The metabolic syndrome quintuples the risk of type 2 diabetes mellitus. Type 2 diabetes is considered a complication of metabolic syndrome. In people with impaired glucose tolerance or impaired fasting glucose, presence of metabolic syndrome doubles the risk of developing type 2 diabetes. It is likely that prediabetes and metabolic syndrome denote the same disorder, defining it by the different sets of biological markers.
Ultrasound-assisted liposuction (known as “ultrasonic”) is a technique used on areas where a greater amount of dense fat resides. It’s a dual process using ultrasound and suction. First, ultrasound waves transmit energy through a special device aimed to help loosen and melt the fat. This liquid is then suctioned out using a cannula. UAL liposuction is commonly used on men seeking a higher level of muscular definition. You may hear this type of liposuction referred to as hi-def liposuction or VASER® Lipo, or simply Vaser hi-def.
That sour cherry is pretty sweet when it comes to your health. The results of a study conducted at the University of Michigan found that rats given high-fat foods along with tart cherries ditched nine percent more body fat than those in a control group over just 12 weeks. Cherries are also a good source of antioxidant pigment resveratrol, which has been linked to reductions in belly fat, dementia risk, and lower rates of macular degeneration among the elderly.
People claiming huge benefits of these supplements – despite the lack of solid scientific support – may sometimes have a financial reason to believe in the supplements. Some of these products are sold under a multi-level marketing arrangement, where sales people are paid based on commission. For example, the company Prüvit sells drinkable ketones, called KETO//OS with a multi-level marketing structure.
If you’re taking lots of vitamins and probiotics each day, you may want to reevaluate your strategy. Increased levels of B vitamins have long been associated with a higher prevalence of obesity and diabetes, perhaps because megadosing triggers our fat genes. A daily multivitamin is probably fine, but don’t try to convince yourself that more is better. And a recent study by ConsumerLab.com found that most commercial probiotics have far less healthy bacteria than they claim. Your better bet is to focus on the Zero Belly foods to ensure your belly is getting plenty of love—and your fat genes are being cut off at the pass.
Research shows that Western diet habits are a factor in development of metabolic syndrome, with high consumption of food that is not biochemically suited to humans. Weight gain is associated with metabolic syndrome. Rather than total adiposity, the core clinical component of the syndrome is visceral and/or ectopic fat (i.e., fat in organs not designed for fat storage) whereas the principal metabolic abnormality is insulin resistance. The continuous provision of energy via dietary carbohydrate, lipid, and protein fuels, unmatched by physical activity/energy demand creates a backlog of the products of mitochondrial oxidation, a process associated with progressive mitochondrial dysfunction and insulin resistance.
Pierre Fournier of Paris France, improvised on the Fischer's' liposculpture technique and was the initial advocate of the ‘dry technique’ in which no fluids were infiltrated prior to liposuction. He went on to become an authority in liposuction and fat transplantation and later promoted the benefits of tumescent anaesthesia. He was instrumental in technology transfer to the next generation of surgeons representing varied specialties all over the world.
Yes you can lose fat on a low carb because it’s just another low calorie diet. How do I know this? I’ve done low carb, (Atkins, etc) high carb, (Slimming Word) moderate carb etc and log my food and was shocked each time to see they were all low calorie. After the initial week or so the rate of fat loss is same as any other diet. It’s calories in calories out. Simple. It’s what some call indirect deficit diet placing silly restriction, rules can eat must eat etc. and of course you lose weight but nothing to do with low carb. It works because it’s a low calorie diet.
Dr. Schlessinger does not recommend tumescent liposuction for skin tightening. Tumescent liposuction is useful for removing fat, but it does not help improve the appearance of loose skin. If you are truly looking for only skin tightening, it won't be that impressive. Many other options for skin tightening work better, are less expensive and have shorter recovery times, such as laser procedures.
The first modern study of fasting as a treatment for epilepsy was in France in 1911. Twenty epilepsy patients of all ages were "detoxified" by consuming a low-calorie vegetarian diet, combined with periods of fasting and purging. Two benefited enormously, but most failed to maintain compliance with the imposed restrictions. The diet improved the patients' mental capabilities, in contrast to their medication, potassium bromide, which dulled the mind.
Glucose. Usually a fasting glucose test is performed but, in some cases, a healthcare practitioner may also order a post prandial glucose (after a meal) or a GTT (glucose tolerance test – several glucose tests that are taken before and at timed intervals after a glucose challenge). The goal of glucose testing is to determine whether a person has diabetes or a decreased ability to process glucose (impaired glucose tolerance), which can eventually result in diabetes.
“For some people, it’s knowing, ‘Typically I eat a whole sandwich,’” says Gagliardi. “‘Now, I’m going to make the decision to eat half a sandwich at lunch and save the other half for my dinner and essentially cut my calories in half. And they feel good about that. They’re not having to do math.” To get started, check out these 25 simple ways to cut 500 calories a day.
The ketogenic diet is calculated by a dietitian for each child. Age, weight, activity levels, culture, and food preferences all affect the meal plan. First, the energy requirements are set at 80–90% of the recommended daily amounts (RDA) for the child's age (the high-fat diet requires less energy to process than a typical high-carbohydrate diet). Highly active children or those with muscle spasticity require more food energy than this; immobile children require less. The ketogenic ratio of the diet compares the weight of fat to the combined weight of carbohydrate and protein. This is typically 4:1, but children who are younger than 18 months, older than 12 years, or who are obese may be started on a 3:1 ratio. Fat is energy-rich, with 9 kcal/g (38 kJ/g) compared to 4 kcal/g (17 kJ/g) for carbohydrate or protein, so portions on the ketogenic diet are smaller than normal. The quantity of fat in the diet can be calculated from the overall energy requirements and the chosen ketogenic ratio. Next, the protein levels are set to allow for growth and body maintenance, and are around 1 g protein for each kg of body weight. Lastly, the amount of carbohydrate is set according to what allowance is left while maintaining the chosen ratio. Any carbohydrate in medications or supplements must be subtracted from this allowance. The total daily amount of fat, protein, and carbohydrate is then evenly divided across the meals.
For patients who benefit, half achieve a seizure reduction within five days (if the diet starts with an initial fast of one to two days), three-quarters achieve a reduction within two weeks, and 90% achieve a reduction within 23 days. If the diet does not begin with a fast, the time for half of the patients to achieve an improvement is longer (two weeks), but the long-term seizure reduction rates are unaffected. Parents are encouraged to persist with the diet for at least three months before any final consideration is made regarding efficacy.
The notion that metabolic syndrome, or its surrogate markers hyperinsulinemia and insulin resistance, antedate and contribute to the pathogenesis of coronary heart disease, diabetes, and at least some cases of hypertension was proposed many years ago.21,35 Coronary heart disease in the setting of metabolic syndrome can to a great extent be attributed to dyslipidemia (increased dense LDL cholesterol, diminished HDL cholesterol, and hypertriglyceridemia)231 as well as to elevations in blood pressure and blood glucose and the presence of a procoagulant, proinflammatory state.22,228 In addition, some studies suggest that hyperinsulinemia and insulin resistance, as well as hyperglycemia, may be independent risk factors.51 Whether elevated FFA levels or a dysregulation of intracellular fatty acid metabolism contribute to atherosclerosis by directly altering the function of endothelium (see the section entitled “Vascular Endothelial Cells and Atherogenesis”) or other cells in the vascular wall remains to be determined. Relevant to this discussion, low levels of adiponectin are associated with an increased risk for coronary heart disease in humans,155 whereas, as noted earlier, overexpression of adiponectin or its globular subunit diminishes the severity of atherosclerosis in ApoE–/– mice.232,233
Non-cosmetic applications of liposuction were pioneered or developed by surgeons of other specialties. Liposuction could be used to remove lipomas, angiolipomas, and improve hyperhidrosis. Liposuction techniques can assist in hematoma evacuation. Klein demonstrated liposuction techniques for breast reduction [Figure 4]. Field pioneered liposuction to facilitate flap movement in cutaneous reconstruction, gynaecomastia, [Figure 5] and benign symmetrical lipomatosis (Madelung's disease), and Dercum's disease.
In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.
Português: Queimar a Gordura da Barriga Rapidamente, Español: quemar la grasa del estómago rápidamente, Italiano: Eliminare Velocemente la Pancetta, Deutsch: Bauchfett schnell verbrennen, Français: faire fondre rapidement la graisse du ventre, Русский: быстро сжечь жир на животе, 中文: 快速燃烧腹部脂肪, Nederlands: Snel buikvet verbranden, Čeština: Jak rychle spalovat tuk na břiše, Bahasa Indonesia: Cepat Membakar Lemak Perut, 日本語: 即効でお腹周りの脂肪を燃焼する, हिन्दी: तेजी से पेट की चर्बी घटाएं, العربية: حرق دهون منطقة البطن بسرعة, ไทย: ลดพุง, 한국어: 뱃살 빨리 빼는 법, Tiếng Việt: Đốt cháy Mỡ bụng Nhanh chóng
For a diagnosis of metabolic syndrome, a child must have at least three of the four risk factors. The most common risk factors in teens are hypertension and abnormal cholesterol. Even when just one risk factor is present, a doctor will likely check for the others. This is especially true if a child is overweight, has a family member with type 2 diabetes, or has acanthosis nigricans.
In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (the process is called ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over two to four days of eating fewer than 20 to 50 grams of carbohydrates per day. Keep in mind that this is a highly individualized process, and some people need a more restricted diet to start producing enough ketones.
Dr. Yaker specializes in liposuction surgery and offers this procedure to Plano area men and women who desire a slimmer appearance. Liposuction (“Lipo”) is a surgery that removes fat from the body. During this procedure, a small puncture is made in the skin and a “cannula” helps to loosen fat cells and suction them out. Common areas for fat removal include the stomach, hips, lower back, thighs, arms, neck and chest. Liposuction is ideal for those who are at a healthy weight and is not an alternative to a weight loss plan, nor is it a surgery to “treat” being overweight. Dr. Yaker offers various techniques including liposuction surgery, ultrasound assisted lipo and laser lipo procedures. Each of these will be discussed during the consultation.
Modern liposuction began with the technique and instruments of Giorgio Fischer, and his father Arpad Fischer, both, Gynaecologists from Rome, Italy, in 1974. They developed their instruments themselves and their early cannulae contained a cutting blade within them. They eventually developed a blunt hollow canula connected to a suction apparatus and published their results in 1976. They developed the technique of crisscross tunnel formation from multiple access sites with their improved cannulae and demonstrated good results with fewer complications. In 1978 Kesselring and Meyer published results of a sharp curettage aided by suction. The technique did not gain much acceptance in view of the significant complications.
Here's something else most people probably don't know: Fidgeting is good for you. It's considered a nonexercise physical activity, and it's an important way to burn energy. You get more health benefits if, in addition to exercising, you are a more fidgety, more active person the rest of the day. This means gesturing while you're talking, tapping your foot, just moving around.
Indulging in delicious food is a core principle of Zero Belly Diet. It was the balanced, “zero sacrifice” approach that helped test panelist Jennie Joshi finally lose her pregnancy weight. In just over a month on Zero Belly Diet, Jennie lost 11 pounds, “and the pregnancy pooch is leaving!” she said. “I couldn’t believe I was indulging in dark chocolate—and finally getting results! It’s a lifestyle, not a diet. It’s easy to stick with, and it makes sense.”
The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients. Three-quarters of children who respond do so within two weeks, though experts recommend a trial of at least three months before assuming it has been ineffective. Children with refractory epilepsy are more likely to benefit from the ketogenic diet than from trying another anticonvulsant drug. Some evidence indicates that adolescents and adults may also benefit from the diet.
A Cochrane systematic review in 2018 found and analysed eleven randomized controlled trials of ketogenic diet in people with epilepsy for whom drugs failed to control their seizures. Six of the trials compared a group assigned to a ketogenic diet with a group not assigned to one. The other trials compared types of diets or ways of introducing them to make them more tolerable. In the largest trial of the ketogenic diet with a non-diet control, nearly 38% of the children and young people had half or fewer seizures with the diet compared 6% with the group not assigned to the diet. Two large trials of the Modified Atkins Diet compared to a non-diet control had similar results, with over 50% of children having half or fewer seizures with the diet compared to around 10% in the control group.
Keeping a toothbrush handy can do more than polish up that smile (and counter the effects of all that belly-slimming garlic); brushing your teeth throughout the day can also help you ditch that belly fat fast. A study conducted a sample of over 14,000 participants found that brushing after every meal was linked to lower weight. That minty toothpaste flavor not only clashes with virtually every food, brushing may also trigger a Pavlovian response that tells your brain the kitchen’s closed.
Use fat as a lever. We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
This process of burning fat provides more benefits than simply helping us to shed extra weight — it also helps control the release of hormones like insulin, which plays a role in development of diabetes and other health problems. When we eat carbohydrates, insulin is released as a reaction to elevated blood glucose (an increase in sugar circulating in our blood) and insulin levels rise. Insulin is a “storage hormone” that signals cells to store as much available energy as possible, initially as glycogen (aka stored carbohydrates in our muscles) and then as body fat.
2No interest will be charged on the promotional purchase if you pay the promotional purchase amount in full within the 6 or 12 month promotional period. If you do not, interest will be charged on the promotional purchase from the purchase date. For new accounts, Purchase APR (interest rate) is 26.99%. For example, a 12 month promotional period on a $10,000 purchase will have a deferred interest rate of 26.99%. If monthly payments of $834 are made for 12 months, there would be no interest charged and the total cost of the loan would be $10,000. Regular minimum monthly payment terms of the account will apply. There is no prepayment penalty. Terms offered are based on income, credit score and history, and other factors. Financing provided by Synchrony Bank, a consumer financial services company headquartered in Stamford, Connecticut.
Eating the right kinds of fats is crucial if you want to cut down on your belly fat. Some fats will only contribute more to visceral fat, such as saturated fats. Lead author Lucinda Summers from the Oxford Centre for Diabetes says in her research report, if you add polyunsaturated fats, like those found in nuts and certain types of fish, you can benefit from their anti-inflammatory potential and actually help to reduce your visceral fat levels.
Hi I’m new to Keto. I have been reading about it, and understanding what to eat and what not to eat. My problem is I’m not sure if I’m doing it correctly. I’m constantly hungry whereas information reads that I will never be hungry. I use fats as required along with topping up with vegetables in my meals yet this does not fill me up. I haven’t experienced the Keto flu and I’ve even put on weight! I have been doing this for about 3 weeks now. Any ideas where I am going wrong.
While many people turn to artificial sweeteners in a misguided attempt to whittle their waistlines, those fake sugars are likely to have the opposite effect. According to Yale researchers, artificial sweeteners are actually linked with an increased risk of abdominal obesity and weight gain, possibly because they can trigger cravings for the real stuff and spike insulin levels in a similar fashion to real sugar.
Tight deadlines, bills, your kids—whatever your source of stress, having too much of it may make it harder for you to drop unwanted pounds, especially from your middle. And it's not just because you tend to reach for high-fat, high-calorie fare when you're stressed, though that's part of it. It's also due to the stress hormone cortisol, which may increase the amount of fat your body clings to and enlarge your fat cells. Higher levels of cortisol have been linked to more visceral fat.
Inner knee, medial thigh or submandibular region [Figure 14] with a less dense fat are better managed with a standard wet technique rather than the UAL. Improved results with less fatigue in treating fibrous areas such as gynecomastia, posterior trunk, upper abdomen, posterior hip rolls and trochanteric regions [Figure 15] support the use of UAL as an adjunct to SAL rather than as an alternative.
Wilder's colleague, paediatrician Mynie Gustav Peterman, later formulated the classic diet, with a ratio of one gram of protein per kilogram of body weight in children, 10–15 g of carbohydrate per day, and the remainder of calories from fat. Peterman's work in the 1920s established the techniques for induction and maintenance of the diet. Peterman documented positive effects (improved alertness, behaviour, and sleep) and adverse effects (nausea and vomiting due to excess ketosis). The diet proved to be very successful in children: Peterman reported in 1925 that 95% of 37 young patients had improved seizure control on the diet and 60% became seizure-free. By 1930, the diet had also been studied in 100 teenagers and adults. Clifford Joseph Barborka, Sr., also from the Mayo Clinic, reported that 56% of those older patients improved on the diet and 12% became seizure-free. Although the adult results are similar to modern studies of children, they did not compare as well to contemporary studies. Barborka concluded that adults were least likely to benefit from the diet, and the use of the ketogenic diet in adults was not studied again until 1999.
Most people who have metabolic syndrome already have a closely related condition called insulin resistance, which is when the body stops responding to insulin (a hormone produced in the pancreas). After the food we eat is converted into a type of sugar called glucose, insulin is what enables the glucose to enter the body’s cells and be used as energy. For someone who is insulin resistant, however, the glucose builds up in the blood, setting the stage for damage.
Researchers believe that the ketogenic diet can also help patients with schizophrenia to normalize the pathophysiological processes that are causing symptoms like delusions, hallucinations, lack of restraint and unpredictable behavior. One study found that the keto diet lead to elevated concentrations of kynurenic acid (KYNA) in the hippocampus and striatum, which promotes neuroactive activity. Some studies even point to the elimination of gluten as a possible reason for improved symptoms, as researchers observed that patients with schizophrenia tended to eat more carbohydrates immediately before a psychotic episode. (19)
When in the hospital, glucose levels are checked several times daily and the patient is monitored for signs of symptomatic ketosis (which can be treated with a small quantity of orange juice). Lack of energy and lethargy are common, but disappear within two weeks. The parents attend classes over the first three full days, which cover nutrition, managing the diet, preparing meals, avoiding sugar, and handling illness. The level of parental education and commitment required is higher than with medication.
Eating avocados in particular has been found to be clinically associated with lower metabolic syndrome in U.S. adults because avocado benefits your gut. (11) Think of a rainbow as you make your daily vegetable choices (red bell peppers to pumpkin to yellow squash to arugula to purple eggplant). This way, not only do you keep your meals interesting, but you obtain all of the great vitamins and nutrients vegetables can offer you!
Chickpeas are naturally high in carbs — a single cup contains 45 grams of carbohydrates.31 However, you can modify the recipe to make it more nutritious. Try this recipe from Pete Evans, which replaces the chickpeas with beetroot.32 Beware, though, that beets have the highest sugar content of all vegetables, so consume them in very controlled amounts.
In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works. Note: If you want to use the liposuction fat as filler for the face or the lips, it is of great importance to know how and using which technique the fat will be removed.
^ Vancampfort D, Correll CU, Wampers M, Sienaert P, Mitchell AJ, De Herdt A, Probst M, Scheewe TW, De Hert M (July 2014). "Metabolic syndrome and metabolic abnormalities in patients with major depressive disorder: a meta-analysis of prevalences and moderating variables". Psychological Medicine. 44 (10): 2017–28. doi:10.1017/S0033291713002778. PMID 24262678.
Yes, they're technically a fruit, but we think olives deserve a shout-out all of their own, since they're also a great source of healthy fats and are one of a few keto-approved packaged foods. Plus, they're a great source of antioxidants, will satisfy your craving for something salty, and are blissfully low-carb. “About a palm's worth only has 3 grams of net carbs,” Sarah Jadin, RD, told Health in a previous interview.
The goal of metabolic syndrome treatment is to reduce the risk of heart disease and diabetes by controlling the associated problematic health conditions (high blood pressure, high cholesterol, diabetes, insulin resistance). “A study in which 53 percent of people had metabolic syndrome at the start found that over three years, intensive lifestyle changes—mainly diet and exercise—resulted in the lowest risk of developing diabetes and the lowest risk of developing metabolic syndrome in those who didn’t have it,” Ndumele says. Recommended changes include:
Jim said people can healthily lose half a pound to two pounds a week. In a month, that could add up to four to eight pounds lost. Since one pound of fat equals 3,500 calories, to lose one pound a week, you would have to burn approximately 500 extra calories a day. This can be achieved through eating in a healthy calorie deficit or working out to burn extra calories (or a combination of both). Other lifestyle factors also play a role. Getting enough sleep will ensure your body recovers well and that you'll be energized for your workouts the next day. And too much stress increases the stress hormone cortisol, which can increase your cravings for caloric refined carbs and comfort food, which will prevent you from losing weight (especially in your belly). Make sure, in addition to eating in a calorie deficit, that you're also getting at least seven hours of sleep a night and managing your stress.
This was a great read. I aim to restrict carbs always because I believe most are why the American population is obese. I would very much like to hear more about carb restriction excluding the discussion on processed meats and processed high salt content foods because I consume neither. I also don’t consume dairy or eggs. So can you provide some substance.
Pre-tunnelling (Mladick) increases instrument control as, without suction, it creates desired superficial as well as deep planes of fat removal. It prevents an inadvertent removal in the sub-dermal fat layer that can result in contour irregularities. Similarly, cross tunnelling with at least two port sites at right angles are used to treat an area of adiposity. The use of multiple port sites provides for better contouring and feathering of edges.
When you eat less than 50 grams of carbs a day, your body eventually runs out of fuel (blood sugar) it can use quickly. This typically takes 3 to 4 days. Then you’ll start to break down protein and fat for energy, which can make you lose weight. This is called ketosis. It's important to note that the ketogenic diet is a short term diet that's focussed on weight loss rather than the pursuit of health benefits.
This isn’t your ordinary cosmetic surgery center. Imagen is a Liposuction center in Omaha specifically focused on achieving significant, life-changing results for our patients - just read our liposuction reviews. While we advocate living a healthy lifestyle, we also understand that 90% of diets fail and that for many, diet and exercise alone cannot help you achieve the body you desire. If you’re ready to seriously improve the way you see yourself, call us for a complimentary consultation. All you have to lose is the fat!
Get enough calcium. Adults typically need around 1,000 milligrams of calcium every day to help maintain muscle and nerve function, and it's necessary for healthy bones and teeth. But calcium may also help prevent the body from storing visceral fat in the abdomen. Though studies have not shown a drastic change in weight due to increased calcium intake, researchers suggest that it may have a small effect in some people. Calcium requires vitamin D to be absorbed into the body; therefore, be sure to get enough vitamin D as well. Sources of calcium include:
Studies have shown that post-natal and post-menopausal women have seen significant reductions in visceral fat stores when adding yoga to their workout and health regimens. Yoga is a wonderful way to reduce stress and eliminate excess stress hormones from your body, namely cortisol. Dr. Janice Kiecolt-Glaser, an eminent psychologist from The Ohio State University, carried out a study in which she found yoga fastened an individual’s physiological recovery. Furthermore, it also stated that there’s a direct link between chronic stress, cortisol levels, and belly fat. Thus it is important to clear your mind, calm down, and keep that visceral fat at bay!
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
The exact cause of metabolic syndrome is not known. Many features of the metabolic syndrome are associated with "insulin resistance." Insulin resistance means that the body does not use insulin efficiently to lower glucose and triglyceride levels. Insulin resistance is a combination of genetic and lifestyle factors. Lifestyle factors include diet, activity and perhaps interrupted sleep patterns (such as sleep apnea).