomically small carpal tunnel
  • Edema conditions as seen in pregnancy, menopause or in various disease conditions
  • Extensive use of the computer (but this point is controversial)


A detailed history of the illness and a comprehensive physical examination of the patient will very likely make the diagnosis of carpal tunnel syndrome obvious. Physical examination includes tests like the Tinel test and the Phalen (wrist flexion) test. Diagnostic tests include:

  • Wrist X-ray to rule out other wrist conditions or injuries.
  • Electromyography to test wrist muscles’ integrity
  • Nerve conduction tests
  • Ultrasound imaging
  • Magnetic Resonance Imaging – MRI

Management of carpal tunnel syndrome

The outcome is best if treatment is started as early as possible. The treatment can be surgical or non-surgical. The surgery can be open or endoscopic in nature. Non-surgical measures include:

  • Splinting the wrist
  • Use of common non-steroidal anti-inflammatory drugs – NSAIDs
  • Use of corticosteroids
  • Physiotherapy

Physiotherapy plays an important role during active management of this condition and also in the prevention stage. A physiotherapist can train those at risk on the type of exercises to perform either at hope or at their place of work. Physiotherapy measures include:

  • Stretching exercises
  • Use of corrective splints
  • Heat or ice therapy
  • Hand therapy techniques
  • Ultra-sound treatment
  • Mobilization of the carpal bone
  • Gliding exercises for tendon and nerves
  • Looking for sources of possible referred pain

Carpal tunnel syndrome can be a disabling condition if left untreated but if diagnosed early, physiotherapy can correct the condition before it gets worse.


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Plantar fasciitis

Plantar fasciitis

This is a common and painful condition of the foot that affects many people.The problem comes about due to inflammation and thickening of the plantar fascia of the foot. This is a band of tissue that runs on the lower side of the foot from the front to the back.

Symptoms of plantar fasciitis

Most of the symptoms are in the foot and they include:

  • Sharp foot pain close to the heel
  • Pain worse on waking up – referred to as ‘first step pain’
  • Foot joints stiffness
  • Pain that improves with exercises but returns after the exercises
  • Pain triggered by walking for long
  • Limiting foot pain on standing up after prolonged sitting.

Causes and risk factors

The exact cause of plantar fasciitis is not well understood. Some experts theorize that repeated small injuries lead to the thickening and inflammation of the fibrous tissue of the plantar fascia. There are however, situations and conditions that increase the risk of developing this condition. They include:

Anatomical factors

This includes a short calf muscle that prevents the full flexion of the foot. The other problem here is an abnormally high arch of the foot. Flat footed people and those with other problems of the feet which affect their gait are also at an increased risk.

Lifestyle factors

This includes excessive body weight that creates too much strain on the foot. People who are mostly active on their feet, like athletes and soldiers, are also more likely to develop the problem. Changing from high heels to ordinary shoes suddenly can trigger the symptoms.

Ill-fitting and poorly padded shoes also increase the risk of plantar fasciitis.

Health conditions

Rheumatoid arthritis and other types of arthritis or inflammatory conditions such as systemic lupus erythematosus can increase chances of plantar fasciitis. Calcaneal spurs are common in people with this condition but they are not the cause. For this reason each of these conditions can be treated independent of the other.


Plantar fasciitis is more common in those above middle age.

Injury may, but is rare, lead to the condition.


The diagnosis can be made almost conclusively based on the clinical presentation. A thorough history about the pain and its association with time of waking up, exercises, occupation and type can all help in making an accurate diagnosis. Physical examination may reveal risk factors like obesity or anatomical foot problems.

Imaging investigations like X-rays and MRIs are not used routinely to diagnose plantar fasciitis. Instead, they are for ruling out other conditions of the foot.


Treatment can be non-surgical or surgical. Majority of patients don’t need surgery. Non-surgical treatments include:

  • Analgesics
  • Corticosteroids
  • Physiotherapy.

Physiotherapy forms an import part of treatment. This alone can lead to many patients getting relief. Physiotherapy measures include:

  • Assisted exercises that stretch the calf muscles and the plantar fascia.
  • Use of special shoes and orthotics
  • Application of specialized ice or heat therapies.
  • Use of high energy Extra-corporeal shockwave therapy
  • Use of night splints

As a part of the treatment a physiotherapist educates the patient on how to take good care of their feet and how to prevent plantar fasciitis from getting complications or recurring in the future.

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High Blood Pressure (Hypertension)

High blood pressure is defined as the force of blood in the arteries which is sustainably higher than usual under specific prevailing circumstances. If elevated for long enough this pressure can create health problems not only in the cardiovascular system but also in other organs and systems of the body. This pressure is determined by two factors:

  1. The pumping force of the heart
  2. The arterial resistance to the flow of the pumped blood.

This means if the arteries are narrowed due to any of many reasons, then the heart will have to pump more strongly to overcome this resistance and in order to supply all the body parts with enough oxygen/nutrient rich blood.

Symptoms of high blood pressure

High blood pressure can remain symptom free even when extremely high. It is a common saying in the medical field that ‘the first sign of cardiovascular disease could be the last one’. This emphasizes the fact that the first symptom of high blood pressure could be a stroke or heart attack which could be serious enough to result in death.

The only way to know if you have high blood pressure is to have your blood pressure measured. However, in some rare cases, a person with a very high blood pressure can present with the symptoms, including:

  • a persistent headache
  • blurred or double vision
  • nosebleeds
  • shortness of breath

Symptoms secondary to hypertension complications may also be observed. Such symptoms may point to problems in the lungs, liver or kidneys.

Many cases of hypertension are discovered during routine visits to the doctor or when carrying out medical examination for other purposes.

Causes of hypertension

There are two main classifications of hypertension causes.

  1. Primary hypertension refers a type whose cause is not identifiable. It follows a chronic trend over many years.
  2. Secondary hypertension. In this type there is a primary underlying cause that has precipitated the hypertension. Common causes include:
  • Kidney problems
  • Liver problems
  • Adrenal gland tumors (pheochromocytoma)
  • Medications
  • Substance abuse including smoking, alcohol and use of narcotics and other drugs.

There are many factors that increase the risk of developing hypertension. Common ones include:

  • Lifestyle choices including a sedentary lifestyle, use of tobacco products and alcohol as well as obesity
  • Genetic predisposition. It tends to run in families
  • Aging increases the risk although there is a worrying trend in many countries where younger people are getting hypertension due to dietary and other factors
  • Diet is a major determinant of risks associated with hypertension. The typical Western countries diet and that of the urban population in the developing world is typically made up of too much fat, salt (sodium chloride) and sugar not to mention highly processed packaged foods full of harmful preservatives and additives.


This is made by a simple non-invasive blood pressure measuring by use of an ordinary aneroid or non-aneroid sphygmomanometer. Other electronic and imaging tests may be done for assessing related problems.


Treatment involves the use of medications and a change in lifestyle in an attempt to gradually bring down the blood pressure to healthy levels and to prevent complications. Treating the primary cause, if known, is the best option. It also means treating any associated complications. Other measures include

  • A healthy diet. The typical Mediterranean diet is recommended.
  • Low salt (sodium) diet
  • Weight reduction and management to healthy levels.

The role of physiotherapy in the management of hypertension

  • Physiotherapy can help in guiding people on how to engage in beneficial exercises that can keep them fit and healthy.
  • A physiotherapist will take into account any present medical conditions to design appropriate exercise programme. For instance, people arthritis in their weight-bearing joints should avoid some types of exercises.
  • If complications of hypertension have already occurred, a physiotherapist plays a major role in rehabilitating the affected functions.


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