Get pillow smart

Thursday, 25 l 03 l 2010 ; Source: Mind Your Body, The StraitsTimes
By Stacey Chia

Investing in the right one can mean the difference between a good night’s sleep and waking up with neck ache. STACEY CHIA reports

Like most people, you probably spend about a third of your time in bed, so investing in the right pillow can be an asset to your health.

The right pillow can help you acquire better sleep and at the same time lower your risk of neck pain and headaches, said Dr Charles Siow, a consultant neurologist and pain specialist at Siow Neurology Headache and Pain Centre.

These aches and pains usually result from a lack of head and neck support from your pillow.

Dr Kenny Pang, the director of Pacific Sleep Centre, explained that the human neck curves slightly forward to take the weight of the head when upright and it is important that this curve is maintained while at rest.

Pillows help ensure that your head is kept in a neutral alignment.

This means that your head should not lean too far forward or backwards.

When buying a pillow, it is important to take into account your sleeping position, said Ms Karen Koh, a senior principal physiotherapist at the Singapore General Hospital (SGH).If you tend to sleep on your back, your pillow should be kept low so that your head and neck is fairly aligned with your body.

If you sleep on your side, you will need a higher pillow. Ms Koh said a higher pillow would be more suitable in maintaining the alignment as it fills the space between your head and the mattress.

Dr Kevin Lau, a chiropractor at Orchard Clinic, advised against sleeping on your stomach as it causes a strain on your back by exaggerating the arch at the base of your spine.

If you are particular about the type of pillow stuffing, Dr Lau recommends buying a memory foam pillow.

Such a pillow is said to reduce pressure points by moulding and adjusting itself as you move throughout the night, thus ensuring that your neck is always supported.

It is, however, not a necessity, he said.

Dr Lim Li Ning, the medical director of the Sleep Neurology and Sleep Centre agreed, adding that there is no good scientific evidence to support the use of one type of pillow over another.

“Most people can sleep on any type of pillow depending on their preference and no special stuffing is needed,” said Dr Lim.

Dr Lau said that pillows to avoid are those stuffed with feathers as they tend to lose firmness over time and become too flat to provide sufficient support.

Dr Pang said: “A large part of what makes a good pillow is personal preference. If the pillow feels comfortable, it is likely to help one become relaxed and thus get a good night’s sleep.”

Thursday, 25 l 03 l 2010 ; Source: Mind Your Body, The StraitsTimes
By Stacey Chia

Investing in the right one can mean the difference between a good night’s sleep and waking up with neck ache. STACEY CHIA reports

Like most people, you probably spend about a third of your time in bed, so investing in the right pillow can be an asset to your health.

The right pillow can help you acquire better sleep and at the same time lower your risk of neck pain and headaches, said Dr Charles Siow, a consultant neurologist and pain specialist at Siow Neurology Headache and Pain Centre.

These aches and pains usually result from a lack of head and neck support from your pillow.

Dr Kenny Pang, the director of Pacific Sleep Centre, explained that the human neck curves slightly forward to take the weight of the head when upright and it is important that this curve is maintained while at rest.

Pillows help ensure that your head is kept in a neutral alignment.

This means that your head should not lean too far forward or backwards.

When buying a pillow, it is important to take into account your sleeping position, said Ms Karen Koh, a senior principal physiotherapist at the Singapore General Hospital (SGH).If you tend to sleep on your back, your pillow should be kept low so that your head and neck is fairly aligned with your body.

If you sleep on your side, you will need a higher pillow. Ms Koh said a higher pillow would be more suitable in maintaining the alignment as it fills the space between your head and the mattress.

Dr Kevin Lau, a chiropractor at Orchard Clinic, advised against sleeping on your stomach as it causes a strain on your back by exaggerating the arch at the base of your spine.

If you are particular about the type of pillow stuffing, Dr Lau recommends buying a memory foam pillow.

Such a pillow is said to reduce pressure points by moulding and adjusting itself as you move throughout the night, thus ensuring that your neck is always supported.

It is, however, not a necessity, he said.

Dr Lim Li Ning, the medical director of the Sleep Neurology and Sleep Centre agreed, adding that there is no good scientific evidence to support the use of one type of pillow over another.

“Most people can sleep on any type of pillow depending on their preference and no special stuffing is needed,” said Dr Lim.

Dr Lau said that pillows to avoid are those stuffed with feathers as they tend to lose firmness over time and become too flat to provide sufficient support.

Dr Pang said: “A large part of what makes a good pillow is personal preference. If the pillow feels comfortable, it is likely to help one become relaxed and thus get a good night’s sleep.”

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Collars and Microchips for Cats

Lord LK, Griffin B, Slater MR et al: Evaluation of collars and microchips for visual and permanent identification of pet cats, J Am Vet Med Assoc 237:387, 2010.

The objective of this study was to determine the percentage of pet cats still wearing collars and having a functioning microchip six months after application. In prior studies, only 14% of cats were wearing any form of visual identification such as a collar or tag at the time they were lost and only 7% had a microchip. Less than 2% of cats entering a shelter with unknown owner status were reunited with their owners. The primary reasons owners give for not providing a form of identification for their cats are because the cats are kept exclusively indoors, their cats did not get lost, and a belief that their cats won’t tolerate a collar or will be hurt by collars or that microchips are too expensive. Most cats successfully wore their collars (approximately 75%). The plastic buckle collars stayed on better than the plastic breakaway buckle form or elastic stretch plastic collars. However, it was noted that owner willingness to replace a collar repeatedly if it did come off and owner expectations for success were more important than collar types. The results also found that many owners do not think to put a collar on their cat though are willing to do so once educated. Each cat in the study was also microchipped and of the 478 microchips scanned at the conclusion of the study, only one was found to be non-functioning. Microchips are considered a good backup, long-term identification system following the use of a visual form of identification. Since one earlier study showed that 40% of all cats lost were considered to be exclusively indoors, veterinarians should recommend some form of identification to cat owners. [VT]

Related articles:
Lord LK, Ingwersen W, Gray JL et al: Characterization of animals with microchips entering animal shelters, J Am Vet Med Assoc 235:160, 2009.

More on cat health: Winn Feline Foundation Library
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Lord LK, Griffin B, Slater MR et al: Evaluation of collars and microchips for visual and permanent identification of pet cats, J Am Vet Med Assoc 237:387, 2010.

The objective of this study was to determine the percentage of pet cats still wearing collars and having a functioning microchip six months after application. In prior studies, only 14% of cats were wearing any form of visual identification such as a collar or tag at the time they were lost and only 7% had a microchip. Less than 2% of cats entering a shelter with unknown owner status were reunited with their owners. The primary reasons owners give for not providing a form of identification for their cats are because the cats are kept exclusively indoors, their cats did not get lost, and a belief that their cats won’t tolerate a collar or will be hurt by collars or that microchips are too expensive. Most cats successfully wore their collars (approximately 75%). The plastic buckle collars stayed on better than the plastic breakaway buckle form or elastic stretch plastic collars. However, it was noted that owner willingness to replace a collar repeatedly if it did come off and owner expectations for success were more important than collar types. The results also found that many owners do not think to put a collar on their cat though are willing to do so once educated. Each cat in the study was also microchipped and of the 478 microchips scanned at the conclusion of the study, only one was found to be non-functioning. Microchips are considered a good backup, long-term identification system following the use of a visual form of identification. Since one earlier study showed that 40% of all cats lost were considered to be exclusively indoors, veterinarians should recommend some form of identification to cat owners. [VT]

Related articles:
Lord LK, Ingwersen W, Gray JL et al: Characterization of animals with microchips entering animal shelters, J Am Vet Med Assoc 235:160, 2009.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

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Alternate Medication Formulations for Cats

Traas AM, Fleck T, Ellings A et al: Ease of oral administration and owner-perceived acceptability of triglyceride oil, dissolving thin film strip, and gelatin capsule formulations to healthy cats, Am J Vet Res 71:610, 2010.

Giving oral medications can be a challenge for many cat owners and compliance by owners can be a concern for veterinarians when treatment is required using such medications. This study compared owner-assessed ease of administration and overall acceptability by cats to three chemically inactive (i.e., no drug) formulations administered orally. Ninety healthy client-owned cats were randomly assigned to receive one of three formulations by mouth once daily for 14 days. The formulations were a medium chain triglyceride (MCT) oil (at 0.1 ml/kg), thin film strips (single strip applied to the outer gingival surface), and gelatin capsules (using a pill-administration device). The thin film strip formulation has been developed for human use and has not been evaluated for use in cats. The MCT oil and dissolving thin film strip formulations were rated subjectively on a daily basis by owners as easier to administer and more acceptable to cats than was the gelatin capsule formulation in this study of healthy tractable cats. This information should be considered in the future when prescribing treatments or formulating new medications for cats. [VT]

Related articles:
Lecuyer M, Prini S, Dunn ME et al: Clinical efficacy and safety of transdermal methimazole in the treatment of feline hyperthyroidism, Canadian Veterinary Journal 47:131, 2006.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Traas AM, Fleck T, Ellings A et al: Ease of oral administration and owner-perceived acceptability of triglyceride oil, dissolving thin film strip, and gelatin capsule formulations to healthy cats, Am J Vet Res 71:610, 2010.

Giving oral medications can be a challenge for many cat owners and compliance by owners can be a concern for veterinarians when treatment is required using such medications. This study compared owner-assessed ease of administration and overall acceptability by cats to three chemically inactive (i.e., no drug) formulations administered orally. Ninety healthy client-owned cats were randomly assigned to receive one of three formulations by mouth once daily for 14 days. The formulations were a medium chain triglyceride (MCT) oil (at 0.1 ml/kg), thin film strips (single strip applied to the outer gingival surface), and gelatin capsules (using a pill-administration device). The thin film strip formulation has been developed for human use and has not been evaluated for use in cats. The MCT oil and dissolving thin film strip formulations were rated subjectively on a daily basis by owners as easier to administer and more acceptable to cats than was the gelatin capsule formulation in this study of healthy tractable cats. This information should be considered in the future when prescribing treatments or formulating new medications for cats. [VT]

Related articles:
Lecuyer M, Prini S, Dunn ME et al: Clinical efficacy and safety of transdermal methimazole in the treatment of feline hyperthyroidism, Canadian Veterinary Journal 47:131, 2006.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

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When is a Placebo Not Really a Placebo? Maybe More Often Than You Think

By Katherine Hobson

When you read in a study that a drug performed better or worse than a placebo, you probably don’t give much thought to whether the ingredients of the placebo had anything to do with the results.

Beatrice Golomb, an associate professor of medicine at the University of California, San Diego, School of Medicine, was researching cholesterol when she came across some older drug studies that actually said what was in the dummy pills — corn oil and olive oil, which of course we know now may have their own cholesterol-fighting properties. Study researchers noticed that the mortality rate in the control group was unexpectedly low, and that the drug being studied showed no improvement over the placebo, but they didn’t connect the dots and hypothesize that the placebo might actually have been helping.

“We hear the word ‘placebo’ and think ‘inert,’” even though there no known substances that are completely physiologically inert, Golomb tells the Health Blog. Even “filler” ingredients that pass through the body without being absorbed can have effects, say, by also preventing other things from being absorbed, she says.

Substances in placebos can also bias findings in favor of the drug being studied, she says, pointing to a study of a drug aimed at helping cancer patients keep weight on. The placebo included lactose, and cancer patients are prone to lactose intolerance, leading to increased GI symptoms in the control group. That may have made the drug look better than it was, she says.

There are no regulations on what goes into placebos, and very few studies actually report the composition of dummy pills or capsules: just 8.2% of the two years’ worth of studies published in four major medical journals that Golomb and colleagues combed through. The results of their research appear in Annals of Internal Medicine. For all placebos, including injections and other treatments, the disclosure rate was 26.7%.

“There’s a lot of attention paid to making them look and taste similar, but there’s very little attention paid to the actual ingredients,” she says. The placebo and nocebo effects (the latter is when a study subject reports ill effects from a supposedly inert dummy pill) get chalked up to patient suggestibility rather than possible physiological effects, she says.

Given that there’s no perfectly inert placebo, Golomb and her co-authors suggest that disclosure is key and call for major journals to lead the way by instituting a reporting requirement. “We can just accept that among the range of things that are never perfect in a clinical trial, placebos are seldom perfect,” she says.

Clarification: Golomb is an associate professor of medicine in the division of general internal medicine at UCSD School of Medicine. A previous version of this post referred imprecisely to her title.

By Katherine Hobson

When you read in a study that a drug performed better or worse than a placebo, you probably don’t give much thought to whether the ingredients of the placebo had anything to do with the results.

Beatrice Golomb, an associate professor of medicine at the University of California, San Diego, School of Medicine, was researching cholesterol when she came across some older drug studies that actually said what was in the dummy pills — corn oil and olive oil, which of course we know now may have their own cholesterol-fighting properties. Study researchers noticed that the mortality rate in the control group was unexpectedly low, and that the drug being studied showed no improvement over the placebo, but they didn’t connect the dots and hypothesize that the placebo might actually have been helping.

“We hear the word ‘placebo’ and think ‘inert,’” even though there no known substances that are completely physiologically inert, Golomb tells the Health Blog. Even “filler” ingredients that pass through the body without being absorbed can have effects, say, by also preventing other things from being absorbed, she says.

Substances in placebos can also bias findings in favor of the drug being studied, she says, pointing to a study of a drug aimed at helping cancer patients keep weight on. The placebo included lactose, and cancer patients are prone to lactose intolerance, leading to increased GI symptoms in the control group. That may have made the drug look better than it was, she says.

There are no regulations on what goes into placebos, and very few studies actually report the composition of dummy pills or capsules: just 8.2% of the two years’ worth of studies published in four major medical journals that Golomb and colleagues combed through. The results of their research appear in Annals of Internal Medicine. For all placebos, including injections and other treatments, the disclosure rate was 26.7%.

“There’s a lot of attention paid to making them look and taste similar, but there’s very little attention paid to the actual ingredients,” she says. The placebo and nocebo effects (the latter is when a study subject reports ill effects from a supposedly inert dummy pill) get chalked up to patient suggestibility rather than possible physiological effects, she says.

Given that there’s no perfectly inert placebo, Golomb and her co-authors suggest that disclosure is key and call for major journals to lead the way by instituting a reporting requirement. “We can just accept that among the range of things that are never perfect in a clinical trial, placebos are seldom perfect,” she says.

Clarification: Golomb is an associate professor of medicine in the division of general internal medicine at UCSD School of Medicine. A previous version of this post referred imprecisely to her title.

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