benzodiazepine

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What are HDL and LDL?

HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:

• HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
• LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.

How do I know what my HDL level is?

A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What should my HDL level be?

With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

GroupHealthy HDL LevelAge 19 or youngerMore than 45mg/dlMen age 20 or olderMore than 40mg/dlWomen age 20 or olderMore than 50mg/dlHow can I raise my HDL level?

If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:

• Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
• Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
• Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
• Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
• Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.

Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.

What else can affect my HDL level?

Taking certain medicines can lower HDL levels in some people. They include:

• Beta blockers, a type of blood pressure medicine
• Anabolic steroids, including testosterone, a male hormone
• Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
• Benzodiazepines, sedatives that are often used for anxiety and insomnia

If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.

Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

What are the side effects and risks of opioids?

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

• Very small pupils of the eyes
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Vomiting
• Limp body
• Pale, blue, or cold skin
• Faint heartbeat
• Purple lips and fingernails

When using opioids, there is also a risk of opioid use disorder (OUD).

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

How are opioid use disorder (OUD) and opioid overdose treated?

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

How can I prevent problems when taking prescription opioids?

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse

What is prescription drug misuse?

If you take a medicine in a different way than your health care provider prescribed, it's called prescription drug misuse. It could be:

• Taking medicine prescribed for someone else.
• Taking a larger dose than you are supposed to.
• Taking the medicine in a different way than you are supposed to. For example, instead of swallowing your tablets, you might crush them and then snort or inject them.
• Using the medicine for another purpose, such as getting high.

Misusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants. Drug addiction is a chronic brain disease. It causes a person to take drugs repeatedly despite the harm they cause.

Who is at risk for prescription drug misuse?

Prescription drug misuse can affect anyone at any age, including teenagers and older adults. It can happen if you need certain medicines to treat a medical condition, reduce pain after an injury or surgery, or for chronic pain.

Risk factors can include:

• A lack of knowledge about the prescription drug and possible risks
• A previous addiction to other substances, including alcohol and tobacco
• Certain mental health conditions

What are the risks of prescription drug misuse?

Prescription drug misuse can have serious medical consequences. Every medicine has some risk of side effects, which providers think about when prescribing medicines. People who misuse these drugs may not know the risks. Some medicines may not be safe for them, especially at higher doses or when taken with other medicines.

What are treatments for prescription drug misuse?

Treatment for prescription drug misuse often includes medicines and counseling, but it depends on the type of drug and your needs.

The counseling may be individual, family, and/or group therapy. It can help you:

• Understand why prescription drug misuse began
• Learn how to change unhealthy patterns of thinking and behavior
• Manage personal problems and develop positive relationships
• Learn how to manage cravings and avoid situations that could lead to a relapse

Stopping or cutting back on prescription drugs used for a while, may cause different symptoms for different drugs. This is called withdrawal. Your provider will work with you to manage the symptoms as your body gets used to being taken off the medicine.

How can I prevent problems with taking prescription drugs?

Providers and pharmacists play a role in preventing or reducing prescription drug misuse, but you can also take steps to reduce your risk.

A few ways to help reduce your risk and make sure that you are using any prescription medicines correctly include:

• Talk to your provider about any other prescription medicines, over-the-counter-medicines, and supplements that you're taking to see if it is safe to take the prescription drug with them.
• Follow the directions carefully and take medicine as prescribed. If you're taking prescription drugs for pain and it isn't working, don't stop or change the amount you're taking without talking to your provider.
• If your provider prescribes opioids, ask about the risks and benefits of taking the medicine, and if another medicine with less risk of addiction could be used.

NIH: National Institute on Drug Abuse

What is sleep?

While you are sleeping your brain and body functions are still active. Sleep is a natural process that helps your body restore energy, supports learning and memory, and keeps you healthy.

It's not just the number of hours of sleep you get that matters. The quality of your sleep is also important. During the night, your brain cycles through different stages of non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. If your sleep is often interrupted, you may not get enough time in certain stages of sleep. Poor-quality sleep does more than make you feel tired. It can affect your physical and mental health, thinking, and daily functioning.

What are sleep disorders?

Sleep disorders are conditions that disturb your normal sleep patterns. There are many types of sleep disorders. Some general types include:

• Insomnia, which is trouble falling asleep or staying asleep.
• Sleep-related breathing disorders such as sleep apnea, a condition in which you stop breathing for 10 seconds or more during sleep.
• Sleep-related movement disorders such as restless leg syndrome (RLS), which involves tingling or prickling sensations in your legs, and a strong urge to move them.
• Hypersomnia, which is extreme daytime sleepiness. This includes narcolepsy.
• Circadian rhythm sleep-wake disorders, which are problems falling asleep or waking up at the right times. This may be due to shift work or jet lag.
• Parasomnia, which is unusual behaviors during sleep or while falling asleep or waking up. This may include sleepwalking, talking, or eating during sleep.

Some people who feel tired during the day have a true sleep disorder, while others simply don't get enough sleep. The amount of sleep you need depends on your age, lifestyle, health, and sleep patterns. Most adults need about 7-9 hours each night.

What causes sleep disorders?

There are different causes for different sleep disorders. They may include:

• Other health conditions, such as heart disease, lung disease, nerve disorders, or pain
• Mental illnesses, including depression and anxiety
• Medicines
• Genetics

Sometimes the cause is unknown.

Other factors that may contribute to sleep problems include:

• Using caffeine or alcohol
• Having an irregular schedule, such as working the night shift
• Aging, since older adults may sleep less, spend less time in deep sleep, and wake easily

What are the symptoms of sleep disorders?

The symptoms of sleep disorders depend on the specific disorder. Some signs that you may have a sleep disorder include that:

• You regularly take more than 30 minutes to fall asleep.
• You regularly wake up several times and then have trouble falling back to sleep, or you wake up too early in the morning.
• You often feel sleepy during the day, take frequent naps, or fall asleep at the wrong times during the day.
• Your bed partner says that when you sleep, you snore loudly, snort, gasp, make choking sounds, or stop breathing for short periods.
• You have creeping or tingling sensations in your legs or arms that are relieved by moving or massaging them, especially in the evening and when trying to fall asleep.
• Your bed partner notices that your legs or arms jerk often during sleep.
• You have vivid, dreamlike experiences while falling asleep or dozing.
• You have episodes of sudden muscle weakness triggered by strong emotions.
• You feel as though you cannot move or speak for a brief time when you first wake up.

How are sleep disorders diagnosed?

To diagnose a sleep disorder, your health care provider will review your medical and sleep history and do a physical exam. You may also have a sleep study (polysomnogram). Most sleep studies monitor and record data about your body during a full night of sleep. The data includes:

• Brain wave activity
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate and electrical activity in the heart and other muscles

Other types of sleep studies may check how quickly you fall asleep during daytime naps or how well you can stay awake during the day.

What are the treatments for sleep disorders?

Treatments for sleep disorders depend on which disorder you have. They may include:

• Practicing good sleep habits and other lifestyle changes, such as eating a healthy diet and getting regular exercise
• Reducing anxiety about sleep with cognitive behavioral therapy or relaxation techniques
• Using a CPAP (continuous positive airway pressure) machine for sleep apnea
• Using bright light therapy (in the morning)
• Taking sleep aid medicines, or natural products such as melatonin

Always check with your provider before taking any medicine or supplement. Most sleep aid medicines are generally for short-term use.