Insomnia, Snoring, Sleep Apnea

The world and life of a sleep tech

Archive for April, 2009

CPAP Compliance; How to get used to it fast

Posted by amykr on April 27, 2009

The new Medicare guidelines require patients to become compliant with their CPAP in 90 days or they will not pay for it. This has some positives and negatives. It now requires the doctors and homecare companies to become more actively involved. The problem is that CPAP sometimes takes a while to get used to. So what do you do when you need to get comfortable in a short period of time?
1. Take your time choosing your mask. If you can afford it get two different styles. The reason being that they place pressure points on different parts of the face. Also they feel different when you wear them. Pillows make the pressure feel stronger where a nasal mask will feel more diffuse. Full face masks are good because you can breathe through your mouth but they leak more.
2. Take advantage of the RAMP feature on most machines. That allows you to decrease the pressure and slowly build while you are falling asleep. This is for comfort and usually rises over 20 minutes to give you time to fall asleep.
3. Humidity is your friend. Many will not use the humidifier because of they do not like their nose to be warm. Humidity will make it more comfortable. Your nose is made to be humidified not dried out. Turn it up so your nose is more comfortable.
4. To follow the humidity, avoid rain out. Put the machine in the draw of the night stand so it is lower then the bed. You can also use some flannel and fabric glue to make a sleeve for the tube.
5. Talk to your doctor and homecare company. If you find that you still can not get used to the machine after a week call the homecare company or your doctor and discuss the problem with them. They should be able to help you find a solution to your problem.

CPAP is a long term therapy for sleep apnea. It takes a little time to get used to. Ninety days is not a lot of time to get used to it but taking advantage of your family, homecare company and doctor will help you to adjust faster.

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You’re Sleep Environment; 7 Tips to Create a Room that Promotes Sleep

Posted by amykr on April 26, 2009

A good night sleep is influenced by many things. If you are suffering from insomnia the first thing you should do is rule out where you sleep as the cause of the problem. The easiest thing to do is to look at your room and see if a change here could change your sleep problems.

1. Is your bedroom and office the same room?
Life is stressful especially in this economy. If you are using your bedroom as your office to manage the household, do work at home, study for school or plan your volunteer activities. This can keep your mind going so you can not relax and sleep.
2. How cluttered is your room?
Do you make the bed each morning? Is the laundry picked up? What is on the top of your dresser, night stand and other furniture? Clutter causes thoughts of what chores need to be done. It also causes chaotic thoughts. These do not help anyone to relax and go to sleep. Plus there is the issue of having to get up in the middle of the night, the clutter could cause you to become more awake if you hit or trip on it.
3. What sounds are you in your room?
Is a television or radio on in your room? What about the noise outside your room. Is there a loud television in the room next door? Are your neighbors noisy? If this is the case there are several things you can do to help ease the problem. White noise will help to mask the issue. This can be a fan, a white noise machine, or other consistent noise that will mask the outside noises. This does not include television or radio because the level of volume and the sound itself changes. You can also use light absorbing curtains because they also help to absorb noise from the outside. This is especially helpful to those who live on a busy street.
4. How much light is in your room?
A small night light is acceptable for sleeping but any more light and it can disturb your sleep. We all arouse several times during the night to change positions as we change from one stage of sleep to the next. The light can disturb you and actually change that short arousal into an awakening and take you longer to go back to sleep.
Outside light can also disturb your sleep. This can affect you if there is a streetlight outside your bedroom window, or if you are a shift worker. The investment in room darkening curtains is relatively inexpensive if you shop around. The help in getting a good seven to eight hours of quality sleep is priceless.
5. Who is sleeping in your room?
When you go to bed at night is there more then just your significant other in your bed. Pets can be one of the biggest disturbances when you sleep. They can be noisy they move around at night and can keep you from getting the sleep you need. The best place for them is outside your bedroom.
Where do your children sleep? Many parents share there beds with their children, however you need to be aware of the size of your bed and the more people sleeping in it the less space you will have to get comfortable. The idea is for everyone who shares the bed to get a good 8 hours of sleep not just the kids.
6. How is your bedroom decorated?
A relaxing surrounding is important to sleep. The color and comfort of your bedroom contributes to this. A soothing color is important to a good night sleep. So is the comfort of the bed you sleep in. Investments in such things as an egg crate or pillow top for your bed might make a mattress that is a little too hard more comfortable. Good quality sheets and bed linens are important. Softer sheets whether they are high thread count, flannel, satin or other materials that you like will help you to sleep better. A pillow that is right for your body position is also a good investment. They should be replaced on a regular basis. Pillows are not really lifetime investments, especially if they are of the foam variety. They wear our and you do not get the support you would get when you bought it. If you tend to like using three or four pillows when you sleep you might want to consider buying a wedge pillow. This will allow you to sleep at a 45 degree angle and would not require you to wake up and readjust your pillows several times a night.
7. What temperature is your room?
I know that many people think they sleep best when the room is warm but our bodies are designed for a cooler temperature at night. This is a natural thing, as our body temperature falls and is lowest during the 3am to 5am time period. If you get cold during the night consider adding a blanket or socks.

When you create a bedroom that is designed to help you fall asleep you will find that insomnia may not be as big a problem as it has been in the past. If you find that you are still having issues with insomnia look at your sleep routine and talk to your doctor. Sleep is too important to let anything stand in its way.

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Off Topic: Success and Business Survey. Please answer as best you can

Posted by amykr on April 14, 2009

This can be anonamous if you wish or first name last initial. If you do nto want it online please e mail it to amy8028472@yahoo.com. Thank you

Questionnaire for Entrepreneurs Start-up Support
Name:
Name of Business:
Do you want to stay anonymous or can I quote you?
Why did you choose the business you did?
Do you have a business education?
When you were going through the start-up process where did you go for advice?
Did you use the small business administration, SCORE, or any other government sponsored small business assistant organization?
What assistance did they give you?
Did they help with areas where your education was limited?
Do you or did you belong to a mentoring program or mastermind group?
What do you feel you gain from this relationship?

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Travel can Affect Your Internal Clock

Posted by amykr on April 12, 2009

It is the start of vacation season. With that many people have plans to travel. Or is it just that you travel around the country or the world for your job. Either way you can be affected by the sleep disorder that does not discriminate. It can affect anyone whether they have normal sleep or suffer another sleep disorder. Jet leg or desynchronosis is when your body’s internal clock and the external environment do not match.

The problem with jet lag is that there is so much information about it that it is hard to determine helpful information from inaccurate information. So let’s take a look at what causes it, how to minimize its effects and what might be in the future.

Jet lag happens when we quickly change time zones and can last for several days after the change. Our bodies have a rhythm that naturally cycles throughout the day. You are most awake between eight and ten and most drowsy between three and five. As you can see this is a 12 hour cycle. The problem is that just because you moved from New York to California does not mean your body’s internal clock has moved with you.

So how can you help yourself when you are going to travel? The first thing you should really do is consider is what time you are traveling. If you are traveling eastbound consider a daytime flight and then try to go to bed at the normal local time or soon after arriving if you arrive late in the night. Westbound travel does not have the same issues because you can just elongate the day to go to bed at the normal local time.

While you are traveling make sure that you stay well hydrated by drinking plenty of water. This will help to limit some of the other issues caused by flight like headaches and stomach aches. Avoid caffeine and alcohol. Their effects well actually add to the problems of trying to sleep at the new time you are trying to adjust to. Do not eat anything too heavy late in the evening as it can also interfere with sleep.

Take advantage of bright light. It can help your body adjust. If you want to delay sleep expose yourself to bright light late in the afternoon. If you need to go to sleep earlier then try exposing yourself to bright light first thing in the day.

Exercise can be helpful as well. Light exercising such as yoga, Pilates or a walk in the morning or early afternoon will help you to sleep better at night. If you exercise too late the day it can be more stimulating then relaxing.

Create the best sleep environment for yourself. Make sure the room is dark and there is no noise. If you nee bring ear plugs or a sleep mask if it will help. Bring something for your room that reminds you of home. A picture of your family, pillow or blanket from home might help you be more comfortable and fall asleep easier.

Medication is a last option. Currently there are only sleep aides to help. There is currently a new medication being tested called Tasimelteon can help to adjust Melatonin levels so that they change the circadian rhythm of the person. It looks to work on a 5 hours change or longer. This medication is in early testing still and will not be available for some time.

Jet lag may be a problem for many people but with a little planning and some good sleep habits it can be minimal zed.

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. She is also the coordinator of A.W.A.K.E. Orlando a support group for people with sleep disorders http://awakeorlando.ning.com. 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

References:

Monash University (2008, December 17). New Medication Brings Hope Of Jet Lag Cure. ScienceDaily. Retrieved April 11, 2009, from http://www.sciencedaily.com¬ /releases/2008/12/081208212901.html

National Sleep Foundation. Jet Lag and Sleep/ Retreived April 11, 2009, from http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.4813263/k.9987/Jet_Lag_and_Sleep.htm

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High Tech Helps in Sleep Disorder Testing and Treatment

Posted by amykr on April 8, 2009

With all the new ways of communicating you knew that it would eventually leak to the medical field. In sleep it has changed to allow us to perform studies and follow up with patients in a whole new way.

Home sleep studies has come up with a whole new arsenal of new equipment to test for sleep. The newest technology the WatchPat uses peripheral arterial tension to determine if you stop breathing in your sleep. All you do is where a monitor around your wrist and a probe on two fingers all night. It is simple for anyone to wear.

There are several companies that monitor more information that include oxygen level, heart rate, body position, snoring, and air flow and chest movement. This allows the doctor a bit more information to determine what is going on during the night. The information is downloaded after the patient wears it for the night and then scored by a sleep technician. Some example of these is the Respironics Stardust, Watermark Ares and the Clevemed Scout. The drawback is that the test is limited to testing for sleep apnea only. It also can not tell when a patient is asleep and when he or she is awake.

Bluetooth technology is now allowing a complete sleep study to be done at home. A technician comes to the house sets up the patient with a fell sleep setup including head leads, leg leads, EKG, pulse oximeter, flow and respiratory belts. They then attach it to a wireless box and set up a laptop with a camera and Bluetooth and a technician will monitor it from a central location. The benefit of this is that you get to sleep in your own bed. The drawback is no one is immediately available and if there is an issue except through the computer. The other one is that many insurance policies will not pay for a study performed this way.

Treatment for sleep apnea has also gone high tech. The newest technology puts modems in inside CPAP machine s so you can monitor the patient’s usage and any issues they might have from the first night. This will allow the technicians that monitor the CPAP as well as the doctors to find out if there are issues earlier instead of waiting for a patient to call and ask for help or give up.

All this technology is here and there is more being developed and released all the time. Remote will allow access for patients who might miss an opportunity for care.

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. She is also the coordinator of A.W.A.K.E. Orlando a support group for people with sleep disorders http://awakeorlando.ning.com. 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

Posted in education, Sleep Apnea | 2 Comments »

How to Tell What Research to Believe

Posted by amykr on April 8, 2009

You see it on television. You hear them on radio stations, you read them all over. The medical commercials talk about research. Diet products talk about research. So then the question is what research can you trust?

The fact is anyone can do a research project. I know that for my current class I am doing research on education in new businesses. In some sleep labs they do research for physicians or for medical companies. It is distinguishing what research you should trust and what research should you questions.

The first thing when looking at the research is to find out what publication it has been published in. If the only thing said is that the doctor works at a University but there is no publication to have printed it the research may be questionable. In order to be published in a medical Journal like JAMA or The Journal of Sleep Medicine the research must meet certain criteria. The procedure must be well controlled. There is a standard procedure to be followed. The study has to be reviewed by a panel to be part of these journals.

Next you need to look at the Journal and who is sponsoring it. Is it the company that produces the product, a college or is a specific physician or team doing research? If the company is the one supplying the money for the research then the goal is to find solutions that would benefit the company. If the research is for a university it is more likely to be unbiased. Although you must keep in mind that there is probably grant money involved that they want to continue to collect.

Finally you will want to read how many patients started and how many finished the study. You want to see how big the study was. The number of people involved makes a huge difference. It is much easier to replicate something among 15 people then among 150 people. If there were a large number of people who were dropped from the study you have to ask yourself why they were dropped. The numbers are what end up giving you the statistical answers that are the conclusion to the study.

Studies usually have the same layout as you are reading them, so it is pretty easy to follow it. The beginning is usually a summary of the report with the thesis, a short overview of the research and synapses of the conclusion. It is followed by a detailed report of the research including how the patients were chosen, how the study was performed and reasons anyone was dropped from it. There is a detailed conclusion and finally a disclosure of any conflict of interest.

It is great that we have access to a lot more information then we used to. It is necessary to understand how to read these reports so that you know what might be reliable information and what might be misleading information used to sell you a product. This keeps you a well informed advocate for yourself rather than a victim.

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. She is also the coordinator of A.W.A.K.E. Orlando a support group for people with sleep disorders http://awakeorlando.ning.com. 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

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