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Child Development – Assumptions for Assessment and Improvement of Sleep in Children suffering from Attention deficit hyperactivity disorder (ADHD).

ADHD is one of the most commonly diagnosed disorders in pediatrics and adults. It affects around 3% – 5% of youths and 2.9 % of adults worldwide. ADHD, affecting 2-3% of children, is characterized by problems with attention, hyperactivity and impulsivity. Sleep disturbance mainly occurs in approximately around 70% of children diagnosed with ADHD.1 In an individual one suffering through ADHD, sleep disturbances that results in sleep fragmentation or sleep restriction can lead to daytime sleepiness, breathing problems during sleep, interference with mood, attention, physical health and behavior. However, although sleep problems are very common in individuals with ADHD, Co-morbid psychiatric problems are very frequent and are left untreated. In addition children suffering from ADHD are more likely to have increased risk of restless leg syndrome (RLR), obstructive sleep apnea (OSP), and disrupted sleep.3

There may be a number of reasons why children suffering from ADHD have problems with sleep: use of stimulant medications, lack of sleep routine, circadian rhythm disturbance and poor sleeping habits. Often it becomes difficult to resolve the real problem, i.e. the sleep problem exacerbating the ADHD behaviors or the ADHD causing the sleep problem? 4

Therefore, an evaluation of a child suffering from ADHD and sleep disturbance should be assessed when the child goes to bed has difficulty staying asleep, seems restless during sleep, or has increased daytime sleepiness or irritability and whether the child snores. The use of sleep diary, BEARS((B=Bedtime Issues, E=Excessive Daytime Sleepiness, A=Night Awakenings, R=Regularity and Duration of Sleep, S=Snoring) tool or Children Sleep Habits Questionnaire (CSHQ), this may be a useful tool for screening for environmental or behavioral influences as well as primary sleep disorders.2 The caregiver should assess for evaluation for comorbid disorders that might be contributing such as oppositional defiant disorder, substance abuse or depression as these children tend to exacerbate sleep disturbances, appropriate discipline measures used in the home and evaluate the child’s sleep schedule. In the end the physician should also monitor the use of ADHD stimulant medications, the dose and the dosage. Individuals suffering from ADHD should be educated on healthy sleep habits and treat comorbid conditions and routines and behavior with appropriate therapies. Only after these issues are addressed accordingly the medication for ADHD should be adjusted. Additionally for improving routines and sleep habits, for children with circadian rhythm delay or sleep-onset insomnia, melatonin may be added at 3-6 mg around 30 minutes before bedtime and 2-10 mg/day maximum.5

Children suffering from ADHD and sleep disturbances may be benefited from an adjustment in their medication regimens. Each regimen should be adjusted to the timing of administration, individualized, typically, a decrease in the total daily dose of the medication or changes in the formulation may be sufficient to improve sleep, also a non-stimulant medication or shorter-acting stimulants may be an alternative choice to treat ADHD.

References:

  1. Gruber R. Sleep characteristics of children and adolescents with attention deficit-hyperactivity disorder. Child and Adolescent Psychiatric Clinics. 2009 Oct 1;18(4):863-76.
  1. Kieling R, Rohde LA. ADHD in children and adults: diagnosis and prognosis. Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. 2010:1-6.
  2. Feldman HM, Reiff MI. Attention deficit–hyperactivity disorder in children and adolescents. New England Journal of Medicine. 2014 Feb 27;370(9):838-46.
  1. Felt BT, Biermann B, Christner JG, Kochhar P, Van Harrison R. Diagnosis and management of ADHD in children. American Family Physician. 2014 Oct 1;90(7):456-64.
  1. Tsai MH, Hsu JF, Huang YS. Sleep problems in children with attention deficit/hyperactivity disorder: current status of knowledge and appropriate management. Current psychiatry reports. 2016 Aug;18(8):1-9.

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The Rise of Nutraceutical Products in India

In recent years, there has been a rise in the usage of nutraceutical products in India. Nutraceuticals are defined as foods or food components that offer health and medical benefits, including the prevention and treatment of disease. This trend is being driven by several factors, including an increase in awareness about the importance of good nutrition, the growing prevalence of chronic diseases, and the changing demographics of the country. There are several reasons for the popularity of nutraceuticals in India. First, they are seen as a more natural way to improve one’s health. Second, they are generally considered to be safe and free of side effects. Finally, nutraceuticals are seen as a way to promote overall wellness, rather than just treating specific diseases. The following blog post will explore the rise of nutraceutical products in India and the factors driving this trend.

What are nutraceutical products?

When it comes to the Best nutraceutical products, there are a lot of different options available on the market. However, not all of these products are created equal. There are many other factors that need to be considered when choosing a nutraceutical product, such as the quality of the ingredients, the manufacturing process, and the company that makes the product.
The term “nutraceutical” is used to describe any food or food product that provides health benefits beyond the traditional nutrients found in foods. Nutraceuticals can come in many different forms, such as capsules, tablets, powders, bars, or liquids. They can also be derived from natural sources or synthetic sources. There are many different reasons why people take nutraceuticals. Some people take them to improve their overall health, while others take them to treat specific conditions or diseases.

Nutritional supplements can also be used to increase energy levels, improve mental clarity, and reduce stress levels.
When choosing a nutraceutical product, it is important to research and ensure that the product is of good quality & from a reputable company. There are many scams out there and not all products are created equal. Be sure to read the label carefully and choose a product that contains only high-quality ingredients.

The market for nutraceuticals in India

In India, the nutraceutical market is expected to grow at a compound annual growth rate (CAGR) of 20.8% from 2016 to 2021, according to a report by Markets and Markets. The nutraceutical market was valued at INR 94.6 billion in 2016 and is projected to reach INR 176.4 billion by 2021. The growing health consciousness among Indian consumers is the key driver for the nutraceutical market growth in India. Increasing incidence of lifestyle diseases, such as obesity, diabetes, and cardiovascular diseases, is also fuelling the demand for nutraceutical products in India. In addition, the rising disposable incomes and changing food habits are driving the growth of the nutraceuticals market in India.
However, the high cost of these products and lack of awareness about their benefits are some of the major challenges faced by the nutraceutical industry in India.

The benefits of nutraceuticals

There are numerous benefits of nutraceuticals, which is why they are becoming increasingly popular in India. Nutraceuticals are food products that offer health and medical benefits, including the prevention and treatment of disease.

Some of the most common benefits of nutraceuticals include:

  • Improved overall health: Nutraceuticals can help improve your overall health by providing essential vitamins, minerals, and other nutrients that your body needs to function properly
  • Enhanced cognitive function: Many nutraceuticals contain ingredients that can help improve cognitive functions, including memory and concentration.
  • Increased energy levels: The nutrients in nutraceuticals can help increase energy levels, allowing for an active lifestyle and being productive throughout the day.
  • Better digestion: Digestive problems are a common issue in India, but nutraceuticals can help improve digestion and promote regularity.
  • Stronger immune system: Nutrients like vitamin C and zinc found in nutraceuticals can help boost your immune system, making you less likely to get sick.
  • Healthier skin: The antioxidants in nutraceuticals can help protect your skin from damage caused by free radicals, resulting in healthier, younger-looking skin

How to choose the right nutraceutical product

When it comes to choosing the right nutraceutical product, there are a few things that need to be kept in mind. First and foremost, the product needs to be backed by science.. There are a lot of products on the market that claim to be effective, but don’t have any scientific evidence to back up their claims. Secondly, the product needs to be safe. There are a lot of products on the market that contain ingredients that may be harmful to health. So, it’s important that a proper research is done and only products made with safe ingredients are chosen. Finally, the product needs to be effective. There’s no point in taking a product if it’s not going to deliver results. So, it is imperative to read reviews & discuss with consumers who have already used the products before the purchase decision is made.

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