In This Issue

Are you getting enough sleep?

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Kudos from Martial Arts Teacher

"Doing is believing! Finding yourself needing a total hip replacement at 50 isn't anyone's ideal predicament. After many other doctor visits and subsequent hours of research, finding Dr. Zehr was a blessing. I cannot say enough positive things about he and his staff. My surgery was just as explained. I was fortunate to be home within 24 hours, and my recovery was minimal.

I teach martial arts to young children and I never missed a class. My surgery was Sept. 18th and I taught my next class on Sept. 24th.

So thankful I found you...kudos Dr. Zehr! I only wish you had twins in various medical fields. :)"

- Respectfully,

Renee Squatrito

Our website is full of testimonies like Renee's - patients who are living pain-free lives. You can read them here. Thank you to everyone who has taken the time to send us photos and stories for our office "Wall of Fame." We invite you to share your success story too, just hit "Reply!"

Celebrate Your Independence

Independence Day is upon us. That singularly American holiday where we picnic, parade and pause to reflect on our individual and collective liberties. As a nation and as people, we value our freedom. A freedom that was purchased and is maintained by the blood and moral courage of many.

The staff of the Zehr Center thanks those who continue to protect our heritage of independence and those who are investing their lives in the future of our beloved country.Soldiers, Airmen, teachers, first responders, civic leaders, public servants...when you think about what it takes to keep our nation free and independent, it's clear that everyone plays a part!

Happy Birthday America!

Seminar Online

There are no live seminars scheduled, but we want to remind you that the entire educational seminar "Joint Arthritis - What's New, What Works" is available for viewing online, either in its entirety or in segments.

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Issue: #28

July 1, 2014

If you have any doubt that summertime is here - just step outside in Southwest Florida! Temperatures in the 90s and our trademark summer humidity combine to make it feel like triple-digit weather. This is a gentle reminder to stay hydrated.

In our June newsletter we offered several tips for managing your arthritis pain during the summer. Be sure to add news@zehrcenter.com to your address book so you don't miss future issues. You can read past issues in our archive.

Our website is chock-full of educational information too, and we are constantly adding short articles to our blog, where you can choose to read about hips, knees, general orthopaedics or catch up on our latest news. Stay informed this summer, and stay cool!

Warm regards,

Robert J. Zehr, M.D.

The Importance of Sleep to Pain Management

Sleep and pain problems are among the most common complaints in our society, frequently occurring in the same person. The pain of osteoarthritis may interfere with sleep. Conversely, poor sleep may also promote pain and fatigue.

Proper sleep is absolutely necessary for the normal function of the body. Moreover, there are many processes in the body that rely on the sleep-wake cycle, processes important in fighting infection and healing your body. Sleep disturbances can have significant and serious consequences.

Your body requires approximately seven to eight hours of sleep daily and sleeping too little or too much can be harmful to your health. This sleep occurs in cycles that are generally 90 minutes long, with five stages of sleep within each cycle. These stages are further divided into two separate states, non-rapid eye movements (NREM) and rapid eye movement (REM).

During NREM sleep, body movements occur, but the mind is quiet.

During REM sleep, there is total muscle relaxation except for bursts of rapid eye movements. Because the brain is active in REM sleep, dreaming occurs in this stage of sleep. REM sleep is deep sleep that is more refreshing. Ideally, 20 to 50 percent of an adult's sleep should be in REM sleep.

As your night's sleep continues, the time spent in NREM sleep decreases and the amount of time in REM sleep increases. The last third of the night is mostly REM sleep. As we approach age 65 and older, less time is spent in REM sleep.

If you are suffering from disturbed sleep, it may be for one of these reasons:

Sleep Apnea

Apnea means "without breath" and if you stop breathing for more than 10 seconds, you are having what is referred to as an apneic episode. If you have more than five apneic episodes in an hour, you may be diagnosed with sleep apnea. The oxygen level in your blood or tissues also plays a part in a diagnosis of sleep apnea. A normal oxygen level is 95 percent and above. In sleep apnea, your oxygen level may drop to 80 percent or lower and levels below 70 percent are considered dangerously low.

Narcolepsy

If you experience excessive daytime sleepiness and can fall asleep with a short delay, but your nighttime sleep is not disturbed, you may have narcolepsy. Narcolepsy appears to be genetic and is treated with medications.

Restless Legs Syndrome

A sleep-related movement disorder, restless legs syndrome is a strong, nearly uncontrollable desire to move the legs while at rest, occurring more frequently in the evening or during the night.

Insomnia

If you have difficulty falling asleep or staying asleep, or you experience sleep that is not refreshing and restorative, you have insomnia. As many as 30% of Americans have insomnia and it occurs more frequently as we age. Other symptoms include daytime exhaustion or fatigue, lack of energy, lack of concentration, forgetfulness, irritability, and depression. Insomnia can be caused by:

Stress
Depression
Anxiety
Mental illness
Noise
Extreme temperatures
Shift work
Jet lag
Nighttime activity schedules
Medication side effects
Alcohol, tobacco or illicit drug use

A person with insomnia may also have one of the other sleep disorders mentioned above.

Good quality sleep is essential to managing the chronic pain of arthritis. It is also important to a successful recovery from knee and hip surgery. If you are experiencing difficulty sleeping, be sure to mention it to us at The Zehr Center. Call us at 239-596-0100 to discuss your symptoms of sleep disorder and how they relate to your joint pain.

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