The most common signs of stroke are facial weakness, arm weakness and difficulty with speech. But they are not only signs. Other signs that may occur alone or in combination include:

• weakness
• numbness or paralysis of the face, arm or leg
• dizziness
• loss of balance, or an unexplained fall
• loss of vision
• sudden blurring or decreased vision
• headache, often severe and abrupt
• difficulty swallowing

A stroke is always a medical emergency. Don’t put off calling an ambulance, even if you think you’re making a fuss over nothing, or the signs disappear within a short space of time. If you suspect stroke, no matter how long the symptoms last, call emergency services immediately. The longer a stroke remains untreated, the greater the chance of stroke-related brain damage.

Over 80% of strokes can be prevented

High blood pressure is the most important known risk factor for stroke. Reduce your risk by making time for a health check with your GP for all stroke risk factors. Take charge of your health too, by a healthy lifestyle – being active, eating well, quitting smoking and drinking alcohol in moderation.

But as psychiatrist Mark Cross, author of the book Anxiety, explains: “When anxiety is intense, enduring and causing the kind of panic that interferes with a person’s life so they can’t function well, then it may be that they are suffering from an anxiety disorder and need professional help.”

Unfortunately, anxiety remains a misunderstood condition, which can lead to stigma and discrimination for people who experience it.

“A quarter of us will experience anxiety at some point, so it is concerning that roughly half of us still have either misconceptions or are unaware of the condition, its symptoms and available treatment,” says Beyond Blue CEO Georgie Harman.

Here are three common misconceptions about anxiety:

1.           It’s not a real medical condition

We all get anxious, but for most of us it’s fleeting, and the feelings pass once the stressor disappears.

Part of the problem, is that because most people have experienced anxiety at some level, we tend to minimise it. As described in the book Anxiety: “If I try to explain the debilitating anxiety that I experience, I feel sure that people will roll their eyes and think, ‘We all get anxious sometimes, get over it.’” But anxiety is a real medical condition. On top of the distressing psychological symptoms, anxiety can cause stomach problems, dizziness, chills, increased heartbeat, chest pain, trouble breathing, headaches, muscles tension, and insomnia.

2.           People with anxiety bring it on themselves, or can ‘snap out of it’

There isn’t an on and off button for anxiety, says Beyond Blue. Many people still believe that people dealing with anxiety should be able to just switch it off, or ‘calm down’.

Mark Cross, who suffers from anxiety himself, has experienced this attitude firsthand: “The person [with anxiety] may seem so calm that others doubt the veracity of their distress,” he says. “Because there are often no tangible symptoms, there’s a common perception that people somehow bring anxiety on themselves, that perhaps they have maladjusted temperaments, or lack willpower.

“These views ignore the evidence that people suffering anxiety don’t choose to be in that situation,” he explains, “and that it takes a massive personal effort to maintain clear thinking and acting.”

3.           Anxiety is a sign of personal weakness

Having anxiety does not mean you are weak or inferior. Anxiety, like other mental health conditions, affects people of all ages and all walks of life. Any perception that it is a weakness must change, says Beyond Blue, as this stigma means people dealing with anxiety are less likely to seek support.

Who is most at risk?

Any job that calls for fast and repetitive movements, or one where you have to work in fixed or awkward postures for long periods of time can trigger OOS. People who work with their hands are most at risk, with occupations most affected including:

• Office workers – including anyone who uses a keyboard and those doing clerical duties
• Process workers – working on an assembly line and packing
• Piece workers – such as people working in the clothing industry
• Manual workers – such as bricklayers and carpenters

Performing repetitive manual tasks will put stress on your body. But so too will poor workplace design and poor work practices, such as furniture, tool or equipment that aren’t comfortable for you; benches or workstations that are too high, too low, or too far from your body; machinery that is too fast for user comfort; tight deadlines that mean you don’t take sufficient breaks; and a workspace design that means you have to repeatedly bend, stretch or twist.

Don’t ignore OOS

Your OOS will not go away by itself. Over time the discomfort and pain are likely to get worse without treatment. See your doctor for treatment, advice and a referral to an appropriate specialist. Also tell your manager, as there may be adjustments you can make to your workplace, such as using ergonomically designed furniture and equipment, varying your work tasks, and scheduling work to include frequent breaks.

Would you know if you were stressed? It sounds a simple enough question. You’d feel it wouldn’t you? Worry, anger, anxiety – these are some of the more familiar signs of stress. But stress can also affect your body in more surprising ways, thanks to your body’s stress hormones.

Whatever the cause of stress, everyone responds in a similar way, a way we’ve done for thousands of years, explains Kate Harkness, Professor of Psychology and Psychiatry and Director of the Mood Research Laboratory, Queen’s University, Ontario.

When animals or humans perceive a threat in their environment the adrenal glands release the hormone cortisol and adrenaline, she says. These work to pump oxygen to the major muscles to enable us to fight or escape the perceived danger (the ‘fight or flight’ response). This response produces physical symptoms such as heart palpitations and chest tightness, as the heart pumps oxygen to the muscles; and stomach butterflies, nausea and tingling, as blood leaves the stomach and extremities to reach the major muscles.

Your body doesn’t know the difference between immediate, life-threatening stress, and the slow-burn type of stress we more commonly experience. All it knows is that it needs to release stress hormones because your body is sensing a threat in your environment.

Your body on stress

Cortisol is a potent anti-inflammatory that helps repair wounds and fight infection – useful if you’ve been in a situation that caused injury. But in the long term the cells in your immune system becomes less sensitive to the anti-inflammatory effects of cortisol, and as a result, explains Professor Harkness, all that extra cortisol can start to increase inflammation and affect your immune system. That’s why you’re more likely to pick up infections and viruses after a long period of stress.

Stress can impact your body in other ways too. Without taking steps to reduce or relieve your stress you can experience:

• Headaches
• Muscles aches and pains
• Fatigue and insomnia
• Digestive problems
• High blood pressure
• High blood sugar
• Weight gain, mostly around the midsection and upper back
• Memory and concentration difficulties

As important as the stress response is when we are in a threatening situation, it’s just as important that we learn ways to lower it when we’re faced with everyday problems.

3 ways to lower stress hormones

• Get active. Exercise reduces levels of the body’s stress hormones, such as adrenaline and cortisol, as well as stimulating the production of mood elevating endorphins. Choose a leisurely walk, yoga session, a run, swim, or play a sport.
• Breathe. Simple breathing exercises can help reduce stress. Breathe in lowly and deeply, hold your breath briefly, and exhale slowly, thinking ‘relax’. Repeat the sequence five to 10 times.
• Laugh. Researchers have shown that this natural medicine can improve your mood, lower cortisol, strengthen your immune system, relax your muscles, and combat stress. Listen to a funny podcast, watch amusing YouTube videos, have a laugh with friends, or tune into your favourite comedy show.

We all have the occasional poor night’s sleep, waking up feeling sluggish and tired. During the day we may lack energy, find it hard to concentrate or notice a low mood. But people who have obstructive sleep apnoea (OSA) can experience these feelings every day.

Nearly one billion people globally have OSA, making it one of the most common sleep disorders. The health and financial costs are high. According to Australia’s Sleep Health Foundation, OSA not only disturbs your sleep, it’s a stress on your body.

There is strong evidence that people with untreated moderate to severe OSA have other health problems, says the Sleep Health Foundation. These include increased risk of high blood pressure, heart attack, stroke, diabetes, and depression. Thinking is less clear, mood is affected, and productivity at work and at home suffer. OSA also increases the risk of motor vehicle and workplace accidents by six to seven times.

With a recent study in the Lancet estimating almost one billion people are affected by sleep apnoea, it is not hard to imagine that the financial costs associated with this are high, including health care costs, lost productivity and other financial impacts.

What is OSA?

OSA is more than just bad snoring. If you have OSA the walls of your throat relax and narrow during sleep, interrupting normal breathing. Your airway can partially or completely close, which means your breathing often stops for a short time, even for up to a minute. You’ll wake for a few seconds to open your airway, perhaps snort and gasp, then drift back to sleep again, often without realising you’ve woken up. This can happen hundreds of times a night. OSA is classified as mild, moderate or severe depending on how many times your sleep is interrupted during an hour.

What are the signs of OSA?

Loud snoring is a very common symptom of OSA (so loud your bed partner might complain that it’s intolerable), as is waking during the night choking or gasping for air. You may wake in the morning feeling unrefreshed, experience morning headaches, a dry mouth or a sore throat. Daytime tiredness is common, as is difficulty concentrating, and you may notice your work quality suffering as you experience reduced alertness.

Your mood can be affected when you have OSA – it’s common to feel more irritable, depressed and anxious after unrefreshing sleep, and to lose your sex drive. Rapid weight gain or difficulty losing weight can also result from untreated OSA. But these symptoms can come and go, and many people remain unaware that they have the condition, or don’t realise that it is serious.

Who gets OSA?

While OSA mainly affects men, women can have it too, particularly after menopause. OSA was reportedly a contributing factor behind the death of actress Carrie Fisher in 2016. Sleep apnoea can even affect children. Aside from being male, there are other factors that increase your risk, including:

• Being overweight, in particular having excess fatty tissue around the neck, which can cause a narrowing of the throat. However OSA can also occur in people who aren’t overweight.
• Having a large neck circumference (>43cm for men; >40cm for women).
• Being middle aged and older.
• Smoking – smokers are three times more likely to have sleep apnoea than non-smokers.
• Excess alcohol consumption, particularly at night. Alcohol can relax the muscles in your throat, closing the upper airway. Sleeping pills can have a similar effect.

First, get a diagnosis

Don’t attempt to self-diagnose sleep apnoea. First see your doctor, who can refer you to a sleep specialist if necessary, who may recommend a sleep study. That way you’ll find out if you have sleep apnoea, whether it’s mild, moderate or severe, and what treatment would be most appropriate for you.

What you can do to reduce your risk

According to the Sleep Health Foundation, for people with a mild level of OSA and few symptoms, losing weight, decreasing the amount of alcohol consumed in the evening and adjusting their sleeping position may be all that is needed. (Most people have more OSA episodes if they sleep on their backs).

Of course, losing weight is easier said than done. But losing just 10 per cent of your body weight can have a big effect on sleep apnoea symptoms. Ask your doctor for a referral to a dietitian who can help make achievable adjustments to your diet and physical activity to aid weight loss.

A simple solution to help you sleep on your side that you can do yourself is to place a tennis ball into a pocket sewn onto the back of your pyjamas, making it uncomfortable to sleep on your back. You can buy more sophisticated versions of this – chest belts with back pockets that hold inflatable bumpers, or electronic devices that buzz or vibrate when you lie on your back.

If you have moderate or severe sleep apnoea, other treatment may be needed in addition to weight loss. These include:

1. CPAP. The first line treatment for OSA is continuous positive airway pressure (CPAP). This is where the patient wears a mask and sufficient air is blown into the mask to prevent airway closure during sleep. CPAP is highly effective in reducing sleep-related breathing disturbances and millions of people worldwide have had their lives changed by CPAP therapy.
2. Dental appliances. For some people an oral appliance (mandibular advancement device) fitted by a specialist dentist can hold the jaw forward during the night, helping to keep the airway open.
3. Drug therapy. Researchers are trialling new drug therapies which aim to open up the airways and improve sufferers’ sleep.

Director Professor Danny Eckert says that a range of issues means OSA is often untreated. “New treatments are urgently needed,” he says, “and we’re aiming to use and develop novel approaches to identify the causes of OSA on a per patient basis, improve current therapies and management approaches and test if new targeted therapies can be used to treat OSA.”

We know that alcohol is linked to a wide range of disease including cancer, liver disease and heart disease. Alcohol can also be damaging to your emotional health, especially if you already experience depression or anxiety.

And if you drink before bed, your sleep quality may not improve, says the Sleep Health Foundation. While you may fall asleep quickly after drinking, alcohol is associated with waking in the night, night sweats, nightmares, and headaches. And without sufficient rest, you’re less able to handle stress.

The solution: Tempted to reach for the beer or wine? Get out of the habit and explore non-alcoholic options. If you want the taste of an alcoholic drink, try non-alcoholic wines, distilled spirits and beer. You’d be in good company. According to a DrinkWise study, more and more of us are saying no to alcoholic drinks with 20 per cent of us abstaining from drinking in 2017.

Make a note of when you’re reaching for a drink. If it’s early evening after a stressful day, taking time out for yourself, even as little as 10 to 15 minutes (for a walk, meditation, quiet read, quick workout or listening to music) can work to calm your mind and reduce your stress.

Your stress habit: comfort eating

There’s nothing like a period of stress to throw your good eating intentions out of the window. Since we were children, we’ve known how effective food can be to comfort us during difficult times. The problem of course, is the kind of foods we turn to. Anxious, worried, lonely or bored? It’s easy to reach for sweet or salty snacks or a bowl of ice cream.

Sweet enough

“For many, free sugar consumption is still well above the WHO’s recommended six teaspoons (24 grams) a day limit,” says Dr Chinotti, “and this is affecting quality of life by causing tooth decay.”

Sugar is the enemy of healthy teeth. It feeds the bacteria that live on the surface of your teeth, and they rapidly produce acids that dissolve your protective tooth enamel, leading to decay and cavities. If the bacteria on your teeth spread to the gum line, they can irritate or infect the gums, leading to gingivitis, gum disease and potentially, tooth loss.

The worst offenders are soft drinks and sports drinks. Not only are these full of added sugar, they also contain food acids that can cause further erosion of tooth enamel. And the sugar-free versions should also be consumed with caution – these contain food acids too, so aren’t necessarily much better for your teeth. (Neither is fruit juice, warn dentists, also because of its high acid content.)

Spotting sugar isn’t easy

It’s not always obvious when food contains lots of sugar. Many foods contain both natural and added sweeteners, yet the food label often doesn’t separate the two. The best action is to check nutrition labels and choose foods lowest in sugar, avoid sweet drinks of any type including diet drinks and fruit juice, and drink water or rinse your mouth after any snack or drink. Chewing sugar-free gum for 20 minutes after eating can also help neutralise decay-causing acid attacks.

Make sure you visit your dentist at least once a year for a check-up and advice on how to keep your teeth and mouth healthy.

All types of bread are a good source of carbohydrates, are low in fat, and many are also fortified with added vitamins and minerals. But making a small swap from white to wholemeal or wholegrain bread can deliver a host of added health benefits. Here’s why:

• White bread is made from wheat that has had the germ and bran removed, which reduces B vitamins, vitamin E and minerals such as iron, zinc, magnesium and phosphorus
• Removing the germ and bran also reduces the fibre, which is bad news for our health. According to Australia’s CSIRO, 83 percent of us aren’t getting enough fibre in our diets, and as a result we are more likely to have gut problems such as heartburn, pain and discomfort, bloating and irregular bowel habits. Fibre helps us feel fuller for longer, keeps blood sugar levels stable, and is a source of fuel for our gut bacteria
• Because both wholemeal and wholegrain bread are made from the entire grain, they also naturally contain more protein, unsaturated fat, vitamins and minerals – the ones that are removed in the making of white flour. Wholegrain bread also contains added grains and seeds, which can increase the nutrient and fibre content

Making the switch from white bread to wholemeal or wholegrain is a simple way of adding more fibre and nutrients to your daily diet. Just make sure to compare brands when you’re shopping. Look for ‘wholegrain’ in the list of ingredients, and choose the bread with the highest wholegrain content.

Stay safe with complementary medicines

•             If you are feeling unwell, first see your doctor for a diagnosis and treatment – don’t self-diagnose.
•            Choose a complementary therapist who is registered with the appropriate professional association.
•        It can be hard to tell what is a good product or not. Some countries, like Australia have a register for approved products. It is important to note that there is no guarantee that a product will work for you as advertised.
•           Avoid buying online from an overseas retailer, even though they may appear better value. The products could be out-of-date, poor quality or even fake.

Stay informed. There is plenty of medical misinformation or ‘cyberquackery’ online. Make sure you seek out reputable websites to get information about complementary medicines and therapies, such as National Center for Complemetary and Integrative Health at www.nccih.nih.gov.