Insomnia, Snoring, Sleep Apnea

The world and life of a sleep tech

Archive for March, 2010

Posted by amykr on March 31, 2010

5 Quick Fixes for CPAP Problems.
http://ping.fm/filUs

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Should I Have a Home Sleep Study or Go to the Lab?

Posted by amykr on March 23, 2010

Technology has come a long was and studying sleep is no exception. We are now able to perform sleep studies in the home as well as the sleep lab. This is a great thing because it allows more people to be tested for sleep disorders then every before. The drawback is that there are limitations to what can be done in the home versus the lab.

In home sleep studies are generally modified unsupervised sleep studies. This means that the equipment is delivered to the patient and then they are responsible for applying it and taking it off. In some areas a technician will come out in the evening to apply the equipment and you will wear it the rest of the night, then you may have to take it off or the technician will come back in the morning and remove it. Generally these types of studies are limited in nature and only monitors certain parameters, oxygen level, heart rate, breathing, and whether you are awake or sleep and position. Because the study is limited it is designed strictly to diagnoses sleep apnea. Other conditions a person may have will not be diagnosed, such a periodic limb movement disorder and teeth grinding. This type of testing is also not good for patient with significant health issues such as congestive heart failure or COPD.

In lab testing has several differences. The first one is there is a technician there with you if any problems should arise. If one of the wires become dislodged it can be fixed right away. You do not need to have another study performed. The technician is also there to answer questions should you have any during the nights. The most important role of the technician, however, is that they can intervene if there is a significant health issue during the night. They can also do a special type of study called a split night, or combination study, which allows you to be diagnosed and treated for your sleep apnea on the same night. This way if you have severe sleep apnea you can be treated right away instead of waiting. You also are able to be evaluated for other conditions you may not know you had.

Treating sleep apnea after the home sleep study can occur in two different ways as well. You can be brought into the sleep lab for a titration study. During this test the technician finds a mask that works for you, educates you about CPAP and how it works and then finds the right pressure to eliminate most of the apneas and snoring. This test also allows the doctor to look for the other disorders such as periodic limb movements.

The other option for treatment is to have a homecare company deliver an auto-titrating CPAP. This machine is set to allow a range in pressure that adjusts as you have events during the night. The technician will fit you for a mask and then leave the machine for you to use. The drawback is that there is no one there during that first night to assist you if there is an issue. The other issue is that unless you call your doctor or the company that delivered the machine they may not be able to correct any problems that happen until they download the information in the CPAP memory.

Overall home sleep studies do have a place in the diagnosis and treatment of sleep apnea. They are very good for diagnosing the straight forward sleep apnea patient. If, however, there is any issues that need to be addressed right away or if a person needs some assistance this may not be the best choice. A full sleep study allows for the possibility for quicker treatment and intervention. There is also the ability to diagnose other conditions that might go unnoticed in the home setting. That and the personal care involved in testing help to create a successful long term care situation.

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5 Ways to Make your Sleep Study More Successful

Posted by amykr on March 13, 2010

More people and their physicians are looking at sleep habits and problems that might be contributing to problems such as hypertension, difficult to control diabetes and congestive heart failure. They are also looking beyond medications to take care of issues like chronic fatigue. Snoring is looked at as something more significant then an annoyance. To find out the source of the problem a sleep study has been scheduled. Unfortunately not much is explained before the study and it is hard to figure out what is expected by talking to friends and family. There are a few tips to make the experience more pleasant and get a good night sleep

1. Take a tour of lab. If the doctor owns the lab you can probably take the tour the day the appointment is scheduled. However, if you are going to an independent or hospital based lab then taking the time to visit the facility to will give you and idea of what to expect and if you feel you can not sleep in that facility it gives you a chance to call another center or discuss other options with your physician
2. Make sure your sleep clothes are comfortable. Many facilities keep the rooms cool to prevent sweating. If you know that you will be cold bring socks and warmer clothes. If you tend to be hot during the night shorts and a t-shirt may be all you need.
3. Bring your pillow or blanket. Bring something with you that will make you feel like you are sleeping at home. Many people prefer their own pillow or blanket. Other may bring their child’s teddy bear or an object that belongs to their spouse.
4. Read all the paperwork and instructions carefully. Different facilities have different requirements for preparation. Some basics will be to have your hair washed with no products in it, no lotion on your face and legs, and to avoid caffeine the day of the study. Make sure all paperwork is filled out and a list of all medications you are on is attached. Some labs will want you off or on certain medications.
5. Talk to your doctor if you feel you can not fall asleep. Some labs will prescribe a sleep aid for you to take if you try to fall asleep and are unable to. If you know you have anxiety issues or you have a history of first night effect, the inability to fall asleep in a strange bed the first night, having some medication as a back up might prevent you from having to come back for a second study. This is also useful if you need a titration study. Adjusting to CPAP can take some times. If you have a sleep aide or anti anxiety medication it might make the adjustment to the CPAP go a little more smoothly.

Having a sleep study can be very stressful if you do not prepare for it. But these steps will help to make you more comfortable and allow your sleep through the night. The closer your sleep is to sleep at home the more likely the lab will be able to find a problem you might be having.

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 a sleep lab and teaches at the local community college. Her commitment to the community and the education of healthy sleep has led to her to start an A.W.A.K.E. Orlando support group. She also works with people looking for help to achieving optimal sleep at http://ping.fm/KXkh7

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Teens and Sleep; We Really Need to Rethink Expectation

Posted by amykr on March 12, 2010

An article was released about teens and the effects of caffeine and technology is having an effect of teens and their sleep. I know I live this issue daily. I have a teen son and a daughter who is just in her 20s. The problem is that we have not created a culture that supports teens and their needs.

This article was timely as this week my son took his yearly standardized tests. He has to get up at 6am to get ready for school so he can arrive just before 7am. He will then sit in the testing room he is assigned to and will take a test that will decide his future. Of course what they are not thinking about as these students enter the school is that more than half of the students walk on campus with an energy drink, diet soda or Starbucks in their hand. They are all yawning, dragging their feet and look like they could use two more hours of sleep. When they normally attend class at least 3-4 of the students will want to put their head down during at the very least 1 period. These are not fresh, excited students. These are sleep deprived people who our culture is trying to get to fit into a cheapest easiest way to give them an education. We have not created an education that is designed for them to become successful educated people that can perform at their optimum.

Add to this early more education some new parts to our culture. Their diets include processed food, chemical substances, and stimulants like caffeine. They are exposed to light 24 hours a day and their brains are stimulated from the time they wake up until the time they go to bed. They are in the computer, playing video games or watching television. They have 2-3 hours of homework they need to do when they come home. They also have outside activities. Things like my son’s Boy Scout meeting will last from 7-10:30 at night. We have not set them up for optimal sleep we have set them up to be sleep deprived.

It is difficult to tell a 5’10” boy that it is bed time at 9 or 10 pm. The world has not stopped or even slowed down by then. He still has homework he wants to tweak, friends to chat with or challenge on a game, or just wants to watch a show he knows everyone will be talking about at school the next day. He gets tired around 11-12pm and is sound asleep no later than 1am. On the weekend he sleeps until 11am and sometimes a little longer. His friends are the same way.

I believe that we have to look at what our children need, how to create a healthy environment for them and then nurture that. Is sending our children to school at 7am really in their best interest? One of the local school districts changed the time for the high school children from 7 to 9. Next year they are changing it back because it interferes with after school work and activities. Did they even bother to look at the student’s attendance, grades or test results? They did not.

So what is the result of sleep deprivation with our teens? It is multifold, sleep deprivation can increase the incidence of depression, increase the symptoms of ADD, increase the chances of obesity. It interferes with learning and storing information into long-term memory.

Now we need to explain to our teens why a sleep routine, turning off all electronics and going to bed early I so important. We need to overcome peer pressure so that our children understand that this is the norm. We need to be examples for them. We need a very strong sleep routine that includes turning off the computer and the television. We need to make time for the family to sit and eat together and read together. These changes will help them during the tough teen years. We need to help them reach their true potential.

Resource: http://ping.fm/1kX2q

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When to Question a Snore

Posted by amykr on March 3, 2010

Your wife or husband tell you they need to go to bed before you or they will never sleep. You know if you are going on a trip you can not share a room with anyone else because they will complain. Do you know when a snore is something you need help for or just annoying?

The fact is that no matter what a snore is not normal. If you snore there is something in your anatomy that says you need to have it evaluated. It may be just that you have a large uvula that vibrates when you breath at night. It could also mean you have sleep apnea, a condition where you stop breathing or breathing is partially obstructed and your oxygen levels in your blood drop.

If you have plain snoring this can be treated with several medical treatments including medications, surgery, or an oral appliance. You might also benefit from positional therapy. This is where you avoid sleeping on your back. You can use a special pillow or other device. My personal favorite is to take a t-shirt, sew or glue a pocket down the center of the back of the shirt and place 3 tennis balls into the pocket then close it. Every time the person rolls onto their back they become uncomfortable and roll to their side.

If you are not sure if you might have sleep apnea take the Sleep Quiz. If you have a score of 9 or greater than it is time to speak with your physician. Sleep apnea is important to treat because sleep apnea can contribute to many health issues including depression, high blood pressure and diabetes.

If your child is a snorer you should take the time to talk to his or her pediatrician. Sleep disorders can very easily be disguised as irritability, short attention span and can lead to other health problems. It can be caused by enlarged tonsils and adenoids. It can also be caused by a small airway. The current research is discussion new medication treatments to help children.

No matter who in the family is snoring it is something that is not normal. It is something that should be evaluated by a professional. If they can sleep quieter than everyone will get a better night sleep.

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