Neumología apnea del sueño

We specialize in the detection and treatment of sleep-related disorders. We understand that restorative sleep is essential for your physical, mental, and emotional well-being. Sleep disorders can negatively affect your quality of life.

We offer state-of-the-art sleep disorder screening tests, enabling us to accurately evaluate and diagnose these conditions. Some of the tests we perform include:

• Respiratory polygraphy: This test is conducted during sleep and records various respiratory parameters, such as airflow, blood oxygen saturation, respiratory rate, and respiratory effort. It helps us detect disorders like sleep apnea and assess the severity of abnormal respiratory events occurring during the night.
• Nocturnal polysomnography: Polysomnography is a comprehensive test that monitors various physiological functions during sleep. It records parameters such as brain activity, muscle activity, respiration, heart rate, and eye movements. This test provides detailed information to diagnose sleep disorders such as restless legs syndrome, narcolepsy, and other sleep-related conditions.
• Nocturnal pulse oximetry: This test involves placing a device on the patient’s finger or ear to measure blood oxygen saturation during sleep. It helps us evaluate the presence of oxygen desaturation episodes, which may indicate sleep-related respiratory disorders like obstructive sleep apnea.

We are committed to providing the best diagnostic and treatment options so you can enjoy restorative sleep.

Trust our team of specialists to effectively identify and treat any sleep-related issues.

No fumes Ruber Internacional

Information and Recommendations for Smoking Cessation

Despite all the information we have today about the harm caused by tobacco, at the beginning of the 21st century, smoking remains the leading preventable cause of disease and premature death in Spain.

Every year, more than 50,000 people die prematurely in Spain due to tobacco consumption. This is as if a plane with more than one hundred passengers crashed every day, with no survivors.

Half of the people who die due to smoking have lost an average of 20 years of life. And many more people and their families see the quality of their years significantly diminished.

So, are we really informed?

DID YOU KNOW THAT TOBACCO?

• Is the cause of more than 90% of diagnosed bronchitis cases in our country.
• Is related to 95% of lung cancer cases and 30% of all coronary heart disease cases.
• Is also a well-established causal factor for cancers of the esophagus, bladder, mouth, and larynx.
• In women, tobacco consumption also multiplies the cardiovascular risks associated with oral contraceptives. Therefore, the probability of having a heart attack increases tenfold in women who smoke and use this contraceptive method. Women who smoke experience an average of two to three years earlier menopause compared to women who have never smoked, while simultaneously increasing the risk of osteoporosis.
• Smoking causes skin dryness and accelerates the premature appearance of wrinkles on the face.
• It is also very harmful to the health of those around you, as Secondhand Smoke (SHS) contains carcinogenic and toxic substances generated by the combustion of tobacco. In fact, this polluted air has a higher content of waste products in smaller particles, which, being smaller, can reach deeper areas of the bronchopulmonary system and consequently be more harmful.
• During pregnancy, the fetus is the youngest involuntary smoker, with a higher risk of miscarriage, premature birth, or low birth weight, which increases the risk of perinatal death.
• Finally, if one or both parents smoke during their children's childhood, the risk of sudden infant death syndrome increases, as well as the risk of respiratory infections, asthma, pneumonia, and otitis among their children compared to those of non-smoking parents. Children with asthma exposed to SHS have more severe and frequent symptoms. Children living with smokers overall have worse health and suffer more school absenteeism.

guia deshabituación tabaco

In this Guide, we want to:

• Clarify what you will personally gain if you quit smoking.
• Identify the reasons why you are still smoking.
• Understand the characteristics of your tobacco dependency.
• Anticipate difficulties.
• Prepare you to achieve your goal.
• And most importantly, help you through the process.

REASONS TO QUIT SMOKING:

There are many and very good reasons to quit smoking, but the best ones are your own. You already know that tobacco is harmful to your health, and you may be experiencing the immediate consequences it has on your body. However, all of this is not enough if you are not clear about what you will gain—and more importantly, what you will lose—if you quit smoking. Below, we outline some reasons, and we invite you to choose yours and hold onto them to achieve your goal.

1. Health:

• To breathe better.
• To get less tired and stop coughing.
• To live more years and live them better.
• To reduce my chances of having a heart attack, a stroke, or some type of cancer.
• To respect the right to health of the people I live with, especially: children, the elderly, or people with health problems.

dejar de fumar

2. Senses: When you quit smoking, taste and smell improve spectacularly. The ex-smoker discovers new smells and new tastes within a few weeks of quitting tobacco.

3. Aesthetics: Among the problems associated with tobacco are bad breath (halitosis), yellow teeth, yellow nails and fingers, the smell of tobacco on clothes and hair, wrinkles on the skin, and the appearance of gray hair. All of these improve when you quit smoking.

4. Quality of Life: Among the symptoms that improve when you quit smoking are: fatigue, leg or head pain, impotence and penile flaccidity, muscle fatigue, shortness of breath, cough, and wheezing in the chest.

5. Economy: Quitting smoking leads to significant savings.

Write down what you spend on tobacco daily, multiply it by 30 days, and then by 12 months. Surely, you can make a nice gift, go on a trip, or simply save.

6. Setting an Example: The children of smoking parents are more likely to start smoking.

7. Independence: Smoking is an addiction.

• • To free myself from this horrible slavery.
  • Because I am worth too much to let tobacco crush me.
  • Improves self-control, achieves self-satisfaction, and gives a sense of freedom.

IDENTIFY THE REASONS WHY YOU ARE STILL SMOKING

1. "Tobacco is my stimulant": You feel that tobacco helps you clear your mind, keep a high level of attention, stimulates you, increases your energy, and, in general, helps you move forward.
2. "I use tobacco as a gesture reinforcement": Sometimes, having something between your fingers feels gratifying, helps you face certain situations more confidently, makes you feel more present, or simply entertains you.
3. "I smoke for pleasure/relaxation": It is not always easy to distinguish whether you smoke to feel good, that is, to gain pleasure, or to avoid feeling bad. About two-thirds of smokers do it for pleasure/relaxation.
4. "I smoke to reduce negative states": You often believe that the cigarette helps you get through difficult moments, stress, or daily problems.
5. "I smoke due to addiction": You already know that you have a strong addiction. But what you may not have ever considered is that, precisely because it is so difficult to function normally without the cigarette, when you manage to stop, you will realize that, in reality, you are stronger than tobacco, you will greatly value your achievement, and will feel that it’s not worth returning to the previous state of dependence.
6. "I smoke out of automatism": You no longer enjoy most of the cigarettes you smoke; your relationship with tobacco is unconscious, mechanical, automatic. Your main goal now is to break the unconscious associations you have established between smoking and your daily habits.

Now, let's clarify what’s more important to you.

To know if you really want to quit smoking, we propose a very simple exercise: make two lists—one of reasons you smoke, and another of reasons to quit smoking.

Which reasons do you value more? If the list of reasons to quit is truly more important than the list of reasons why you smoke, you are ready to keep moving forward with your quit-smoking plan. If the reasons to quit are less important than the reasons why you smoke, you may need a bit more time to find your own reasons for quitting. But don't get discouraged—keep thinking about them, and when you're ready, take the step.

Dejar de fumar ahura

If the reasons to quit smoking win, go ahead, it’s time to create a personalized plan to help you through the process.

If you’ve made a previous attempt, you know how difficult it can be.

Smoking is not a vice, nor do people who can't quit at the first attempt lack willpower. There are two powerful reasons that explain why quitting smoking is so difficult for many people:

1. Tobacco is addictive because it contains nicotine, an addictive drug

The deprivation of the nicotine level your body has become accustomed to is the cause of the unpleasant symptoms you experience each time you try to quit. The good news is that these symptoms significantly decrease after the first month.

2. The cigarette reinforces the addictive power of nicotine by greatly facilitating the repetition of the smoking behavior thousands of times, to the point that now it seems impossible for you to live without smoking.

The thought of living a normal day-to-day life without the cigarette may cause a feeling of emptiness, of loss, which makes you doubt your ability to overcome it. It is normal to feel this way because you have developed a significant psychological dependence on tobacco. But you should know that it is possible to live without tobacco again: you can do it.

Additionally, you identify yourself as a smoker. That is, at your deepest beliefs, you feel like a smoker and act in ways that avoid cognitive dissonance. Changing that belief is key to starting to act as a non-smoker.

Prepare yourself

Take the necessary time to carry out your plan and think about the fact that what you are aiming for is to quit smoking in a serious and permanent way. Once you’ve made this commitment, continue:

Within one month, set a day to quit smoking:

This day should be non-negotiable under any circumstances.

Make sure it is not a time of special stress, excessive work, major worries, changes, exams, etc.

Between now and that day, read your list of reasons for quitting frequently and identify the circumstances in which you smoke. This will help you de-automate your smoking behavior.

Improve your environment, prepare it for a tobacco-free life:

• Throw away ashtrays, lighters, and any objects related to tobacco consumption, both at home and at work, as well as in your car.
• Get a dental cleaning.
• If the walls of your house are stained from smoke, you may want to consider repainting them: this time they will stay clean much longer.
• If your car’s upholstery or your house’s sofas smell of tobacco, have them cleaned and enjoy their fresh, renewed look.
• Ask your friends not to smoke in your house. Most likely, your friends will understand, but sometimes they won’t, and your environment might not fully understand the changes you want to make. In that case, they might tempt you and invite you to smoke again. If this happens, limit contact with those people until you feel confident enough to refuse tobacco.

Let’s start uncovering the truth about tobacco…

Start by stripping it of the virtues it doesn’t have: Be aware that it is you, not tobacco, who solves daily problems, faces monotony or routine, overcomes stress, confronts frustration, beats tiredness, and enjoys pleasure.

Let’s also put tobacco in its proper place: The cigarette is not a help for you, but rather a burden.

PREPARATION FOR FACING POTENTIAL DIFFICULTIES

Let’s return to the reasons you smoke and plan strategies.

If you use tobacco because you’ve developed a strong addiction and your behavior is strongly automated:

• Start becoming aware of the situations you associate with tobacco consumption.
• Think about what alternative activity will help you face them without the cigarette.
• Ask those close to you (family, friends, and coworkers) that from the day you’ve set to quit smoking, they should not offer you cigarettes, smoke in your presence, or allow you to smoke.

* Alternative activities I will do instead of smoking:

At home:

• When I wake up… I will take several deep breaths.
• After meals… I will brush my teeth immediately.
• Watching TV… I will go for a walk, go to the movies, or call a friend.
• If my partner smokes… I will ask them not to do so in my presence.

At work:

• When trying to concentrate… I will take several deep breaths.
• During breaks or pauses… I will go outside, take a walk, or read my favorite magazine.
• When answering the phone… I will hold a pen in my hand.
• In moments of stress… I will breathe, and I will try to lighten my schedule for a few days.

During free time:

• Friends who smoke… I will ask them not to smoke in my presence, I will hang out with non-smoking friends.
• At a party… I will go outside and breathe.
• Going out for drinks… I will go to the movies, to the theater, or to a museum.
• Reading a book/listening to music… I will have juice or a delicious fruit cocktail on hand

If until now you have used tobacco as a stimulant:

You can activate your body and mind in other ways. For example:

• When you want to improve your alertness, breathe rapidly for 30-40 seconds.
• When you can take a brief break from your daily tasks, take advantage of the moment to activate your body with some moderate exercise.

If until now you have used tobacco as a gesture reinforcement:

• Find something to hold in your hands: a pen, a keychain, glasses, a book, or any small object within reach that can be manipulated (a rubber ball to squeeze).
• Use a simple relaxation technique.
• Release your anxiety with a simple exercise: walk quickly up and down the hall several times, open the window. If you can, change location or activity.

If until now you have used tobacco to obtain pleasure or reduce negative states:

Seek greater and better pleasures:

• Look for pleasant sensations through taste, sight, or smell; for example, have sugar-free candies or chewing gum, treat yourself to that perfume you always liked, give yourself some flowers, go to a spa for a massage, etc.
• Do an activity you enjoy: take a walk outdoors, listen to music, meet up with a good friend you haven’t seen in a while, start that book you’ve been meaning to read for months.
• Give yourself a relaxing bath with essential oils and good music.
• Sign up for that course you never had time for: painting, ballroom dancing, singing, model aircraft, lace-making, bookbinding; whatever it is, as long as it’s something you enjoy.

SYMPTOMS OF WITHDRAWAL SYNDROME AND TIPS TO MANAGE THEM:

Intense desire to smoke or "craving":

• Wait. The "cravings" last for a few minutes and will become less frequent and intense over time.
• Change your place or situation.
• Drink water or juice.
• Chew sugar-free gum.
• Eat something low in calories.
• Stay busy: hobbies, sports.

Irritability:

• Take a walk.
• Take a shower or bath.
• Drink relaxing herbal teas.
• Practice relaxation and breathing techniques.
• Avoid coffee or stimulating drinks.

Difficulty concentrating:

• Don’t push yourself too hard for a couple of weeks.
• Sleep more.
• Avoid alcoholic beverages.
• Exercise.

Headache:

• Take a shower or bath.
• Avoid coffee and alcohol.
• Sleep more.

Increased appetite:

• Drink plenty of water and fluids.
• Avoid fats and sweets.
• Increase vegetables and fruits in your diet.
• Eat more frequently but in smaller amounts.

Insomnia:

• Avoid coffee, tea, and soda in the afternoon.
• Increase physical exercise in the afternoon.
• Before bed, have a glass of warm milk, lime blossom tea, or valerian.
• Avoid naps.
• Be very regular with your sleep schedule.
• Have a light dinner and eat it at least two hours before going to bed.

Fatigue, discouragement:

• Keep yourself active.
• Do what you enjoy most.
• Reward yourself.
• Avoid loneliness. Seek the company of friends.
• Increase your hours of sleep.

Constipation:

• Walk. Exercise.
• Eat a fiber-rich diet.
• Drink plenty of liquids, especially water.
• Be regular in your habits.

It will be very helpful during the process of quitting smoking to seek support and make use of it:

• Personal support:

• • Talk about your decision, preferably with someone who has successfully gone through the experience of quitting smoking. This could be a family member, a coworker, or one of your friends.
  • Ask this trusted person to commit to providing you the support you will need at certain moments of the process you’re starting.
  • Choose someone who can listen to you and provide support whenever you need it, even if it’s by phone, email, or any other communication method.
• If your addiction is high… consider professional support:
  • If your addiction level is high, consult your doctor, who can offer individual or group counseling, or if they are unable to meet your needs, they can direct you to available resources in your area. Specialized psychological support can also be effective.

TEN STEPS TO RELAX WITH EASE:

1. Sit comfortably, making sure your back is straight and relaxed.
2. Breathe normally.
3. Hold your breath while counting to 10, without having previously taken a deep breath. If you cannot hold your breath while counting to 10, count to half and gradually increase the number until you feel comfortable.
4. Exhale slowly.
5. Inhale deeply and slowly.
6. Hold your breath while counting to 10.
7. Exhale slowly.
8. Relax the muscles in your neck.
9. Loosen your shoulders.
10. Perform steps 5 to 7 five times.

"RISK" SITUATIONS ONCE YOU HAVE STARTED QUITTING:

It is possible that at certain moments, the idea of staying smoke-free may seem difficult. Don't despair; you can overcome it.

Although the overwhelming desire to smoke will become less intense and will appear less frequently, do not let your guard down. Most relapses happen within the first three months after quitting smoking.

Some difficult situations to be aware of during the first weeks of quitting:

• When you go out for drinks. Avoid alcoholic beverages. Drinking alcohol reduces your chances of success.
• When you're around people who smoke. Being around people who smoke can make you want to smoke as well. Avoid these situations whenever possible, but without causing unnecessary discomfort. If you cannot avoid it, let them know you're quitting and kindly ask them not to smoke in your presence.
• If you gain weight. Follow a healthy diet and maintain a manageable physical activity routine. Don't let weight gain distract you from your main goal: quitting smoking.
• If you feel irritable or depressed. Acknowledge your feelings, but stay strong. Remember, there are many ways to improve your mood without smoking.

Many relapses happen due to overconfidence. Once you've made it through the first few days, don't think that everything is won—it would be a mistake.

In all of these situations, and others that you may not foresee, you must remain particularly alert and know that you should not give in, not for a single cigarette or even a single puff.

In general, the following will be helpful:

• Review the alternative activities you planned during your preparation phase.
• Change your usual routines and activities, your routes, and settings. Do something relaxing and enjoyable.
• Don't worry if you need to change many of your daily habits during this first week. Don't be alarmed; this won't last forever.
• Review your list of reasons for quitting smoking and add new reasons if you come up with any.
• Practice a simple relaxation technique that you can do at home, at work, etc.

And what about weight?

We know that one of the main concerns when quitting smoking is potential weight gain, so in addition to some basic recommendations, we've attached separate dietary and physical activity guidelines.

It is possible to quit smoking without gaining weight. However, it is true that many people do gain weight after quitting. This is due to:

• An increase in calorie intake when, to calm anxiety, cigarettes are replaced with sweets, cookies, pastries, and other high-calorie foods.
• While smoking, the body burns calories to eliminate the toxins in tobacco. After quitting, the body reduces energy expenditure.
• People who quit smoking regain their sense of taste and smell, which makes food taste and smell better, and they often feel hungrier, leading to snacking and an increase in calorie-dense food consumption: sweets, salty snacks, chips, pasta, bread, etc.

That said, know that it is possible to incorporate strategies into your quitting plan to avoid this weight gain.

If you do gain a little weight, remember that you can address this issue later. For now, keep in mind that the extra pounds gained are far less harmful to your health than your current tobacco consumption.

DIETARY RECOMMENDATIONS FOR PATIENTS QUITTING SMOKING:

• Drink at least two liters of water per day.
• Have five small meals a day.
• Eat slowly.
• Cook with less fat (avoid frying or breading) and choose foods that are low in fat or calories.
• Use olive oil as the primary cooking fat, not exceeding two or three tablespoons a day.
• Replace sugar with saccharin.
• Consume more fish (especially white fish and shellfish) than meat, which should be lean, with poultry being the best option.
• Avoid alcohol and carbonated beverages, as they provide calories rather than nutrients.
• Consume sweets, ice cream, cream, sauces, fatty or cured cheeses, cold cuts, and pre-cooked meals only a few times a month.
• Use salt sparingly.
• Replace full-fat dairy with skimmed dairy products.
• Increase the consumption of vegetables, fruits, and greens.
• Exercise daily, for at least one hour.
• If you feel hungry between meals, consume fruit, low-fat or high-protein yogurts, herbal teas.
• Follow a varied and balanced diet.

aumento de peso y dejar tabaco

WEIGHT GAIN AND QUITTING SMOKING

1. Think about quitting smoking only for the present day.
2. Quitting smoking is difficult but not impossible; it's worth dedicating extra time and effort to.
3. By keeping an eye on your diet and exercising, you can maintain your weight.
4. Try to eat frequently but in small portions. Avoid alcohol and stimulating drinks. Protein snacks, vegetables, fruits, unsalted nuts, homemade popcorn, or a warm drink with pure cocoa, low-calorie sweetener, and skim milk or plant-based milk will be your best foods during this period.
5. In the first few days, you'll feel a strong and intermittent urge to smoke, but by practicing relaxation and breathing techniques, as well as engaging in distracting activities, you'll overcome it.
6. Remember the improvements you will feel when you quit smoking and the benefits for your present and future health.
7. Stressful situations can be overcome without a cigarette.
8. Seek people who can support and help you. If necessary, ask for professional help.
9. Treat yourself to something special with the money you save every day.
10. Congratulate yourself daily for the progress you're making.
11. Never give in, not even for one cigarette, because once you smoke one, you relapse.

With all this information in hand, all that's left is the final step, the one only you can take, with all of our help if you need it:

QUIT SMOKING!