Links Between Excessive Daytime Sleepiness and Falls in the Elderly

Based in Fayetteville, Georgia, Ginari G. Price, MD, is a longtime psychiatrist who maintains the practice Psycare, LLC. A member of the American Association of Sleep Medicine, Dr. Ginari G. Price has presented on the subject of Narcolepsy in the Elderly. 

A condition involving excessive sleepiness during the daytime, narcolepsy often begins in adults in their 40s and above and includes symptoms such as sudden loss of muscle tone and control while awake (cataplexy), sudden inability to move or speak while falling asleep or waking up (sleep paralysis), vivid dreams while falling asleep or waking up (hallucinations), difficulty staying asleep at night, extreme exhaustion, and depression.

A recent BMC Geriatrics study evaluated the links between sleepiness, fall risk, and falls among more than 750 men and women from the ages of 60 to 93. The Epworth Sleepiness Scale was used in assessing sleepiness and identifying patients with excessive daytime sleepiness (EDS). At the same time, participants self-reported previous falls and the predictive Elderly Fall Screening Test was utilized. 

A key finding was that women with EDS also had a higher risk of falling, particularly in outdoor situations (though men showed similar tendencies, they were ultimately attributed to aging). The findings reinforced the idea that early diagnosis and care for EDS could have a positive effect in boosting the physical wellbeing of elderly persons.

In the scope of her Sleep Medicine Practice, Dr. Ginari Price, also treats conditions such as sleep apnea, periodic leg movements, restless leg syndrome, insomnia, and REM sleep behavior disorder. 

Treating Opioid Dependence

Ginari Gibb Price is a psychiatrist who lives and works in Atlanta, Georgia, where she specializes in Child, Adolescent, and Adult Psychiatry. She attended Meharry Medical College in Nashville, Tennessee, and has completed a general psychiatry residency and two fellowship programs.

Her areas of expertise include autism, developmental disorders, sleep medicine, substance dependence, depression, trauma, anxiety disorders, psychosis, and neurodegenerative disorders such as dementia. “I am one of the few physicians in my area trained and certified to prescribe Suboxone for opiate detoxification and addiction,” she says.

Suboxone, says Ginari Gibb Price, is a highly effective treatment of opioid dependence. Opioids are medications used to treat pain, but that can be highly addictive if not used properly. Medications that are classified as opioids include morphine and hydrocodone, also known as Vicodin.

As Ginari Gibb Price knows, this class of drugs can be very dangerous when used recreationally. She says that by treating a patient who has become dependent on opioids with Suboxone, the effects of withdrawal symptoms and cravings can be reduced, thereby helping the patient begin to recover from the dependence. But it must be carefully prescribed and managed, because Suboxone itself can be addictive, and patients may feel withdrawal symptoms as they come off of it.

Opioid dependence is a complex condition, says Ginari Gibb Price, and recovery involves more than just the physical symptoms of craving and withdrawal. Counseling is an equally important part of the recovery process, and ideally goes to the root causes of the use and misuse of opioids. Even after kicking their habits, former addicts are at risk for relapse from numerous psychological and social factors. But with a personal commitment and with the kind of help she can provide, many addicts stand an excellent chance of recovery.

Teenagers Need More Sleep

Double board certified Dr. Ginari G. Price has been practicing medicine for over 10 years. Currently serving as the medical director at Psycare, LLC, in Fayetteville, Georgia, Dr. Ginari G. Price has also completed a fellowship in sleep medicine. According to the American Academy of Sleep Medicine, most 13-18-year olds do not sleep enough each night.

Recent studies conducted by the Centers for Disease Control show that up to 69 percent of teenagers do not sleep the recommended 8-10 hours per night. The lack of sleep not only hinders a teen’s ability to learn, but can also increase mood problems and patterns of bad decision-making.

Sleep is an important ingredient in promoting a teenager’s overall good health. In order to help teenagers receive the recommended amount of sleep, parents can set good examples and work to optimize good sleep habits.

First, a regular and consistent routine helps establish a teenager’s natural sleep rhythms. Additionally, parents can help their teen wake up more fully by exposing them to sunlight first thing in the morning. Finally, ridding a bedroom of electronic devices such as televisions, phones, and computers can help a teen rest more fully by eliminating the temptation to stay up late communicating with peers.

Since most junior and senior high schools begin classes at a very early hour, many parents have petitioned their school boards to delay school start times in an effort to help teens get the rest they need. These efforts have met varying results across the country. Currently, only 14 percent of schools begin at 8:30 or later.

AMA Backs ONC's Expanded Oversight of Electronic Health Records

Since 2008, experienced psychiatrist Dr. Ginari G. Price has served as the medical director of Psycare, LLC in Fayetteville, Georgia. In conjunction with her career, Dr. Ginari G. Price belongs to various medical organizations as part of her ongoing professional development. One such organization is the American Medical Association.

The American Medical Association (AMA) recently announced its support of more rigorous monitoring and testing standards released by the Office of the National Coordinator (ONC) regarding oversight of electronic health records. The AMA also says it will provide support for the ONC’s framework.

Under the new rules, the ONC has an increased ability to analyze and remedy problems with electronic health records. They will also assess these records to ensure they adhere to certification standards. In cases where electronic health records are not in compliance, the ONC can require vendors to draft and follow plans to correct the issues. 

Health record compliance is one of the key issues that the ONC has brought to the attention of the Obama Administration, and the AMA has gone on record supporting this effort.
By taking a greater role in ensuring electronic health record compliance, the ONC provides physician support by relaying appropriate information regarding the health of their IT programs.

The Roots of Soul Food

Board certified in general psychiatry and child and adolescent psychiatry, Dr. Ginari G. Price has over 10 years of experience practicing medicine. In addition to managing a demanding schedule at Psycare, LLC, in Fayetteville, Georgia, Dr. Ginari G. Price enjoys cooking, especially soul food recipes.

At the height of the civil rights movement in the 1960s, “soul food” became popular across the nation. Soul food consists of traditional recipes that have been prepared within the African-American community for hundreds of years. Although the name is relatively new, the food has stood the test of time.

Soul food traditionally consists of basic, inexpensive, locally sourced ingredients that were accessible to the newly freed African Americans after the abolition of slavery. Ingredients that are commonly used in soul food include lard (rendered pork fat), cornmeal, and a wide variety of cuts of pork. Some popular soul food dishes include black-eyed peas, stewed greens, friend chicken, hushpuppies, and cornbread.

More recently, soul food has taken a turn, reflecting the health-conscious trends of the day. “Down Home Healthy” soul food uses lighter ingredients such as margarine instead of lard, turkey instead of pork, and sugar substitutes. Down home recipes return to the vegetarian roots of traditional soul food recipes.

Depression and Insomnia in Adolescents

Dr. Ginari G. Price leverages more than a decade of clinical experience to serve as medical director of Psycare, a psychiatric treatment agency in Fayetteville, Georgia. Dr. Ginari G. Price also completed a fellowship in sleep medicine, a field which she has researched extensively.

The link between depression and insomnia is broadly documented across multiple populations. For instance, clinical evidence shows that those diagnosed with insomnia are 10 times more likely to develop depression than those who experience regular sleep, while those with depression are prone to develop sleep disturbances. 

For teenagers with insomnia, this dual diagnosis presents both mental and physical health risks. Recent studies reveal that children with co-morbid sleep disorders have more severe and longer-term depression symptoms, as well as a risk of impaired movement, weight loss, and the inability to experience feelings of pleasure.

Co-morbid depression and anxiety may also lead to increased risk-taking behaviors, such as substance abuse. Fortunately, clinical data also reveals that early treatment of insomnia can reduce depression risk by as much as 47 percent. Such treatment often involves the implementation of good sleep hygiene practices, which include eliminating screen time before bed and establishing a regular bedtime routine. However, because of the potential severity of adolescent insomnia and its side effects, experts recommend professional assessment for teenagers who show signs of sleep disturbances.

Sleep and the Circadian Rhythm

The medical director of Psycare, LLC, in Fayetteville, Georgia, psychiatrist Dr. Ginari G. Price is double board certified in general psychiatry and child and adolescent psychiatry. A member of the American Academy of Sleep Medicine, Dr. Ginari G. Price is eligible to take the sleep medicine board examination. 

Physicians working in the field of sleep medicine are educated in a wide variety of related topics, including sleep issues such as parasomnias (sleepwalking) and insomnia, sleep-related breathing and movement, and circadian rhythms.

A circadian rhythm is a natural 24-hour cycle present in all living beings, from plants and fungi to humans and animals. A person’s circadian rhythm dictates when he or she wants or requires sleep and nourishment.

The circadian rhythm is largely an endogenic process, which means it is controlled by forces within the body. However, the human biological clock that controls the circadian rhythm does not span an exact 24 hours. Rather, estimates place the actual time between 24.2 and 25.5 hours. Because of this, outside variables such as patterns of daylight and darkness also affect one’s circadian rhythm. 

Circadian rhythms are responsible for more than just determining when a person needs sleep and food. They also play a role in hormone release and body temperature, and abnormal rhythms can even affect weight gain and emotional health.