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Sudden loss of speech. Causes. Symptoms Diagnostics. “Even speechless”: reaction to the acquittal of Russian athletes by the court in Lausanne Elena Vyalbe, President of the Russian Ski Federation

Any cold is at least unpleasant. But sometimes loss of voice also joins the general “bouquet” of cold symptoms. And the person feels not just unable to work, but truly inferior, literally speechless. Why is this happening? How much recovery time can you expect? What should you not do and what is recommended to do if you lose your voice due to a cold?

The main question is not what should be done in this situation, but what should not be done. The very first and most important thing is that it is forbidden to talk. At all. And even in a whisper. Let's even say otherwise - especially in a whisper, because it makes the vocal cords tense more than normal conversation, and everything will be even worse. They need complete rest. It would never occur to any of us to jump on a bad leg! The absence of pain when the vocal cords are tense gives rise to the misconception about the impunity of their use during illness. However, it is not.

And a few more “don’ts”

It is better not to go out into the cold at all during this period. If this is not possible, keep your mouth shut. Talking in the frosty air is an additional blow to the sore spot, which will not only prolong the torment, but can also cause additional problems. On the street, in general, it is better to always breathe through your nose, so that dust and possible infection pass through the filters intended for them in the body, and do not fall along a wide public road straight into the wide open gate. And during nasal breathing, the air is warmed and moistened, which is also important for sensitive ligaments.
No smoking! Smoking itself can lead to the same problem.
Gargling with a soda solution is very common mistake! Soda's composition is an irritant to the ligaments. There are many other, much more useful compounds.
Drink alcohol (we'll look at some useful exceptions below).
There are spicy and sour foods.

Why does my voice disappear when I have a cold?

A cold is just one of many causes of hoarseness. IN in this case doctors talk about laryngitis - inflammation of the larynx involving the vocal cords. The problem can also occur with sore throat and bronchitis. Most often, the disease manifests itself as a sore throat (cats scratching their throats), pain during swallowing, and an unproductive, debilitating cough. All these symptoms can appear either in a certain order or unpredictably and even seemingly illogically. It seems that the pain has gone away, and the cough has calmed down, and suddenly bam - the person is hoarse and cannot speak. The cause of this course of laryngitis is, as a rule, errors in treatment, resulting in a bacterial complication. In this case, it is necessary to adjust the therapy with a doctor.

How to quickly get your voice back when you have a cold?

First of all, it doesn’t always work out quickly. Some may recover in 3-4 days, while others may take a month. Everything is very individual and depends on the severity of inflammation and the body’s own adaptive capabilities. Medications are prescribed by a doctor, since only he can accurately determine the cause that needs to be dealt with. But besides this, you can and should help yourself.

The main recommendation is to drink a lot and plentifully. Unless otherwise specified in the recipe, the liquid should be neither cold nor hot, but pleasantly warm. It might be warm mineral water, fruit and berry juices homemade, various herbal decoctions (chamomile, sage, St. John's wort, etc.). There are many folk secrets and time-tested original recipes.

Chaliapin's cocktail

Who, if not opera singers, knows how to quickly regain their voice when they have a cold! The famous artist used this recipe. He mixed two beaten egg whites with 2 tsp. sugar, and then added 50 g of cognac to the mixture. I took it in the evening before going to bed. He washed down each sip of the resulting mixture with the same amount warm water. And immediately lay down under a warm blanket. According to contemporaries, the voice was restored the next morning. Although, of course, it is difficult for us to compete with Chaliapin in terms of the strength of the ligaments, the method is worth adopting.

Another “opera” recipe

It is no longer known who invented it, but to this day many opera singers treat hoarseness with milk and dried figs. The dried fruit is cut in half, after which the pulp is scraped out with a spoon, added to the milk and, as far as possible, mixed thoroughly. The mixture must be put on fire, but heated not to a boil, but to such a hot state that the throat can withstand it. And drink right away. The procedure must be repeated 2-3 times a day.

On onion skins

When boiling the husk, at the very beginning of the boil, add 1 tbsp. viburnum berries, ground with sugar. Boil for another 10 minutes and then cool. Drink instead of tea, warming it up, for three days.

Hot beer

Yes, yes, this is exactly the exception to the ban on alcoholic beverages. Although it is unlikely to give you pleasure, since beer should not even be drunk warm, but hot. It will be disgusting, but quite effective. You need to lie down under the covers right away! You can replace beer with hot mulled wine, but it should be noted that this method only works at the very beginning, as soon as the first signs of hoarseness appear.

On garlic and potatoes

Chop the garlic, add to boiling water and cook for another 5 minutes. Grate the raw potatoes, add to the garlic and cook a little more. Cool, strain and drink in small sips at the rate of 2 cups per day. Keep refrigerated.

Rinse: two effective recipes

With aloe. Squeeze juice from aloe leaves and dilute hot water in a ratio of 1:2. Rinse three times a day.
With red beets. Finely grate the medium root vegetable and squeeze out the juice. Add 1 tbsp. l. apple cider vinegar. Rinse carefully: this is a very strong product!

Classic folk recipe

Even a doctor can prescribe it for you. This is Borjomi and milk mixed in half. It is recommended to drink warm, almost hot, a glass three times a day. There are few fans of this “medicine”, but it gives a noticeable effect on hoarseness and debilitating cough.

If people say about a runny nose that, depending on the intervention, it goes away either in 7 days or in a week, then the same cannot be said about a missing voice. If laryngitis is not treated and the prohibitions are ignored, then you can not only remain with your problem for a long time, but also get a whole bunch of additional complications. Of course, treatment is rarely pleasant, but what a joy it is to regain a full gift of speech!

Illustration copyright EPA

The Court of Arbitration for Sport (CAS) in Lausanne on Thursday upheld the appeals of Russian athletes, overturning the International Olympic Committee's (IOC) decision to ban them for life from the Olympics.

The BBC Russian service tells how athletes, officials and journalists reacted to this decision.

International Olympic Committee

This could have a major impact on future anti-doping efforts. The IOC will therefore review the rationale for decisions very carefully as soon as they are available and will consider possible consequences- including the possibility of appeal to the Swiss Federal Tribunal.

With regard to the participation of athletes from Russia in the 2018 Winter Olympic Games in Pyeongchang, the decision of the IOC Executive Committee of December 5, 2017 remains in force. This suggests that since the Russian Olympic Committee is suspended, Russian athletes will only be able to compete in Pyeongchang if they are invited by the IOC.

Illustration copyright AFP/Getty Image caption CAS considered that the evidence collected against the athletes was not enough to definitively speak of a violation of anti-doping rules.

The decision of the Arbitration Court in Lausanne does not mean that 28 athletes will be invited to the Games. Just because they are not under sanctions does not mean that they automatically receive the privilege of an invitation to the Games.

It is also important to note that at the press conference, the CAS Secretary General stated that the court's decision "does not mean that the 28 athletes are declared innocent."

Pavel Kolobkov, Minister of Sports of Russia

Now the Russian Olympic Committee will send a letter to the IOC with a proposal that they nominate our athletes to participate in the Olympic Games. We will wait for the official decision of the IOC. (Interfax)

All athletes were acquitted of charges of violating anti-doping rules during the Sochi Games. Both the guys and all of us are glad that justice has finally been served.

The CAS panel admitted that they were innocent and overturned the decisions of the Oswald Commission (IOC). Today's CAS decisions confirm that many of those accused are "clean athletes." (RIA News)

Dmitry Peskov, press secretary of the Russian President

We have repeatedly said that, of course, we will continue to support our athletes through all possible channels in any steps aimed at defending their rights.

The information received about the decision of the Court of Arbitration for Sport regarding our athletes confirms that vigorous actions to defend rights both in court and in other categories are justified, can be effective and should continue. And we hope that, of course, these actions will continue.

Dmitry Medvedev, Prime Minister of Russia

We have never doubted that our athletes absolutely deservedly received all the medals they won in Sochi. It’s good that the court fully confirmed this and proved their purity.

This means that the athletes who filed claims are fully exonerated. And no prohibitory decisions apply to them anymore; their biography is absolutely clean. And all the awards that they acquired have been restored.

Illustration copyright Getty Images Image caption Skeletonist Alexander Tretyakov should now get his gold medal back

Everything (...) needs to be done as quickly as possible so that fully rehabilitated athletes can take advantage of all the opportunities that open up for them as a result of this court decision. (Interfax)

Vitaly Mutko, former Russian Minister of Sports

Good news, but with bitterness. To be frank, this was not exactly the kind of decision we expected, but we still proceeded from the fact that in all these hearings and commissions of Oswald, WADA (World Anti-Doping Agency), the accusations were so superficial, hasty, without justification.

All this week the athletes have been proving their innocence. Doping is a fairly simple thing: there are tests, and all this talk and speculation should not be considered at all. As soon as some consideration reaches a legal basis, then everything falls into place.

One can only express regret that WADA entrusted all these processes to commissions; Richard McLaren was absolutely unconvincing during this process.

Of course, we are very happy that 28 athletes were acquitted. We never doubted them. All of them have always been outstanding athletes for us, and we had no doubt that they won their podiums in a fair fight. And the president said that we never intended to leave them without support and help. (RIA News)

Mikhail Degtyarev, head of the State Duma Committee on Physical Culture, Sports, Tourism and Youth Affairs

We were counting on positive decisions in court. You should always go to court, because silence means agreement with decisions taken or accusations. The next stage should be lawsuits in civil courts in order to refute the false theses of the McLaren report and protect the honor and dignity of athletes and coaches.

Elena Vyalbe, President of the Russian Ski Federation

When they found out the decision, I was even speechless. It is a pity that three are still not fully acquitted, but the disqualification is only for these Olympic Games. In general, we are just happy, I believed that sooner or later this would happen. (RIA News)

Olga Fatkulina, world champion in speed skating

Illustration copyright AFP/Getty Images

I earned a medal with my honest work. When I learned about today's decision, my happiness did not decrease or increase. Everything was as it should have been. It will be a victory if we are allowed to the Olympic Games. We will now wait to see how everything will be decided regarding the admission. Then we will rejoice. Now the state is such that there are no emotions. We are waiting to see how the situation will turn out. (RIA News)

Artem Kuznetsov, speed skater

Of course, common sense has triumphed, but many questions remain: what happened, why we were accused, and, I’m afraid, they will remain unanswered. It’s a shame that we most likely won’t go to the Olympics anyway, because there are no invitations yet, and it’s unclear what will happen. (TASS)

Alexey Petukhov, skier

Illustration copyright Reuters

Having learned the decision, I simply thought that justice had triumphed, there are higher powers and truth is above all nasty things. Now let those who spoke badly about us think about it, let them be ashamed. And we came out victorious, it’s great that the court heard us.

I’m a little confused, I understand that it’s all over, but the state is incomprehensible, twofold. It turns out that it’s unclear with the Olympic Games, the IOC probably won’t allow it, and the list has already been formed. But the fact that we will continue to prepare for the World Cup is a positive decision. With new strength for a new battle. (RIA News)

Alena Zavarzina, snowboarder

Nikita Kryukov, skier

I want to go to court, because the decision to disqualify me had a very strong impact. My name, name Olympic champion, they just took it and dipped it in the mud. I fully admit that this could make the fans doubt the purity of my results, my victories. I see no reason to tolerate this with impunity. Therefore, going to court seems to me a completely logical step.

In case of sudden loss of speech, first of all it should be determined whether it is anarthria (that is, the inability to pronounce words due to a violation of the coordinated activity of the respiratory, vocal and articulatory apparatuses due to their paresis, ataxia, etc.) or aphasia (the there is a violation of speech praxis).

This task is not easy, even when the patient is conscious and able to follow instructions, which generally rarely happens in acute pathology. For simple questions, it is possible to obtain “yes”/“no” answers, which with a 50% probability are answers at random. Moreover, even with aphasia, patients can grasp the meaning of what they hear exceptionally well by using the strategy “ keyword”, by which they understand the general meaning of the phrase thanks to the existing situational (“pragmatic”) skills, which do not suffer in case of speech impairment.

Examination using simple commands is difficult if the patient is hemiplegic and/or immobilized. In addition, coexisting apraxia may also limit the clinician's options. In the case of oral apraxia, the patient will not be able to perform even enough simple instructions(for example, “open your mouth” or “stick out your tongue”).

The ability to read is difficult to study because reading requires intact responses to oral gestures and motor skills, but studying written language can help to accept correct solution. For right-sided hemiplegia, the following test is used: the patient is asked to arrange in the correct order the words of a complete sentence, which he receives in written form on separate sheets of paper, mixed together. However, in some cases, even an experienced aphasia specialist cannot immediately make the right decision (for example, when the patient does not even attempt to utter at least a sound). It should be remembered that over time, the picture can quickly change, and instead of the aphasia that the patient had at the time of admission, dysarthria, that is, a purely articulatory speech disorder, can quickly come to the fore. When making a diagnosis, the age of the patient plays an important role.

The main causes of sudden loss of speech:

Migraine with aura (aphasic migraine)
Stroke in the left hemisphere
Postictal state
Brain tumor or abscess
Encephalitis caused by herpes simplex virus
Psychogenic mutism
Psychotic mutism

Migraine with aura

In patients young First of all, you can suspect migraine with aura. In these cases, there is the following typical combination of symptoms: acute or subacute loss of speech (usually without hemiplegia), accompanied by headache, which the patient has repeatedly experienced in the past and which may or may not be accompanied by changes in neurological status. If such a migraine attack occurs for the first time in this patient, useful information A study of family history (if possible), since in 60% of cases this disease is familial in nature, can provide information.

An EEG most likely reveals a focus of slow-wave activity in the left temporo-parietal region, which can persist for 3 weeks, while neuroimaging does not detect any pathology. Pronounced focal changes in the EEG in the absence of abnormalities according to the results of a neuroimaging study on the 2nd day of the disease, in principle, make it possible to make the correct diagnosis, with the exception of cases of herpetic encephalitis (see below). The patient should not have cardiac murmurs, which may indicate the possibility of cardiogenic embolism, which can occur at any age. A possible source of embolism is identified (or excluded) using echocardiography. Listening to vascular murmurs over the neck vessels is less reliable than Doppler ultrasound. If possible, transcranial Doppler ultrasound should be performed. A patient suffering from migraine and belonging to the age group from 40 to 50 years may have asymptomatic stenotic vascular lesions, but the typical nature of the headache, rapid reversal of symptoms and the absence of structural changes in the brain according to the results of neuroimaging research methods in combination with the changes described above EEG allows a correct diagnosis to be made. If symptoms do not progress, there is no need for CSF testing.

Left hemisphere stroke

When speech impairment occurs in an elderly patient, the most likely diagnosis is a stroke. In most cases of speech impairment during a stroke, the patient exhibits right-sided hemiparesis or hemiplegia, hemihypesthesia, and sometimes hemianopsia or a defect in the right visual field. In such cases, neuroimaging is the only way to reliably differentiate intracerebral hemorrhage and ischemic stroke.

Loss of speech almost always occurs with a left-hemisphere stroke. It can also be observed with a right-hemisphere stroke (i.e., with damage to the non-dominant hemisphere), but in these cases speech is restored much faster, and the likelihood of complete recovery is very high.

Mutism may precede the appearance of aphasia with damage to Broca's area; it has also been described in patients with damage to the supplementary motor area and severe pseudobulbar palsy. In general, mutism often develops with bilateral lesions of the brain: the thalamus, anterior areas of the cingulate cortex, damage to the putamen on both sides, and the cerebellum (cerebellar mutism with acute bilateral damage to the cerebellar hemispheres).

Severe articulation disorders can occur when blood circulation in the vertebrobasilar system is impaired, but complete absence speech is observed only with occlusion of the basilar artery, when akinetic mutism develops, which is a rather rare phenomenon (bilateral damage to the mesencephalon). Mutism as a lack of vocalization is also possible with bilateral paralysis of the muscles of the pharynx or vocal cords (“peripheral” mutism).

Postictal state (state after a seizure)

In all age groups With the exception of infants, speech loss may be a postictal phenomenon. The epileptic seizure itself may go unnoticed, and the bite of the tongue or lips may be absent; An increase in the level of creatine phosphokinase in the blood may be an indication of a seizure, but this finding is unreliable in terms of diagnosis.

Quite often, diagnosis is facilitated by EEG: generalized or local slow and sharp wave activity is recorded. Speech is quickly restored, and the doctor is faced with the task of determining the cause of the epileptic seizure.

Brain tumor or abscess

In the history of patients with a brain tumor or abscess, any valuable information may be missing: there was no headache, there were no behavioral changes (aspontaneity, flattening of affect, apathy). An obvious inflammatory process of the ENT organs may also be absent. Sudden loss of speech can occur: due to the rupture of a vessel supplying blood to the tumor, and the resulting hemorrhage into the tumor; due to the rapid increase in perifocal edema; or - in the case of a left-hemispheric tumor or abscess - due to a partial or generalized epileptic seizure. Staging correct diagnosis is possible only with a systematic examination of the patient. It is necessary to conduct an EEG study, in which it is possible to register a focus of slow-wave activity, the presence of which cannot be unambiguously interpreted. However, the presence of very slow delta waves in combination with a general slowing of electrical activity in the brain may indicate a brain abscess or a hemispheric tumor.

With computed tomography, both in the case of a tumor and in the case of an abscess, it is possible to identify a large intracerebral process in the form of a low-density focus with or without contrast uptake. With abscesses there is often more pronounced perifocal edema.

Thrombosis of the intracerebral sagittal sinus

There is the following typical triad of symptoms that may indicate thrombosis of the intracerebral sinus: partial or generalized epileptic seizures, hemispheric focal symptoms, decreased level of wakefulness. The EEG records generalized low-amplitude slow-wave activity over the entire hemisphere, also extending to the opposite hemisphere. With neuroimaging, sinus thrombosis is indicated by hemispheric edema (mainly in the parasagittal region) with diapedetic hemorrhages, signal hyperintensity in the area of the sinus(es) and a deltoid-shaped zone that does not accumulate the injected contrast and corresponds to the affected sinus.

Encephalitis caused by herpes simplex virus (HSV)

Because herpetic encephalitis caused by HSV primarily affects the temporal lobe, aphasia (or paraphasia) is often the first symptom. The EEG reveals focal slow-wave activity, which, upon repeated EEG recording, is transformed into periodically occurring three-phase complexes (triplets). Gradually, these complexes spread to the frontal and contralateral leads. Neuroimaging identifies a low-density zone, which soon acquires the characteristics of a volumetric process and spreads from the deep parts of the temporal lobe to the frontal lobe, and then contralaterally, involving primarily areas related to the limbic system. Signs of an inflammatory process are found in the cerebrospinal fluid. Unfortunately, verification of HSV infection by direct visualization of viral particles or using immunofluorescence analysis is possible only with a significant time delay, while antiviral therapy should begin immediately when the first suspicion of viral encephalitis arises (taking into account the fact that the mortality rate of HSV- encephalitis reaches 85%).

Any cold is at least unpleasant. But sometimes loss of voice also joins the general “bouquet” of cold symptoms. And the person feels not just unable to work, but truly inferior, literally speechless. Why is this happening? How much recovery time can you expect? What should you not do and what is recommended to do if you lose your voice due to a cold?

When silence is golden!

And a few more "don'ts"

It is better not to go out into the cold at all during this period. If this is not possible, keep your mouth shut. Talking in the frosty air is an additional blow to the sore spot, which will not only prolong the torment, but can also cause additional problems. On the street, in general, it is better to always breathe through your nose, so that dust and possible infection pass through the filters intended for them in the body, and do not fall along a wide public road straight into the wide open gate. And during nasal breathing, the air is warmed and moistened, which is also important for sensitive ligaments.
No smoking! Smoking itself can lead to the same problem.
Gargling with soda solution is a very common mistake! Soda's composition is an irritant to the ligaments. There are many other, much more useful compounds.
Drink alcohol (we'll look at some useful exceptions below).
There are spicy and sour foods.

Why does my voice disappear when I have a cold?

A cold is just one of many causes of hoarseness. In this case, doctors talk about laryngitis - inflammation of the larynx involving the vocal cords. The problem can also occur with sore throat and bronchitis. Most often, the disease manifests itself as a sore throat (cats scratching their throats), pain during swallowing, and an unproductive, debilitating cough. All these symptoms can appear either in a certain order or unpredictably and even seemingly illogically. It seems that the pain has gone away, and the cough has calmed down, and suddenly bam - the person is hoarse and cannot speak. The cause of this course of laryngitis is, as a rule, errors in treatment, resulting in a bacterial complication. In this case, it is necessary to adjust the therapy with a doctor.

Another "opera" recipe

On onion skins

Hot beer

On garlic and potatoes

Rinse: two effective recipes

With aloe. Squeeze juice from aloe leaves and dilute with hot water in a ratio of 1:2. Rinse three times a day.
With red beets. Finely grate the medium root vegetable and squeeze out the juice. Add 1 tbsp. l. apple cider vinegar. Rinse carefully: this is a very strong product!

Classic folk recipe

Professor L. S. PETELIN

THIS HAPPENED unexpectedly and for no apparent reason. I completely stopped understanding my interlocutor. He said something, it seemed to me that he spoke very quickly, I did not perceive it well. The words seemed familiar to me, but I did not understand or remember their connection and meaning. The dialogue was clearly not working out; the interlocutor noticed this and was perplexed. I made several attempts to tell him something, but nothing worked except for absurdity. I couldn’t say a single intelligible word, I didn’t know them at all, I didn’t remember them. He noticed the failure of attempts to speak and immediately stopped his babbling, accompanying this with gestures of annoyance. Not without difficulty I managed to squeeze out of myself: “I am sick, I feel bad.” The matter became clearer; the help of a doctor was urgently needed.

The questions were asked to me very clearly and in such a way that it was possible to answer them quite definitely with a movement of the head, meaning “yes” or “no”. I understood the questions well. I felt generally satisfactory, there were no pain, nausea or dizziness, no signs of fear or panic. On the contrary, I was inclined to make jokes, but the jokes didn’t work either.

An infusion of a vasodilator restored my ability to speak. I was alone in the room, I thought that I would have to learn to speak again.

I repeated this thought out loud, and I succeeded. Ten minutes later the doctors returned, and I talked to them normally. And everything could have ended sadly, because I was not aware of the danger of the situation and behaved, to put it mildly, frivolously...

I ask the experts to explain to me: why am I speechless? Either he forgot the words or lost the ability to pronounce them?

I repeat: I myself was unable to remember them.

Reader K. KIRILLOV

Dear comrade Kirillov!

The letter that you sent to the editor of the magazine “Health” very accurately reflects the psychological state of a person who has suffered a temporary, transient, so-called dynamic disorder of cerebral circulation.

First of all, the main question that worries you is: why are you suddenly speechless?

As you know, the human brain consists of two hemispheres. The centers that control speech are located in the left cortex. There are two of them: the sensitive one is designed to understand oral speech addressed to a person, and the other, the motor one, gives orders to the muscles of the pharynx, vocal cords, and tongue to reproduce mentally composed speech complexes and voices them.

Apparently, only your motor speech center has suffered. In view of

A dynamic disorder of cerebral circulation, similar to the one you described, occurs, as a rule, in people suffering from initial forms of hypertension and atherosclerosis. These pathological processes can cause spasms of cerebral vessels and thereby lead to a slowdown in cerebral blood flow. Due to limited blood supply, oxygen starvation of the brain tissue (hypoxia) occurs and disruption of its functions occurs. It should be said that the cerebral cortex is very sensitive to a lack of oxygen, and if it is prolonged, irreversible damage may occur.

What helps prevent them?

At the first signs of a dynamic disorder of cerebral circulation, the patient should lie down, and those around him should help him get comfortable. If his face is red at this time, his head should be raised on two pillows, mustard plasters should be placed on his calves, and a heating pad wrapped in a towel should be placed on his feet. Before the doctor arrives, you can give a validol tablet or 30 drops of valocordin

Some patients may have other symptoms: numbness in the face, arms or legs, crawling sensations, tingling, weakness, accompanied by dizziness. In all these cases, you should immediately call a doctor.

As a rule, a dynamic disturbance of cerebral circulation is short-lived, it passes within a few minutes or hours.

But the doctor does not immediately allow the patient to get up. Depending on his condition, bed rest can be extended to 2-3 weeks.

You, Comrade Kirillov, frankly speaking, were lucky; you behaved unacceptably actively at the time of the onset of a dynamic cerebrovascular accident, and this could have ended sadly. A person who has suffered a dynamic cerebrovascular accident must remember the need for systematic treatment of hypertension and atherosclerosis. He shouldn't take hot bath

, visit the bathhouse, sunbathe. It is important to take care of maintaining a rational regime of work, rest, and nutrition. Preference should be given to such products as vegetables, herbs, milk, cottage cheese, cod, soaked herring, lean fish and meats, legumes, and vegetable oils.

It is advisable for the person to maintain normal household habits. He should not give up his favorite activity - collecting, say, stamps, wood carving, caring for flowers, fish, if, of course, he is able to do it. Such work gives rest nervous system. Reading books can also be considered relaxation

Those who suffer from insomnia need evening walks.

In general, we should try to be “closer to nature.” A long stay on the banks of a river, lake, in a forest, in a field is the best vacation in both summer and winter. Depending on age and physical capabilities, skiing, fishing, and trips to the forest to pick mushrooms and berries are recommended. Walk to and from work, and if it's a long way, walk at least part of the way. Useful physical exercise, breathing exercises.

People engaged in physical work do not have to give it up, but they are not allowed to lift heavy weights or exert much effort.