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Identifying_sleep_apnea

Could You Have Sleep Apnea? 3 Things to Consider

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Obstructive Sleep Apnea (OSA) is a condition characterized by pauses in breathing while you sleep. It usually occurs when the soft tissue in the rear of the throat collapses and the airway is blocked. Throughout the night as an individual struggles to breathe, they repeatedly leave deep sleep and partially awaken as they gasp for air. However, when morning comes they are unaware of their sleep disturbance. According to the National Sleep Foundation, sleep apnea affects somewhere between 10-30% of adults.

Symptoms and risk factors

OSA symptoms may first be noticed by another person, like snoring loudly (although not everyone who snores has sleep apnea), gasping for air, and moments when you stop breathing during sleep. Other symptoms can include headaches, daytime sleepiness, and waking up with a dry mouth.

The risk factors for the disorder include being overweight, male, and more than 40 years of age; but the disorder can affect anyone (even small children whose breathing may be obstructed by enlarged tonsils). Unfortunately, most sufferers are unaware that they have the disorder, so it often remains undiagnosed. But ignorance is not bliss.

Untreated obstructive sleep apnea can cause a host of serious medical problems including chronic tiredness, headaches, memory lapses, irritability, weight gain, depression, increased sensitivity to body aches and pain, and for postmenopausal women, an increase in joint pain. It also places sufferers at a higher risk of developing heart disease, stroke, and high blood pressure.

Finally, excessive sleepiness has public safety consequences: The American Automobile Association (AAA) estimates that one out of every six (16.5%) deadly traffic accidents, and one out of eight (13%) crashes requiring hospitalization of car drivers or passengers is due to drowsy driving.

Diagnosis and treatments

If you suspect you may have sleep apnea, you shouldn’t delay an evaluation. A good place to start is the Epworth Sleepiness Scale. It asks Eight Questions to assess your risk – if your score is equal to or higher than 10, you are at high risk for sleep apnea and should consult your provider. At The Kaplan Center, to help us detect sleep apnea, as well as providing markers for quality of sleep, we prescribe our patients a recyclable Home Sleep Apnea Test called the WatchPAT ONE (scroll down for more information).

Although there is no cure, there are steps you can take to help you get a more restful sleep. Here are 3 things to consider doing now:

  1. Examine your lifestyle factors. Weight loss and/or maintaining a healthy weight, eliminating alcohol, and smoking cessation have all been shown to improve sleep. A one-step-at-a-time approach for any major lifestyle modifications will help you maintain these healthier practices for life.
  2. Consider trying a mouthpiece. Patients diagnosed with mild to moderate sleep apnea may benefit from using an oral appliance. These are customized mouthpieces that are meant to reposition your jaw and/or tongue, depending on the specific device, to help keep your airway passage open while you sleep. If you think this may be a good fit for you, speak to both your healthcare provider and dentist for more information.
  3. If you have been diagnosed with moderate-to-severe sleep apnea, a CPAP (continuous positive airway pressure) machine may be recommended by your provider. The machine uses a mask that fits over the mouth and nose, or just the nose, and gently blows air into the throat. The pressure from the air helps keep the airway open during sleep, minimizing disturbances due to sleep apnea.

Again, if you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Your sleep is very important, and we are here to get you back on track. Call us at 703-532-4892, ext. 2 to make an appointment.

WatchPAT® ONE for Diagnosing Sleep Apnea and Other Sleep Disorders

WatchPAT ONE Home Sleep Apnea Test (HSAT) can be a valuable tool to help us monitor if there are adequate amounts of Deep and REM sleep, apnea episodes, oxygen and heart rate, snoring, movement, and more.

Patients benefit from:

  1. Convenience. WatchPAT ONE utilizes Bluetooth technology which allows patients to pair the device to their smartphone using Itamar’s proprietary app. Sleep study data is collected during the test and automatically sent to a secure, cloud-based server. Once the test is complete, a comprehensive report is automatically generated and sent directly to the prescribing physician.
  2. An accelerated diagnosis. The sooner we have your data the sooner we can devise a treatment plan to improve your sleep.
  3. Less travel. Patients do not need to come into our office to pick up or return their equipment.
  4. A safe, hygienic product. Using a fully disposable product cuts down on the concern of spreading infection. No cleaning, sanitizing, or reusing of equipment.

For more information about sleep apnea, please visit the National Institute of Neurological Disorders & Stroke website.

This article was originally published in March 2016. It was reviewed and updated in May 2023.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References

National Sleep Foundation

Owens, J.M., Dingus, T.A., Guo, F., Fang, Y., Perez, M., McClafferty, J. & Tefft, B.C. (2018). Prevalence of Drowsy Driving Crashes: Estimates from a Large-Scale Naturalistic Driving Study (Research Brief). Washington, D.C.: AAA Foundation for Traffic Safety.

Li, M., Zou, X., Lu, H. et al. Association of sleep apnea and depressive symptoms among US adults: a cross-sectional study. BMC Public Health 23, 427 (2023). https://doi.org/10.1186/s12889-023-15358-8

Odai T, Terauchi M, Umeki H, Miyasaka N, Somekawa Y. Sleep apnea in postmenopausal women is associated with joint pain severity and fatigability: a cross-sectional study. Menopause. 2022 Jun 1;29(6):680-686. doi: 10.1097/GME.0000000000001974. PMID: 35231006.

Gomase VG, Deshmukh P, Lekurwale VY. Obstructive Sleep Apnea and Its Management: A Narrative Review. Cureus. 2023 Apr 10;15(4):e37359. doi: 10.7759/cureus.37359. PMID: 37182079; PMCID: PMC10174073.

RMIT University. (2019, January 31). Sleep apnea creates gaps in life memories: People with sleep apnea struggle to remember details of memories from their own lives, putting them at risk of depression. ScienceDaily.

 

 

 

10_ways_to_get_good_nights_sleep

Are You Dying For A Good Night’s Sleep?

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It is estimated that over 70 million people suffer from a chronic sleep disorder in the United States, impacting not only the individual struggling to get a good night’s sleep but potentially all of us. It is conservatively estimated that more than 91,000 car accidents resulting in 800 deaths and 51,000 injuries each year are the result of driver fatigue.

And here’s another thought that might keep you up at night

One of the most common medical responses to helping you sleep may actually be putting your health at risk. About 4% of U.S. adults use a prescription sleeping aid in any given month. Yet taking as few as 18 sleeping pills a year increases your risk of dying 3.6 fold compared to people not using them. Those who take a prescription sleeping medication more than 132 nights a year have a 6.6-fold increase of death and a 35% increased risk of developing cancer.

A better response?

Individualized treatment to discern the underlying cause of sleep loss.

Sleep deprivation is the most common sleep disorder.

Newborns need as much as 18 hours a day, while teenagers — the most notoriously sleep-deprived group — require nine to 10 hours. Adults should have between seven and eight hours a night of restful sleep, yet a 2013 Gallup poll found that as many as 40% of Americans get only six hours or less of sleep a night.

Sleep deprivation can exhibit as insomnia, taking longer than 20 minutes to fall asleep, multiple awakenings during the night with difficulty returning to sleep, early wakening, and shortened sleep due to demands of work or school. Whatever the cause, its long-term consequences on your health and well-being are the same.

In the short term, your mental performance and reaction time when chronically sleep-deprived are the equivalent of being drunk. And like the inebriated, the chronically sleep-deprived do not recognize the extent of their impairment. Lack of sleep compromises the normal functioning of your immune system, and long-term sleep deprivation causes your body and brain to be in a chronic state of inflammation, potentially leading to an increase in heart disease, stroke, obesity, chronic pain, ADD, depression, and anxiety. The problem is also bidirectional; conditions such as chronic pain, depression, and heart disease can cause sleep disturbance, which then worsens the underlying condition.

Questions? Give Us a Call!

703-532-4892 x2

So how sleepy are you?

If you think you may be suffering from sleep apnea or another type of sleep disorder, don’t put off seeking help. Being this tired is a potential danger to your own health as well as the health of others. One way to quickly assess your level of daytime sleepiness is the Epworth Sleepiness Scale. It takes about a minute to complete the test and should be part of any medical exam when someone is complaining of fatigue. A score of 10 or higher is suggestive of a significant sleep issue.  At the Kaplan Center, we also utilize WatchPAT ONE, a recyclable Home Sleep Apnea Test (HSAT) to help us detect sleep apnea as well as providing markers for quality of sleep.

Here are some steps you can take right now to improve the length and quality of your sleep:

  1. Go to your room! Try to tuck in and rise around the same time each day.
  2. Move it! Regular exercise improves sleep and regular sleep improves exercise performance. The regular practice of yoga, especially in older adults, has been shown to improve the duration and quality of sleep.
  3. Cut caffeine. If you have a sleep problem, minimize or eliminate your caffeine consumption. Caffeine in all forms — tea, chocolate, energy drink or pill — disrupts sleep.
  4. Eat more fish. Eating fatty fish, salmon, and tuna appears to not only lower your risk of heart disease but also betters your sleep.
  5. Eat at regular intervals. When and how much we eat, as well as the types of foods we eat, impact our internal clock, called our circadian rhythm. While we are just beginning to understand the relationship between food and internal clocks, it is clear that the two are related and the consequences of eating at irregular intervals are obesity and increased risk for disease, in addition to disruption of your sleep.
  6. Cooldown to sleep sound. People may have trouble falling asleep because they have trouble cooling down their core temperature, which reaches its maximum typically around 3 pm. A warm room will exacerbate the problem. Temperatures above 75 degrees and below 54 degrees Fahrenheit can disrupt sleep. So what is ideal for sleep? The consensus is that a room temperature between 65 and 68 degrees is probably ideal; this will vary among individuals.
  7. Go dark. Light is a major factor that regulates our sleep-wake cycle. Light exposure at night not only disrupts our sleep but also increases our risk for obesity, high blood pressure, and possibly breast cancer in women.
  8. Keep it quiet. Any amount of noise starting at 30 to 40 decibels, a level between a whisper and a quiet conversation, begins to impact sleep quality. That said, people generally find the sounds of their usual environment relaxing. Sound can also be used to help with sleep. One study looking at patients suffering from a generalized pain syndrome called fibromyalgia found that music embedded with a specific sound frequency called Delta wave that pulsated between .25 to 4 Hertz improved the quality of patients’ sleep and decreased their pain symptoms.
  9. Meditate. Numerous studies demonstrate that the regular practice of meditation can improve the quality of sleep, as well as help in the treatment of anxiety disorders, depression, and chronic pain.
  10. Sample supplements. Some supplements that might help in getting a good night’s sleep include 5-HTP and melatonin. The FDA does not regulate supplements, so be careful that the supplement you purchase actually contains the substance and the amount of the substance stated on the label. Also, supplements are drugs and can have side effects and interactions with other medications. If you are taking medications on a regular basis, please check with your physician before taking any supplements.

For more information on identifying & treating sleep disorders click here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Note: This post was originally published in August 2014 and has been reviewed and updated for accuracy. 

sleep-disorders

How Sleep Disorders Affect Us and How To Lay Them to Rest

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Sleep is absolutely essential to good physical and mental health, and most adults need 7-9 hours of sleep EVERY night. Sleep deprivation — caused by insufficient sleep or poor quality of sleep — impairs the body’s immune system, physical reflexes, emotional stability, and cognitive functions, such as memory, decision-making, the capacity to focus one’s attention, and the ability to complete complex creative activities or mathematical calculations. Severe sleep deprivation may lead to weight gain, an increase in muscle, joint, and nerve pain, depression, and even hallucinations. Sleep disorders can also be symptomatic of more serious illness, such as clinical depression and/or heart disease, meaning that it’s essential to talk with your doctor if you are having problems falling, or staying, asleep.

If you or your doctor think that you might have a sleep disorder, the first step in further evaluation is to answer the 8 questions on the Epworth Sleepiness Scale. If your score is equal to or higher than 10, the results should be discussed with your doctor. Depending upon your symptoms, your physician may determine that you are a candidate for a sleep study.

Another step is to begin keeping a sleep diary that documents your daily activities, including your sleep activities (i.e. tossing and turning, waking in the middle of the night, sleepwalking, grinding teeth, etc.). Take careful note of the times you actually get good sleep versus the times you don’t. If you’re attempting to heal from an acute injury or a chronic illness, your treatment program will be greatly enhanced by your commitment to proper sleep hygiene.

Commonly-Diagnosed Sleep Problems

There are a large variety of sleep disorders. Some are caused by physical problems, such as an airway obstruction that leads to sleep apnea, or chronic pain or indigestion/reflux sufficient enough to cause insomnia. Sleep problems can also occur as a side effect of taking certain medications or supplements, or because of emotional difficulties including depression, post-traumatic stress disorders and/or anxiety about life situations. In many cases, there can be several factors contributing to the sleep disturbance, including anxiety about the sleep deprivation itself. Some commonly-diagnosed sleep disorders include:

  • Insomnia: Inability to fall asleep within 15 to 20 minutes.
  • Dyssomnia: Frequent awakenings throughout the night and/or early-morning awakenings.
  • Restless leg syndrome: When lying in bed, unpleasant “crawling” sensations in the legs that create an irresistible and sleep-disruptive urge to move one’s legs.
  • Sleepwalking: Walking during sleep or engaging in other activities, like eating, that are normally associated with wakefulness.
  • Sleep apnea: Obstruction of airway during sleep, causing breathing irregularities that interrupt and interfere with sleep. Sufferers are at higher risk of developing high blood pressure, heart disease, and stroke. Snoring may be a sign or symptom of sleep apnea, so it’s something you should mention to your doctor. (Click here for more info from the National Institutes of Health about sleep apnea.)

Questions? Give Us a Call!

703-532-4892 x2

Treatment of Sleep Disorders

There is a wide range of over-the-counter and prescription medications advertised as sleep aids. All of them – including nutritional supplements, Chinese herbs, non-prescription-medications and prescribed-medications – may have side effects or cause drug interactions; for example, long-term use of Benadryl or Tylenol PM may increase your risk for developing Alzheimer’s. Please talk with your doctor before taking any sleep aids.

Alternative Treatments

  • Calcium (1,500 to 2,000 mg daily, taken after meals – 500 mg per meal – and 500 mg at bedtime). Calcium is a nutritional supplement that helps relax the body’s muscles.
  • Magnesium (1,000 mg daily). A nutritional supplement that helps to calm the body’s nervous system and relax the muscles.
  • Cortisol Manager (One tablet daily). Cortisol Manager reduces cortisol levels for all-day stress reduction and restful sleep. It’s safe to use every night.
  • Valerian (1,000 mg daily). Valerian is an American herb that has been found effective in helping to induce the onset of sleep.
  • Phosphatidylserine (PS 100; take one to two at bedtime). Phosphatidylserine is a phospholipid nutritional supplement that stops hyperactive production of cortisol in the body, allowing unhealthy, elevated cortisol levels to decrease, and consequently, more restful sleep to occur.
  • Melatonin (1 to 3 mg daily, but consult with your doctor before using, especially if you’re taking an antidepressant). Melatonin is a hormone that helps induce and maintain sleep. It can be useful in helping people recover from jet lag by reorganizing the sleep cycle (assisting the body in adjusting to time-zone changes).
  • L-Tryptophan (1,000 to 3,000 mg, 30 to 40 minutes before going to bed). L-Tryptophan is a serotonin-precursor, amino-acid nutritional supplement that can help initiate sleep and can be used to reduce chronic pain and depression.
  • Chinese herbs. These can be very helpful in treating and resolving sleep problems but need to be prescribed by a physician or licensed acupuncturist trained in Chinese herbal medicine.
  • Acupuncture. Talk with your doctor about the frequency of treatments that might be helpful for you.
  • Meditation. Twenty minutes daily.
  • Aerobic exercise. Three to four times a week, completed at least three hours prior to bedtime.

Immediate Steps You Can Take to Help Ensure You Get the Rest You Need

  1. Plan your daily schedule to allow seven to nine hours for sleeping every night.
  2. Keep a consistent sleep pattern, even on weekends.
  3. Eliminate caffeine from your diet or reduce your consumption to one cup of coffee or tea, or one soda per day. Caffeine is a stimulant, and it takes six hours or more for your body to metabolize.
  4. After 3 p.m., drink only non-caffeinated beverages.
  5. Take B-vitamins and ginseng in the morning, not before bedtime.
  6. Get regular physical exercise (three to four times a week).
  7. Avoid drinking alcohol near bedtime (although alcohol may cause drowsiness initially, alcohol inhibits sleep continuation).
  8. Make sure sleeping conditions are comfortable (proper temperature and darkness).
  9. Create a bedtime-relaxation routine, which might include:
    • Getting ready for and going to bed at the same time each night.
    • Taking a hot shower or bath before bed.
    • Enjoying a cup of chamomile tea before sleep.
    • Reading a book rather than watching TV once in bed. (Instead of having a relaxing effect, watching television before bed actually stimulates the mind.)
    • Journaling – as a way of getting problems “off your mind” and onto paper – so they can be dealt with in an orderly way in the future.


Overall, try to remain consistent with your sleep routine – even on weekends and holidays.

Good night!

This article was first seen on US News & World Report.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2