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Posts Tagged ‘Snoring

brain-damage

Studies show that obstructive sleep apnea (OSA) affects much more than just your sleep. It can even damage your brain.

A recent brain imaging study from France involved 16 adults. Each of them had just been diagnosed with sleep apnea.

In numerous brain regions the study found a loss of “gray matter.” This is brain tissue that contains fibers and nerve cell  bodies. There also was a decrease in brain metabolism.

The authors suggest that these changes may explain some of the impairments that often occur in people with sleep apnea. Examples include attention lapses and memory loss. The study was published in March 2009 issue of the Journal of Sleep Research.

The results are similar to those found by a research team from UCLA. Their study was published in Neuroscience Letters in June 2008. They reported that people with sleep apnea have tissue loss in the “mammillary bodies.” These are brain regions that help store memory.

In July 2008 the UCLA team published another brain imaging study in the journal Sleep.It involved 41 people with moderate to severe sleep apnea. It also included 69 control subjects matched by age.

Results show that people with sleep apnea have extensive alterations in “white matter.” This is nerve tissue in the brain. It contains fibers that are insulated with myelin -a white, fatty sheath. The structural changes appear in brain regions that help control mood and memory. These regions also play a role in adjusting your blood pressure. Damage also was found in fiber pathways that connect these brain regions.

What causes the brain damage? The authors suggest that oxygen, blood flow and blood pressure may be involved. Sleep apnea involves breathing pauses that can occur hundreds of times a night of sleep. These pauses can produce drastic changes in oxygen levels.

These breathing pauses also reduce blood flow in the brain. People with sleep apnea also are at risk for high blood pressure. Both of these conditions create a potential for brain tissue damage.

Dr. Ronald Harper of UCLA said that the studies show how important it is for sleep apnea to be treated. CPAP is the most common treatment for sleep apnea. The findings make it all the more imperative that OSA be treated as soon as possible to prevent further injury. The long-term effects of OSA are terribly damaging to memory and thinking processes.

Can treatment reverse the brain damage caused by sleep apnea? The authors are uncertain if the changes are permanent.

But studies show that CPAP does help your heart, it may even save your life.

mind-racing

Insomnia can make you feel like your mind is racing out of control. A revealing new study explains why your brain may be unable to put the brakes on your thoughts. It links the problem to low levels of a brain chemical.

A new study shows that GABA levels are reduced by 30 percent in adults with chronic primary insomnia. The study was published in the Nov. 1 issue of the journal Sleep.

GABA is reduced in the brain of individuals with insomnia, suggesting over activity is present. It was explained that low GABA levels create an imbalance of brain activity. This may lead to an inability to shut down waking signals in the brain.

If your GABA levels are low, then your mind can’t slow down. It may race forward at full speed even when it is time to sleep. An over active mind is a key feature of psychophsicological insomnia. At bedtime you are unable to stop thinking and worrying. Your body may be ready for sleep, but your mind remains alert. This state of “hyperarousal” can make it hard for you to fall asleep.

Most with insomnia have “secondary” insomnia. It occurs along with another medical problem, mental illness or sleep disorder. It also may result from the use of a medication or substance. In contrast primary insomnia is unrelated to another health problem. Estimates that about 25 percent of people with insomnia have primary insomnia. The study only links low GABA levels to long lasting, primary insomnia.

All participants in the study had been suffering from primary insomnia for mor than six months. The average duration of their symptoms was about 10 years. The GABA connection affirms that primary insomnia is a legitimate disorder.

Recognition that insomnia has manifestations in the brain may increase the legitimacy of those who have insomnia and report substantial daytime  consequences. It was also explained that insomnia can affect your energy, concentration and mood. It also increases your risk of depression.

One solution for the problem of primary insomnia is the use of hypnotic medication. The short-term use of a sleeping pill can help break the cycle of sleepless nights. The study notes that many of the most effective sleeping pills increase activity at the GABA neurons.

Another treatment option is cognitive behavioral therapy. CBT helps you learn how to correct attitudes and habits that hinder your sleep. Many of these bad habits develop as people try to cope with chronic insomnia.

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HomeSleepQuiz

1. The record for the longest period without sleep is 18 days, 21 hours, 40 minutes during a rocking chair marathon.  The record  holder reported hallucinations, paranoia, blurred vision, slurred speech and memory and concentration lapses.

2. Anything less than five minutes to fall asleep at night means you’re sleep deprived. The ideal is between 10 and 15 minutes, meaning you’re still tired enough to sleep deeply, but no so exhausted you feel sleepy by day.

3. It’s impossible to tell if someone is really awake without close medical supervison. People can take cat naps with their eyes open without even being aware of it, microsleep.

4. A new baby typically results in 400-750 hours lost sleep for parents in the first year.

5. One of the best predicors of insomnia later in life is the development of bad habits from having been sleep deprived by young children.

6. The continuous brain recordings that led to the discovery of REM (rapid eye movement) sleep were not done until 1953, partly because the scientists involved were concerned about wasting paper.

7. REM sleep occurs in bursts totaling about 2 hours a night, usually beginning about 90 minutes after falling asleep.

8. Dreams, once thought to occure only during REM sleep, also occure (but to a lesser extent) in non-REM sleep phases. It’s possible there may not be a single moment of our sleep when we are actually dreamless.

9. REM dreams are characterized by bizarre plots, but non-REM dreams are repetirive and thought-like, with little imagery obesessively returning to a suspicion that you left your mobile phone somewhere, for example.

10. Certain types of eye movements during REM sleep correspond to specific movements in dreams, suggesting at least part of the dreaming process is analogous to watching a film.

11. No-one knows for sure if other species dream, but some do have similar sleep cycles to humans.

12. Elephants sleep standing up during non-REM sleep, but lie down for REM sleep.

13. Some scientists believe we dream to fix experiences in long-term memory, that is, we dream about things worth remembering. Others reckon we dream about things worth forgetting to eliminate overlapping memories that would otherwise clog up our brains.

14. Dreams may not serve any purpose at all but be merely a meaningless byproduct of two evolutionary adaptations: sleep and consciousness.

15. REM sleep may help developing brains mature. Premature babies have 75 percent REM sleep, 20 percent more than full-term babies. Similerly, a newborn kitten, puppy, rat or hamster experiences only REM sleep, while a  newborn guinea pig (which is much more developed at birth) has almost no REM sleep at all.

16. Scientists have not been able to explain a 1998 study showing a bright light shone on the backs of human knees can reset the brain’s sleep-wake clock.

17. British Ministy of Defense researchers has been able to reset soldiers’ body clocks so they can go without sleep for up to 36 hours. Tiny optical fibers embedded in special spectacles project a ring of bright white light ( with a spectrum identical to a sunrise) around the edge of soldiers’ retinas, fooling them into thinking they have just woken up. The system was first used on US pilots during the bombing in Kosovo.

18. Seventeen hours of sustained wakefulness leads to a decrease in performance equivalent to a blood alcohol-level of 0.05%.

19. The 1989 Exxon Valdex oil spill off Alaska, the Challenger space shuttle disaster and the Chernobyl nuclear accident have all been attributed to human errors in which sleep-deprivation played a role.

20. The NRMA insurance estimated fatigue is involved in one in 6 fatal road accidents.

21. Exposure to noise at night can suppress immune function even if the sleeper doesn’t wake. Unfamiliar noise, and noise during the first and last two hours of sleep, has the greatest disruptive effect on the sleep cycle.

22. The “natural alarm clock” which enables some people to wake up more or less when they want to is caused by a burst of the stress hormone adrenocorticotropin. Researchers say this reflects an unconscious anticipation of the stress of waking up.

23. Some sleeping tablets, such as barbiturates supress REM sleep, which can be harmful over a long period.

24. In insomnia following bereavement, sleeping pills can disrupt grieving.

25. Tiny luminous rays froma digital alarm clock can be enough to disrupt the sleep cycle even if you are not fully awake. The light turns off a “neutral switch” in the brain, causing levels of a key sleep chemical to decline within minutes.

26. To doze off, we must cool off; body temperature and the brain’s sleep-wake cycle are closely linked. That’s why hot summer nights can cause a restless sleep. The blood flow mechanism that transfer core body heat to the skin works best between 18-30 degress. But later in life, the comfort zone shrinks to between 23-25 degress, one reason why older people have more sleep disorders.

27. A night on the grog (alochol) will help you get to sleep but it will be a light slumber and you won’t dream much.

28. After five nights of partial sleep deprivation, three drinks will have the same effect on your body as six would when you’ve slept enough.

29. Humans sleep on average around three hours less than other primates like chimps, rhesus monkeys, squirrel monkeys and baboons, all of whome sleep for 10 hours.

30. Dolphins at risk of attack by predators are able to balance the need for sleep and survival, keeping one half of the brain awake while the other slips into sleep mode.

31. Ten percent of snorers have sleep apnea, a disorder which causes sufferers to stop breathing up to 300 times a night and significantly increases the risk of sufferig a heart attack or stroke.

32. Snoring occurs only in noo-REM sleep.

33. Teenagers need as much sleep as small children ( about 10 hrs.) while those over 65 need the least of all ( about six hours). For the average adult aged 25-55, eight hours is considered optimal.

34. Some studies suggest women need up to an hour’s extra sleep a night compared to men, and not getting it may be one reason women are much more susceptible to depression than men.

35. Feeling tired can feel normal after a short time. Those deliberately deprived of sleep for research initially noticed greatly the effects on their alterness, mood and physical performance, but the awareness dropped off after the first few days.

36. Diaries from the pre-electric-light-globe Victorian era show adults slept nine to ten hours a night with periods of rest changing with the seasons in line with sunrise and sunsets.

37. Most of what we know about sleep we’ve learned in the past 25 years.

38. As a group, 18-24 year-olds deprived of sleep suffer more from impaired performance than older adults.

39. Experts say one of the most alluring sleep distractions is the 24-hour accessibility of the internet.

40. The extra-hour of sleep received when clock are put back at the start of daylight savings has been found to coincide with a fall in the number of road accidents.

  At one time or another, most of us have gotten behind the wheel without the benefit of adequate sleep. At the time, we were probably unaware sleep deprivation imparied our driving as significantly as driving drunk! Drowsy drivers are a serious threat to themselves and everyone else on the road.

          Know the Facts:

The U.S. National Highway Traffic Safety Admin. estimates that 100,000 of reported crashes occur as a result of drowsiness, and considers sleep deprived drivers a hazard equal in severity to drunk drivers. Studies show that staying awake for 18 hours and driving produces the same effect of being illegally drunk behind the wheel. The greater the sleep deprivation, the closer to correlation to higher levels of intoxication.

Actual statistics on crashes, injuries and fatalities caused by drowsy driving are difficult to calculate as there is no way to test the fatigue levels of drivers. The cost, damages, injuries, and fatalities resulting from sleep deprived drivers have been estimated at $12.5 billion.

           Who Is Doing It?

A study conducted by Farmers Insurace found that 10 percent of drivers admitted to falling asleep at the wheel and 20 percent admitted to momentarily dozing off. Three times more men than women reported falling asleep while driving.

          How Bad Are the Results, What Could Really Happen?

Ford Motor Company performed a study that painted a sobering picture of the potential for damage. Ford found that a driver sleeping even 2.5 seconds ina car traveling 70 mph covers the length of one football field. With other vehicles on the road or pedestrians nearby, that one driver can cause significant harm. In a effort to increase safety, Ford plans to incorporate findings from the study into the design of features for their vehicles.

          Can There Really Be Legal Ramifications?

New Jersey passed “Maggie’s Law” in 2003. It allows sleep deprived drivers who cause accidents and have been awake more than 24 hours to be charged with vehicular homicide. The law also provides liability for companies that require empolyees to keep such hours. Existing laws in all states may cover the prosection of drowsy drivers for damages caused, but unfortunately do little to prevent an impaired driver from getting behind the wheel in the first place.

           How Can I Prevent Being a Drowsy Driver?

Many popular methods to stay awake, such as drinking a caffeniated beverage, opening windows, turning on air conditioning, or blasting the radio. But studies have shown that these methods are very much ineffective. The only proven preventative measure is to pull off the road and catch some shut eye. Even if its only 20 minutes. This small break is enough to restore a drivers abilities. It’s best to nap, awaken more refreshed, and then continue on to a safe place to sleep longer.

Wheather you are behind the wheel or a passenger, recognize the signs of drowsy driving:

  • Heavy eyelids, frequent blinking, difficulty focusing vision
  • Impaired concentration
  • Missing exits or traffic signals
  • Repeated yawning
  • Drifting into other lanes or off the road
  • Irritability or jumpiness

These symptoms are a warning no one can afford to ignore.

Driving drowsy is a hazardous practice, no one should try. Sleep is not something a body can do without. At some point, the human body will simple take that rest it needs no matter where you are. Look for the signals of drowsy driving, choose not to operate a vehicle in this state and help keep the roads safer for everyone.

Some sleep disorders can be diagnosed during a routine exam and a conversation with a sleep specialist. But if you or your doctor suspects you have sleep apnea a further examination may be requested.

It use to be that you had to travel to an actual ‘lab’/hospital. Most of the time they are hours away, booked for months at a time, and a big inconenience. Some people may have a disability, or dependents, or a job that makes a night in a lab too difficult. Now, finally with our latest technology, cases like these have been answered with: The Home Sleep Test (HST).

There are many home test kits available on the market today. But, none of them record all of the full vital signs that a complete in-lab study would, for other sleep disorders -eye and limb movements that might be related with a neurological disorder, for example. The increasing evidence, however, shows they are highly effective in diagnosing obstructive sleep apnea. A home sleep test will collect this kind of information though to be symptoms of OSA:

  • Airflow
  • Breathing efforts
  • Blood oxygen
  • Snoring vibrations/density
  • Head and neck movements
  • Calculated cessations/stops in breathing

With the new acceptance of home testing growing in the sleep community: in 2007 the American Academy of Sleep Medicine (AASM) revised their policy and now endorses the use of portable monitoring for a specific group of people. Now, many insurance plans are starting to cover home tests for eligible patients. Many providers of home sleep testing, have an on-site doctor or therapist who will help you with obtaining a home sleep test, if you have difficulties with your insurance plan (we do 😉 )

So…who’s eligible?

The following points are taken into consideration when determining eligibility:

  • You are between 18 and 65 years of age. Home sleep test haven’t been recommended for children or older adults.
  • You have no other major medical problens; such as pulmonary disease (ALS, multiple sclerosis, Parkinson’s disease)
  • Patients suspected of having no co-morbid sleep disorder other than OSA.
  • To monitor response to non-CPAP treatments after the dianosis has already been made.

Other medical problems can affect your results, including lung disease, neuromuscular disease, and congestive heart failure, be sure to talk to your doctor to rule out any possible infracions that may effect your testing.

You also maybe eligible for a Home Sleep test if health or safety concerns prevent you from being able to leave home for a night. The Home Sleep test may be used to evaluate your response to some sleep apnea treatments, such a titration pressure, and weather you’re a nasal breather or a mouth breather.

A Home Sleep test can and will make things much more clear if you feel that your just not getting a good nights sleep, or if your partner complains about your snoring and even if you’ve ever nodded off while driving. Give yourself and your loved ones the peace and ease of knowing that you’ll be save and yourself a complete and whole night of sleep, waking feeling refreshed! 🙂

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.


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