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Life Expectancy in People With COPD

After being diagnosed with chronic obstructive pulmonary disease (COPD) many people wonder about their life expectancy – a difficult topic to think about for sure. However, once you or your loved one learns the prognosis of COPD, motivation increases and that’s the point when most people get determined to incorporate the lifestyle changes needed to improve life quality and increase longevity.

How to Predict Life Expectancy in COPD Patients?

In general, doctors use a tool named the BODE index to predict life expectancy, i.e. the mortality rate from COPD, based on four different measures including body mass index – B, airway obstruction – O, dyspnea – D, and exercise capacity – E. Each of these measures is given a number of points which when added together can make a more accurate prognosis about how long may a person live after being diagnosed with COPD.

But, understand that the BODE index can only be used for making a general prediction, i.e. there are also other factors, like age, for example, affecting life expectancy in people with COPD. Now, let’s have a closer look at each of the four measures:

Body Mass Index

A body mass index (BMI) is a measure of body fat by comparing height and weight that applies to adult men and women. In other words, it is a calculation showing how overweight or underweight a person is based on their body frame. 

In addition, when it comes to chronic obstructive pulmonary disease, being underweight is a bad sign. If a person’s BMI is higher than 21, they get zero points for their BODE index, and if it’s less than 21, they get one point.

Airway Obstruction

A spirometry test is the simplest tool for measuring airway obstruction. The test includes a marker called FEV1 (forced expiratory volume) which measures the percentage of air that is forcefully exhaled in one second.

Typically, this percentage is higher than 65% which gives zero BODE index points. But in case of an obstruction in the airways, it decreases significantly. So, for 50% to 64%, patients will get one point, for 36% to 49% two points, and for less than 36% three BODE index points.

Dyspnea

The physical sensation of breathlessness or shortness of breath is called dyspnea. It is normally described as an intense tightening in the chest, difficulty breathing, air hunger, or a feeling of suffocation. This sensation is often more fierce after some activities which is why doctors usually make distinctions based on what patients do before they experience the feeling.

Dyspnea is normally expressed by the modified Medical Research Council (MMRC) Dyspnea Index, measured on a scale of zero to four. COPD patients will get zero BODE index points for MMRC Value of zero to one, one point for a value of two, three points for a value of three, and two points, for a value of four.

Exercise Capacity

Finally, exercise capacity is the measurement showing how active can someone be regardless of their COPD. Typically, exercise tolerance remarkably reduces by this lung disease. Yet, to get the measurements a standard test applies called the six-minute walk test.

If a person can walk more than 349 meters, they get zero BODE index points. For 250 to 249 meters, one point. For 150 to 249, two points. And for 150 meters or less, they get three BODE index points.

The Bottom Line

Once a doctor has determined the points for each of the four factors listed above, they are added together. The result is graded on a scale of 0 to 10, with higher grades corresponding to shorter life expectancy, and lower grades corresponding to longer life expectancy.

How Side Sleepers Can Improve Nighttime Comfort to Stop Sleep Loss

Sixty-nine percent of people sleep on their side, according to the Alaska Sleep Clinic. Some assume the fetal position, some lay long and straight, and others reach out in a position known as “the Yearner,” but while side sleepers come in several forms, they all face similar challenges. A good night’s sleep is essential to active, healthy living. So if you’re a side sleeper who’s looking to improve your sleep, then this article, presented by the sleep and fitness experts at Virtuox, can arm you with the important information you need to finally get that good night’s sleep your body has been craving.

 

Pros and Cons of Side Sleeping

First, the good news: Side sleeping is good for your back. Laying on your side lengthens the spine and alleviates back pain, and as long as you sleep on your left side, side sleeping promotes healthy digestion. Side sleeping is also ideal for people with sleep apnea, a health condition that causes you to stop breathing during the night.

However, sleeping on your side can also cause nerve compression and pain in the shoulders, hips, and knees. That's especially true if your hips rotate out of alignment or you strain your neck while sleeping in the fetal position. That doesn't mean you need to abandon your sleep position and start sleeping on your back — although back sleeping is widely considered the ideal sleep position. If side sleeping is the most comfortable position for you, a few minor adjustments will eliminate nighttime discomfort and protect your spine so you can sleep better and feel better.

 

Pay Attention to Dental Health

For TMJ sufferers, side sleeping also aggravates jaw pain. And when you’re suffering from any sort of oral discomfort, you can experience an unhealthy amount of sleep loss. Although it’s important to consult your dentist to see if you require surgery or advanced treatment to address TMJ, there are some at-home treatment programs that can help, especially if your problems stem from misaligned teeth. Aligners at SmileDirect can treat most mild to moderate misalignments, and the company offers a whitening program to help improve the look of your teeth after your teeth have been straightened. If you have serious concerns or want professional advice before starting any kind of oral treatment, talk to your dentist.

 

Look at Your Mattress

The first thing to do is to take a close look at your mattress. A side sleeper's mattress should give in the right places — primarily the hips and shoulders — while pushing back in other areas. This creates a contour that supports the spine's natural curve and prevents pain in pressure points. If your bed is too firm, too soft, or doesn't respond when you change positions, you'll wake up with soreness and an aching back.

Most side sleepers prefer a mattress made of memory foam, especially memory foam constructed with natural latex or gel. These mattresses have a reputation for being highly supportive and responsive, so your spine stays aligned even as you shift positions. It’s also important to identify where you’re feeling pain. For instance, if you’re a side sleeper with lower back pain, you’re better off with a medium to the medium-firm mattress that provides pressure relief and enough support to keep your spine aligned. However, if you have pain in your upper back or shoulders, you’ll want a slightly softer mattress.   

Even with the right mattress, side sleepers can experience pain and discomfort due to improper alignment. That's because it's not just your spine that needs to be in balance — the position of your pelvis matters too. You want your hips to be stacked on top of each other, not rotated. The best way to do that is by placing a pillow between your knees to keep your legs parallel to one another. If your stomach sinks down toward the mattress, placing a small pillow or rolled towel under your waist for added support is a quick fix (although a more supportive mattress is a better long-term solution).

 

Upgrade Your Pillow

Using the wrong pillow is another big problem for side sleepers. Since your shoulders keep your head elevated above the bed, you need a pillow that fills the gap and keeps your neck in line with your spine. If your pillow is too flat, your neck collapses downward. If your pillow is too high, your neck flexes upward. Either way, you wake up with a stiff neck. Firm, lofty pillows are the best choice for side sleepers because they provide adequate height and prevent your head from sinking too deep into the pillow. However, the exact height depends on your stature: People with broad shoulders need a higher pillow, while petite individuals need something less lofty. If your current pillow isn't cutting it, use Wirecutter's guide to find your ideal replacement.

If you've tried all these tips and you're still waking up in pain, it may be worth training yourself to sleep on your back. It's easier to keep your spine in alignment while sleeping on your back, and back sleeping also takes the pressure off your shoulders, jaw, and hips. Changing long-standing sleep behaviors isn't easy, but pain-free sleep is worth the effort.

Getting Relief from COPD

An irreversible and incurable lung disease causing airflow blockage and breathing-related issues is called chronic obstructive pulmonary disease (COPD). And, although there’s no cure for the condition, patients can get relief and control symptoms with medication, lifestyle changes, or surgical procedures and interventions, in severe cases.

Indeed, COPD treatment is essential for avoiding exacerbations that may have negative and serious effects on a patient’s health. That said, let’s have a look at the most common COPD treatment options.

Lifestyle Changes

Although it may sound surprising, lifestyle has a significant impact on COPD. Therefore, patients suffering from this lung disease may get relief by incorporating some healthy lifestyle changes including:

Quit Smoking

This is the crucial step to take to manage COPD as the cigarette habit is the most common cause of COPD. So, if you have the disease, consider smoking cessation seriously as this is sometimes enough to manage symptoms and prevent disease progression.

Regular Exercise

We all know that exercise is great for our overall health but it can also help in optimizing lung function with COPD, by maximizing oxygen exchange and lung capacity. In addition, regular exercise will help you keep muscle strength and improve endurance.

Combat Malnutrition

Sometimes, COPD may lead to a reduced appetite which may, in turn, make symptoms worse and increase the risk of infections which will eventually lead to exacerbation of COPD. Hence, ensure you get enough calories daily, especially if you have experienced remarkable weight loss.

Practice Breathing Techniques

Finally, you can significantly improve muscle control and oxygen exchange by practicing breathing techniques. Thus, next time you see your doctor, make sure you ask him/her about which techniques to use or to refer you to a respiratory therapist.

Medications

Apart from healthy lifestyle changes, especially if they don’t provide the results needed, patients with COPD may have to take prescribed medications on a regular schedule or a short-acting medication in case symptoms flare-up. COPD prescriptions may include:

Bronchodilators

These medications, typically taken with an inhaler or through aerosol therapy, are efficient for relaxing the wall muscles of your airways, thus enabling breathing, reducing cough, and improving or preventing acute dyspnea.

Furthermore, bronchodilators are broken up into two major categories based on how fast they act. The first type is called short-acting bronchodilators and work within seconds to minutes. Examples include Ventolin, Proair, Xopenex, and Atrovent.

On the other hand, long-acting bronchodilators are used to keep airways open and muscles relaxed for extended periods, from 12 to 24 hours. These are also divided into two categories based on the mode of action:

  • long-acting beta-agonists (LABAs) – Serevent, Arcapta, Brovana, and Performist; and
  • long-acting muscarinic antagonists (LAMAs) – Spiriva and TudorzaPressair

Corticosteroids

Patients with COPD may also have to take corticosteroids which keep inflammation down and decrease the number of exacerbations. They are also divided into two main categories: inhaled and oral corticosteroids.

Inhaled corticosteroids are recommended for people who also have asthma or a high eosinophil count and those who have one or more COPD exacerbations a year. Otherwise, you shouldn’t take them as they increase the risk of pneumonia, mouth infections, and skin bruising. Examples include Flovent and Pulmicort.

On the other side, oral corticosteroids such as Prednisone are used for helping you recover faster during a COPD exacerbation by improving lung function and alleviating hypoxemia. Plus, they may decrease the risk of relapse and avoid treatment failure. Yet, long-term use of these medications can lead to serious side effects like osteoporosis, diabetes, and an increased risk of cataracts, weight gain, and infections.

Phosphodiesterase-4 (PDE4) Inhibitors

Last but not least, COPD patients may be prescribed PDE4 inhibitors as this lung disease can cause an overproduction of the phosphodiesterase-4 enzyme which causes lung inflammation. These medications block this enzyme and thus reduce COPD exacerbations in people who suffer from chronic bronchitis or severe COPD. A common example of a PDE4 inhibitor is Daliresp and may cause side effects like weight loss, diarrhea, abdominal pain, nausea, and headache.

Can Retirement Provoke Insomnia

Retirement is supposedly the greatest time of life when people stop working and fill their time with activities they enjoy doing. However, for many retirees health issues become a serious obstacle to enjoying life in these latter years. To be more specific, retirement together with certain health conditions significantly increase the risk of developing a sleep disorder, especially insomnia.

But, how does retirement affect sleep? Continue reading this article and you will soon find out why retirees spend so many sleepless nights.

Retirement: The Beginning of a New Lifestyle as a Cause of Insomnia

In general, people are joyfully waiting for retirement to come as a successful end of their working life. However, this period brings drastic changes to their lifestyles and most retirees aren’t fully prepared for embracing them.

As a matter of fact, people are used to following a strict schedule during the working years. Speaking precisely, they are woken up by an alarm clock at a consistent wake time, prepare for work, commute, perform their job tasks, have lunch, get back home, do housework, relax, and go to bed at a consistent bedtime.

That said, they truly follow a consistent schedule during weekdays which helps in reinforcing the circadian rhythm and sleep patterns, thus preventing insomnia. So, as soon as retirement arrives, people don’t have to wake up early or perform any tasks at a specific time. As a result, sleep schedule varies with most retirees sleeping in during the morning and having troubles falling asleep at night.

In addition, not only do they experience difficulties falling asleep, but also have lower sleep quality as falling asleep harder may result in frequent nighttime awakenings or even too early morning awakenings. Hence, they may end up sleeping less than the recommended amount of sleep for their age which is often 7 to 8 hours per night for people older than 65.

Among other things, the changes introduce into retirees’ everyday life may also harm sleep. Namely, once people retire are less physically and socially active and such a restricted lifestyle could also diminish sleep quality. Then, frequent napping, depression, anxiety, or increased use of medications or alcohol are also some of the most common causes of sleep issues in retirees.

Sleep Conditions that Impair Sleep in Retirement

On the other hand, like the many lifestyle changes that lead to insomnia, certain health conditions could contribute to sleep impairment too. One frequent condition in elderly people is obstructive sleep apnea which may come with aging and is characterized by breathing interruptions during the night. If untreated, this sleep disorder can even worsen diabetes or hypertension and increase the risk of dementia, stroke, or heart attack.

Other sleep disorders that may develop late in life include restless legs syndrome and leg cramps which make falling asleep quite difficult, REM behavior disorder which results in dream enactment behaviors, advanced sleep-wake phase disorder that leads to falling asleep too early at night and waking up too early in the morning.

Therefore, if you start experiencing difficulties with sleep after retirement, ensure you address the issue right away by:

  • Get about 20 minutes of sunlight after awakening
  • Try to be as active as possible during daytime
  • Avoid or at least limit napping to one a day
  • Follow consistent wake and bedtimes every day.