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Sleep Apnoea and Mental Health


The link between sleep disorders and mental health is now well established. At any given time, nearly half of all adults are affected with one or more sleep problems. Sleep problems can be secondary to other conditions, like stress, they can be a side effect of medications, or they can signal underlying physical or brain-based disturbances.


Sleep problems like insomnia can occur when people react to life stressors with obsessive worry. Some antidepressants may worsen or induce primary sleep disorders like restless legs syndrome, sleep bruxism (teeth grinding), REM sleep behaviour disorder (sleep-walking), nightmares, and sleep apnoea.


Lifestyle-related factors like poor diet or lack of exercise with weight gain can result in disorders like sleep apnoea. Pain is a common physical cause of sleep problems. And in some cases, changes to brain function such as a fault in the "internal body clock" (circadian rhythm) or mismatch between this and the external environment is the cause. This is often found in shiftworkers, and increasingly found in young people who spend many hours at night on their smartphones.


Snoring is estimated to be the most common sleep problem. Snoring occurs when the muscles in the throat that hold open the pharynx (at the back of the of the tongue) relax, partially choking the airway. This blocking causes the pharyngeal walls to vibrate, giving the sound of snoring. A UK study found that 41.5% of the adult population snore. The male to female ratio is approximately 2:1, with about twice as many males snoring compared to females. It affects 2–5% of all children and is associated with cognitive and behavioural problems, resulting in poor school performance.


Whilst snoring alone might not be a major problem for the snorer, it can cause sleep disorders for their partners. This is because regularly disturbed sleep can reset your own brain’s circadian rhythm (sleep-wake cycle).


Sleep deprivation has serious physical and mental consequences including mood instability, impaired memory, decreased concentration, changes to brainstem activity resulting in hyper-aroused sympathetic system activity, and even specific changes to your genes. To check whether you might be suffering from sleep problems, try the Epworth Sleepiness Scale at https://www.kinnect.com.au/wp-content/uploads/2014/09/Epworth-Sleepiness-Scale-Questionnaire1.pdf


Snoring doesn’t necessarily predict sleep apnoea, but it can be an easy frontline indicator.  One study showed that 76% of the habitual snorers and 64% of the non-habitual snorers had apnoea-hypopnoea scores >0 presumably with snoring (that is, they showed signs of brain oxygen deprivation). Diagnosis of sleep apnoea, especially when it comes to monitoring reduction in airflow, oxygen saturation, cardiac activity, and EEG, is a complex process and often considered too intrusive so many people go undiagnosed. Home-based portable devices are proving more acceptable and can provide a primitive diagnosis sufficient to start therapy. Given the severity of health impacts of sleep apnoea, though, routine screening and early intervention are highly recommended.


Guidelines published in 2017 by the American Academy of Sleep Medicine recommend that doctors routinely screen for risk factors linked to sleep apnoea. Warning signs include:


  • Frequent reports of low energy, daytime fatigue, or difficulty staying asleep throughout the night
  • Loud snoring, witnessed apnoea or gasping or choking
  • Diagnosed hypertension (high blood pressure)
  • Overweight or neck circumference> 40cm
  • Waking in the morning with a sore throat or dry mouth
  • Morning headaches
  • Frequent night-time urination (often between 2:00 a.m. and 4:00 a.m.)
  • New onset of symptoms during perimenopause or menopause in women.

To find out more about Apnoea and other sleep disorders, including non-medical treatment approaches, join the half-day workshop on Tuesday 26 June with Professor Leon Lack from Flinders University.


Dr Kate Lemerle, Psychologist

Chrysalis Counselling & Coaching, Norfolk Island

WEB: www.chrysaliswellnessservices.com

TEL: 52112 or email drkate@iinet.net.au

Please 'contact us' for more information.

Health Tip of the week


Forward locomotion such as walking or running is actually the process of losing and catching one's balance.

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Fitness Tip of the Week - PROTEIN


Add protein to smoothies. I like BiPro protein as there’s no added sugars or artificial flavors.

Please 'contact us' for more information.

Health Tip of the week


Forward locomotion such as walking or running is actually the process of losing and catching one's balance.

Please 'contact us' for more information.

Fitness Tip of the Week - PROTEIN


Add protein to smoothies. I like BiPro protein as there’s no added sugars or artificial flavors.

Please 'contact us' for more information.

Norfolk Island Fitness and Health News


FITLOSOPHY: Movement is medicine for creating change in a person's physical, emotional and mental states.


FOODLOSOPHY: Drinking a few large lattes a day is the equivalent of eating an extra meal.


Want some encouragement through the dark and cold Winter months?


Consider our 8 week BODY BLITZ program ... a 2 month Membership with PT and lots of TLC!!!


MEMBERSHIP SPECIAL: Free program with every 3, 6 or 12 month membership in JUNE and JULY.


LORNA JANE TIGHTS SALE ... $60 for 4 days only ... starts Monday 11th June.


All Gym inquiries to Kay on 52809.

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Thriving in Retirement: Making Life Meaningful After Work


Baby Boomers - the 5.5 million people born between 1946 and 1965 - have been retiring now for some ten years. Hot on their heels are the Generation X-ers – the 6.5 million people born 1965 to 1984 – now in their mid-fifties and heading towards retirement. The Baby Boomers comprise about 24% of Australia’s population, and the Gen-X-ers make up another 28%. That means over half Australia’s population is facing retirement.


So you’re certainly not alone…but what does retirement mean for YOU?


Even if you’re well and truly over the drudgery of work, stepping out of the workforce is a significant life change. Many people will have struggled with the dilemma of when to make the move, typically weighing up financial matters. Fewer will consider less measurable factors such as the impact on their identity, being solely responsible for managing the structure of their days, or having other people at hand to chew the fat. If you’re not working, who are you and what do you do?


Many people facing retirement will think back to the days their own parents retired. Many with a sense of dread. Recalling their grandparents in rocking chairs waiting for death to snap them up, or worse still, withering away in squalid nursing homes, doesn’t imbue retirement with much of a glow!


Others who have had careers that filled their life with satisfaction, meaning, and excitement face the prospect of life without their career with despair. Even more so when considering retirement could last 28 years now that almost 1-in-5 people live to age 90.


Many people put a lot of thought and planning into their financial portfolio in preparation for retirement. Far fewer plan the other side - the emotional, psychological, and social side – with the same attention to detail. They might plan the “trip of a lifetime” touring Europe, or set off and join the grey nomads for a year touring Australia’s outback. After returning home, the future can begin to look very bleak.


Whether you’re still a few years off retirement, or you’re in that slump of “What next?”, here are some practical tips to build up your psychological portfolio for retirement:

  • Do a stocktake of the “If only I had the time…” dreams. In days gone by, what did you dream about experiencing if you didn’t have to go to work? Some call this the bucket list. Now is the time to write your bucket list. Sort these dreams into categories – travel (the places you’d love to see), new skills (learning a language, musical instrument, craft), volunteering (helping out the homeless, tour guiding, running a community group). Even add new career options you never thought would be possible, like teaching private classes or doing that degree or writing the next great novel.
  • Identify your “retirement robbers”.  Are the children planning your retirement as a chance to save on their childcare costs? Have you already become so caught up working for local charities or community groups that there’s no time for you? Learning to graciously say “Thanks for the invitation, I’ll have to check my commitments” is an essential life skill to ensure your retirement is just that – YOUR retirement.
  • Tackle procrastination head-on. This really gets down to taking control over time management. When you went to work, you knew you were being paid for a “good day’s work” and you made sure time was allocated for getting the jobs done. Retirement is no different – each day needs jobs to be done, they may just be much more diverse than those of your working life. Think about retirement as a set of projects – there’s the “staying healthy” project that requires daily activities, there’s the “staying connected” project that requires setting aside time to nurture relationships, there’s the “stretching the mind” project that requires time for learning. Setting up annual, monthly, weekly and daily goals and project task lists is essential. Even making it a project to learn practical tools for overcoming procrastination, then writing your own anti-procrastination guidebook, is a start to conquering this retirement robber.
  • Keep replenishing your relationships. The human brain needs other brains to stay operational. We know this from stories of people who’ve been isolated for long periods of time, and we know it from developmental neuroscience that proves brains grow from interacting with each other. It’s also a sad fact that as we age, the people who made up our social connections begin falling off the perch. Ageing – and death – are facts of life. Bemoaning it won’t change this. So learning to face loss and replenish our lives with new people is not a sign of disrespect for those who have passed on, it’s a healthy way of maintaining a high quality of mental wellbeing right to the end of your own journey. Make sure you allocate fun time to share with your inner circle of loved ones, whilst also seizing opportunities to meet new people of all ages. Join local community groups, offer time as a volunteer, start your own classes mentoring people in skills you have. Set yourself the goal of talking to at least one stranger every day!
  • Plan the legacy you want to leave. There’s nothing more important than the question, “What was the purpose of my life?”. It might seem gloomy to think of this, but inevitably we’ll all face that question at some time. Don’t wait until that moment when you want to beg for an extension of time. What will be the most significant contributions you’ll make for this world? Or the memories you’ll leave behind for your descendants? Retirement is the time to start getting your legacy in order, whether it’s doing the family tree, writing your memoirs, passing on your talents to others, or creating a garden wonderland. Your legacy is the most important project that gives meaning to every day of the rest of your life.

Dr Kate Lemerle, Psychologist

Chrysalis Counselling & Coaching, Norfolk Island

WEB: www.chrysaliswellnessservices.com

TEL: 52112 or email drkate@iinet.net.au

Please 'contact us' for more information.

Frequently Asked Questions about Psychologists and Psychotherapy



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Norfolk island Fitness and Health News


FITLOSOPHY:    Dark + Cold + Rain(?) = Group Exercise at Norfolk Fitness!!

                                What do our many classes involve?

  • Lots of fun and new "stuff"
  • Working with others in a Team environment
  • Compound functional movements which make you stronger for daily tasks
  • Interesting Equipment

and ... all done in an Interval (H.I.I.T.) format and run by our Qualified Trainers.

This style is best for Body Re composition ie changing shape for the better!!

FOODLOSOPHY:     Make peace with FOOD!!!

It should not be a battleground, a struggle, or a choice between GOOD and BAD!

ENJOY the variety and follow the K.I.S.S. principle ... "keep it simple sma

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Understanding the Mind – Obsessive Compulsive Disorder


It’s common to have finicky ways of doing things – washing up the glasses first, start dressing with socks, mow the lawn in straight lines, count the pegs as you hang up the clothes. These quirky habits don’t cause any problems…that is, unless something cuts across the ritual and causes a meltdown, or you just can’t snap off the thoughts. In the same vein, we all have times when our thoughts keep going back to something specific, maybe an idea we’ve had or something that isn’t yet solved. Again, this is not a problem as long as it’s easy to turn it off and re-focus onto something else.

When thoughts get stuck or quirky habits take up too much time and can’t be stopped, this is Obsessive Compulsive Disorder (OCD). It sits in the category of Anxiety problems because the person caught up by these rituals typically suffers high levels of distress when they are blocked from doing the rituals (compulsions) or they are exhausted from the constant thoughts churning around in the mind (obsessions). In some extreme cases, everything else in life takes a back seat to the obsessive thoughts or behaviour rituals.

Do I have OCD?

Worrying about something, or liking to do things a certain way, are not generally a problem. The DSM-5 defines OCD as “the presence of either obsessions or compulsions which are significantly distressing, time-consuming, or interfering with normal routines and social or occupational functioning”. That is, thoughts or rituals that interrupt our lives so we can’t function normally. A quick and easy online screening test is available at  https://psychology-tools.com/yale-brown-obsessive-compulsive-scale.

What causes OCD?

The precise cause of OCD still isn’t known but like many mental health disorders, is likely to be a mix of genetic, biological, and environmental factors.

Brain scan studies show that certain areas of the brain function differently in people with OCD compared with those who don’t. Faulty wiring in the neural pathways between different parts of the brain, including the orbitofrontal cortex, the anterior cingulate cortex (both in the front of the brain), the striatum, and the thalamus (deeper parts of the brain) has been found in people with OCD. This is often linked to irregularities in key neurotransmitters – the chemicals that send messages between brain cells, such as serotonin, dopamine, and glutamate.

About 25% of people with OCD have an immediate family member with the disorder. Twin studies suggest that genetics contributes about 45-65% of the risk for developing OCD. This may be linked to a mutation of the human serotonin transporter gene (hSERT) which is then inherited.

Operant learning – having rewards or punishment linked to behaviours – also plays a part. People who are vulnerable to stress, where the sympathetic arousal system doesn’t settle quickly, seem to get an instant reward – relief – when they engage in rituals, either actions or thoughts. The disorder might start this way, as a means of self-soothing which is rewarding, but then it becomes almost like an addiction where the need for relief takes over everything.

Cognitive theories suggest that OCD starts with misinterpreting the meaning of certain thoughts, for example, over-personalising something another person has said, or exaggerating the meaning given to a thought. This triggers stress which is then relieved by doing certain compulsive actions. This is known as thought-action fusion.

Finally, OCD can develop from environmental factors. Having highly critical parents or experiencing trauma in childhood often underlie OCD. Some brain injuries trigger this disorder, and there is evidence that some severe bacterial or viral infections in childhood underlie the condition.

How is it treated?

There is no cure for the disorder, but there are effective, evidence-based therapies that mean the person with OCD can get on and still manage the condition so it has less impact on day-to-day life. Medications such as selective serotonin reuptake inhibitors (SSRI’s) may be necessary in extreme cases where the disorder is profoundly affecting quality of life or threatening health. In extreme cases, other medical treatments such as antipsychotics or tranquillizers, deep-brain stimulation, and brain surgery may be necessary.

Treatment plans should also include “talk therapies” to help the patient understand the disorder and develop better coping skills. This can include cognitive therapy – learning to think differently about rituals so they are given less significance. Paired with coaching in anxiety reduction techniques such as mindfulness, deep relaxation or self-hypnosis, this approach has a high success rate.

Danger Ideation Reduction Therapy has recently been shown to be highly effective. This treatment targets danger-related thoughts through a 6-step process aimed at restructuring faulty beliefs using techniques like attentional focusing, providing corrective and factual information, and cognitive restructuring.

Like all serious mental health problems, the sooner treatment is started the higher the chance of a good recovery. However, successful treatment depends on investing time and effort into getting well again and having a strong positive believe that the brain can be healed.

Dr Kate Lemerle, Psychologist

Chrysalis Counselling & Coaching, Norfolk Island

WEB: www.chrysaliswellnessservices.com

TEL: 52112 or email drkate@iinet.net.au

Please 'contact us' for more information.



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