By Lisa Feierstein, RN
Migraines are no fun. While their cause is not known, they are likely triggered by changes in the brain stem and/or overactive neurons in the trigeminal nerve, which is a major pain pathway. In a recent “People’s Pharmacy” column, Joe and Terry Graedon answered a reader who said that her PAP device help relieve her migraines. Diagnosed with severe sleep apnea twelve years ago, her doctor said her new PAP device would increase her oxygen flow to her vital organs. It did and she dropped her need for her migraine medications by 80 to 90 percent. I love how she adds that her PAP device saved her life! I see this scenario repeated frequently in our practice.
A variety of masks are available for your PAP device including the ResMed Swift FX for Her
It’s wonderful that sleep apnea is getting more press and awareness from widely-read syndicated columns such as the “People’s Pharmacy.” Sleep apnea is a sleep-related breathing disorder that causes your body to stop breathing from a few to hundreds of times a night, sometimes for just a few seconds or it can be for minutes at a time. This occurs because the tissue in the back of your throat collapses and blocks the airway during sleep, decreasing oxygen to your lungs and vital organs.
Your PAP device helps open up your troubled airway with a gentle stream of air. Not only will you be able to have better quality sleep, you’ll reduce your fatigue, daytime sleepiness, irritability, poor memory, depression, morning headaches, loss of interest in sex and frequent nighttime awakenings to urinate. Now we can also add relief from migraine pain to this list.
Sleep apnea also affects 20 million Americans, with 80 percent of this number leaving their sleep apnea untreated. Migraines affect 28 million Americans and they arrive as a pounding, throbbing moderate to severe headache. They can be produced by hormones or certain foods and can occur a few times a month and last from a few hours to several days. Migraine sufferers experience light sensitivity, nausea or vomiting and stomach upset. Some sufferers also see or feel an aura, which can be a visual, motor or a verbal disturbance caused by brain chemicals.
We Want to Hear from You:
Do you have sleep apnea and also suffer from migraines? Has your PAP device helped your migraines and if so, by how much?
Posted in CPAP | Tagged cpap, migraine, migraine treatment, OSA, sleep, sleep apnea |
By Lisa Feierstein, RN
Humidity is not something you think about every day when it comes to managing your sleep apnea, but lower room temperatures may cause excess moisture to build up in your tubing. Your tubing may wear out faster and won’t be able to deliver the right amount of pressurized air you need to sleep through the night. Now excess humidity in your tubing can be fixed with Tube Wraps and ResMed’s ClimateLine Heated Tubing (only available for ResMed’s S9 Positive Airway Pressure (PAP) devices). With these products the air moving in the tubes stays warm and humidified and tubing condensation is minimized.
S9 ClimateLine Tubing
help eliminate rainout which happens when you have heated air in your tube and your bedroom temperature is much cooler than the tube’s temperature, for example 60° in the bedroom and 80° in the tubing. This condition happens more frequently in the wintertime. The S9’s
ClimateLine Heated Tubing’s internal heated coil and mask temperature sensor senses the room temperature to adjust the unit’s electrical system and monitor humidity changes to eliminate rainout.
Tube Wraps insulate your CPAP tubing to prevent rainout.
If you have a PAP device without the heated tubing options, you can get
Tube Wraps or another tubing cover, which keep the room temperature from affecting the temperature in the tube. Think of the tube wraps as koozies for your tubing!
Now is a great time to insulate your tubing. This may be a good time to update your PAP device with ResMed’s S9 series, which features the ClimateLine Heated Tubing or if you want to wait a bit on that purchase, the Tube Wraps have a cash price of $20. Don’t forget you can receive FREE shipping on these products with your next resupply order.
Your Turn:
For you users of ClimateLine Heated Tubing and Tube Wraps, how has this feature/product changed your experience with managing your sleep apnea?
Posted in CPAP | Tagged comfort features, cpap, CPAP challenges, CPAP tube wraps, heated CPAP tubing, humidficiation, OSA, rainout, sleep, sleep apnea |
By Lisa Feierstein, RN
Do you suffer from depression? Not able to sleep? Feel depressed from your lack of sleep? Adding insomnia to the equation can make your depression ten times worse: it may take you longer to get to sleep, your total sleep time feels shorter and there is little or no deep sleep, which is essential for good overall health. Clinical depression affects 19 million Americans. Women and the elderly are more likely to experience the condition than other groups. They also have higher rates of insomnia.
Research has shown that people with depression are more likely to have breathing-related sleep disorders! I’ve written many times about the dangers of untreated sleep apnea: increased risk for heart disease, stroke, high blood pressure, and diabetes, just to name a few. Patients diagnosed with depression may benefit from a sleep disorders screening as a part of their overall treatment plan.
Understanding depression is the first step in treating it. If you have experienced these symptoms below you may want to seek out the advice of a healthcare professional:
• persistent sad, anxious or “empty” mood
• you oversleep or you can’t get to sleep
• reduced appetite, or increased appetite or weight gain
• loss of pleasure in once-enjoyable activities
• loss of libido
• restlessness
• chronic pain and digestive disorders such as Irritable Bowel Syndrome (IBS)
• difficulty concentrating at work
• fatigue or loss of energy
• feeling guilty, hopeless or worthless
• thoughts of suicide or death
Medications for Treatment of Depression and Sleep Apnea
If you suspect you may have depression, a healthcare professional can recommend proper treatment, psychotherapy, drugs, etc. But if you do have untreated sleep apnea, you may want to avoid any sedating antidepressant medications such as amitriptyline and dosulepin which may worsen your sleep apnea; check in with your healthcare provider.
Great sleep tips to help have a better nights rest:
• Keep a regular sleep schedule (For example, go to bed every night at 10:30pm and wake up at 6 am, even on weekends)
• Move into bright light after you wake up
• Don’t nap if you suffer from insomnia
• Get your daily exercise in, but don’t work out too close to bedtime
• Limit or stop your caffeine and alcohol intake
If you have any other questions about sleep, visit Active Healthcare for immediate information and education. Sign up for our monthly newsletter Sleep EZzzz. Also keep up with our blog posts so you can take charge of your health through better sleep tonight!
Posted in Sleep Apnea, Sleep Tips | Tagged depression, insomnia, OSA, risk for depression, sleep, sleep apnea, sleep disorders, sleep hygiene, untreated sleep apnea |
By Lisa Feierstein, RN
It’s no longer a coincidence—if you are not treating your sleep apnea the right way with a PAP device, you will have a more difficult time losing weight. Unfortunately, many sleep apnea sufferers already are overweight and their poor sleep routine of stops and starts contributes even more to their weight gain. This is because of their hormones, ghrelin and leptin, receiving the wrong signals at the wrong time of the day making it difficult to feel satisfied with ones food intake and hungry all the time. Not getting enough sleep causes one to take in more calories during the day to fuel their energy needs and reduces any motivation to exercise. Weight gain is more damaging to your health than not fitting into your favorite pair of jeans—excess weight can bring on type 2 diabetes, hypertension, heart disease and stroke.
Recent studies in scientific journals have reported that sleep apnea patients who lose weight through a regimented weight loss plan with portion controls are able to lose a significant amount of weight which in turns helps reduce or bring their sleep apnea into remission. Before these studies, doctors recommended sleep apnea patients to lose weight, but really in a more general sense for their overall health and well-being—now it’s a given connection that sleep apnea will lead to weight gain and by managing your weight you will manage and maybe even beat your sleep apnea.
Now that we know about the connection, what can we do about it? First, we educate undiagnosed sleep apnea sufferers that they need to see a health professional if they have snoring issues, if they have daytime sleepiness or fatigue coupled with high blood pressure and/or diabetes. They may recommend a sleep study to determine if they have sleep apnea and if they have a positive diagnosis, a PAP (positive airway pressure) device may be recommended. Patients will be educated on use of the PAP device and mask every night. Overweight sleep apnea sufferers should also combine their PAP management with a regimented weight loss plan. We’re not talking about any crash diets, but a lifestyle plan that involves portion control, social support and daily exercise. Losing weight is never easy, but there’s so much to gain in terms of health and longevity when you do!
Your Turn:
What’s your best tip for someone who is overweight and who has sleep apnea?
Posted in CPAP, Sleep Apnea | Tagged cpap, ghrelin, leptin, OSA, sleep, sleep apnea, weight control, weight loss |
By Lisa Feierstein, RN
Boost your comfort and your compliance with our great PAP accessories such as:
ResMed Gecko Nasal Pad and RemZzzs Mask Liners
SleePAP Pillow
ClimateLine Heated Tubing and Tube Wraps
Humidifier
ResMed S9 Skinits
These comfort accessories can help you overcome common PAP therapy challenges such as mask discomfort, mask leaking, dry mouth and can even give your PAP device a makeover!
Read up on them briefly in this post and for the next series of blog posts we’ll spend more time with each of them. Now’s a great time to think about using them because we’re offering free shipping with your next resupply order.
Gecko Nasal Pad
If your nasal or your full face mask rubs your skin and doesn’t fit as well as it should, try the
ResMed Gecko Nasal Pad or the
RemZzzs Mask Liners. If chafing was a problem before you’ll look forward every night to your sleep knowing your mask won’t irritate your skin or leak. Another great thing about these two products is that they are affordable (cash price is $25 per package) and it may be possible to obtain insurance coverage for them. The
Nasal Pad is adhesive and silicone-free and can be placed where your mask connects with your nose. The
Mask Liners are placed over the forehead stabilizing bar and the other over the nose/mouth area.
SleePAP Pillow
The
SleePAP Pillow looks like a regular pillow, but for the concaved cut-out sides and bottom which help you prevent mask leak and reduce pressure points on your face. The pillow is designed like this to keep your tubing and mask in place if you’re a nasal or a full face mask user. The cut-outs also prevent carbon monoxide build-up if the mask’s exhalation ports are blocked. It comes with its own all cotton white pillow case that can be removed for washing. The cash price is $65.
S9 ClimateLine Tubing
(typically an insurance covered item; cash price of $ 66) and
Tube Wraps (cash price of $20) help eliminate rainout which happens when you have heated air in your tube and your bedroom temperature is much cooler than the tube’s temperature, for example 60° in the bedroom and 80° in the tubing. This condition happens more frequently in the wintertime. The S9’s
ClimateLine Heated Tubing’s internal heated coil and mask temperature sensor senses the room temperature adjust the unit’s electrical system and monitor humidity changes to eliminate rainout.
ResMed H5i Humidifier
The air in your PAP device can quickly irritate you since you’ll be trying harder to breathe with drier air. If you’re someone who suffers from nasal congestion where you breathe through your nose, not your mouth, you now have complete control with a heated humidifier. Heated humidifiers can be stand alone, integrated or can be built into your machine. Another top benefit of using a humidifier with your PAP device is the ability to adjust your settings to the season. Just as I mentioned with the
Tube Wraps, a heated humidifier can increase your comfort while it eliminates rainout in your tubing. Humidifiers are typically an insurance covered item. Cash pricing varies based on device.
ResMed S9 Skinits
Goodbye boring PAP machine! Now you can match your PAP machine to your bedroom’s décor or to your favorite sports team. Maybe by personalizing your machine with a variety of designs (art, sports, Disney, Hello Kitty, abstract designs) from
ResMed or by uploading your own photo, you’ll be more apt to use your machine every night! The Skinits are only available for RedMed’s S9 machine. The cash price is $25.99 for one device or $44.99 for the device+humidifier (the system).
You can even save $10 with a discount card available through Active Healthcare till January 31, 2012.
Your Turn: If you are a user of any of these devices, how have they helped your comfort and success?
Posted in CPAP, Sleep Apnea | Tagged Climateline Tubing, cpap, CPAP accessories, CPAP comfort, dry mouth, Gecko Nasal Pad, humidifiers, mask leak, preventing rainout, RemZzzs mask liners, ResMed Skinits, sleep, sleep apnea, SleePAP pillow, tubing wraps |
By Lisa Feierstein, RN
It’s not every day you’re a calendar girl. I’m thrilled to be featured Saturday, January 7th in The Woman’s Advantage 2012 Shared Wisdom Calendar.
My quote is “Sleep your way to the top! With proper sleep, your goals are attainable.”
Mary Cantando, Growth Expert of The Woman’s Advantage selected this quote from over 5,000 submissions last year. As you know, I talk about the advantages of sleep everywhere I go because these days many people, especially women, complain about not getting enough sleep. The good news is that major media influencers like Oprah and Dr. Oz are touting the “Get More Sleep” message and women are starting to pay attention.
Getting the recommended 7 to 8 hours of sleep is necessary for the body to repair itself from all the damaging exposure to the sun and pollution, as well as the daily stresses of our modern lifestyles. Not getting enough sleep may lead to insufficient repair of the body’s systems and can invite sickness and chronic health problems to your door. Poor sleep also leads to weight gain because of hormone fluctuations and lethargy which stalls exercise.
It takes a conscious effort for most women to the get the right amount of sleep for themselves because they’re overworked, they have poor sleep habits or they have a breathing disorder, such as sleep apnea.
Here are a few tips to get your 7-8 hours of beauty sleep in 2012:
• Lower your bedroom’s temperature
• Treat yourself to high quality sheets and a firm, supportive pillow (convince yourself you deserve it)
• Begin a nighttime ritual of turning off televisions, computers, lights, and saying good night should begin about one hour before you expect to fall asleep—sacrifice that late night movie or book
• Keep your bedroom dark and quiet, unless you prefer some soothing night music; cover up all extra lights, including your digital clock
• Drink warm milk, but avoid eating too much or drinking too much water before bed
• Use your PAP device every night if you suffer from sleep apnea
Why not use all of the resources at your disposal, including getting a good night’s sleep, to help you realize your 2012 goals. Remember that a good sleep will improve your memory, reaction time to stress, and most of all, your health. You can’t be the best you can be in business and in your personal life without it. And remember that with sleep, it is not quantity but quality that counts.
Your Turn: For all of you busy women out there: share your best methods for getting your sleep with us.
Posted in News, Sleep Tips | Tagged inspirational quotes, sleep, sleep tips, women's health |
By Lisa Feierstein, RN
Obesity is a national health problem that is not going away any time soon. Two thirds of adults and one third of children are currently overweight or obese in this country. According to the most recent study of this year, North Carolina is rated the 14th fattest state with Mississippi at number one and Colorado at 50. Obesity brings along a host of other health issues such as diabetes, hypertension, heart disease and sleep apnea.
The Relationship between Sleep Apnea and Obesity
Sleep apnea can cause weight gain in many people and in many cases obesity exacerbates sleep apnea, which affects 20 million adults. It has serious health consequences when present with other conditions such as the ones listed above. Studies show that the lack of quality sleep can cause an increase in caloric intake during the day as folks try to “wake” up by eating more food for energy. More weight leads to greater lethargy with no energy for exercise, which leads to further health issues.
Those with sleep apnea have their sleep interrupted multiple times each night, which in turn affects their leptin and ghrelin levels. Sending messages to the brain during sleep, leptin and ghrelin are sleep hormones that work in tandem to stimulate appetite (ghrelin) and nutrition (leptin). Leptin is released by the fat cells and ghrelin is released by the gastrointestinal tract. Without the 7-8 hours of recommended sleep per night, sleep apnea sufferers get hungry when their leptin levels go down and when their ghrelin levels go up.
Of all patients who suffer from sleep apnea more than 95% are obese, with many having above average neck dimensions (about a seventeen-inch collar size for men and sixteen-inch collar size for women). The excess fatty tissue in the neck can contribute to airway obstruction, and their larger-than-normal waist circumference may add to improper positioning in bed.
The American Journal of Respiratory and Critical Care Medicine have published reports that show definite associations between symptoms linked to obesity and those related to breathing problems. These conditions include liver disease, insulin resistance, and a sedentary lifestyle. Researchers at Johns Hopkins University discovered that a strong connection exists between the inability to metabolize glucose—known as insulin resistance—and breathing difficulties during sleep.
The good news is that sleep apnea can be managed with PAP therapy. Using the gold standard of a CPAP (continuous positive airway pressure) device and mask every night, the patient now has a chance to get some quality sleep, which will help with weight control and energy. With more energy sleep apnea patients will be able to exercise more often, and exercise will result in a better night’s rest. With the CPAP device, the troubled airway that closes during sleep is kept open via pressured air delivered via a mask.
Is weight loss enough to combat obesity and sleep related disorders?
Once sleep apnea is treated, the patient is better positioned to lose weight. If a person loses a significant chunk of weight, i.e. 20%, they may want to be retested for sleep apnea, since this condition may or may not go away.
And even if the patient does lose the weight, if they have hypertension, diabetes, or cardiac disease those diseases also need specific treatments. The best thing to do after you are diagnosed with sleep apnea and are obese is to eat right, exercise and manage your sleep apnea every night with your prescribed treatment!
Your Turn
Tell us your story of how your sleep apnea therapy helped you manage your weight. What are you plans to manage your sleep apnea in 2012?
Posted in CPAP, Sleep Apnea | Tagged cpap, diabetes, ghrelin, insulin resistance, leptin, losing weight, obesity, OSA, overweight, sleep, sleep apnea, uncontrolled sleep apnea, weight control |
By Lisa Feierstein, RN
Listen to most women and they’ll tell you they’re not getting enough sleep at night, but according to a recent study they are! Is this why women outlive men because we get more sleep?
According to a study presented at the American Academy of Sleep Medicine’s annual meeting, men and women have different circadian rhythms with men having a circadian rhythm that’s six minutes longer than women, clocking in at 24 hours and 11 minutes—longer than a day. On the other hand, women have a body clock that’s shorter than 24 hours. Read about this sleep study in Andrea Peterson’s article in The Wall Street Journal (Aug 23). “Women on average have longer sleep than men; women on average are healthier than men. It could be that those are related,” says Daniel J. Buysse, MD, a professor of psychiatry and clinical and translational science at the University of Pittsburgh.
It sounds crazy that women are sleeping longer then men when they usually are the ones who tell their friends, co-workers and health practitioners that they’re not getting enough rest. Since women have a body clock less than 24 hours, they want to go to bed earlier and get up earlier, while men’s body clocks are six minutes longer so they go to bed later and get up later. The study also reported that women enter a deeper sleep than men and get to sleep faster than men. With this deeper sleep, which is slow-wave sleep, women experience strong memory retention, which aids their cognitive abilities even when they don’t sleep enough at night.feel you are getting enough rest? What’s your favorite tip for getting the rest you need?
The study also showed that women can handle sleep deprivation better than men due to the slow-wave sleep they’re getting. The men and women in the study only had six hours of sleep and their performances both slowed down on a 10-minute computer task, with the men’s scores slipping more than the women’s. Apparently the guys needed their rest.
But as with all studies, more investigation is needed. Why do some women feel they’re not getting enough rest? Why do many women experience chronic insomnia? It could be because women’s brains aren’t shutting off or that more women than men experience depression and anxiety, which leads to insomnia. Menopause, pregnancy and young children at home aren’t conducive to quality sleep. Dr. Buysee also stated that mothers are getting more sleep than fathers, but they don’t feel rested because their sleep is fragmented.
So what can we learn from this study? If men are getting short-changed by their sleep length and quality, it could be related to sleep apnea or another sleep disorder. And women who have a tendency to go to bed earlier and get up earlier than they want to can help their circadian rhythms by extending their exposure to light at night and keeping their bedroom dark in the morning. Women might also be better able to cope without sleep because of evolution and our adeptness at multi-tasking. After all, cavewomen had to make sure the children stayed away from wild boars while they gathered berries, all on four hours of sleep.
Your Turn:
What do you think of this study? If you’re a woman, do you feel you are getting enough rest? What’s your favorite tip for getting the rest you need?
Posted in News, Sleep Apnea, Sleep Tips | Tagged cpap, insomnia, men's health, menopause, OSA, sleep, sleep apnea, sleep deprivation, sleep differences, women's health |
By Lisa Feierstein, RN
One of the first things you’ll know about me after we meet is that I tell everyone sleep apnea is a serious condition that can cost you your life if it’s not treated. Twenty million people in this country have sleep apnea and 75 percent of that number are leaving their condition untreated. It’s my life’s work to tell everyone I know that getting enough sleep is vital for your health.
So when I read in the Journal of the American Medical Association (Aug 10) that a recent study of elderly women with sleep apnea show that their low oxygen levels are connected to their cognitive decline, I was excited to see this study published in such a revered medical journal as JAMA since we know that sleep apnea does cause oxygen deprivation to the vital organs and damage to the blood vessel cells. Usually blood pressure lowers in sleep, but when someone has sleep apnea, their blood pressure is elevated due to the pauses in breathing and abnormal oxygen flow. Strokes can occur with the increase in blood pressure that raises the blood pressure in the brain. However, my excitement was soon tempered by some investigation: this study did NOT treat the women’s sleep apnea. That’s giving those women a faster death sentence than necessary. You can read about this discrepancy, pointed out by Elizabeth S. Rowe, PhD, in KevinMD.com.
Many masks have options specifically designed for women including the Mirage FX for Her from ResMed
Rowe states that the patients didn’t receive care for their disorder because sleep apnea is still not considered a serious condition by some in the medical community. How can this be after all of the hard evidence? Untreated sleep apnea is responsible for strokes, diabetes, heart attack and hypertension, not to mention drowsy driving, depression, migraines, snoring, poor memory, anxiety—do I need to go on?
We need to critically examine sleep apnea studies to make sure they address sleep apnea as the serious condition it is. Participants in any sort of study of this nature need to be treated for their sleep apnea and monitored so they’re not risking their lives for the sake of science. We don’t want to back a study that brings about better sleep apnea awareness at a terrible participant/patient cost.
We still have a long way to go, but we’ll get there!
Your Turn:
Has anyone ever told you that your sleep apnea is not a serious condition? Tell us about it here!
Posted in News, Sleep Apnea | Tagged cpap, diabetes, heart disease, high blood pressure, OSA, sleep, sleep apnea, sleep disorders, stroke, untreated sleep apnea |
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