Insomnia, Snoring, Sleep Apnea

The world and life of a sleep tech

Archive for February, 2009

Where do you get your medical information?

Posted by amykr on February 24, 2009

 

 

As a sleep tech and as a respiratory therapist I have learned a great deal from the web on where to get information.  I have learned how to find continuing education classes.  I am even attending college to finish my BA in business.  But one of the things I also do is look up new medications I take or ones my patients may be taking and I do not know.  I look up different conditions that I may not be as knowledgeable as I want to be.

 

It is sharing this knowledge that I think is the most important.  It is why I blog.  It is why I write what I learn.  But the fact is many people do not blog because they do not know how important it is.  This study article that was written by businessbuilders.com shows how little people understand the power of the internet and marketing.

http://www.practicebuilders.com/news/reports/esr200901.asp

Although most facilities have a website they do not do anything with it.  Even the number who answered the questionnaire was small.  This questionnaire was done by a company that helps physicians build their practices.  But even if you do not hire them they have an excellent newsletter filled with important information.  The sad part was how few practices actually answered the questionnaire and even fewer take advantage of educating the public.

 

As a field healthcare seems to like the status quo or to complain about what is wrong with care.  How many are actually out there putting information on the internet.  How many are telling the world about their practice, lab, and facility and in the process sharing their knowledge.  I say there are not enough of us.  And this survey shows it.  The fact that we do not optimize our sites or create newletters or any other helpful information just says we have not yet embraced this new cyberworld.

 

Of course it may be the fact that I have teenagers and that I grew up with pong and Commodore 64 computers in my high school that allows me to be open.  I also think that to me the most important thing I can do is share the word that sleep is important and that I and my fellow sleep professional want to help you get the best nights sleep of your life.

 

If you have any questions about sleep or if are just looking for a little more information please do not hesitate to ask or email or call.

 

Amy Korn-Reavis, RRT, RPSGT has been in the respiratory field for over twenty years.  She has worked in all areas and is currently focusing on sleep and how to help the community feel better by sleeping better.  She is the manager of Emery Sleep Solutions an independent testing facility located in Apopka, Florida.  If you have any questions about sleep or are looking for someone to speak at your community function she can be reached at areavis@emerymedicalsolutions.com or you can visit the facility’s website at www.emerysleepsolutions.com

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Who Does Your Snoring Affect?

Posted by amykr on February 22, 2009

Today on Yahoo.com the reason I do my job was evident.  if you watch this video:

http://video.yahoo.com/network/100743807?v=4438098

You will See father snoring and how it disrupts the sleep of his new son.  Many of my patients who have sleep apnea would rather deny their sleep apnea, their snoring , their leg movement or their teeth grinding the fact is that it affect more then just themselves.  Your family needs to be taken into consideration as well. 

The treatment for these disorders are not always be simple or ideal but it will help everyone in the family.  Everyone will have more energy, less health issues and have a great night’s sleep.  Like this baby who is missing much of the time he should be growing because his father keeps him from going into a deep sleep.  Now think of the mom.  She works all day, comes home and cleans and cooks and plays all evening and finally when she is ready to go to sleep she has a long night where her sleep is not as restorative as it could be. 

So where do am I going with this other then to create a hypothetical situation.  I am asking people to consider what affect your health issues have on those who love you. 

Amy Korn-Reavis, RRT, RPSGT has been in the respiratory field for over twenty years.  She has worked in all areas and is currently focusing on sleep and how to help the community feel better by sleeping better.  She is the manager of Emery Sleep Solutions an independent testing facility located in Apopka, Florida.  If you have any questions about sleep or are looking for someone to speak at your community function she can be reached at areavis@emerymedicalsolutions.com or you can visit the facility’s website at www.emerysleepsolutions.com

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PCOS is linked to Obstructive Sleep Apnea

Posted by amykr on February 20, 2009

PCOS or Poly Cystic Ovary Disease is an problem where small cysts develop on the overaies and uterus.  It has become a bigger issue in recent years.  The condition is associated with two of the biggest problems in womens health today, insulin resistance and sleep apnea.  Woman are becoming more knowledgeable about their health and how best to treat it.  With this knowledge they are going to their doctors prepared for getting the help they need.

With this you should know that you are 30% more likely to have a sleep disorder.  So if you snore ask your doctor if you can have a sleep study.  The stress on your body from having sleep apnea and not being able to have a good night’s sleep will make your other symptoms worse. 

Consider this if you have sleep apnea.  as you fall asleep or as you reach a deeper sleep your airway closes and your body struggles to get oxygen.  Eventually you arouse or awaken so you can take a deep breathe.  If you have sleep apnea you do this over and over again all night.  While this is happening the oxygen levels in your blood goes up and down.  This can happen many times an hour.  You end up having an exhausting night without getting sufficient rest.  Usually your family notices this because of the snoring and silence over and over again all night. 

The treatment of sleep apnea depends on the results of your study.  It can be as simple as positional therapy so you sleep in a certain position, an oral appliance to keep your jaw and tongue aligned, a CPAP or BiPAP machine, or surgery.  All these are based on your discussion with your physician, or the sleep specialist. 

If you have any questions or comments please do not hesitate to share.  You can email me at amy8028472@yahoo.com or share here on the site.

 

 http://bit.ly/Sl2e7

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The Shell Game

Posted by amykr on February 18, 2009

Every time I get a new patient I think “What mask I am going to use?” I think about what we have available now, what we used to have available, and who is going to perform the study.

Everyone has a favorite mask. Everyone who has been in the field for a long period of time has seen their favorite mask change over time.

When I was first doing home care for Bane Respiratory many years ago, I had specific masks for specific types of patients. I always started with the nasal mask except if the patient was claustrophobic or had fragile skin.

Then we would get into some of the stranger masks out there. I had a mask I used specifically for my little old ladies who went to the hair dresser once a week. (These little ladies were always my favorites)

Back then, I would use mostly the new gel masks that you had to boil to make fit. It served two purposes. One, to get the mask fit properly and two, I would see what medications they were taking and make sure they did not have three bottles of the same med by different names that they were taking. If I was calling a doctor’s office in the middle of the day, they know I was calling because I had just found someone who was overmedicating themselves. It was always about patient care.

If I had one of my little old ladies who did not want to muss their hair, I would break out a mask that was a cross between a wrestler’s headgear and Princess Leah’s hairdo. But oh, the things you could do with it to get a patient to wear their CPAP or BiPAP. I almost never put the straps where they were supposed to go. This way I had one strap across the forehead and one at the back of the neck and the nasal cushion secured using Velcro around the hose. The great part was that this mask was one of the first where a patient could wear glasses so they could read in bed before lights out.

Full face masks to this day I use whenever someone is claustrophobic and the wires do not bother them. This means it is not having something touching their face that keeps them from wearing the mask but it is a control issue. When you tell someone to breathe through their nose only you take away some of their control. With a full face mask and having the patient hold it to their face they are in control and they learn to adjust to using CPAP. I have many successes that way.

In the end, choosing masks is all about how much communication I have with the patient. I will always give them at least two choices, I will always listen to their fears and any health issues and I will always look at my biocals for upper airway resistance. Then I give choices. This is how I find the pea under the shell almost every time.

 

As seen in Advanceforsleep.com

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I Hate My Morning Headache

Posted by amykr on February 16, 2009

Many people wake in the morning with headaches.  It almost makes people feel like they do not want to go to bed because in the morning they know they will feel worse.  If you are one of them there may be a solution to getting rid of these am headaches. 

 

Morning headaches are one of the symptoms of sleep apnea.  This is due to two facts.  One, having had a night with disrupted sleep where you arouse, but not awake, frequently throughout the night causes a disruption in sleep and causes sleep deprivation.  This stresses the body and causes the morning headaches.  The second issue can be because your oxygen levels can rise and fall and there is stress every time you have either a partial or full obstruction of your airway the pressure to your circulatory system and your brain can cause the morning headaches.  This is actually most common in menopausal woman and middle to older men who have moderate to severe sleep apnea.

 

There is hope.  If you do have sleep apnea causing your morning headaches treatment of the sleep apnea using a CPAP or BiPAP machine resolved over 90% of the headaches according to study done by Goksan, et all.  This means if you do wake with morning headaches on a regular basis you should talk to your doctor. 

 

 

Amy Korn-Reavis, RRT, RPSGT has been in the respiratory field for over twenty years.  She has worked in all areas and is currently focusing on sleep and how to help the community feel better by sleeping better.  She is the manager of Emery Sleep Solutions a independent testing facility located in Apopka, Florida.  If you have any questions about sleep or are looking for someone to speak at your community function she can be reached at areavis@emerymedicalsolutions.com or you can visit the facility’s website at www.emerysleepsolutions.com

 

http://sleepassociation.org/abstract-morning-headache-in-sleep-apnoea-clinical-and-polysomnographic-evaluation-and-response-to-nasal-continuous-positive-airway-pressure.html

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The Epworth Qestionnaire

Posted by amykr on February 12, 2009

________________________ Date: _____________

Epworth Sleepiness Scale

How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work our how they would affected you. Use the following scale to choose the most appropriate number for each situation.

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

1. Sitting and reading _______________

2. Watching television _______________

3. Sitting inactive in a public place _______________

4. As a passenger in a care for an hour without a break ________________

5. Lying down to rest in the afternoon when
circumstances permit. ________________

6. Sitting and talking to someone ________________

7. Sitting quietly after lunch without alcohol ________________

8. In a care, while stopped, for a few minutes in traffic _________________

total score ___________________
Score great thern 9 see your doctor

If neck size is great ther 17 inches it can contribute to sleep issues
If you snore it can contribute to sleep issues
If you wake with morning headaches it can contribute to sleep issues
If you have uncontrolled HTN or Diabetes it can contribute to sleep issues
If you are tired all the time it can contribute to sleep issues
If you have insomnia it can contribute to sleep issues
If you move your legs or gring your teeth it can contribute to sleep issues

Talk to your primary care doctor about your sleep

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Can you reverse heart disease?

Posted by amykr on February 12, 2009

Many of us have developed high blood pressure, enlarged hearts and heart failure. The one thing that these all have in common is that they can be improved if they have sleep apnea and it is treated. Each time a patient either stops breathing or has their airway partially obstructed it causes an increase in pressure in their chest. This also puts pressure on the chest. The results are obvious especially if you take your blood pressure in the morning. You wake with higher blood pressure, headaches, a fuzzy head and being as tired as when you went to bed.

Treating the sleep apnea takes the pressure off the body. You also get the benefit of your body truly being able to sleep and go through all the stages. The result is that enlarged hearts tend to decrease in size, blood pressure is reduced, and an overall feeling of energy and focus.

The best thing you can do is talk to your doctor if you have any symptoms of sleep apnea. Snoring (and yes woman you snore too) waking up frequently at night, restlessness, morning headaches, and fatigue all day. They can order a simple, painless study to find out how best to treat you. But it all starts with a conversation. Remember you are in charge of your health and the better educated you are the better your care will be.

http://www.aasmnet.org/jcsm/AcceptedPapers/1267.pdf

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Is your job causing you to loose sleep?

Posted by amykr on February 9, 2009

Our bodies are designed to be active, but in this day and age of desk jobs and sitting in front of the computer we may very well be causing our own sleep issues.  When we sit we do not allow our body to move fluids from our legs around out body.  This accumulation in our legs then gets moved around the body when we sleep and seem to accumulate in the upper body as we sleep, in particular the neck. 

 

What does this mean?  That if we are sedentary during the day that we increase our chances and the severity of our sleep apnea at night.  When our necks get bigger because of this extra fluid we put more pressure on our airways and that causes it to become partially or fully blocked. 

 

The other problem with being sedentary is very obvious and that is that it contributes to obesity. However, only about 40% of obstructive sleep apnea sufferers are obese.  So, if we reduce our chance of obesity then we can decrease the severity of sleep apnea or possibly eliminate it.    

 

This study just tells us what we already know.  Our bodies are happiest when we are moving.  If you have a desk job get up every hour or so and walk around for a few minutes will help to move the fluids that have accumulated in your legs by using the calf and thigh muscles.  This will not only help you to loose weight but will help you to sleep better at night.

 

 

 

http://uk.reuters.com/article/healthNewsMolt/idUKTRE50Q6JK20090127

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Are you Happy In Your Marriage

Posted by amykr on February 5, 2009

A new study states that there is new way to tell if a man has a sleep disturbance. Ask his wife how happy she is. A study done at the University of Pittsburg stated that “We found that happily married women report fewer sleep disturbances including difficulty falling asleep, nighttime awakenings, early morning awakenings, and restless sleep, as compared to women reporting lower marital happiness,” said Wendy Troxel, an associate professor of psychiatry who headed the study. (Rueter. 2009, January 28) When they looked at this and ruled out personal issues what they found was that Men’s sleep disorders were disturbing the wives’ sleep. I think thuis says it all. If mom is happy everyone is happy. But if mom is not getting enough sleep then no one is happy. So if you have a husband who is not sleeping well and keeping you up at night or if you are a husband and you know you snore and gasp at night. Please talk to your doctor. It will help your marriage in this time where we have so many other stresses. Amy Korn-Reavis, RRT, RPSGT has been in the respiratory field for over twenty years. She has worked in all areas and is currently focusing on sleep and how to help the community feel better by sleeping better. She is the manager of Emery Sleep Solutions a independent testing facility located in Apopka, Florida. If you have any questions about sleep or are looking for someone to speak at yrou community function she can be reached at areavis@emerymedicalsolutions.com or you can visit the facility’s website at http://www.emerysleepsolutions.com source http://tinyurl.com/c8ox9f

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The test I could never pass

Posted by amykr on February 3, 2009

As a sleep lab manager, I get to perform many different types of tests but the one that I am always amazed about is the MWT. I do not think even on my best day-having had a week of nights without being woken up by technicians, my son, or my dogs-I could pass that test. I need light and sound to keep me going.
The MWT, for those who are not in sleep, is the Maintenance of Wakefulness test. It is given to those who are on CPAP and need to stay awake for their job such as truck drivers, airline pilots, and train conductors. It is a series of 4 “naps” each lasting 40 minutes where you sit reclined in a low lit room with no noise and you are not to make any repetitive movements that might keep you awake.

Now if you have ever met me you know two things about me: One, I am a fidgeter, and, two, I am a foot tapper to end all foot tappers. I could probably get into the Guinness Book of World Records for tapping my foot so much. So the idea of taking those two behaviors away from me sounds like torture-even if it is only for 40 minutes. And if I could not tap or fidget I would probably end up tapping my fingers or falling asleep.

Now, just imagine you are doing a sleep study and it is totally quiet (that includes the fact that the patient you are watching is a quiet breather and does not snore) and you have the lights turned down to night light level. Now tell me: how you are supposed to stay awake for that?

I have technicians who turn the lights off during the night and I just can not imagine how they stay awake. I want light and noise. Otherwise it is nighty night time for me.

The last MWT I did, I was absolutely amazed at the guy. He came in as soon as he got up that morning. Skipped his morning coffee and followed all the directions. He was set up and ready to do his first nap. He got in the room, relaxed and I explained the test to him, turned off the light, and he did great. He stayed awake through the first three naps like a pro.

The fourth nap came after he had lunch. I should have known. I turn off the lights and started the test. Two minutes later, he is snoring away. I felt so bad. I wanted to help him but I had my job to do. I finished the test, scored it, and sent it to the doctor.

The worst part of my job is to call the patient to tell them the results of the test.

In the end, what I am really grateful for is that I do not have to take this test so that I can perform my job. I know that there are times I have to fight to stay awake, but at least I can get up and walk.

I just wonder how many truck drivers, pilots, and conductors really need this test and have not gotten it.

Published in Advanceforsleep.com

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