This poorly understood neurological disorder often comes with other types of recognition impairment, say, place, car, facial expression, or emotion. In general though, face blindness is confined more strictly to facial identity.

It is not surprising to know about the social problems and difficulties experienced by persons suffering from the condition – imagine a person having difficulty in recognizing members of his own family, close friends, and in some cases, even themselves.

Symptoms of Prosopagnosia

While everyone normally experiences at some point in time some difficulty in face recognition or in remembering names, face blindness is on a level that is much more severe than usual forgetfulness. The difficulty in face recognition by prosopagnosics extends to people they have been seeing on a regular basis or spending most time with, like spouses or children.

To offset the impairment, people with prosopagnosia rely greatly on other information such as hair, way of walking, built, or clothing which are all non-facial features of a person. And because they have trouble even imagining the facial appearance of people they know, it is hard for them to even keep track of the identity of the famous characters in even the most popular TV shows and movies.

There are tests available online which will help assess your abilities on facial recognition. Harvard University and University College London have developed diagnostic tests for face blindness which are available through a website (http://www.faceblind.org). They use the data collected from such tests to determine and identify hundreds of individuals who are face blind.

Causes of Face Blindness

Documented cases of face blindness showed that the impairment had been an effect of damage in brain suffered from head trauma, degenerative diseases, or stroke. These patients before the trauma or stroke were able to recognize faces without any difficulty. After the trauma or stroke, the facial recognition ability became impaired. Cases of acquired prosopagnosia were made known to the public for two reasons:

• The fact that they were able to recognize faces before trauma, they can notice the difficulty they experienced after the trauma.
• Their sickness or condition (head trauma, stroke, etc.) made them always in contact with medical doctors who can detect and assess their face recognition abilities. Their assessment will then result to ordering further face recognition tests.

Developmental prosopagnosia is associated with individuals whose face blindness has genetic links (genetic prosopagnosia), or when individuals suffer prenatal brain damage (preexperiential prosopagnosia), or when individuals suffered brain damage or severe visual problems when they were very young (postexperiential prosopagnosia).

Persons with developmental prosopagnosia usually are not aware that they are unable to recognize faces as well as other people. This is because they have never recognized faces normally which makes their impairment not obvious to them. This could be the reason why there were a number of individuals who became aware of their face blindness only when they reached adulthood.

Prosopagnosia is, as mentioned earlier, a poorly understood disorder. Currently, there are very limited understanding of prosopagnosia, and this is primarily due to the few cases of face blindness that have been thoroughly investigated and studied, especially for developmental prosopagnosia.

Treatment

Individuals suffering from face blindness or prosopagnosia are taught to learn other ways to remember faces. Social situations may pose anxiety and awkwardness and may cause severe shyness. We hope researchers will discover or develop new ways to help individuals with prosopagnosia improve their face recognition abilities. You may find more info and watch clips from a 60 Minutes episode about facial blindness: http://www.cbs.com/shows/60_minutes/ .

A mental disorder known as ADHD (Attention Deficit Hyperactivity Disorder) is characterized by hyperactivity, inattention, and inability to control urges or drives. ADHD has proven links to various sleep disorders.

Children who have ADHD may be observed to have disturbed or interrupted sleep. Studies have shown that ADHD children have more severe sleep disorder than other similar illnesses. There are more below on relationship between ADHD and some Sleep disorders:

• Snoring and ADHD. Snoring in children is usually caused by large adenoids or tonsils blocking the airway. This blockage may develop into sleep apnea and cause ADHD-like  symptoms. Snoring may be a reason for poor sleep quality and this may eventually cause attention problems the following day. Studies have shown that snoring is common among ADHD children. And snoring children are likely to be afflicted with ADHD as well.

 Removing the tonsils or adenoids is found to help improve the child’s sleep pattern and better behavior without the need to take medications.

• Sleep Apnea and ADHD. Apnea means ‘without breathing’. Sleep apnea is used to describe airflow disruption of at least ten seconds. One of the three kinds of apneas is obstructive apnea – it makes up *65% of all apneas. The absence of airflow from the nose and mouth to the lungs happens during obstructive sleep apnea. There is no airflow because the entrance to the trachea is blocked caused by various collapsed structures in the pharynx. The respiratory muscles continue to make efforts to get air into the lungs even when the trachea entrance had closed.

In general, people with sleep apnea have episodes of stopped breathing. When this happens, they are awakened from their sleep – awakening could happen from early stage of sleeping and even from the time they are already sleeping soundly.  Even with the awakening, one will remain absolutely oblivious of the sleep interruption or breathing disruption. The episodes are likely to happen many times during the night.

In the U.S. there are more or less *2% of the children population who manifest some form of disrupted breathing while sleeping. Enlarged tonsils and adenoids are found to be the most noted reason for the children’s having apnea. This sleep  problem  observed in children may also be caused by obesity and chronic allergies. As with adults, children with sleep apnea will be tired during the day.

There is treatment available for sleep apnea in children. To begin with, your  pediatric doctor  or a specialist for ear, nose, and throat problems can identify and diagnose if your child’s tonsils are causing the apnea. The size of the child’s tonsils must be significantly larger than normal to cause obstruction in the airway to cause breathing disruption. For the diagnosis of sleep apnea to be confirmed, the child should undergo polysomnogram – a special laboratory-based study of sleep. Some children may have enlarged tonsils or are snoring loudly but do not have sleep apnea.

For children with abnormally large tonsils and adenoids, the treatment option is surgery. There are other treatments available for those having constrained breathing while sleeping due to other health problems.

• RLS (restless leg syndrome) and ADHD. Restless leg syndrome is characterized by crawling sensations felt in the legs or arms which are very uncomfortable and annoying. This creates an overwhelming urge to move, thereby causing disruption in sleep and sleepiness during the day. People with RLS are not able to get good sleep. Hence, they will experience inattentiveness, moodiness, or hyperactivity. These are the same symptoms for ADHD. RLS is identified using polysomnogram or sleep study. Both ADHD and RLS may be treated with medications.

These cases show the clear relationship between ADHD and Sleep disorder symptoms. It sometimes happens that because of the overlapping symptoms of ADHD and Sleep disorder, some patients are misdiagnosed for the other disease.

 Ways to Help ADHD Children Get the Needed Sleep

• Stay away from caffeine or other sleep-disrupting food or beverages. Check the label of the foods being eaten by your ADHD child. They increase nervousness, agitation which results to interrupted and disrupted sleep.
• Keep a consistent and regular routine for sleeping, waking up or even eating schedules.
• Soundproof your kid’s bedroom to shield from outside noises.
• Don’t take sleep medication unless prescribed and recommended by the doctor..
• Check for other medical problem or illnesses. Asthma, allergies and other conditions which cause airway narrowing or pain may contribute to disrupted sleeping.
• Introduce your children to a light exercise regimen during the day. Exercise should not be done near bedtime.
• A hot bath before bedtime can do wonders. A cool-temperature room may be helpful for a child to sleep in after a warm bath.

*Sourced from webMD

Photo by: CarbonNYC

People have different reasons for not getting enough sleep – stress with school, family problems, or work-related issues. Other times, lack of sleep is caused by a sleep disorder, which breaks and disrupts sleep in many ways. And it has significant negative effects on one’s quality of life and health. Sleep deprivation can also put one at risk for serious medical problems. Identifying the causes of sleeplessness and subsequently implementing lifestyle changes will help protect you from daytime exhaustion and health problems.

A lot of times people experience the after effects of sleep loss such as exhaustion, lack of concentration, forgetfulness, clumsiness, and irritability. A person’s overall functioning and feeling during the day reflect how well a person slept the night before. In the same light, some remedies for sleep problems result from one’s daily lifestyle choices and they can make a huge difference in the quality of sleep.

Sleep Hygiene Practices

The following sleep habits, also named sleep hygiene can help optimize one’s nightly rest in order to be productive, focused, refreshed, emotionally stable, and physically energetic throughout the next day:

• No napping during the day as this disturbs the normal sleep pattern (possibly except up to 1 hour siesta after lunch).
• No stimulants (caffeine, nicotine, etc.), or alcohol. These should not be taken close to sleeping time.
• No heavy meals before bedtime.
• Not sleep with an empty stomach.
• No heavy exercising before bedtime. Usual energetic exercises should be completed at least 4-6 hours before bedtime.
• Remove anything that adds to light and noise in the bedroom at night. Keeping the room dim, quiet, with comfortable room temperature and with relaxing music can set the right mood for sleeping.
• Practice relaxation exercises like yoga, meditation, deep breathing, light stretching or a winding down routine before going to sleep.
• Avoid stressful activities and conversations before going to bed. The subconscious might pick up on these thoughts and cause sleep disruption.
• Keeping a regular bedtime and wake up time every day including weekends and holidays.
• Use the bed ONLY for sex and sleep and not for other activities like watching TV, reading, surfing internet, listening to the radio, texting, etc.

Keeping a Sleep Diary

Some sleep specialists also recommend keeping a sleep diary where all sleep habits and patterns will be recorded. The diary should contain the following information:

• What time you go to bed?
• What time you wake up?
• What time you wake up during the night, how many times, how long does it take to fall back asleep?
• How much alcohol, caffeine, and cigarette were consumed and at what times?
• What time you had your meal, what food you ate and beverages you drank?
• Any emotion or stress experienced during the day, and what time?
• Any drugs or medicine taken and what time they were taken?

The sleep diary may contain more than the information listed above. Any information that might be associated with having sleep problems should be included. This will help the doctor or the sleep specialist to identify the possible triggers to the sleep problem.

Sleep Hygiene for Travelers

A common problem of frequent travelers is jet lag. The change in time zones causes disruption in the body’s biological clock and the difficulties in adjusting to the new time zone results to sleep disturbance. There are ways to minimize the effects of jet lag on one’s sleeping pattern:

• Condition the mind and body to the change in time zone when you make the trip by adjusting your sleeping and waking up schedule according to the time zone of your destination a week or so before the scheduled travel date.
• Adjusting your watch to destination time as soon as you board the plane.
• If possible, select a flight that arrives in the destination early evening.
• Do not take alcohol or caffeine for 3 – 4 hours before bedtime at your destination.
• No heavy exercising before bedtime.
• Use earplugs and blindfolds to mask outside noise and lighting while sleeping.
• Don’t stay indoors most of the time as this worsens the jet lag.
• Make arrangements with the hotel for voice mail services and let them handle all your calls.
• Request wake-up calls from the hotel staff.
• Some people find use of melatonin to induce sleep helpful.

A change in the environment, i.e., time zone, requires the body and mind some time to adjust. By allowing the mind and body to prepare early for such anticipated change, the adjustments will be less when you are actually in the new time zone area.

Sleep Hygiene for Older Adults

As people age, there are normal changes in the sleeping patterns – sleeping and waking up earlier, and feeling rested even with less deep sleep. However, if less sleep becomes disturbing and disruptive to daily functions, it is not any more a normal part of aging. And just as good sleep is important to younger people, so it is as equally important to senior people as it helps maintain good concentration and memory function, refreshes the immune system, and allows the body to recover from the effects of cell damage that happened during the day. The following sleep hygiene tips can help alleviate age-related sleep problems to have better sleep at night:

• Limit caffeine intake late in the day. Avoid caffeinated drinks such as coffee, tea, soft drinks and chocolate.
• Don’t take alcoholic beverages before sleeping because alcohol disrupts sleep.
• Keep stomach satisfied before sleeping. Light snacks like crackers, cereal, and warm milk may help having a good night sleep.
• Do not eat big meals or spicy foods before bedtime. Spicy food can cause indigestion and stomach discomfort. The best is eating dinner at least three hours before sleeping.
• Reduce intake of liquid before sleeping to minimize middle of night bathroom visits. Drinking liquid should be limited an hour and a half before sleeping.

Mild cognitive impairment is said to be a precursor to dementia or Alzheimer’s disease, which is the most common type of dementia, as it increases the risk of dementia especially if the main difficulty of the person is with memory. This is not to say, however, that a person with MCI will get worse no matter what. There are some people with MCI, who never get worse or develop dementia and some of them may actually get better eventually.

Symptoms

The brain undergoes some changes as a person grows older like the rest of the body. Most aging people become too forgetful or it may take a longer time to think of a word or remember a person’s name.

Cognitive problems may go beyond what is expected and may indicate possible MCI if a person experience the following symptoms:

• Frequent forgetfulness of things
• Forgetfulness of events like appointments or social events
• Getting lost in the middle of a conversation, or a book, or a movie
• Feeling overwhelmed with decision making, planning steps to accomplish a task or following instructions
• Having trouble remembering ways around familiar places
• Showing signs of impulsivity or increasing poor judgment
• Family and friends of the person are aware of these changes

A person with MCI may also experience depression, aggression and irritability, apathy, and anxiety.

Classic examples of symptoms observed in people with MCI are being unable to recall the names of people they already know or met recently; trouble keeping track of the flow of a conversation, and frequent misplacing of things. In most cases, the person is quite aware of these problems and tries to compensate the difficulty by using notes and calendars as reminders.

These problems are similar on a milder level to the neuropsychological findings associated with Alzheimer’s disease or other dementias. In some cases, the patient may have mild difficulties performing daily activities.

Diagnosis

The doctors conduct a clinical evaluation that may lead to the diagnosis of MCI as the likely cause of the symptoms observed in a person as there is no specific test to confirm such diagnosis. The doctor’s medical evaluation include extensive investigation of the memory loss problems like details on what was forgotten, when it happened, and how long has it been happening. The doctor also orders imaging and lab tests and if necessary psychological tests to rule in or out MCI diagnosis and explores if other cognitive problems are present or occurring like organization and planning problems, visuospatial abilities, etc.

Most doctors diagnose MCI based on the following criteria determined and developed by a panel of international experts:

• You have memory problems or another mental function, such as planning, following instructions or making decisions. Aware of the problems, you affirm by checking with someone close to you.

• Some of your abilities and capabilities have dramatically declined over time. Your medical history reveals that your performance and thinking abilities have declined from a higher level. Again, this change will be confirmed by someone close to you.

• Your overall mental function and daily activities are not affected despite these changes. In a general sense, your overall abilities and daily activities are not impaired, although there may be specific symptoms that can cause worry and inconvenience.

• Testing of mental status will show a mild level of impairment based on your age and education level. Doctors usually assess mental performance with the Mini-Mental State Examination (MMSE) test. If necessary, more detailed neuropsychological testing may be conducted to understand how severe memory impairment is, if other mental abilities are affected and which types of memory are seriously affected.

• Your findings do not meet criteria for dementia. The doctor evaluated that the memory problems complained about which are also documented through corroborating reports, your medical history or mental status testing are not severe enough to make a diagnosis of Alzheimer’s disease or another type of dementia.

The doctor may conduct other neuropsychological tests to help in determining the degree of memory impairment.

• Neurological exam

The neurological exam includes basic tests that will indicate the coordination level of your brain and nervous system –spontaneous response, eye movements, gait and balance, and the sensory ability. These tests can also help detect any indication of Parkinson’s disease, or other medical conditions like strokes or tumors that can affect memory and physical functions, as well.

• Laboratory tests

Laboratory blood analysis may be required to help rule out specific problems that affect memory such as deficiency in Vitamin B12, folate, vascular inflammation, systemic lupus, rhematoid arthritis, sarcoidosis, HIV infection, syphilis, lyme disease, or thyroid problems.

• Brain imaging

If necessary, MRI or CT scan of head may be ordered by the doctor to check for the presence of other brain-associated problems such as tumors.

Treatment

There are not any the Food and Drug Administration (FDA) approved drugs or treatment for MCI. But MCI is an active area of research and clinical studies aimed at shedding more information and valid explanation on the disorder to find treatments that may help improve the symptoms or prevent or delay progression to dementia.

• Alzheimer’s drugs

Cholinesterase inhibitors or NMDA inhibitors (memantine), FDA approved drugs for Alzheimer’s disease are sometimes prescribed for people with MCI if the main symptom observed is memory loss. However, these drugs aren’t advised for routine use in MCI for their short-term benefit.

• Treating other conditions that can affect mental function

MCI is not the only condition causing memory loss. There are other medical conditions that can be attributed for a person’s forgetfulness. Diagnosis and treatment of such medical problems can help enhance memory and mental functioning. These conditions that commonly contribute to memory loss include:

• High blood pressure. MCI usually links problems with the blood arteries inside the brain. Memory difficulties may be aggravated by hypertension. Monitoring of blood pressure is necessary and interventions or treatment to lower it are recommended if it’s above normal limit, usually 140/80 mmHg.
• Depression. Depressed people often become forgetful and mentally “foggy.” This condition is common in people with MCI, too. Treatment of depression is essential to minimize memory loss problems and even may eliminate all memory problems. Hence another name for depression is “pseudodementia.”
• Sleep apnea. This condition, in which breathing stops and starts repeatedly while asleep can make a person feel excessively tired during the day. It will also cause forgetfulness and inability to concentrate. Treating sleep apnea can improve sleeping habits of the person and consequently improve MCI symptoms and restore alertness.

People tend to have difficulty in remembering things more as they get older. It is a normal and common sign of aging. However, if memory loss is disruptive and affecting the person’s daily functioning it might be a symptom of dementia. A person with dementia may not able to remember names, faces, directions, and can confuse one person with another. Some changes in personality and social behavioral patterns may also be evident.

Symptoms

The first and most common symptom of dementia is memory loss. Family and friends notice the following symptoms as dementia gets worse:

• Tasks that involve planning like making a list and going for shopping may become a struggle for the person.
• Having trouble with the use and understanding of words.
• Getting lost in familiar places
• Acting or behaving differently over time like becoming scared or lashing out at others; sometimes becoming clingy and childlike; patients might stop routine tasks like brushing teeth or bathing
• Difficulty in communication
• Having problems with coordination and motor functions
• Paranoia
• Agitation
• Hallucinations

Diagnosis

Doctors and licensed mental health providers diagnose dementia by asking questions about the person’s medical history and performing physical exam, comprehensive psychiatric evaluation, and laboratory and imaging tests.

These tests help the doctors to find out if dementia is caused by a treatable condition or not. Common reversible dementias are caused by thyroid gland problems, Vitamin B12 or folate deficiencies, vasculitis, syphilis, etc. Proper medication and treatment options will be prescribed with the proper diagnosis and identifying of the type of dementia a person has.

• Medical history. Questionnaires may be required to be answered to help trace back some timelines – when the symptoms began, what other health issues the person have like diabetes, high blood pressure, etc. This will also help determine if other members of the family have been diagnosed with the same or similar conditions before.
• Physical examination. A comprehensive head to toe assessment is required including height and weight measurements, vital signs – blood pressure, temperature, heart rate; heart and lung and abdomen exam.
• Cognitive and neuropsychological tests. Any person screened for dementia will be asked to undergo cognitive function evaluation in order to determine if the person has dementia.
• Neurological evaluation. In order to determine the conditions that may affect the diagnosis, a person’s function on balance, sensory and reflexes have to be examined.
• Brain scans. Doctors may require this to check on the presence of tumors, previous stroke or other problems that are associated with dementia. These scans enable the doctors to see if there are brain structure changes caused by Alzheimer’s disease. Computerized tomography or CT scan and Magnetic Resonance Imaging or MRI scans may be required depending on the doctor’s initial assessment or evaluation.
• Electroencephalogram (EEG). This tool helps doctors to detect and record electrical activity patterns in brain and check for any abnormalities in this area. Any abnormalities can indicate problem in cognitive functions. An EEG may also identify other dementia-associated problems.
• Laboratory tests. Complete blood count or CBC, blood glucose test, blood tests for kidney functions, urinalysis to screen for drug or alcohol abuse, blood testing for thyroid problems help the doctor rule out other medical conditions as causing dementia.
• Psychiatric evaluation. Doctor may require this examination to determine the presence of depression or other comorbid psychiatric conditions.

Treatment

Currently available dementia treatments help to slow down or minimize the progress of symptoms.

• Cholinesterase inhibitors. These are drugs intended for Alzheimer’s that help boost levels of a brain chemical messenger involved in memory and judgment. Side effects include nausea, vomiting, appetite suppression, and diarrhea.
• Memantine (Namenda). This is another Alzheimer’s medication which regulates glutamate activity – glutamate is another brain chemical or neurotransmitter involved in learning functions and memory part of the brain. Dizziness is a common side effect. There are studies suggesting that a combination of memantine and cholinesterase inhibitors may cause even better results. This drug helps improve symptoms in other dementias other than Alzheimer’s.

Doctors may prescribe anti-hypertensive medications if this is a direct cause of dementia. In addition, sedatives, antidepressants, and other medications may be prescribed for some specific symptoms and behavioral problems. For any of these drugs prescribed, the doctor or mental health provider should monitor the person in order to prevent the risk of abuse and other complications.

Studies were conducted by Jeffrey Kaye, MD and colleagues at Oregon Health and Science University in Portland and both showed that people with MCI withdraw and isolate themselves as the condition progresses over time.

Amnestic mild cognitive impairment (MCI) is a condition that involves memory, language, thinking, and judgment problems that are more severe than normal for their age and education. MCI increases the risk of developing dementia or Alzheimer’s disease especially if the main problem is with the memory.

The researchers studied 148 people, 28 of whom have MCI, enrolled in the Intelligent Systems for Assessing Aging Change (ISAAC) trial. The participants had a mean age of 84.2 and were followed for up to three years. During that time, their homes were outfitted with new technologies to evaluate 24/7 activity patterns with a focus on quantity of time that was spent out of the home.

The study revealed that an average of 4.5 hours a day out of their home is spent by the participants during the first month. As the study progressed, people with MCI displayed a significant decline in spending time out – from 4.5 hours, it went down to 2.4 hours a day compared to 3.8 hours spent outside by those without MCI.

The findings suggest that withdrawal from social activities can be a warning sign of future Alzheimer’s disease and that it is important that people living with MCI or dementia maintain a connection with the community and have continuous social interaction with other people in the community.

For more details on the studies, you can visit:   http://www.alzheimersreadingroom.com/2012/07/research-links-mild-cognitive.html.

One of the studies was conducted by Mindy Katz, MPH and colleagues at Albert Einstein College of Medicine of Yeshiva University in Bronx, New York and it showed that people with dementia is at risk of death 3.26 times more than those who are cognitively normal and the mortality risk was found 2.17 times higher for those with amnestic MCI, which is a precursor to Alzheimer’s dementia.

The study further supports how early detection of MCI or Alzheimer’s can prevent the worsening of the conditions but also in prolonging life. If MCI or Alzheimer’s is detected or diagnosed early, the patient will likely to have the opportunity for proper medical care plan that will address the challenges and reduce the exposure to the risk of death and may also be able to have access to resources available in the community that offer support to this cause.

For more information click http://www.einstein.yu.edu/news/releases/810/amnestic-mild-cognitive-impairment-mci-doubles-risk-of-death/