Medical News Today: A waking nightmare: The enigma of sleep paralysis

You wake up in the middle of the night, convinced that an evil figure is lying in wait. You attempt to move, but your body just will not budge. You try to scream, but nothing comes out. The monster draws closer. It may sound like a horror movie scene, but this is the real deal — you’re experiencing sleep paralysis.
terrified woman in bed
Sleep paralysis is like a waking nightmare, and the underlying causes for this condition remain unclear.

This terrifying and mysterious sleep disorder, or parasomnia, has been experienced by people possibly since the dawn of humankind.

And, it may have given rise to numerous ghost stories and mysterious accounts involving “things that go bump in the night.”

This most unsettling experience was first clearly documented in a medical treatise in the 17th century, by Dutch physician Isbrand Van Diembroeck, who wrote about the case of a woman “50 years of age, in good plight [health], strong,” yet who complained of mysterious experiences at night.

“[W]hen she was composing her self to sleep,” explains Van Diembroeck, “sometimes she believed the devil lay upon her and held her down, sometimes that she was [choked] by a great dog or thief lying upon her breast, so that she could hardly speak or [breathe], and when she endeavored to throw off the [burden], she was not able to stir her members.”

What the woman in Van Dimbroeck’s account likely experienced was a condition that has come to be known as “sleep paralysis.”

Researchers define it as “a common, generally benign, parasomnia characterized by brief episodes of inability to move or speak combined with waking consciousness.”

Sleep paralysis and hallucinations

The reason why sleep paralysis is so scary is not just because you will suddenly become alert but realize that you are, in fact, unable to move a muscle or utter a sound, but also because this experience is often — as in the case above — accompanied by terrifying hallucinations.

These, as specialized literature has now ascertained, typically fall into three distinct categories:

  1. a sensed presence, or intruder hallucinations, in which the person feels the presence of an evil, threatening individual
  2. incubus hallucinations, in which the person might feel someone or something pressing down uncomfortably, even painfully, on their chest or abdomen, or trying to choke them
  3. vestibular-motor hallucinations, during which the individual thinks that they are floating, flying, or moving — these may also sometimes include out-of-body experiences, in which a person thinks that their spirit or mind has left their body and is moving and observing events from above

Among the types of dreamlike hallucinations listed above, the first type — a sensed presence — is one of the most commonly experienced by people with sleep paralysis.

As for the time of sleep at which sleep paralysis — with or without hallucinations — normally takes place, again, there is no single answer.

According to a study that was published in the Journal of Sleep Research, sleep paralysis typically happens soon after falling asleep (or hypnagogic episodes), at some point during the course of sleep (or hypnomesic episodes), or a little before the person’s usual time of awakening (or hypnopompic episodes).

The authors of that study note that the most common instances of sleep paralysis are hypnomesic, and that they usually take place after 1–3 hours from falling asleep.

‘A strange, shadowy man’

In fact, these visions and sensations can seem so realistic to many people that they may think that they are having a paranormal experience, or even being subjected to strange tests and rituals.

shadowy figure
The most common hallucination linked to sleep paralysis is the ‘sensed presence’ of a sinister figure.

“Witness accounts” of such hallucinations can be truly unsettling, and a number of long-time experients — such as Louid Proud in his book Dark Intrusions — have offered detailed accounts of years of uncanny nightly encounters.

One person who told me about his nightmarish hallucinations said he felt as if “someone knelt on [his] chest so that it [felt] as if [he was] being choked out.”

Another person spoke of a night-time assailant that takes pleasure in tormenting her in myriad ways.

“When [sleep paralysis] strikes, I get both visual and auditory hallucinations, which most often involve a strange, shadowy man coming up my stairs and into my bedroom. Occasionally, he’ll prod or tickle me.”

Often, she told me, this sinister figure even “co-opts” her partner in his mischief.

“Sometimes,” she says, “I’ll even hallucinate my partner lying next to me and laughing maliciously at me, or siding with the shadowy figure in annoying me. This is very frustrating, since all I want him to do is help me!”

Given the intensity of these hallucinatory experiences, it may come as no surprise that researchers have repeatedly argued that hallucinations linked with sleep paralysis can be held responsible for many reports of magical events, sightings of ghouls and demons, and alien abductions.

Some happy exceptions

Although usually people with sleep paralysis report experiencing terrifying hallucinations, a happy few actually point to a state of bliss that makes them look forward to these episodes.

A study that was conducted by James Allan Cheyne, from the University of Waterloo in Ontario, Canada, suggests that the people who most often describe experiencing positive feelings and sensations during an episode of sleep paralysis are those who are prone to vestibular-motor hallucinations.

These hallucinations were found to involve feelings of floating and [out-of-body experiences], which are associated with feelings of bliss rather than fear.”

James Allan Cheyne

“In contrast to the other-oriented nature of the Intruder and Incubus hallucinations,” he adds, “these experiences are very much focused on the experient’s own person.”

Sometimes, Cheyne continues, feelings of bliss during sleep paralysis are derived from pleasant erotic sensations that arise from vestibular-motor hallucinations.

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What is the underlying mechanism?

So, what happens in the body during an episode of sleep paralysis? Essentially, during the dream phase of sleep — known as the rapid eye movement (REM) phase — our skeletal muscles are paralyzed.

The reasons behind this are not fully understood, though researchers have been making progress in uncovering the mechanisms attached to this process.

One popular theory posits that this temporary state of paralysis is meant to prevent us from hurting ourselves, perhaps in automatic response to some violent dream.

During sleep paralysis, paradoxically, our brains — or parts of our brains — become awake and conscious, but the rest of the body is still immobilized.

At the same time, during sleep paralysis, many people experience dream visions and sensations as though they were real — hence the hallucinations — and the fact that they are, in fact, partly awake and conscious blurs the line between reality and dreams.

Who is at risk of sleep paralysis?

Sleep paralysis is more common than we may think. A 2016 study declares that it is “surprisingly common,” but that “determining accurate prevalence rates is complicated” because researchers and study participants alike have different understandings of what counts as sleep paralysis.

man dealing with insomnia
Although a fair amount of research has been conducted in this respect, it remais unclear as to who is most at risk of sleep paralysis.

A recent review of the available data, however, suggests that 7.6 percent of the population have experienced at least one episode throughout their lives.

That said, the numbers may be even higher.

What causes sleep paralysis, and what the main risks are for experiencing such an episode, remain largely mysterious.

Sleep paralysis is a common symptom of the neurological disorder “narcolepsy,” which is characterized by uncontrollable sleepiness throughout the waking day.

But many people who experience sleep paralysis do so independently of neurological conditions. And, to distinguish between narcolepsy-related episodes and independently occurring sleep paralysis, specialists usually refer to the latter as “isolated sleep paralysis.”

Recurrent isolated sleep paralysis often starts in adolescence, and around 28.3 percent of students apparently experience it.

Moreover, people with poor “sleep hygiene” — for instance, those who sleep too much or too little — may also be more likely to experience sleep paralysis. The authors of a systematic review published in Sleep Medicine Reviews note:

Specifically, excessively short (fewer than 6 hours) or long (over 9 hours) sleep duration and napping, especially long naps (over 2 hours), were associated with increased odds of sleep paralysis.”

“Long self-reported sleep latency [how long it takes to fall asleep] (over 30 minutes) and difficulty initiating sleep were related to an increased likelihood of reporting sleep paralysis,” they add.

Are mental health issues to blame?

Given the frightening nature of the most of the hallucinations associated with sleep paralysis, many have wondered whether individuals experiencing mental health issues — such as depression or anxiety — are more susceptible to these experiences.

The results of existing research, however, are mixed. Some have argued that individuals who have experienced abuse in early life — whether or not they remember it — may be more exposed to sleep paralysis.

According to the study that was published in Sleep Medicine Reviews, “Levels of waking state dissociative experiences, involving depersonalisation, derealisation, and amnesia, were found to be related to both sleep paralysis frequency and the frequency/intensity of all three hallucination types.”

But links to other neurological and psychiatric disorders are more uncertain.

The authors of a study that was published in the journal Consciousness and Cognition note that previous research has tried to make a case that bipolar disorder, post-traumatic stress disorder, depression, panic disorder, and generalized anxiety disorder — to name but a few — may play a role in sleep paralysis.

However, they report that their analysis of the available data has revealed “no general relationship between [isolated sleep paralysis] and major psychopathology.”

Instead, they decided to focus on the most common “symptom” of sleep paralysis — that is, sensed presence hallucinations that induce a feeling of fear — and explained that there may be a link between it and what they call “passive social imagery.”

Passive social imagery refers to the experience of individuals who are prone to being more socially anxious, and to imagining themselves in embarrassing or distressing social situations as the passive victim on the receiving end of abuse.

These individuals, the researchers suggest, appear to be more at risk of experiencing distress due to sensed presence hallucinations.

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What can you do to prevent it?

Prevention and coping strategies for sleep paralysis are, unfortunately, mostly anecdotal, but there are some methods that seem to have been repeatedly validated by many individuals who say that they — usually or often — work for them.

These include:

  • trying not to fall asleep on on your back, since studies have associated episodes of sleep paralysis with lying on one’s back when going to sleep
  • trying to ensure, on a regular basis, that your sleep will not be disrupted, since repeatedly waking up during the night has been flagged up as a potential risk factor
  • avoiding overuse of stimulants, such as tobacco and alcohol — coffee, surprisingly, has not been deemed risky in this context — though the evidence that these affect the chances of experiencing sleep paralysis is mixed
  • learning meditation and muscle relaxation techniques may help you to better cope with the experience
  • persisting in the attempt “to move extremities,” such as fingers or toes, during sleep paralysis also seems to help disrupt the experience

Finally, if you regularly experience sleep paralysis with “sensed presence” and you think that this may be related to other experiences of anxiety in your day-to-day life, then it may be worth considering cognitive behavioral therapy.

According to the authors of the Consciousness and Cognition study, there is a distinct “possibility that frightening [isolated sleep paralysis] sensed presence experiences […] may contribute to maintenance of an individual’s negative social imagery biases.”

If that is the case, they argue, “cognitive behavioral treatment of [these] experiences could help to alleviate the more general social imagery dysfunction,” which may improve the overall situation.

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Medical News Today: How can you unblock your ear?

There are times when the ears can become clogged due to factors both outside and inside the ear. Clogged ears can affect hearing and balance and cause pain and discomfort.

Clogged ears can happen to almost anyone. Children are the most likely to have clogged ears, especially during a cold or sinus infection. People are most likely to experience a clogged feeling in their ears from:

  • earwax buildup
  • blocked Eustachian tube
  • sinus infections, colds, or allergies
  • high altitudes
  • acoustic neuroma or benign growth inside the ear

Natural remedies to help earwax

Ear drops of oil in syringe being dispensed into clogged ear.
Ear drops of oil may be used to soften earwax.

Earwax forms a barrier between the opening of the ear and the sensitive apparatus of the inner ear.

Earwax blocks foreign objects from entering the ear. The glands responsible for creating earwax sometimes create too much. This buildup can cause the wax to become hard.

The wax builds up and eventually blocks the entire tube.

Some signs of earwax buildup include:

  • feeling dizzy
  • earache
  • ringing in ears

1. Ear drops to loosen or soften earwax

The following are some natural solutions people can use to soften the earwax, and allow it to exit the ear safely. These are often added to the ear in the form of drops:

  • mineral oil
  • baby oil
  • carbamide peroxide
  • hydrogen peroxide
  • glycerin

There are commercial drops specifically made for removing excessive earwax. Debrox is one over-the-counter (OTC) ear drop available online that can help remove excessive earwax buildup.

2. Ear irrigation

Ear irrigation is another method that people can try at home. It is important to note that this should not be done at home on anyone who has had surgery or an injury to their ear.

It is also essential that people follow all instructions found on the OTC kit sold for ear irrigation.

Avoid cotton swabs or tools

People should never use cotton swabs to clean their ears. Cotton swabs can cause blockages by pushing earwax deeper into the ear.

People should also not attempt to dig the earwax out as this can cause damage.

Avoid candling

Another method is known as candling, but this is not recommended by science.

For this procedure, people insert a lit, cone-shaped, hollow candle into their ear.

During candling, the heat is supposed to cause a vacuum effect and allow the earwax to stick to the candle as it is pulled out.

This method does not work, however. People are likely to burn their ear, cause a perforation, or an ear canal obstruction.

Anyone experiencing clogged ears should never try this method.

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Natural remedies for allergies and infections

Woman blowing nose on tissues while sitting on sofa unwell.
Symptoms of an infection may include sneezing, a sore throat, or a fever.

If someone experiences a blocked ear due to an allergy or infection, they will also likely experience one or more of the following symptoms:

In these instances, a person should try to unclog their ear as soon as possible. A person can develop an ear infection when their ear is blocked, which would then require further treatment. The following are some at home methods to help:

1. Use steam

Steam can help unclog an ear when the cause is an infection or allergies. This is because the sinuses connect directly back to the ears.

To use steam:

  • heat up water in a pot until it boils
  • remove the pot from heat and place a towel over it and the head
  • take several deep breaths to inhale the steam

A person can alternatively take a hot shower, as it creates stream and has a similar effect.

2. Consider mineral and essential oils

Many oils reportedly have antibiotic, antiseptic, or anti-inflammatory properties. There is an increasing number of studies being conducted to test essential oils.

Some essential oils that are recommended to either help clear mucus, reduce inflammation, or treat infections include:

  • tea tree oil
  • eucalyptus oil
  • peppermint oil

These can often be inhaled as steam or placed near the nose so that the vapors are breathed in.

3. Use a warm compress

A warm compress can be applied to drain the nasal passages of mucus and reduce the amount in the ears.

Applying a warm compress is simply done, as follows:

  • pour hot water onto a clean washcloth
  • once the cloth is soaked, it should be squeezed out
  • hold the washcloth below the affected ear for about 5 to 10 minutes

4. Gargle salt water

A saltwater gargle can aid in reducing mucus in both the nose and the ears. It is also an easy remedy.

To use a saltwater gargle, a person needs to add a little salt to some water and mix them together. Once mixed, they should gargle the salt water for a few seconds then spit it out.

Other remedies

People can try the following in cases of blockage caused by high altitude:

  • yawning
  • swallowing
  • chewing
  • gently blowing the nose while pinching the nostrils shut until a popping sound is heard

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When to see a doctor

Elderly woman having ear inspected by doctor.
A doctor should be seen if home remedies fail to relieve clogged ears.

People should see a doctor for clogged ears if home remedies fail or if blocked ears are accompanied by any of the following additional symptoms:

  • fever
  • refusal to clear on own
  • pain in the ear
  • loss of hearing
  • cannot be unclogged

The clogged feeling may be a result of an acoustic neuroma in some cases. This is a benign growth that can put pressure on and eventually close the tubes in the ear. A doctor will likely need to remove the growth through surgery if this is the source of the clog.


Clogged ears are almost never serious but can be irritating and uncomfortable. Most people can relieve their clogged ears using home remedies.

People should never try to use a scraping object or a cotton swab to remove a clog as these can be quite dangerous.

If someone with a clogged ear does not get relief from home remedies or OTC medications, their doctor should be able to treat the clogged ear for them effectively.

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Medical News Today: What causes mucus in the chest?

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Medical News Today: What can you eat on a low-carb diet?

Low-carb diets limit the number of carbohydrates a person eats. Instead of carbs, people focus on eating proteins, healthful fats, and vegetables.

Carbohydrates or carbs are one of three main food types that the body needs to work properly. The other two are protein and fat. Carbs give the body energy. The body breaks carbs down to use immediately or later.

If the body does not need to use the carbs for energy as soon as a person eats them, it stores them in the muscles and liver to use later. However, if the body does not use these stored carbs, the body converts them to fat.

Why follow a low-carb diet?

Eggs cooked in various ways are a good option for a low-carb diet
Eggs are a low-carb food.

Many people follow low-carb diets on the basis that if the body does not receive extra carbohydrates, it will not store excess fat.

The idea, then, is that the body will burn some of the stored fat rather than the carbs, which will promote fat loss.

Research from 2003 in the New England Journal of Medicine found that people who followed a low-carb diet lost more weight than those on a low-fat diet after 6 months, but not after 12 months.

The study noted that “longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets.”

Ten low-carb diet tips

Many people find following a low-carb diet challenging, particularly at the beginning of the diet. The following low-carb diet tips might help people stick to their diet and may help them lose weight successfully.

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1. Knowing what foods are low-carb

Low-carb foods include:

  • lean meats, such as sirloin, chicken breast, or pork
  • fish
  • eggs
  • leafy green vegetables
  • cauliflower and broccoli
  • nuts and seeds, including nut butter
  • oils, such as coconut oil, olive oil, and rapeseed oil
  • some fruit, such as apples, blueberries, and strawberries
  • unsweetened dairy products including plain whole milk and plain Greek yogurt

2. Know the carb counts and serving sizes of foods

Most low carb diets only allow for 20 to 50 grams (g) of carbohydrates per day. Because of this, it is essential that people following low-carb diets choose foods that have a lower carb count but a high nutritional value per serving.

The foods in the quantities listed below all contain approximately 15 g of carbs:

  • 1 tennis ball sized apple or orange
  • 1 cup of berries
  • 1 cup of melon cubes
  • ½ medium banana
  • 2 tablespoons of raisins
  • 8 ounces of milk
  • 6 ounces of plain yogurt
  • ½ cup corn
  • ½ cup peas
  • ½ cup beans or legumes
  • 1 small baked potato
  • 1 slice of bread
  • 1/3 cup of cooked rice

While the foods listed above all contain roughly equal amounts of carbohydrates, they are not all nutritionally equivalent. The dairy products on the list contain protein and vital nutrients, such as Vitamin D and calcium in addition to the carbohydrate content.

The fruit and vegetables also contain essential vitamins and minerals. Choosing whole-grain varieties of bread and rice will provide more nutrients than white varieties, even though the carb content is similar.

3. Make a meal plan

meal plan and pencil for a low-carb diet
A meal plan can help a person organise their food for the forthcoming week.

A meal plan can help make things easier.

Anyone trying to follow a low-carb diet could try mapping out their week and plan all meals before heading to the grocery store.

Planning meals in advance can help people stick to the diet.

Knowing what they are going to eat for lunch and dinner can help a person avoid making unhealthful food choices, such as stopping at a fast food restaurant.

4. Meal prep

Planning is one thing, but preparing meals ahead of time can also help. Meal prep can help a person:

  • avoid making unhealthful food choices
  • save time during busier times of the week
  • save money

Some people like to prepare a week’s worth of breakfasts and lunches ahead of time and store the meals in containers, so they are convenient and ready to go. It is possible to freeze some meals too, meaning people can prepare even more food in advance.

Having lots of pre-prepared meals on hand can help people avoid choosing less healthful options.

Popular low-carb meals to prepare in advance include:

  • egg muffins
  • Greek yogurt bowls
  • protein pancakes
  • chicken lettuce wraps
  • protein and vegetable stir fry with no rice

5. Carry low-carb snacks

Low-carb snack options for between meals include:

  • hard boiled eggs
  • unsweetened yogurt
  • baby or regular carrots
  • handful of nuts
  • cheese

It is essential to regulate portion size of any snacks to avoid overeating.

6. Consider carb cycling

Carb cycling involves eating very low-carb foods for a set amount of days, followed by one day of eating higher carb meals. This helps the body avoid fat-burning plateaus that can develop after weeks of low-carb dieting.

Carb cycling is not for everyone, and anyone considering it should talk to their doctor or nutritionist first.

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7. Not all carbs are created equal

Carbs come in different forms.

Simple carbs consist of easy to digest sugars. Refined and processed carbs, such as white sugar and white flour, are simple carbs.

People who are starting on a low-carb diet need to think about reducing their intake of refined and processed carbs. Avoiding these carbs will be beneficial for reaching an ideal weight and for health in general.

However, not all simple carbs are created equal. Fruits include fructose, which is a simple carb, but eating fruit is recommended in a low-carb diet, as it is loaded with nutrients and is a whole-food source of carbs.

Complex carbs take longer to digest than simple carbs, as they need to be broken down into a simpler form. Complex carbs are found in more nutrient-rich foods, such as beans, whole-grains, and fiber-rich fruits, such as bananas.

Complex carbs also have the added benefit of making a person feel full faster, which might prevent them from overeating. Complex carbs also make people feel full for longer, which might help them avoid snacking between meals.

8. Be aware of alternatives

lettuce leaf tacos for a low-carb diet
Lettuce leaf tacos are a recommended low-carb alternative.

Substituting high-carb foods for low-carb or no-carb foods can help reduce carb intake.

Some low-carb substitutions include:

  • lettuce leaves instead of taco shells
  • portobello mushroom caps instead of buns
  • baked butternut squash fries
  • eggplant lasagna
  • cauliflower pizza crust
  • spaghetti squash instead of noodles
  • zucchini ribbons instead of pasta

9. Exercise appropriately

Exercise is an important part of overall health. People should avoid a sedentary lifestyle but refrain from excessive exercising.

The Centers for Disease Control and Prevention (CDC) recommend that adults do moderate exercise for 150 minutes a week for a minimum 10 minutes at a time for moderate health benefits. For optimal health benefits, the CDC recommend 300 minutes of exercise. The CDC also suggest that people lift weights or do other strength training exercises to improve overall health.

Those on low-carb diets may want to avoid long periods of intense activity such as distance running. This is because people who are doing a form of exercise that requires extra endurance, such as marathon training, will need extra carbohydrates to fuel their bodies.

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10. Use common sense

People should know about potential health risks before starting a low-carb diet.

Short-term health risks caused by a low-carb diet may include:

Long-term health risks caused by a low-carb diet may include:

  • nutritional deficiencies
  • loss of bone density
  • gastrointestinal problems

Some people should not follow a low-carb diet unless instructed to do so by a doctor. These groups of people include those with kidney disease and teenagers.

Not everyone will benefit from, or should even consider, a low-carb diet. Anyone thinking about doing a low-carb diet should speak with a doctor before starting.


A low-carb diet can have some benefits, including weight loss. With some planning and appropriate substitutions, most people can follow a low-carb diet. However, a low-carb diet may not be the best way to achieve long-term or sustainable health goals.

When following a low-carb diet, it is essential that people eat healthfully and do not overeat certain foods, such as very fatty meats.

People looking to lose weight or considering going on a low-carb diet should speak to their doctor or nutritionist before making any significant changes.

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Medical News Today: Pancreatic cancer: Some blood pressure drugs put women at risk

New research suggests that certain blood pressure drugs may increase the risk of pancreatic cancer in postmenopausal women.
blood pressure drugs
A certain class of blood pressure drugs may double the risk of pancreatic cancer, a new study suggests.

Zhensheng Wang, a postdoctoral researcher at the Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston, TX, along with his colleagues, set out to examine the effects of a class of drugs called calcium channel blockers (CCBs) on the risk of pancreatic cancer.

CCBs are used to stop calcium from entering the heart’s muscle cells, which, in turn, relaxes the blood vessels.

This relaxation makes them useful drugs for the treatment of hypertension.

Previous studies, the authors of the new research explain, have shown that antihypertensive medication increases levels of a receptor called soluble receptor for advanced glycation end-product (sRAGE).

sRAGE receptors help control the body’s immune response and inflammation; Wang and team point out that earlier research found that sRAGE reduces inflammation and lowers the risk of pancreatic cancer.

Blood pressure drugs, on the other hand, raise sRAGE levels, so the authors started out with the hypothesis that, on the contrary, antihypertensive medication would lower the risk of pancreatic cancer.

But the results of the study surprised the researchers. The findings were presented at the American Association for Cancer Research Annual Meeting, which took place in Chicago, IL.

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CCBs may double pancreatic cancer risk

Wang and colleagues examined the data on 145,551 postmenopausal women aged between 50 and 79 who were registered in the Women’s Health Initiative (WHI) — a large, long-term study spanning more than 20 years.

In addition to CCBs, three other types of blood pressure drugs were included in the analysis: beta-blockers, diuretics, and angiotensin-converting enzyme inhibitors.

The researchers looked at women who were enrolled in the WHI study between 1993 and 1998, and they followed them until 2014.

During this period, 841 cases of pancreatic cancer were recorded. Wang and colleagues measured the sRAGE serum levels of 489 of these women, and those of 977 women who did not develop the condition.

The researchers used statistical models to examine the link between the four types of blood pressure medication and pancreatic cancer risk.

The analysis revealed that women who had ever taken short-acting CCBs were 66 percent more likely to develop pancreatic cancer; women who had taken CCBs for 3 or more years were more than twice as likely to have pancreatic cancer than women who had taken other blood pressure drugs.

Additionally, women who had used short-acting CCBs had considerably lower sRAGE levels than those who took other blood pressure drugs.

None of the other blood pressure drugs were linked with an increased risk of pancreatic cancer.

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What explains the link?

This was just an observational study, but the researchers have a few clues regarding the potential mechanisms that may explain the findings.

“[T]he blockage of the calcium channel caused by [the] use of CCBs may potentially reduce sRAGE release,” Wang explains, “and thus further decrease the levels of anti-inflammatory sRAGE.”

“This is important as chronic inflammation is a well-recognized risk factor for pancreatic as well as many other cancers,” he adds.

Also, as Wang explains, “hypertension, […] is one of the components of metabolic syndrome, and metabolic syndrome is a possible risk factor for pancreatic cancer.”

These links may explain why “[p]ancreatic cancer typically occurs in elderly individuals who also have chronic comorbid medical conditions, such as hypertension,” Wang suggests.

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Findings ‘of great public health significance’

“Pancreatic cancer is the fourth leading cause of cancer-related mortality in the United States,” Wang says.

According to the National Cancer Institute (NCI), over 55,000 people will have been diagnosed with pancreatic cancer in 2018, and only 8.5 percent of these will survive for 5 years.

Antihypertensive medication use has increased significantly; therefore, it is of great public health significance to address the potential association between antihypertensive medication use and risk of pancreatic cancer in the general population.”

Zhensheng Wang

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Medical News Today: Is it lung cancer? This blood test can tell

Some cancers — particularly lung cancer — are often detected incidentally, after unrelated medical exams. In many cases, it is difficult to tell the malign from benign tumors, except by using invasive methods such as a biopsy. However, one blood test that can rule out cancer may be the game-changer that we require.
health care practitioner draws blood from patient
One simple blood test could accurately tell whether pulmonary nodules are likely to be malign.

Recent data indicate that currently, in the United States, around 1.6 million pulmonary nodules per year are detected that require further testing to ascertain whether they are cancerous.

Biopsies are invasive. And, often, healthcare practitioners will advise even more invasive solutions, such as surgery, to remove the nodules and the patient’s doubts.

For such sensitive, fragile organs as the lungs, however, an invasive method brings with it a whole set of risks that can potentially make matters worse.

Dr. Gerard Silvestri, of the Medical University of South Carolina in Charleston, led a study to explore a noninvasive method of determining whether lung nodules are benign or malign. He explains why this research is important.

“Think of your lung as a 2-liter bottle of soda, and the nodule as a pea in the center of it,” notes Dr. Silvestri. “During a biopsy, for example, the lung could collapse and need a tube to expand it,” he explains.

That is why he and a team of researchers have explored the merits of a blood test focusing on the presence of biomarkers that would indicate how likely it is that the detected nodules are cancerous.

Our goals for this biomarker are to help calculate the risk of cancer, present the patient with options and recommendations, and avoid subjecting patients with benign disease to expensive, unnecessary, and intrusive procedures.”

Dr. Gerard Silvestri

The results of their research have now been published in the journal Chest.

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Test demonstrates accuracy of 98 percent

Dr. Silvestri and team’s research is part of the Pulmonary Nodule Plasma Proteomic Classifier study, which the study authors call “a prospective, multicenter, observational study” that retrospectively evaluates the effectiveness of a specially designed blood test that can evaluate “two [telling] proteins and five clinical risk factors” for lung cancer.

The blood test’s purpose is to determine whether patients with lung nodules who have a low or moderate risk of lung cancer are likely to have developed harmless or malign tumors.

The main biomarkers that the test assesses are the proteins LG3BP and C163A, the plasma concentrations of which predicts this type of cancer.

If the test results are negative and the person being tested has a lung cancer chance of under 50 percent, the possibility of cancer is very reduced. In this case, healthcare practitioners can devise an appropriate treatment plan and follow-up routine.

“It serves as a ‘rule out’ test for those with low to moderate risk,” Dr. Silvestri says of the blood test.

“The biomarker is a tool,” he continues, “to help calculate the general risk of cancer and present a patient with recommendations and options. It can push people out of indeterminate risk and into low-risk — without having to undergo invasive and potential risky procedures.”

The results of the current study indicated that the blood test was 98 percent effective in ruling out the possibility of lung cancer.

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For added certainty, however, patients with negative results — and thus with a low likelihood of malign tumors — would still be monitored periodically to make sure that no errors were made.

“A low-risk tumor,” Dr. Silvestri goes on to say, “will be followed with serial imaging. After 2 years of [computed tomography] scans being performed periodically and without evidence of growth, we can say it’s benign.”

For this study, the researchers retrospectively evaluated the data of 685 clinical trial participants of 40 years or older, all of whom presented newly detected lung nodules at baseline.

The specialists suggest that, had the blood test they studied been used to inform patient care, 40 percent fewer invasive procedures would have taken place in the case of people with harmless nodules.

Taking this into account, Dr. Silvestri and colleagues say that the next step from here should be to conduct a “clinical utility study to assess how clinical decision-making and use of invasive procedures are altered with knowledge of the results of [the recently studied] test.”

“Anything to provide physicians with more confidence in how they would manage patients would be helpful,” concludes Dr. Silvestri.

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Medical News Today: How long can a person live with congestive heart failure?

Congestive heart failure is a progressive disease that gets worse over time, especially if it remains untreated. It is often caused by other conditions that weaken the heart, such as:

There are four stages of congestive heart failure (CHF), each with a different outlook. Many other disorders and lifestyle choices contribute to the development of CHF.

In some cases, life expectancy and outlook can be positively affected by lifestyle changes, medications, and surgery.

Life expectancy

Life expectancy after diagnosis of heart failure will depend on a number of factors. Senior woman listening to doctor explain results.
Life expectancy after a CHF diagnosis will depend on a range of factors.

A 2016 study estimated that about half of people who develop heart failure live beyond 5 years after being diagnosed.

However, there is no simple answer for life expectancy rates, as the average life expectancy for each stage of CHF varies greatly. Personal lifestyle choices may also play a factor, as well as whether a person has other medical problems.

CHF is not curable, but early detection and treatment may help improve a person’s life expectancy. Following a treatment plan that includes lifestyle changes may help improve their quality of life.

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Symptoms and stages

When a person has CHF, their heart has difficulty pumping blood to the other organs in the body. This problem occurs because the walls of the ventricles, which typically pump the blood through the body, become too thin and weak, causing the blood stay in the ventricle, rather than pushing it out.

Blood remaining in the heart can cause fluid retention because the heart is not pumping enough blood through the body to push out excess fluids.

CHF has four stages based on the severity of symptoms. Understanding each stage may help shed light on a person’s life expectancy rates, and explain why they can vary so much.

  • Stage 1 or pre-CHF: People with pre-CHF may have disorders that affect the heart, or doctors may have noticed a weakness in their heart that has not yet caused any symptoms.
  • Stage 2: People with stage 2 CHF may have minor symptoms but are still otherwise healthy. People with stage 2 CHF often have existing heart complications but lack definitive symptoms of heart failure. Doctors may recommend that these people reduce their workload and make lifestyle changes.
  • Stage 3: People with stage 3 CHF may experience symptoms regularly and may not be able to do their regular tasks, especially if they have other health conditions.
  • Stage 4 or late-stage CHF: A person with stage 4 CHF may have severe or debilitating symptoms throughout the day, even while at rest. Late-stage CHF often requires extensive medical and surgical treatment to manage.

The symptoms of CHF vary greatly depending on the stage, and whether a person has any other medical conditions. However, common symptoms include:

swelling in the legs and feet caused by a buildup of excess fluid

  • bloating
  • shortness of breath
  • fatigue
  • nausea
  • chest pain

Other conditions that affect the heart can also cause CHF, and the person will probably also be dealing with the symptoms that these additional conditions create.

Early diagnosis of CHF may help people manage their symptoms and make preventative lifestyle changes, which may give them a better long-term outlook.


Medical treatment for CHF involves reducing the amount of fluid in the body to ease some of the strain on the heart and improving the heart’s ability to pump blood.

Doctors may prescribe angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) as a way to help the heart pump blood more effectively.

In some cases, doctors may also prescribe beta-blockers to support these efforts and control the heart rate.

Doctors also commonly prescribe diuretics for people with CHF, as they may help the body eliminate excess liquid. Common diuretics include hydrochlorothiazide, bumetanide, and furosemide.

In the later stages of heart failure, doctors may recommend surgery to insert a left ventricular assisted device (LVAD) into the heart. An LVAD is a pump that helps the heart muscle contract, and it is often a permanent solution. A full heart transplant may also be an option if the person is considered suitable for the operation.

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Lifestyle changes

No matter what stage of CHF a person is at, or what medical treatment they follow, doctors will likely recommend making lifestyle changes to minimize the impact of CHF. These changes may help slow the condition and increase a person’s quality of life.

Diet and exercise

Senior man jogging in park.
Exercises that raise the heart rate, such as jogging, may be beneficial for those with CHF.

Eating a healthful, varied diet and getting regular exercise is recommended for everyone, but is especially important for people with CHF.

Doctors often recommend that people with CHF eliminate excess salt (sodium) from their diet, as it causes the body to retain fluids. Doctors may also recommend cutting out alcohol.

Aerobic exercise is any activity that elevates the heart rate and breathing rate. Activities include swimming, bicycling, or jogging.

Regular aerobic exercise may improve heart health, leading to a better quality of life and perhaps even increasing life expectancy in people with CHF. Doctors can help individuals make a personalized exercise routine that works for them.

Fluid restriction

People with CHF tend to retain fluid in the body, so doctors often recommend restricting their fluid intake to the minimum each day.

Consuming too much liquid may cancel out the effects of diuretic medicines. While it is essential to stay hydrated, a doctor will be able to recommend just how much fluid a person can safely consume a day.


For someone with CHF, watching their weight is often less about fat accumulation than it is about fluid retention.

Doctors will often ask people to monitor their weight each day to check for any sudden or fast weight gain, which may be linked to fluid retention.

Monitoring a person’s weight every day can help a doctor prescribe the correct levels of diuretics to help the body release fluid.


Each person with CHF will have a different experience with the condition, and life expectancy for the disease will vary significantly between individuals.

Life expectancy depends on what stage CHF has reached, as well as what other complications or health problems the person has. People who have received an early diagnosis may have a better outlook than those who did not receive a diagnosis until the later stages.

Many people find that positive lifestyle changes can significantly improve the symptoms of CHF and their well-being. Medication helps many people with CHF, and doctors will sometimes recommend surgery.

Working directly with a doctor or medical team is crucial to make an individualized treatment plan and give someone the best possible outlook.

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Medical News Today: Does the 20-20-20 rule prevent eye strain?

Spending long periods looking at computer, phone, or tablet screens can strain the eyes. Using the 20-20-20 rule can help to prevent this problem.

The rule says that for every 20 minutes spent looking at a screen, a person should look at something 20 feet away for 20 seconds.

Following the rule is a great way to remember to take frequent breaks. This should reduce eye strain caused by looking at digital screens for too long.

In this article, we describe how to use the 20-20-20 rule effectively. We also discuss the research behind the rule and other tips for preventing eye strain.

How to use the 20-20-20 rule

20 20 20 rule can help eye strain
Following the 20-20-20 rule involves taking a 20-second break from looking at a screen every 20 minutes.

The 20-20-20 rule was designed by Californian optometrist Jeffrey Anshel as an easy reminder to take breaks and prevent eye strain, according to the Optometry Times.

When following the rule, a person takes a 20-second break from looking at a screen every 20 minutes. During the break, the person focuses on an object 20 feet away, which relaxes the eye muscles.

The following methods can help a person to put this rule into practice:

  • Set an alarm for every 20 minutes while working, as a reminder to take a break.
  • Download an app developed to help people follow the 20-20-20 rule. The ProtectYourVision and eyeCare apps are some examples.
  • Look out a window during the 20-second breaks. Judging a distance of 20 feet inside can be difficult, but focusing on a tree or lamppost across the street should work well.

Alternately, a person can benefit from closing their eyes for 20 seconds every 20 minutes. Also, remembering to blink can prevent dry eye by encouraging tear production.

Anyone who spends the day sitting should periodically get up and walk around, to prevent back and neck pains.

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What evidence supports the 20-20-20 rule?

Little scientific research has tested the effectiveness of the 20-20-20 rule, but both the American Optometric Association and the American Academy of Ophthalmology recommend it as a way to reduce eye strain.

Results of a 2013 study involving 795 university students suggested that those who periodically refocused on distant objects while using the computer had fewer symptoms of computer vision syndrome, which include eye strain, watering or dry eyes, and blurred vision.

Symptoms of eye strain

Several symptoms can indicate eye strain, including:

  • eye watering
  • blurred vision
  • dry eyes
  • headaches
  • eye redness

Sitting in the same position for a long time has other harmful effects on the body. For example, it can cause neck, back, or shoulder pain.

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Tips for preventing eye strain

Like the 20-20-20 rule, the following methods can help to reduce or prevent eye strain:

20 20 20 rule eye drops
Applying eye drops can help a person suffering from dry eyes, which can occur when using digital screens for long periods.
  • Using eye drops. A person blinks less than usual when using digital screens, and this can dry out the eyes. Drops or artificial tears can be purchased at most pharmacies, as well as online. Specialty eye drops are available for people who wear contact lenses. Preservative-free eye drops are best.
  • Change computer settings. Making text twice as large as usual can reduce eye strain. Reading black text against a white background is easiest on the eyes.
  • Reduce screen glare. Protective anti-glare screens can be applied to computers and eyeglasses, to prevent eye problems. Also, flat screens tend to have less glare than curved ones.
  • Adjust the screen’s contrast. Change settings so that the screen is bright enough to read the text without straining. The right contrast may change, depending on the presence of sunlight.
  • Get regular eye checkups. Poor eyesight is a major cause of strain. Regularly attending checkups will ensure that a person has an updated prescription when needed.

The strategies listed above require little time or financial commitment, but they can reduce eye strain related to using tablets, phones, and computers.


The 20-20-20 rule is an effective way to reduce eye strain caused by looking at digital screens for long periods.

If eye strain persists after a person has tried using the rule and other methods of prevention they should see a doctor, who can check for underlying conditions such as chronic dry eye.

The eye doctor may need to evaluate their vision and test the level of moisture in the eyes. When making recommendations, the doctor will take a person’s occupation and overall eye health into account.

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Medical News Today: New drug halves previously untreatable migraine attacks

A new drug offers fresh hope to the millions of people living with treatment-resistant migraine. The compound, called erenumab, has proven successful in people who had been failed by up to four previous preventative treatments.
woman with migraine
People with chronic migraines may soon find relief in a new drug.

The new study was led by Dr. Uwe Reuter, who is affiliated with The Charité – University Medicine Berlin in Germany.

The team’s findings give hope to the 36 million people in the United States whose lives are affected by migraines.

Migraine is a disabling neurological condition for which there is yet no cure.

An episode may last between 4 and 72 hours and is often accompanied by other debilitating symptoms, such as vomiting, dizziness, feelings of numbness in the hands or the feet, and visual impairment.

It is estimated that over 4 million people in the U.S. have chronic daily migraine, which means that they have an attack on at least 15 days per month.

For these people, the new findings — to be presented at the American Academy of Neurology’s 70th Annual Meeting, held in Los Angeles, CA — may bring some much-needed relief.

The drug erenumab was tested in people with particularly challenging migraines that had been resilient to treatment. The compound reduced migraine attacks by 50 percent for a third of the study participants.

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Erenumab vs. previous treatments

Dr. Reuter and team recruited 246 people with episodic migraines who had been failed by previous treatments.

More specifically, 39 percent of the participants had tried two previous medications to no avail, 38 percent had been unsuccessfully treated with three medications, and 23 percent had tried four drugs but had no success.

The participants — who had nine migraines per month, on average, at the beginning of the study — were divided into two groups: one group received injections of 140 milligrams of the new drug, while the other was given a placebo.

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Drug halves attacks and has no side effects

Three months into the treatment, 30 percent of the migraine patients in the intervention group had the monthly number of their attacks reduced by 50 percent, whereas only 14 percent of those in the placebo group had their attacks reduced by half.

This means that those who received the treatment were almost three times more likely to have their attacks halved. Importantly, the drug did not present any side effects.

Dr. Reuter comments on the study’s findings, saying, “The people we included in our study were considered more difficult to treat, meaning that up to four other preventative treatments hadn’t worked for them.”

Our study found that erenumab reduced the average number of monthly migraine headaches by more than 50 percent for nearly a third of study participants. That reduction in migraine headache frequency can greatly improve a person’s quality of life.”

Dr. Uwe Reuter

The drug works by blocking pain signals in the brain. Specifically, erenumab inhibits a receptor for a calcitonin gene-related peptide (CGRP), which is responsible for sending migraine pain signals.

Because erenumab occupies the receptor itself, CGRP has nowhere to bind itself to.

“Our results show that people who thought their migraines were difficult to prevent may actually have hope of finding pain relief,” says Dr. Reuter. “More research is now needed to understand who is most likely to benefit from this new treatment.”

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