Black hairy tongue, a condition characterized by a dark, coated appearance of the tongue, is not sinister despite its alarming look, according to medical advice. It is believed to stem from an imbalance of microorganisms in the mouth, leading to a buildup of dead skin cells on the tongue's papillae. These papillae can trap food, drinks, and tobacco, causing staining that can appear black, brown, green, yellow, or white.
Factors contributing to this imbalance can include certain medications, such as antibiotics like penicillin, tetracycline, and doxycycline, and acid reflux drugs like lansoprazole. Supplements, including echinacea, may also play a role, though it's not a definitively known cause. Medical advice suggests discontinuing echinacea for a period to observe any changes.
Recommendations for managing black hairy tongue include avoiding black tea, coffee, alcohol, and tobacco. A diet focused on fresh, whole foods, free from preservatives and artificial additives, is also advised. Astringent mouthwashes, even natural ones like apple cider vinegar, should be avoided due to the tongue's sensitivity. The use of a liquid probiotic, swished in the mouth before swallowing, may help restore a healthy oral microbiome. Continued physical scraping of the tongue is also encouraged.
In separate medical advice, a 76-year-old woman experiencing night terrors, restless leg movements, screaming, and physically acting out in her sleep, including attacking her sleeping husband, has likely been diagnosed with REM (Rapid Eye Movement) sleep behavior disorder (RBD). During the REM stage of sleep, the body is normally paralyzed, but in RBD, this paralysis does not occur properly, leading individuals to physically act out their dreams.
This condition warrants referral to a sleep disorder clinic for specialized evaluation. Such evaluations typically involve an overnight stay in a unit where sleep is monitored through brain activity, breathing, and heart rate measurements, while movements are filmed. If diagnosed with RBD, treatment options may include the drug clonazepam, and some doctors also recommend melatonin, a sleep hormone. This is presented as a recognized medical condition for which help is available.