The Joint Commission and American Heart Association / American Stroke Associationâs Comprehensive Stroke Center Certification includes a new and exclusive suite of benefits. The total fee for certifying a Comprehensive Stroke Center will be $55,000 for the two-year certification cycle including: 1  Two day on-site fee of $5,600; and. 2  Annual fees of $24,700.
Excessive daytime sleepiness: A neurological disorder in which there is a sudden recurrent uncontrollable compulsion to sleep. Excessive daytime sleepiness is also known as narcolepsy. The condition is often associated with: 1  Cataplexy -- a sudden loss of muscle tone and paralysis of voluntary muscles associated with a strong emotion. 2  Sleep paralysis -- immobility of the body that occurs in the transition from sleep to wakefulness. 3  Hypnagogic hallucinations -- pre-sleep dreams.
If weight gain is occurring in a midlife woman who doesn't have a chronic central coldness, it is likely perimenopausal. In either case, increasing exercise, avoiding sweets and eating sensibly will help control it. Both hypothyroidism and perimenopause may cause sleep problems. The typical kind of sleep disturbance for a perimenopausal woman is mid-sleep wakening. She often will fall asleep instantly and sleep soundly for a few hours only to jolt awake in the wee hours of the morning. Then it is difficult to get back to sleep.