MySleepApnea.Org

Posts Tagged ‘doctor

 
manheadacheWhen you’re feeling stressed on the job, it can be hard to leave work at the office. Your job may preoccupy your mind as you drive, as you eat, and as you interact with family or friends. But the battle to control your mind can intensify when you try to go to sleep.

Sleep and stress are competitors. When stress continually activating a part of the brain that is otherwised used for sleep, then stress wins the tug-of-war.

According the AASM, job stress can be a cause of adjustment insomnia. This involves disturbed sleep or sleeplessness that may last for a few days or a few weeks. Other symptoms may include anxiety, worry and tension.

A common feature of adjustment insomnia is “ruminative thoughts.”  This is when you dwell on the same thoughts, chewing them over and over in your mind. You may lie in bed staring at the ceiling, unable to stop thinking about work. Even when you finally fall asleep, your work may invade your dreams. The Staples National Small-Business Survey polled 302 owners and executives of small businesses, and more than half said they dream about work -or “sleepwork.”

Scientific research confirms that job stress can affect your sleep. In 2005 a study in the journal Sleep involved 8,770 Japanese workers. In both men and women, a high level of stress at work was liked to insomnia.

A 2007 study in the International Journal of Behavioral Medicine linked insomnia to these three types of job stressors:

  • High work demand
  • Low influence over decisions
  • High professional compromise

The type of job stress you experience may affect your sleep in different ways. Another study linked work overload to poor sleep quality.  Having role conflicts at work was related to non-restorative sleep and trouble falling asleeo or staying asleep.

According to the National Institute for Occupational Safety and Health, sleep disturbances are one early warning sign of job stress. Others may include:

  • Headaches
  • Difficulty concentrating
  • Short temper
  • Upset stomach
  • Job dissatisfaction
  • Low morale

Job stress may be unavoidable. But sleep specialists say you can take steps to improve your sleep even when you are stressed.  Establishing a pattern of relaxing behaviors close to bedtime and limiting work to the early evening may help to reduce stress.

Here are jus a few more tips to help you be less restless with work worries:

  • Remain active
    Try to get some exervise every day. Both your mind and body will be more relaxed when its bedtime.
  • Express yourself
    Take some time to slow down before going to bed. Get away from the computer, turn off the TV and the cell phone, and relax quietly for 15 to 30 minutes. Take a warm bath, enjoy a light snack or listen to some soft music.
  • Avoid “bedwork”
    Never bring any work to bed with  you; your bed should be refuge from your job. Also avoid doing other activities in bed such as reading, watching TV or talking on the phone. Only use your bed for sleep.
  • Get out of bed
    If you have trouble falling asleep, get out of bed and do something relaxing until you feel sleep agian. Tossing and turning will only increase your frustrations.
  • See a specialist
    Some doctors are specialists in behavioral sleep medicine. They can teach you how to relax at bedtime so you can fall asleep more easily.
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Sleep disorders can be hard to identify, especially if their symptoms occure while you’re asleep. Amy Petrik, 40, spent three months and visited four doctors searching for the cause of her persistent laryngitis. Once she was diagnosed and treated for sleep apnea, she got back her voice -and reclaimed her health.

 It was about four years ago that I first began to wonder what exactly was wrong with me. I hadn’t felt well in quite some time, and my normally upbeat personality was dragging to the point where other people had started to notice.

I had memory problems, severe mood swings, and anxiety issues. I woke up every morning with headaches and a dry, swollen throat, and was getting up to use the bathroom several times a night.

I felt unhealthy and unhappy, but I work two jobs, so I just assumed I was overly tired. My days were filled with four-hour naps, and still occasionally nodded off. I mentioned my complaints to a few different doctors, but no one seemed to take them too seriously; even my elevated blood pressure and cholesterol level didn’t set off any alarms. And so I attributed it all to a mix of mild depression and extreme fatigue. (Only later did a sleep specailist tell me that depression, weight gain, and fatigue are all symptoms of obstructive sleep apnea.)

A wake-up call to get help
In early February, I lost my voice for three full weeks. I mean literally: Not like laryngitis or just a sore throat, but I actually couldn’t make any sound but squeaks. I was terrified. My family physician was on vacation, so I saw another doctor in his practice. She whipped me into her office and within minutes took my vitals and diagnosed my with strep throat. I tried whispering to her what was going on, but she didn’t pay too much attention to my concerns. Without even giving me any test, she prescribed some medication and told me to come back in a week if I didn’ t improve.

I was back in seven days. The doctor claimed she didn’t have time to see me (my regular physician was still out), but I complanied enough by writing notes back and forth to the nurse on duty and was finally allowed  back into an exam room. I again explained, through writing, that my throat had not improved and that I needed help. Her only solutions? Hot tea with honey and vitamin C.

At this point I turned to an ear, nose, and throat specialist at the advice of some friends. He immediately saw the warning signs that everyone else had missed and scheduled me for a sleep study.

A sleep test and a scary diagnosis
I went to the sleep lab in early April. Afterward my ENT told me that I had the most danerous case of sleep apnea he had ever seen: He told me that I stopped breathing 120 times per hour, I wasn’t getting enough oxygen to my lungs, and my cardiovascular system was steadily wearing dow. It was mind-blowing. I can only remember sitting in his office crying uncontrollably, my mom doing all the talking.

It sounds overdramatic, but I knew I was going down the same path my father had taken: He was overweight the majority of his life, had high blood pressure, and all kinds of medical problems, including untreated sleep apnea. He passed away at 67, and I was afraid I’d end up just like him, gone too soon, if I didn’t get assistance right away.

Slow but steady treatment
The doctor told me that I had to lose a significant amount of weight to cure my sleep apnea, either that, or get a tracheotomy. Of course I didn’t want a hole in my throat, but I was looking for any help I could get: Losing weight seemed impossible, since I was exhausted all the time. One other option, although my doctor warned me that results may be minimal, was to remove my tonsils and adenoids. I had the surgery later that month, followed by another sleep study. I was disappointed: The setting for my CPAP machine went from 13 (the hightest possible pressure) just down to 11.

As a naturally clasustrophobic person, learning to use the CPAP machine has been difficult. The first night I took it home, I made my mom stay overnight because I was so terrified to sleep with it. I had to try three different types before I found one -a small nasal mask -that I can actually tolerate. Even then it took me sometime to get comfortable with.

Now, I swear by my CPAP machine. I actually tell people that it’s time for me to go home to bed so that I can breathe in fresh air all night long! It has become a regular part of my bedtime ritual, and I don’t go anywhere without it. Until I am given the green light that I no longer need to wear this lifesaving device, it will always be with me.

Still room for improvement
My sleep patterns have improved, and I no longer have to take naps to play catch up in the afternoons. I don’t have sore throats in the morning. My blood pressure is back in the healthy range, and I’ve joined Weight Watchers and am finally starting to shed some pounds. I’m feeling a lot better, health-wise.

Getting the word out
I’ve become a spokesperson for my family and friends, letting others know about what can happen if you do not get treated. I’m sure some of my loved one also have sleep apnea, and some them tell me they’re just scared to hear the results. That’s pretty frustrating to hear, considering how much I suffered before I was diagnosed and how much better I feel now.

I try to tell people, please stop what you are doing and make an appointment today! If you are afraid of doctors, don’t be. If your afrais to go to the sleep lab, take along a friend, your mom, your wife or husband, or just take along something comforting to have by your side. This is your life we are talking about, and I promise you, you will not regret it.

-Amy Petrik
Recovering Sleep Apnea Patient.

It’s true, no matter how many hours of sleep you didn’t get, chances are you still have to go to work the next day and do your job successfully enough to keep your boss, clients and colleagues happy. And, the more sleep debt you rack up, from what started as just a one night-er has now turned into what seems like a chronic sleep condition, like musical chairs, only in your head- and the harder it is to function normally during the day.

 Poor sleep affects work performance, there’s no question: The indirect costs of insomnia, including time lost from work and losses in productivity, are estimated to nearly $29 billion a year, according to the U.S. Department of Health and Human Services. You will not only affect you own production, but what about the others you work with or around?  If your irritable, your snap-ish attitude could push people away, cause a rise in awareness to the people around you to notice your now ‘unusal’ behavior, and you could find yourself sitting in the hot seat.

Somehow you’ve got to work around your sleep problem until it’s gone, which could be soon, eventually, or never… Try these tips for staying awake during the day while searching for a better sleep at night:

Drink lots of water!
Not only will it quench your thirst, and it’s healthy, but it’ll keep you active. Yes, running back and forth to the bathroom. I know it may sound a little funny, and you may get some funny looks always heading to the bathroom, but spread the word! It’s healthier than drinking coffee, drinking those high sugared caffinated energy drinks, and your cleansing your system too! When you tell others, it won’t seem like such a funny idea, and you might be seeing more of your colleagues.

 Seek out the sun
If you have irregular sleep patterns, direct sun exposure in the mornig can hel p reset your internal clock. It can also give you a boost when you’re fading during the day. A study found that light affects areas of the brain also involved in attention, arousal, and emotion regulation during the day, so a little sunlight will curb that after lunch, afternoon drowsiness.

 Get up & move!
Find the nearest stairwell at work and use it! Yea we know that sounds like a drag, but it’s good exercise as well! It will help you get your day started. They say one of the best times to get some good cardio is in the morning, yes we know we don’t want you breaking out the sweats or anything, but if anything try to use it when navigating around your building. Get your soda from the caferteria, instead of the vending machine on your floor. Instead of riding the elevator, take the stairs, you will see a difference. Even if you have nowhere to go, walk up and dow a couple flights when you feel yourself flagging. In not time you’ll begin to notice what nice calves you have!

 Working with a schedule
When you have a good sleep regimen, it becomes easier to wake in the mornings. Getting up isn’t such a drag, and you won’t be hearing the kids yelling for you to get up. Simple things like packing lunches, picking out clothes, and making sure your to do list is all ready the night before. This will help you keep things on track, you can go to sleep peacefully and keep your mind clutter free.

 In a 2007 Wake Forest Univer. study, researchers found that workers who felt their jobs had adequate flexibilty to meet personal and family commitments also reported getting more sleep. These people may not be working late or are perhaps less stressed and sleeping better at night. Talk with your employer, let them know about some of the sleep conditions and patterns that taint your work week, talk about whether they might permit some special arrangements to better suite your needs. Showing communications with your employer, instead of showing up late, not being productive, letting them know how serious your sleeping conditions are. The recommendations may be more eligible then you know.

Just a few reasons to take a Home Sleep Test:

Know the Facts!

A home sleep test or (HST) measures the airflow from your nose and mouth, often because of a suspected case of Obstructive sleep apnea (OSA). Partical breath intakes are called hypoapneas & the total cessation of breath is apnea. Either way you still are not providing enough oxygen to your body, and most importantly to your brain. Both can last up to 10 seconds, add that up in an 8 hour sleep period, 10 seconds out of a minute pretty much equals out to only really getting 4-5.5 hours of sleep; possibly not even allowing your brain to go into deep, restorative sleep, causing your to be a bed head! Fatigued, and irritated to start the day!  The home sleep test will calculate the number of both hypo & apneas that you experience through out the night.

  There are two types of consequences of letting sleep apnea take control: 1. Disruptive & 2. Life threatening. Some of the attributes for disruptive issues are, daytime fatigue, depression, irritability, sexual dysfunction, learning and memory difficulties. These can come into effect within days of sleep deprivation. Stress will enforce them more strongly, and surely may make things feel in a fog, forget-fullness, disorientation, and thoughts of inner challenges can soon come to surface. Take the breath that you need, and relax, speak with someone here at our facility and the answers you need, sleep better tonight.

  Life-threatening consequences include congestive heart rhythms, stroke, irregular heart rhythms, and fatal car accidents. Such challenges that arise can hurt you physically and cause harm to others, epesically on the roadways. It takes only seconds for a slip up, this is called micro-sleep. Fours seconds was documented to the quickest time for someone to lose control of their vehicle during the onset of micro-sleep. (example here).

Talking to one of our Certified Respiratory Technicians, we can come up with a plan to getting you back to a more restful, peaceful, enjoyable, & (quieter for your partner) kind of sleep. You both deserve a good night!

This just in… wow, do you really think that she was sleepwalking, or just tried of her partner… it’s a little questionable…leave me a little insight on what you think is wrong with this picture:

  Sleep medicine experts have successfully treated a rare case of a woman having sex with strangers while sleep walking.

  The behaviour had disrupted the lives of the woman and her partner. At night while asleep, the middle aged sleepwalker – who lives in Australia- left her house and had sexual intercourse with strangers. The behaviour continued for several months and the woman had “no memory” of her nocturnal activities.

  Circumstantial evidence, such as condoms found scattered around the house, alerted the couple to the problem. One occasion, her partner awoke to find her missing, went searching for her and found her engaged in the sex act….

 “Incredulity is the leading player in cases like this,” stated Peter Buchanan, a sleep physician, in Sydney Aussie, who handled the case. But a combination of factors convinced him that the case was a real sleepwalking phenomenon, including the distress of the couple, and an in-depth clinical evaluation.

Sleep Talking
 
During that evaluation, the patient was assessed by psychiatrists and checked for  physical problems such as brain tumours, which may cause unusual behaviour. Neither of those examinations could find a cause.

  However, she was found to have a history of talking in her sleep as a teenager and when monitored in the sleep laboratory, she was found to have a higher number of arousals from deep sleep than is usual. Both of  these factors might indicate a susceptibility to abnormal sleep behaviour.

 Roger Allen, a sleep specialist in private practice in Brisbance is sceptical. “Sex is a primal behaviour so it’s not impossible- men have erections in their sleep after all – but this case involved such complex behaviour it seems less likely.” He also points out that eliminating psychiatric conditions as a cause of the behaviour would be difficult.

Sleep Driving
 
But there are some extraordinary cases of sleep walkers leaving their homes, driving cars, or engaging in behaviours that they would not usually. In 1987, Ken Parks, drove 20 miles from his home in Pickering, Ontario, to his in-laws house, where he strangled his father-in-law unconscious, and stabbed his mother-in-law to death. He was acquitted of murder because he was sleepwalking at the time.

“People in a state of automatism don’t have access to their full range of beliefs and desires, so it seems justifiable to excuse them,” says Neil Levy of the Centre for Applied Philosophy and Public Ethics at the University of Melbourne.

Sleepwalking is often triggered by stress, and this may have been the case with the Sydney woman, says Buchanan. She stopped her night-time excursions after psychiatric counselling. Drugs such as benzodiazepines, which are sometimes used to treat sleep walkers, were not necessary.

Any type of sleepwalking is rare. It occurs in around 3% of children and young adolescents, and about 0.5% of adults. Usually it involves little more than walking around in a fairly purposeful way while asleep, although sleepwalkers may lash out if awoken

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  The intention of surgery is to open the airway sufficiently to eliminate or to reduce obstructions to a clinically insignificant level. In order to do so, surgical therapy in adults often must reconstruct the soft tissues (such as the uvula and the palate) or the bony tissues (the jaw) of the throat.

If you have been diagnosed with OSA and are considering surgery, talk to a sleep specialist and/or experienced surgeon about the different procedures, and the chances they will be effective to you, with your anatomy and why, and most of all the risks involved with surgery. Untreated sleep apnea can be harmful to your health, and surgery cannot always address all the points of obstruction. Eliminating the snoring does not necessarily eliminate the apneas. Sometimes surgery does not cure sleep apnea but reduces the number of apneas so that more treatment options are available to you and/or more comfortable. Yet in some circumstances, surgery may actually worsen the apnea.Insurance typically covers surgery for sleep apnea but not all surgical procedures. However, insurance companies that initially refuse to pay for a surgery may be convinced otherwise upon an appeal that demonstrates the efficacy and appropriateness of the surgery in your case. Throat pain from the major surgeries varies but is generally significant, often for one to two weeks. Most surgical procedures for sleep apnea are conducted in a hospital under general anesthetic. (People with sleep apnea must be cautious about general anesthesia–no matter for what medical condition the surgery is–because of the effects anesthesia has on the airway.)The most common surgery for sleep apnea is the uvulopalatopharyngoplasty, or UPPP procedure, which is intended to enlarge the airway by removing or shortening the uvula and removing the tonsils and adenoids, if present, as well as part of the soft palate or roof of the mouth. (The uvula is the tissue that hangs from the middle of the back of the roof of the mouth; the word comes from the Latin “uva” meaning “grapes.”) According to the “Practice Parameters for the Treatment of Obstructive Sleep Apnea: Surgical Modifications of the Upper Airway,” issued in 1996 by the American Academy of Sleep Medicine, the overall efficacy is 40.7%. A more recent surgery using a laser (laser-assisted uvulopalatoplasty or LAUP, a modification of the UPPP where the surgeon cuts the uvula with a laser) is performed for snoring. There is not yet enough information to say whether LAUP is effective for OSA. 

There are other surgical procedures where a part of the tongue is removed, and two which try to enlarge the airway by moving the jaw forward. These surgeries do have very high success rates but are long and involved (lasting several hours) with a significant recovery period and potential complications that patients may reject. As a rule, success rates for these complicated surgeries are higher when preformed by an experienced surgeon. You may have to undergo more than one procedure to eliminate the apneas sufficiently. In review, when weighing surgery, consider whether the safety and efficacy of the procedure have met the medical journals and cases studied are similar to yours. Surgery helps many, but effectiveness varies from person to person. It is also highly recommended that with surgery you have follow up sleep studies often, to evaluate your current conditions. If unsure about proceeding, you should seek a second opinion. Only a doctor who has examined you and your airways/complications can advise you on finding the correct surgery best for your needs.

 **Physicians who perform surgery for sleep apneas are most commonly otolaryngologists (specializing in the ears, nose, and throat) and oral and maxillofacial surgeons. If you are seeking a referral to a surgeon or a second opinion, you may find one through your physician or through a sleep center, and keep in mind that your insurance policy may require you to get a referral for a specialist and/or to see a specific provider.**

 

 

 

 


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