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Support Is the Key to CPAP Success

Posted by amykr on December 11, 2010

If you are just starting out as a new CPAP user you will find that a little support goes a long way. Family support is important but it is support from other users that will truly allow you to find what will work for you. The problem is that most physician’s offices and DME companies do not tell you where to find support. But if you look online and in your community there are some great support groups.

Local Support Groups
The American Sleep Association is an excellent resource for finding local support groups. They are the association that started the A.W.A.K.E. groups. They have even started on online meeting for truck drivers since they have unique issues such as repeated testing and traveling with their machine. Their website sleepapnea.org also has up to date research, and an online forum to have questions answered. If there is not a support group near you then they will help you start one up.

Online Support Groups
Talkaboutsleep.com was started by a sleep apnea patient who felt she needed more support. The site has a chat room, message board and strong basic information about sleep disorders. The most interesting part of the site is the reviews of equipment and the comparisons of the masks. Once a quarter they will trial two similar masks from different manufacturers. They send samples to members to trial and then review. This gives people the opportunity to hear what actual patients think of new masks when they come out. They also have an excellent store to buy masks and accessories for your machine.

Sleepguide.com is a message board for sleep patients. There are patients and health care professionals who frequent the site and answer each others questions. You will find many opinions from different sources.

Physician Sites
DrStevenPark.com is a great resource. He has monthly webinar that answers pre-submitted questions on CPAP and sleep disorders. His site has interviews with other healthcare professionals and medical articles. He also has a book for sale called Sleep Interrupted.

About.com has a page on sleep disorders that is written by Dr. Brandon Peters. He has a weekly newsletter that covers basic topics such as what is sleep apnea and new treatment options. Everything he has written is archived on the website so you are able to look up specific topics or disorders. This site covers many sleep disorders including Restless Leg Syndrome, REM Behavior Disorder ad Sleep Talking to name a few.

Seeking Help is the Key
If you are starting out with CPAP these sites and groups will help you to understand you are not alone. It will also help you to overcome problems that might arise while you get used to the new therapy. The more educated you are about your disorder and the more support you seek the more successful you will be.

Posted in cpap, education, Sleep, Sleep Apnea | Leave a Comment »

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

Posted in education, health care, insomnia, Sleep, Sleep Apnea | 1 Comment »

New Years Gives You a New Chance for Better Health

Posted by amykr on December 31, 2009

As the year ends we know that some very notable people have had health issues the last couple of weeks. Britney Murphy died after a short unidentified illness, Rush Limbaugh was rushed to the hospital after experiencing chest pain and Urban Meyer has taken an indefinite leave from coaching after two health emergencies. This time of year reminds us that our health is our most important asset and should be treated as such. Here are a few things you can do that might help.

Have your yearly physical. Many people feel they should only see the doctor if they are feeling sick. If you value your health and your pocketbook then spending a little wellness time with your doctor is worth it. Your physician will know what tests you need yearly. They may also see something you may miss such as mole that might look a little strange or a change in your skin tone. If you do not have insurance consider taking advantage of the Seminole and Orange County Health Department or Apopka Family Medicine, these facilities can help you find affordable health care and inoculations for your children.

Invest in exercise. You do not need to join a gym. If you are looking for information about exercise there are some great places for free to learn more about it. Sparkpeople.com and Transformations.com are both free and have experts who give information on work outs. If you are looking for people to walk or exercise with try Meetup.com. They have many different groups and if you can not find one you want you can always start one.

Educate yourself. There are many great websites our there. WebMD.com, Livestrong.com and Lifescript.com are great sources for information from many different professionals. If you have questions it is always good to ask your healthcare professional, if they are unavailable a website where professionals are sharing information are great places to find generic information about medications, tests or conditions. Your local hospital also has educational classes throughout the year. Just give a call and ask for the community education department.

Create a healthy eating plan. This is one place where the internet excels and where it fails. There are more sites about eating, diet and food then just about anything else. The trick is to find the healthy information that does not cost you anything. Discovery.com has their yearly National Body Challenge that is free and has several perks including 14 day pass to Bally’s Health Club. Sparkpeople.com has a custom food plan that is free as well. Ivillage.com also has a food planner and program. All of these plans are based on a health balance food plan of 1200 to 1800 calories depending on the site.

This is just a starting point for the New Year. Each person has their own ideas about what they need to create a healthy and successful life. Just remember that the time spent being healthy will pay you back in ways you would not suspect.

Posted in education, health care | Tagged: , , , , | 6 Comments »

Light Therapy as an Option for Depression and SAD

Posted by amykr on December 30, 2009

Many people are looking toward ways of treating health issues without taking medication. One of more interesting alternatives to people with depression or rhythm disorders is light therapy. This therapy is not for everyone, but it gives an option to people with seasonal affective disorder, shift workers and those who might need to try different therapies in addition to traditional therapy.

Recently studies on the effects of Light Therapy have gotten a little more support. It is showing that light may have an effect on melatonin production, serotonin production and circadian rhythms. The idea is that you mimic sunlight and keep your body on the same rhythm all year long.

The first therapy is a dawn simulator that allows a person to wake up as the light gets more intense. It is a much gentler form of waking and the simulation is similar to summer light. This might help those who have a issues with the winter’s weaker light and shorter days. The idea of a gentler way to wake up also may help start the day in a calmer manner. There is very little in the way of studies for this type of therapy, however since the lights are inexpensive and there is no evidence that they are have any adverse effects.

The other source is a light box. There are several types of these including white light boxes, blue light boxes and green light boxes. The most popular currently are white and blue light. They are used in the morning based on your body’s Melatonin cycle to help to regulate your body’s Circadian rhythm. The most recent studies have found that the blue light works as well as the white light but is much smaller and portable. These lights should be up above your head for your eyes to process it properly. It should be used for 30-60 minutes depending on what is recommended for you.

There are some potential side effects to this type of therapy. You should not look into the light and it has been associated with Macular Degeneration. You can also have too much exposure which can cause mania in some people, especially those with Manic Depression.

The idea of using light to treat depression has not been pursued by many researchers currently. There are some small studies that have been shown that this can be a very effective treatment for depression. It is also a good choice for those who wish to try other therapies before trying medication. There are small, inexpensive boxes available online. Like all therapies you should discuss this with your physician or therapist before trying it.

Posted in education, health care | Tagged: , , , | 1 Comment »

Chest Pain; Why It Should Not Be Ignored

Posted by amykr on December 30, 2009

Urban Meyer has taken a leave from coaching the Florida Gators due to chest pains he had experienced earlier this month. He was wise and went to the hospital, where test were performed and it was determined that no permanent muscle damage was done. This is an example of why it is important that immediate care is so important in this situation.

Although the reason for Coach Meyer’s chest pain were not disclosed, his reaction to it is very important. Immediate care is essential as it can help minimize damage if a person is having a heart attack. The problem is many people, especially during the holiday season put off care until it is too late. They either believe that it will go away or they do not want to disturb the holiday and wait.

The question then becomes when you should seek help and when you should wait. The symptoms of a heart attack are not just chest pain but including many other symptoms including, abdominal pain, upper body pain including jaw pain and arm pain, nausea and vomiting, anxiety, shortness of breath, lightheadedness and sweating. If you experience these symptoms for longer then a few minutes then you should seek help. Waiting for the symptoms to go away will only lead to a more severe outcome.

Treatment and testing at the hospital will help to get a correct diagnosis. Even if it is not a heart attack, these symptoms can be telling you that there is something wrong and you need to take care of it. Stress and other issues can lead to more serious conditions over the long term. Ultimately it is timely care that will allow for a long and healthy life.

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Mammograms; Understanding the Recommendations

Posted by amykr on November 19, 2009

Yesterday the US Preventative Services Task Force recommended that mammograms and breast self examination teaching be limited. The recommendation was to move screens from age 40 to age 50 for initial mammograms and to decrease them from yearly to every two years. They also felt that breast self exams should not be taught.

This task force is made up of volunteers to evaluate new and existing procedures and make sure they are used optimally. They do not have legislative power. They do not affect policy. They review research and make suggestions.

Katherine Sebelius, the Secretary of Health and Human Services, was quick to say that Medicare and Medicaid will not be adopting these recommendations. As long as a patient’s doctor orders the procedure these health plans will pay. Other organizations such as The American Cancer Society stated that they do not agree with this recommendation and that they are encouraging women to talk to their physicians, having yearly mammograms at age 40 and clinical breast examinations yearly.

The big question that is still out there is how many private insurance companies will adopt this recommendation. This 14 person panel has reviewed information from specific studies. This group is made of people in research, medicine and business who used certain studies. They are not specialists in the field of cancer and there may be other studies that were not used. They also take into account cost effectiveness. “The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s, and 22 percent occurred in women diagnosed in their 50s.”

Research is still going on to find more effective screening for breast cancer. New digital mammography allows for a better screening. Ultrasounds, CT scans and MRIs are allowing for better and more noninvasive follow up for any abnormality. All of this has helped to decrease the death rate of breast cancer patients.

This announcement many cause concerns but it also brings up the necessity to look for other ways of effective screening. It is ultimately up to the patient and her physician to make the final choice of what would be the best choice.

Posted in education, Off Topic | 1 Comment »

Oral Devices for Sleep Disorders

Posted by amykr on May 7, 2009

Oral devices are one of the least talked about ways to help people with sleep disordered breathing. Because of this lack of discussion there is a great deal of misinformation as to who they work for and what they do.
Sleep apnea and primary snoring can have a profound effect on not only the person who has it but also their bed partner. Loud snoring disturbs sleep and if sleep apnea is present then the pauses and gasps can wake their partner from a sound sleep. When the sleep apnea is mild the option of treating it with an oral device can be quite beneficial.
These small devices come in two varieties. The first one, and the most popular is the mandibular advancement device, it moves the lower jaw forward so that the tongue is advanced and develops more muscle tone and opens the airway. Although there are many manufacturers of these devices the person who should choose which you use and fit you is a dentist who is experienced in sleep disorder dentistry.
The other type of device is best for patients who wear dentures or who have issues that would not allow the jaw to be moved into the proper position. It is called a tongue retention device. It uses suction to pull the tongue forward. This moves it out of the back of the throat and also ads muscle tone to it to help to open the airway.
These devices have several advantages over other treatments. It does not require any surgical procedures. It is small and lightweight making it easy to travel with. It is easier to get used to then some of the other treatment options available.
The drawbacks are that they do not work as well for moderate to severe apnea or where the problem is somewhere other then the back of the throat.
If you have primary snoring, or snoring without any other disorder or you have mild sleep apnea and loosing weight or positional therapy, training yourself not to sleep on your back this might be a solutions. It also might be a good solution for those who do not want to have surgery to fix their snoring problem.
If you want more information on this subject http://www.aadsm.org can provide you with links to doctors in your area accredited to perform medical sleep dentistry.

Posted in education, Sleep Apnea, Uncategorized | 4 Comments »

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.

Posted in education, Sleep Apnea | 1 Comment »

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.

Posted in education, insomnia | 3 Comments »

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

Posted in education, insomnia | 1 Comment »