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Inhalers and nebulizers are both effective at delivering medications for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). A nebulizer is a device that transforms a liquid medication into a fine mist which is then inhaled into the lungs through a mouthpiece. While nebulizers take longer to deliver medications than inhalers, their accurate dosage delivery is often a good fit for children living with asthma and other lung diseases, and many adults find them helpful as well. Here’s what to know if you’re considering using a nebulizer.

What to Know About Nebulizers

Three types of nebulizers can be used to treat asthma, COPD, and other lung diseases like pulmonary fibrosis.

Jet nebulizers transform liquid medication into an aerosol or fine mist using an air compressor. They are the most common type of nebulizer.

Mesh nebulizers use a fine mesh to create an aerosol from the liquid medication. They are the newest type of nebulizer and emit the smallest particles.

Ultrasonic nebulizers create an aerosol through high-frequency vibrations. They are typically used in hospitals or at doctors’ offices.

There are different models of nebulizers, including portable, battery-run nebulizers that can be taken with you on the go and larger tabletop nebulizers that require an electrical outlet. These devices can deliver a variety of medications, including quick-relief medications that treat acute symptoms of lung diseases as well as longer-term maintenance medications. They may even be used to deliver more than one medication at once.

Your healthcare provider can advise you on the best method of medication delivery for your individual treatment plan. As you explore your options, be mindful of the key differences between nebulizers and inhalers.

Inhalers deliver medication quickly, but they require enough coordination to inhale and spray the medication at the same time. Some individuals, particularly young children, may find it challenging to properly use an inhaler. This can result in not receiving the full dose of medication.

To receive a dose of medication from a nebulizer, all that’s required is to breathe normally. However, nebulizers will take at least five to ten minutes to fully deliver the medication. You may want to ask your doctor which type of device they recommend for treating acute symptoms during an asthma attack or COPD flare-up.

If you and your doctor have decided that a nebulizer is a good fit for your needs, learning about proper use and cleaning of the device is a key part of managing your health. It will also ensure that you are taking your medication as prescribed. Be sure to follow your doctor’s instructions and review the manufacturer’s instructions for your nebulizer before using it for the first time, as there is some variation among these devices.

All nebulizers have a medicine cup, a mask and/or mouthpiece, an air compressor, and plastic tubing to connect the compressor to the medicine cup. Always wash and dry your hands before using your nebulizer and make sure that all the pieces of your nebulizer are clean. Pour the correct dose of your medication into the medicine cup and connect the tubing to the air compressor and medicine cup. Turn on your nebulizer and ensure that it’s properly working. You should see a fine mist coming from the mask or mouthpiece.

Once you see a mist appear, your nebulizer is ready for use. To inhale your medication, secure the mask over your nose and mouth or put the mouthpiece in your mouth. Sit upright and breathe normally. Taking slower breaths can help the medication enter your airways. Continue to breathe normally until the medication is gone from the cup.

Bacteria and other germs can grow inside of a nebulizer that has not been properly cleaned, so it’s important to clean your device after every use and disinfect it once a week.

After you’ve finished using your nebulizer, wash the mouthpiece or mask and the medicine cup in warm soapy water and let them air dry. For weekly disinfecting, soak these pieces in a vinegar solution for 30 to 60 minutes, or for the amount of time specified by your doctor or in the manufacturer’s instructions. Your doctor may provide you with a disinfectant solution, but if not, you can mix one part white vinegar with three parts hot water. After the pieces are done soaking, let them air dry. Put these pieces in a plastic container or bag and store it in a cool, dry place.

As part of nebulizer maintenance, you should replace the plastic tubing on a regular basis. Ask your healthcare provider how often to replace the tubing.

When deciding whether a nebulizer is a good fit for your needs, be sure to consider your health insurance benefits. Most insurance plans have separate medical and pharmacy benefits in addition to a Durable Medical Equipment (DME) section. Many nebulizers fall under the DME category of your policy. There may be restrictions on the brands, suppliers, or types of nebulizers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Alto makes it easy to stay on top of your asthma or COPD treatment, with free hand-delivery, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone or chat. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Inhalers and nebulizers are both effective at delivering medications for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD).

Overall heart health involves all the components of this complex network. Coronary artery disease — the most common type of heart disease — affects your blood vessels and the flow of blood to your heart. It typically develops over the course of many years, and many of the key risk factors can be managed. Here’s what to know about preventing and treating this type of heart disease.

Coronary Artery Disease, Explained

Your heart is at work every minute of the day, pumping blood to deliver oxygen to vital organs. Each part of the heart plays a role in this important task, along with the rest of your cardiovascular system, including your arteries and blood vessels.

Like any organ in your body, your heart needs oxygen to function. Coronary arteries are the blood vessels that supply your heart with oxygen-rich blood. Coronary artery disease occurs when these blood vessels are hardened or blocked, affecting the flow of blood to the heart itself.

This condition is often caused by atherosclerosis — the accumulation of substances like cholesterol and blood-clotting material in your arteries. (These substances are collectively referred to as plaque). A variety of factors can increase your risk for atherosclerosis — and therefore your risk for heart disease — including high LDL cholesterol, high blood pressure, diabetes, obesity, physical inactivity, and smoking. Additional key risk factors for heart disease include age and family history. 

There are several known symptoms of coronary artery disease, including chest pain or tightness (also called angina) and shortness of breath. Depending on where your blood vessels have narrowed, you may also experience pain, numbness, or weakness in your arms or legs. Women are more likely than men to experience additional symptoms such as nausea, back and jaw pain, and shortness of breath without accompanying chest pain.

Symptoms of coronary artery disease present differently from one person to another. It is best to discuss your risk of heart disease with your doctor if you have concerns rather than waiting for symptoms to appear. It’s especially important to be proactive if you have a family history of heart disease.

In the long term, coronary artery disease can increase your risk for other heart health issues, including heart attack and heart failure, which occurs when your heart cannot pump all of the blood that your body needs. These serious health risks are preventable — by identifying coronary artery disease at an early stage and following the treatment plan your doctor recommends, you can manage the condition and lower your risk for related complications.

Too often, people learn that they have coronary artery disease only after experiencing a more serious complication like a heart attack, stroke, or heart failure. Consulting with your doctor about your risk for heart disease and staying up to date with blood pressure, cholesterol, and blood glucose screenings is key to detecting heart health problems early on. Here are some of the numbers your doctor will track to identify your risk for heart disease, along with your individual and family health history.

The National Institutes of Health defines normal blood pressure for most adults as below 120 mm Hg systolic and 80 mm Hg diastolic. (Systolic pressure, the first number in your blood pressure reading, is typically the reading that’s most important when monitoring blood pressure.) If your blood pressure falls in this range, typical screening frequency is at least once per year. If your blood pressure is in a higher range, ask your doctor about recommended screening frequency.

Your cholesterol levels can also help your healthcare provider identify your risk for heart health issues. If your total cholesterol is under 200 mg/dL, you can have your cholesterol checked every 4-6 years. If you are at higher risk for heart disease and stroke, consult your doctor about recommended screening frequency.

In the long term, high blood sugar can damage your blood vessels, and diabetes is a risk factor for coronary artery disease. It’s important to monitor your blood glucose levels as part of your broader heart disease prevention efforts, especially once you enter your 50s and 60s. Your doctor can advise you on recommended screening frequency.

Remember that it’s never too early or too late to prioritize heart-healthy living. Read our previous blog, ‘How to Prevent Heart Disease at Any Age’ to learn about important heart disease prevention actions for your age group.

If you have coronary artery disease, your doctor may recommend lifestyle changes and/or medications to manage your heart disease risk factors. Quitting smoking, planning a heart-healthy diet, and exercising more frequently are often a first step in managing coronary artery disease.

The specific medications used to treat coronary artery disease vary by individual. Your doctor may prescribe one or more of the following types of medications depending on your health history:

Cholesterol-lowering medications like statins, fibrates, and niacin

Blood pressure medications like beta blockers, calcium channel blockers, and ACE inhibitors

Anticoagulants and antiplatelets to reduce your risk of blood clots

Heart-healthy living is a lifelong practice, and heart disease prevention or treatment is an ongoing commitment to your health. At Alto, we make it as simple as possible to manage your risk for heart health issues like coronary artery disease and stay on top of cholesterol-lowering or blood pressure management medications. 

We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Emphysema — which falls under the umbrella of chronic obstructive pulmonary disease (COPD), along with chronic bronchitis — is a lung disease that most often develops as the result of many years of heavy smoking. It affects more than 3 million people in the United States.

Emphysema: Causes, Symptoms and Treatments

As a progressive lung disease, symptoms of emphysema become more pronounced over time. While there is no cure, emphysema is both manageable and preventable. You can slow the progression of the disease by following the treatment plan your doctor recommends and maintaining a healthy lifestyle.

Read on to learn more about the causes and symptoms of emphysema and common treatment options.

Emphysema involves slow and gradual damage to the tiny air sacs in your lungs (alveoli). As these air sacs weaken over time, the surface area of the lungs is reduced, limiting how much oxygen can travel to your bloodstream.

Since emphysema progresses gradually, signs and symptoms may not appear until the lung tissue has already been significantly weakened. For many people, the first noticeable symptoms include shortness of breath and more frequent coughing, especially during physical activities. Other symptoms of emphysema include wheezing, exhaustion, and chest tightness, and producing greater amounts of mucus.

In some cases, the lack of oxygen can cause blue or gray lips or fingernails. If you experience this symptom, seek immediate medical attention.

The majority of emphysema cases occur as the result of cigarette smoking, with heavier smoking linked to a higher risk of developing emphysema. Additional risk factors for emphysema include the following:

Age — in many cases of smoking-related emphysema, symptoms first become noticeable between the ages of 40 and 60

Exposure to high pollution chemical fumes or lung irritants

Having a history of childhood respiratory infections

To determine if you have emphysema, your doctor will ask about your health history and the potential symptoms of emphysema that you are experiencing. They may ask you questions about your smoking history, your exposure to secondhand smoke or chemical fumes, and if you have a family history of lung health issues.

After taking your health history, they may order one or more of the following tests to confirm a diagnosis of emphysema:

Imaging tests, including chest X-rays and computerized tomography (CT) scans, which combines X-ray images taken from different angles.

An arterial blood gas test, which measures how well your lungs transfer oxygen to your bloodstream and remove carbon dioxide.

An electrocardiogram (ECG) to check your heart’s function and rule out a diagnosis of heart disease.

A pulse oximetry, which measures the oxygen level of your blood. This can show how well oxygen travels to the parts of your body furthest from your heart.

Lung function tests, which measure how much air your lungs can hold, how easy it is for them to empty air, and how well they deliver oxygen into your bloodstream.

Quitting smoking is the most important thing you can do to slow the progression of emphysema. If you are having trouble quitting, ask your doctor for smoking cessation resources like nicotine replacement therapy to help manage withdrawal symptoms and cravings. In addition, the treatment options below can slow the progression of emphysema and help you live an active lifestyle.

Several types of medications are used to manage and treat emphysema.

Bronchodilators like albuterol (Ventolin®, Proventil®, AccuNeb®), albuterol sulfate (ProAir® HFA®, ProAir RespiClick), and levalbuterol (Xopenex®) help relax your airway muscles and open your lungs to reduce discomfort. Although not common, potential side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches. Your doctor can explain more about the risks and benefits of using a bronchodilator when building your treatment plan.

Inhaled corticosteroids reduce swelling in your lungs and open your airways so that more air can move in and out of your lungs. They may be taken via inhaler or nebulizer. Corticosteroids commonly prescribed to treat emphysema include beclomethasone dipropionate (branded options include Qvar Redihaler®), budesonide (Pulmicort®), ciclesonide (Alvesco®), flunisolide (Aerospan®), fluticasone propionate (Flovent®), and mometasone (Asmanex Twisthaler®). 

Inhaled corticosteroids typically do not cause long-term side effects, but mouth and throat irritation and oral yeast infections may occur. As a precaution, rinse your mouth with water after each dose to prevent infections.

Antibiotics may also be used to fight infections that can lead to emphysema-related complications like acute bronchitis or pneumonia.

Pulmonary rehabilitation is an outpatient educational program that provides the skills and knowledge needed to manage your emphysema and increase your level of physical strength and fitness. The classes are led by a team of healthcare professionals, physical therapists, and dietitians and taught in a group setting, giving you the opportunity to connect with other individuals living with emphysema and other lung diseases. Pulmonary rehabilitation is often a good fit for individuals who frequently experience shortness of breath when performing daily activities despite taking medication as prescribed.

Supplemental oxygen, or oxygen therapy, can relieve shortness of breath and increase your tolerance for physical activities. There are several devices used in oxygen therapy. Your doctor can guide you in choosing the right oxygen delivery system based on your health needs, lifestyle, and insurance benefits. You may be prescribed one oxygen device to use at home and one to use when you are on the go.

Be sure to follow all of your doctor’s instructions when using your oxygen device, including the flow rate setting (how much oxygen you’ll need per minute). In addition, you may find it helpful to explore the American Lung Association's resources on oxygen therapy.

We’re here to support your emphysema treatment

Sticking to the treatment your doctor has recommended is critical to managing emphysema. At Alto, we make that as easy as possible by offering free hand-delivery, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone or through the Alto app. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your emphysema treatment plan.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Prioritizing your heart health becomes even more important during the holiday season. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season

How to Keep Your Heart Healthy During the Holidays

Prioritizing your heart health becomes even more important during the holiday season. Not only is it more difficult to maintain your typical exercise routine and healthy habits amid the shopping, traveling, and hosting, but the seasonal stress can also put more strain on your heart. The good news? A little self-care goes a long way, and even small actions can have a big impact on your physical and mental well-being. Here are simple ways to keep your heart healthy this holiday season.

Stress can increase your risk of heart disease both directly and indirectly. It increases inflammation, which is linked to high blood pressure, and can also lead to sleep deprivation or disruption, another risk factor for heart disease.

As you plan for heart-healthy holidays, identify potential sources of stress in advance and look for opportunities to limit it. Some degree of holiday stress is bound to occur, but try to avoid overextending yourself by setting priorities and limiting how much you take on.

Throughout the season, watch for the emotional, physical, and behavioral symptoms of stress. Each individual experiences stress differently, but common signs include headaches, chronic pain, decreased energy, changes in appetite, digestive issues, and depression.

If you find yourself feeling overwhelmed, seek out positive outlets for stress relief, like mindfulness, meditation, and exercise. Simply pausing to take a breath on a busy day can help counteract the physical effects of stress: in signaling the brain to calm, deep breathing can lower your heart rate and blood pressure.

In addition, here are some apps that can help you proactively manage stress and anxiety this holiday season:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

It may seem difficult to maintain a heart-healthy diet during the holidays: sodium — which can lead to high blood pressure — and trans fats — which increase your blood levels of “bad cholesterol” — are found in many popular seasonal dishes.

Prioritizing your heart health during the holidays doesn’t mean avoiding your favorite foods altogether, but rather trying to strike a balance. If you’re preparing food for holiday celebrations, look for small ingredient swaps that can transform a dish into a heart-healthy recipe. The American Heart Association has a list of holiday recipe hacks like swapping Greek yogurt for sour cream and applesauce for butter, and cooking with low-sodium or frozen vegetables.

The importance of moderation also applies to drinking, as increased alcohol consumption over the holidays can also impact your heart health. In the long term, heavy alcohol use — defined by the CDC as 8 or more drinks per week for a woman and 15 drinks or more for a man — may increase your risk for high blood pressure, heart failure, and stroke. In the shorter term, experiencing an increased heart rate as the result of drinking heavily during holiday celebrations is sometimes referred to as “holiday heart syndrome.”

Get creative with making time for exercise

It’s great to set New Year’s fitness goals, but that doesn’t mean November and December are a time to step back from your exercise routine. Regular physical activity lowers your risk for heart disease, and it’s especially important to stay active during the holidays in light of the added stress and opportunities to overindulge.

If you’re struggling to carve out time for exercise amid the hectic holiday season, get creative with how you fit exercise into your day. While it’s generally good to aim for about 30 minutes of exercise per day, your heart will benefit from even a quick 15 or 20-minute workout. Look for opportunities to fit in quick bursts of physical activity. Doing an extra lap at the mall while holiday shopping or taking the stairs instead of the escalator counts! Other daily activities that will get your heart pumping? Gardening or shoveling snow, depending on where you live, or going for more frequent walks with family.

And if you’re looking for easy ways to get in exercise during your holiday travels, browse free online workouts or try travel-friendly exercises like push-ups, planks, walking lunges, or jumping jacks.

It’s also important to continue to follow the treatment plan your doctor recommends even when celebrating or traveling. Most medications used to treat high cholesterol or blood pressure, or other conditions related to your heart health, need to be taken as prescribed every day in order to be effective. Not only that, but skipping the medication or stopping use of it abruptly may put you at risk for serious heart health issues.

During the holidays, it isn’t uncommon to accidentally leave your medication at home while traveling, or to run out of refills on a holiday. Take stock of your prescriptions well in advance of the holidays and make sure you have what you need to manage your health, especially if traveling. (We designed our app to help you stay on track with your medication, with reminders and auto refills.)

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications this holiday season. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly

We explain how to manage asthma at night through a combination of asthma medications, healthy lifestyle choices, and good sleep hygiene.

How to Manage Asthma at Night

Have you noticed that your asthma symptoms like wheezing, shortness of breath, and tightening of the chest intensify in the nighttime? You’re not alone: nocturnal asthma symptoms are common, especially if you are living with more severe asthma. A Journal of Asthma study involving around 14,000 individuals with asthma found that 60% of those with chronic asthma experienced nocturnal asthma symptoms.

Below, we explain how to manage asthma at night through a combination of asthma medications, healthy lifestyle choices, and good sleep hygiene.

Nocturnal asthma occurs when your symptoms are noticeably worse at night. (If you experience intense symptoms at any time of day, including nighttime, you may need to reevaluate your overall asthma treatment plan with your doctor.)

If you have nocturnal asthma, you may experience the following symptoms while you sleep, and your sleep may be interrupted as a result.

Numerous factors can contribute to nocturnal asthma, including environmental triggers and your personal health history.

The presence of allergens like dust mites and mold can trigger asthma symptoms, especially if you have allergy-induced asthma. Dust mites are small pests that generate allergens. They often live in your pillows, blankets, and mattress, so exposure to them at night is common. In some cases, nocturnal asthma may also be a delayed reaction to exposure to an allergen during the day.

Inhaling cold air from an air conditioner or outside source may contribute to more intense asthma symptoms at night. In addition, sleeping in a reclining position causes your chest and lungs to experience additional pressure, which can also contribute to asthma symptoms. Elevating your shoulders and neck with additional pillows or lying on your left side with or without a pillow between your legs may help you sleep more comfortably.

Your circadian rhythm — the 24-hour natural process that regulates your sleep cycles — affects your nighttime levels of hormones like epinephrine, which relaxes and widens your airways, and histamine, which restricts your airways. Nightly fluctuations in these hormones may contribute to inflammation in your airways, prompting nocturnal asthma symptoms. You are most likely to experience nocturnal asthma symptoms when your epinephrine levels are at their lowest and your histamine levels are at their highest.

The following health conditions have also been linked to nighttime asthma:

Sinusitis, a condition in which there is increased drainage from your sinuses

Mental health disorders and chronic stress

If you have asthma and wake up several nights a week even after following your individual asthma treatment plan, consult with your doctor about additional treatment options. They can evaluate your symptoms, identify potential causes, and suggest modifications to your treatment plan if needed.

Common daily asthma medications can also help you manage worsening symptoms at night. Inhaled corticosteroids like Flovent® HFA and Qvar Redihaler®, which reduce inflammation and swelling in the airways, making them less likely to react to asthma triggers, are frequently prescribed for people who experience nocturnal asthma symptoms.

Quick-acting bronchodilators like albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) or levalbuterol (Xopenex HFA®) may also be used to treat acute asthma symptoms at night. These inhalers relax the muscles around your airways to make it easier to breathe and are taken on an as-needed basis for immediate relief of symptoms . Common side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches.

If you have any concerns about potential side effects of asthma medications, your doctor can explain more about the potential benefits and risks of taking corticosteroids or bronchodilators.

If allergens like dust mites are contributing to your nocturnal asthma symptoms, regularly washing your sheets, blankets, and mattress protector may help you avoid triggers. Wash bedding in hot water if possible, since this will help kill dust mites. In addition, maintain a comfortable temperature — 65-70 degrees Fahrenheit is a good range for many individuals with asthma — by making sure your room is well-insulated and shutting windows to keep cold air out. Using a humidifier to add moisture to the air inside your room can also help.

Better sleep hygiene isn’t a substitute for asthma medication, but getting a good quality of sleep at night can minimize the negative effects of any sleep disturbances you experience from nighttime asthma.

Avoid use of electronic devices like cell phones, tablets, and computers at least 30 minutes before you go to sleep, if possible. In addition to stimulating your brain, these devices emit blue light, which can affect your production of melatonin, a hormone that regulates your sleep.

Meditating and exercising before sleeping can also help you fall and stay asleep more easily, but avoid high-intensity exercise close to when you go to bed.

Create an environment that sets you up for a good night’s sleep. In addition to maintaining a comfortable temperature, make sure that your room is dark or dimly lit without distracting lights from electronic devices. You may also want to consider sleeping with your humidifier on, if you have one.

If you think you may have a sleep disorder like sleep apnea or insomnia, consult with your doctor for a diagnosis and treatment, in addition to taking the actions above.

Alto is here every step of the way to make it easy to manage your asthma symptoms at any time of day. Our team of pharmacists is available to answer questions about your asthma medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

 Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your asthma treatment plan.

Woman sleeping; asthma inhaler on bedside

A consistent lack of sleep can also affect your physical and mental health in the long term. Here's what you can do to improve your sleep hygiene.

How Sleep Affects Heart Health | Alto Pharmacy

If you’ve ever slept less than the CDC-recommended minimum of seven hours per night, you may have experienced short-term effects of sleep deprivation like forgetfulness, irritability, and an inability to focus. A consistent lack of sleep can also affect your physical and mental health in the long term. And just like diet choices and frequency of physical activity, your sleep habits are linked to your risk for heart disease.

Below, we explain more about how sleep affects heart health and what you can do to improve your sleep hygiene.

Sleep allows your body to recharge. As you enter a state of deep sleep, your heart rate slows down and your blood pressure drops. These physical changes give your heart a chance to recover from how hard it works when you’re awake.

When you don’t spend enough time in uninterrupted deep sleep, your heart doesn’t get the opportunity to rest. Research has found that chronic sleep deprivation and sleep disorders can contribute to numerous cardiovascular health issues including high blood pressure, high cholesterol, and a greater risk for a heart attack or stroke.

Cardiovascular health issues related to sleep

Over time, many sleepless nights can lead to higher baseline blood pressure levels during the day. High blood pressure, or hypertension, is among the leading risk factors for heart disease and stroke. If you experience consistent stress or if you have other risk factors for high blood pressure, you may be more likely to develop high blood pressure as a result of sleep deprivation.

Poor sleep may also contribute to these cardiovascular health issues:

Coronary artery disease occurs when cholesterol and other fatty material (collectively referred to as plaque) builds up in your arteries, making it harder for your heart to pump blood to the rest of your body. This accumulation of plaque is also called atherosclerosis.

Some research has found that a lack of sleep may contribute to atherosclerosis. This is partially due to the connection between sleep deprivation and hypertension, as high blood pressure strains your arteries. In addition, poor sleep can trigger chronic inflammation over time, which also contributes to the accumulation of plaque and the hardening of your arteries.

Chronic sleep deprivation may also increase your risk for a heart attack. One research study found that people who slept less than six hours per night had a 20% higher risk of a heart attack in comparison to those who got more sleep.

While your heart slows down when you are in a state of deep sleep, your heart rate and blood pressure can increase if you wake up suddenly. Over time, consistent sleep disruptions can put greater stress on your heart and contribute to your overall heart attack risk.

A stroke is a cardiac event in which blood flow to your brain is interrupted, causing brain cells to die. Because sleep deprivation can drive high blood pressure and plaque accumulation in your arteries — two leading risk factors for strokes — there is also a correlation between a lack of sleep and your risk of having a stroke.

Type 2 diabetes is a condition in which your body’s cells become resistant to insulin, and your pancreas cannot produce enough insulin to regulate levels of blood glucose. It develops gradually due to a mix of genetic, lifestyle, and environmental factors.

Research has linked poor sleep to prediabetes, a health condition defined primarily by blood sugar levels that are higher than normal but below the official range for a type 2 diabetes diagnosis. If left untreated, prediabetes can progress into type 2 diabetes and lead to health complications in the long term, including cardiovascular issues.

If you already have diabetes, a lack of sleep or frequently interrupted sleep may also impact blood sugar management.

There are two primary sleep problems that can impact your long-term cardiovascular health: sleep apnea and insomnia.

Sleep apnea is a disorder in which your airway is blocked during sleep, which causes you to stop breathing for short periods of time. It affects your oxygen levels while sleeping and may increase your risk for high blood pressure, heart attack, and stroke.

Insomnia is when you have trouble going to sleep or staying asleep. Many individuals have experienced insomnia in the short-term, and the CDC estimates that 1 in 10 U.S. adults may experience chronic insomnia.

More than 1 in 3 adults in the U.S. report getting less than the recommended seven hours of sleep per night. The good news is there are steps you can take to improve your sleep hygiene. Start with the following:

Maintain a consistent sleep schedule, going to bed and waking up at the same time every day, including weekends.

Avoid use of electronic devices close to your bedtime.

Get plenty of natural light and stay physically active during the day, but avoid exercising close to bedtime.

Avoid consuming food or beverages close to bedtime, particularly caffeine, alcohol, and high-sugar or high-fat foods.

Keep your bedroom dark and quiet and maintain a comfortable temperature. 

Read our previous blog for strategies that can help you avoid stress-related sleep problems..

If you think you may have a sleep disorder, you should also consult with your doctor for a diagnosis and treatment, in addition to taking the actions above.

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications.  We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly

How Sleep Affects Heart Health & Tips for Better Sleep

Proactively managing COPD with medication and lifestyle changes can help prevent periods of intensified symptoms, referred to as exacerbations or flare-ups. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

How to Manage and Prevent a COPD Flare-Up

Proactively managing chronic obstructive pulmonary disease (COPD) with medication and lifestyle changes can help slow the progression of the chronic lung disease and prevent periods of intensified COPD symptoms, commonly referred to as exacerbations or flare-ups. 

However, these flare-ups may occur even when closely following your doctor’s individualized treatment plan, especially during the more advanced stages of COPD, so it’s important to have a plan in place to quickly address symptoms. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

Recognizing the symptoms of a COPD flare-up

During a COPD flare-up, symptoms like shortness of breath and wheezing quickly intensify and lung function significantly changes. (Lung function refers to how well your lungs work, specifically how much air they can hold and how easy it is for them to empty air.)

Individual experiences of a COPD flare-up may vary, but many people often notice greater amounts of mucus clogging the bronchial tubes in their lungs and sudden tightening of muscles around their airways. Here are key signs and symptoms to be aware of.

More frequent or more intense coughing, wheezing, or shortness of breath

Changes in the color, thickness, or amount of mucus

Using more oxygen than usual, if your treatment plan includes supplemental oxygen

If you experience any of the symptoms above, the best step is to call your doctor right away. Each COPD flare-up can affect your long-term lung function, so it’s important to address symptoms as quickly as possible.

To effectively manage a COPD flare-up, you’ll want to create a COPD action plan with your doctor. Then, if you experience the signs of a flare-up, you’ll have a specific outline of the actions and medications that can help restore your breathing. Here are some of the medications your doctor may include in your individualized COPD treatment plan.

Short-acting medications like bronchodilators relax your airway muscles and open your lungs to quickly reduce discomfort. Albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) is commonly used to treat COPD exacerbations. This medication is typically taken through an inhaler, but can also be taken as a liquid solution for nebulizer use. (A nebulizer is a device that turns a liquid medication into a mist that you can inhale through a face mask. It allows the medication to travel quickly to your lungs.)

Although not common, potential side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches. Your doctor can explain more about the risks and benefits of using a bronchodilator to treat COPD exacerbations when building your treatment plan.

Your doctor may also recommend oral corticosteroids, which are fast-acting medications that reduce swelling in your lungs and open your airways so that more air can move in and out of your lungs. They are primarily prescribed for short-term use, typically five to seven days.

Oral corticosteroids commonly used to treat COPD exacerbations include:

Prednisone (Prednisone Intensol®, Rayos®)

Some people experience mild side effects from short-term corticosteroid use, including swollen hands and feet, elevated blood pressure, increased appetite, and shifts in mood.

Many people with more advanced COPD use supplemental oxygen to increase their tolerance for physical activities, while others use it only to relieve shortness of breath during an exacerbation.

If your flare-up is more mild, you may take oxygen at home. When writing your prescription for oxygen therapy, your doctor will explain how and when to use the oxygen. It is important to follow all of your doctor’s instructions, including the flow rate setting (how much oxygen you’ll need per minute). The American Lung Association has resources for anyone starting oxygen therapy.

If your COPD has progressed to a later stage, some flare-ups may require treatment in a hospital setting. This allows healthcare professionals to more closely observe your symptoms and monitor vital signs like your pulse, temperature, and blood pressure. Consult with your doctor about specific symptoms to look out for that may indicate a need for more intensive treatment or monitoring.

How to lower your risk of COPD exacerbations

There are many steps you can take to lower your risk of a COPD exacerbation and reduce the frequency of COPD-related hospitalizations.

First, it’s important to closely follow your doctor’s recommendations, including taking any maintenance medications exactly as prescribed. (We designed our app to make it as simple as possible to do so, with medication management tools like reminders and auto refills that help you stay on track.)

In addition, try to limit your exposure to leading triggers of COPD exacerbations, including cigarette smoke (this includes secondhand smoke), indoor and outdoor air pollution, cold air, and household dust.

To keep the air inside your home as clean as possible, avoid perfumes and cleaning and hygiene products with strong odors. Use air purifiers and vacuum cleaners with a high-efficiency particulate air (HEPA) filter.

Lastly, the flu and pneumonia can worsen COPD symptoms and potentially lead to a flare-up, so it’s important to get your yearly flu shot and ask your doctor or pharmacist if you are eligible for the pneumonia vaccine.

We’re here to support your COPD treatment

COPD flare-ups can cause discomfort, but we’re here every step of the way to help you manage symptoms and get the medications you need, with free same-day delivery and easy-to-use medication management reminders in our app.

And our team of pharmacists are always here to answer your questions by phone or through the Alto app. Reach out any time by phone at 1-800-874-5881 or in-app messaging.

When there are issues with your heart’s electrical signals it may beat too quickly, too slowly, or irregularly. This is called an arrhythmia. Learn more about the primary types of arrhythmias and the medications most commonly used to treat them.

Medications Commonly Used to Treat Arrhythmias

While a resting heart rate — the number of times your heart beats per minute when you’re at rest — will vary from one individual to the next, the healthy range for an adult is between 60 and 100 beats per minute. However, when there are issues with your heart’s electrical signals, which trigger each individual heartbeat, your heart may beat too quickly, too slowly, or irregularly. This is called an arrhythmia.

The best course of action depends on the type of arrhythmia you have and your overall health. Many cases of mild arrhythmias do not require any treatment. But your doctor may recommend medication to control or resolve your arrhythmia if there is a risk that your arrhythmia could cause more serious heart health issues.

Below, we explain more about the primary types of arrhythmias and the medications most commonly used to treat them.

Arrhythmias are categorized by the speed of the resulting heart rate and the area of the heart in which they originate.

A tachycardia is a fast heart rate, typically over 100 beats per minute when you’re at rest. There are many different types of tachycardias, including the following:

Atrial fibrillation is a rapid heart rate caused by irregularities in the electrical signals in the heart’s upper chambers, or atria. The condition may be temporary in some cases, but it often requires retreatment. It has been linked to more serious health issues including strokes.

Ventricular tachycardia is a rapid but steady heart rate caused by irregular electric signals in the heart’s lower chambers, or ventricles. The condition may lead to health complications depending on your overall cardiovascular health.

A bradycardia is a slow heart rate, typically under 60 beats per minute when you’re at rest. There are several types of bradycardias, including:

Sick sinus syndrome is a condition in which your sinus node — the heart’s natural pacemaker — doesn’t properly send electrical signals, causing your heart rate to beat slowly. (In some individuals, sinus node problems may result in a heart rate that alternates between too slow and too fast, which is also called bradycardia-tachycardia syndrome.)

Heart block, or atrioventricular block, is a condition in which electrical signals running through the atria don’t reach the ventricles. There’s a wide range in the severity of heart blocks, so they are subclassified into first-degree (mildest), second-degree, and third-degree (complete) heart blocks.

It’s also possible to experience a premature heartbeat, which often feels like a skipped heartbeat but is actually an additional beat. Premature heartbeats may occur when you are at rest, or they may be caused by stress, physical exertion, or stimulants like caffeine or nicotine.

Pharmacist discussing medication with patient

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