The SleepGuide Crew's Posts - SleepGuide2024-03-28T16:05:54ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrewhttps://storage.ning.com/topology/rest/1.0/file/get/65079719?profile=RESIZE_48X48&width=48&height=48&crop=1%3A1https://www.sleepguide.com/profiles/blog/feed?user=2aum2jkb2pzwl&xn_auth=noApnea del Suenotag:www.sleepguide.com,2009-05-12:2549090:BlogPost:257082009-05-12T23:01:42.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Que es la <b>Apnea del Sueno</b><br />
<br />
<div id="__ss_1425601" style="width:425px;text-align:left"><a href="http://www.slideshare.net/gueste2dc80/apnea-del-sueno?type=presentation" style="font:14px Helvetica,Arial,Sans-serif;display:block;margin:12px 0 3px 0;text-decoration:underline;" title="apnea del sueno">apnea del sueno</a><object height="355" style="margin:0px" width="425"><param name="movie" value="http://static.slidesharecdn.com/swf/ssplayer2.swf?doc=coisapneapresentacion-090512170346-phpapp02&stripped_title=apnea-del-sueno"></param><param name="allowFullScreen" value="false"></param><param name="allowScriptAccess" value="never"></param><embed allowscriptaccess="never" height="355" src="http://static.slidesharecdn.com/swf/ssplayer2.swf?doc=coisapneapresentacion-090512170346-phpapp02&stripped_title=apnea-del-sueno" type="application/x-shockwave-flash" width="425" wmode="opaque"></embed> <param name="wmode" value="opaque"></param></object>
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Que es la <b>Apnea del Sueno</b><br />
<br />
<div style="width:425px;text-align:left" id="__ss_1425601"><a style="font:14px Helvetica,Arial,Sans-serif;display:block;margin:12px 0 3px 0;text-decoration:underline;" href="http://www.slideshare.net/gueste2dc80/apnea-del-sueno?type=presentation" title="apnea del sueno">apnea del sueno</a><object style="margin:0px" width="425" height="355"><param name="movie" value="http://static.slidesharecdn.com/swf/ssplayer2.swf?doc=coisapneapresentacion-090512170346-phpapp02&stripped_title=apnea-del-sueno"></param><param name="allowFullScreen" value="true"></param><param name="allowScriptAccess" value="never"></param><embed src="http://static.slidesharecdn.com/swf/ssplayer2.swf?doc=coisapneapresentacion-090512170346-phpapp02&stripped_title=apnea-del-sueno" type="application/x-shockwave-flash" allowscriptaccess="never" width="425" height="355"></embed></object>
<div style="font-size:11px;font-family:tahoma,arial;height:26px;padding-top:2px;">View more <a style="text-decoration:underline;" href="http://www.slideshare.net/">presentations</a> from <a style="text-decoration:underline;" href="http://www.slideshare.net/gueste2dc80">gueste2dc80</a>.</div>
</div>History of RPSGTstag:www.sleepguide.com,2009-05-03:2549090:BlogPost:229302009-05-03T18:58:11.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Re-posting this history of Registered Polysomnographic Technologists (RPSGTs) from a Discussion started by Dave Hargett, who is a member of the Board of Directors of the BRPT:<br />
<br />
"Peter McGregor is RPSGT registry number 1, from June 1979. This year the BRPT (Board of Registered Polysomnographic Technologists) celebrates it's 30th birthday as the credentialing agency for the RPSGT credential. In that 30 years there have been about 14,000 persons who have become RPSGTs.<br />
<br />
My understanding is that…
Re-posting this history of Registered Polysomnographic Technologists (RPSGTs) from a Discussion started by Dave Hargett, who is a member of the Board of Directors of the BRPT:<br />
<br />
"Peter McGregor is RPSGT registry number 1, from June 1979. This year the BRPT (Board of Registered Polysomnographic Technologists) celebrates it's 30th birthday as the credentialing agency for the RPSGT credential. In that 30 years there have been about 14,000 persons who have become RPSGTs.<br />
<br />
My understanding is that the Stanford Sleep Disorders Center was the first sleep center in the US, and it was started around 1971 or 1972 (that's from memory - I didn't fact check!) The sleep research that went on in the 50's was done often by the sleep researchers themselves as they developed the techniques for studying sleep.<br />
<br />
The American Association of Sleep Technologists (now the AAST, but formerly known as the APT (Association of Polysomnographic Technologists)) was formally founded in 1981 with a small group of 20 technologists. It now has about 4300 active members (although it is not a requirement to join the AAST if you practice in sleep medicine).<br />
<br />
That's my quick response to the numbers. Over the years, as I've attended annual sleep meetings since 1996 to represent the American Sleep Apnea Association and through my volunteer efforts working with A.W.A.K.E. support groups, I've met and gotten to know a great many sleep technologists. I now serve on the Board of Directors of the BRPT, representing the "public".<br />
<br />
So, the field of "sleep tech" is actually older than CPAP (1981) or oral appliances or even the UPPP surgery.<br />
<br />
I'm sure you will have a few sleep techs on the site chime in later, but that's my understanding of the two main organizations related to the field and the timing of their founding."Didgeridoo for Sleep Apneatag:www.sleepguide.com,2009-04-07:2549090:BlogPost:162572009-04-07T05:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Can playing a musical instrument, the Didgeridoo, help treat Sleep Apnea? Sounds like a gimmick, but there's actually some credible scientific evidence showing exactly that. The Didgeridoo appears to strengthen muscles in the airway, reducing the likelihood of their collapse and obstruction. For some serious scientific evidence on the effectiveness of the Didgeridoo in the treatment of Sleep Apnea, check out <a href="http://www.ncbi.nlm.nih.gov/pubmed/16377643?dopt=abstractplus">PubMed and the…</a>
Can playing a musical instrument, the Didgeridoo, help treat Sleep Apnea? Sounds like a gimmick, but there's actually some credible scientific evidence showing exactly that. The Didgeridoo appears to strengthen muscles in the airway, reducing the likelihood of their collapse and obstruction. For some serious scientific evidence on the effectiveness of the Didgeridoo in the treatment of Sleep Apnea, check out <a href="http://www.ncbi.nlm.nih.gov/pubmed/16377643?dopt=abstractplus">PubMed and the Didgeridoo</a>, <a href="http://www.bmj.com/cgi/content/full/332/7536/0-a">The British Medical Journal and the Didgeridoo</a> and <a href="http://www.sciencedaily.com/releases/2005/12/051224094017.htm">Science Daily and the Didgeridoo</a><br />
<br />
The video below on Sleep Apnea and the Didgeridoo is also instructive.<br />
<br />
<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/qxDYY3xWnIg&hl=en&fs=1&rel=0"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="never"></param><embed src="http://www.youtube.com/v/qxDYY3xWnIg&hl=en&fs=1&rel=0" type="application/x-shockwave-flash" allowscriptaccess="never" width="425" height="344"></embed></object>What is Sleep Apnea?tag:www.sleepguide.com,2009-03-17:2549090:BlogPost:120712009-03-17T08:13:40.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<b>What Is Sleep Apnea?</b><br />
<br />
Here's a simple response to the question of what is sleep apnea: sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.<br />
<br />
Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.<br />
<br />
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. You…
<b>What Is Sleep Apnea?</b><br />
<br />
Here's a simple response to the question of what is sleep apnea: sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.<br />
<br />
Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.<br />
<br />
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. You often move out of deep sleep and into light sleep when your breathing pauses or becomes shallow.<br />
<br />
This results in poor sleep quality that makes you tired during the day. Sleep apnea is one of the leading causes of excessive daytime sleepiness.<br />
<br />
<b>Overview</b><br />
<br />
Sleep apnea often goes undiagnosed. Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member and/or bed partner may first notice the signs of sleep apnea.<br />
<br />
The most common type of sleep apnea is obstructive sleep apnea. This most often means that the airway has collapsed or is blocked during sleep. The blockage may cause shallow breathing or breathing pauses.<br />
<br />
When you try to breathe, any air that squeezes past the blockage can cause loud snoring.<br />
<br />
Central sleep apnea is a less common type of sleep apnea. It happens when the area of your brain that controls your breathing doesn't send the correct signals to your breathing muscles. You make no effort to breathe for brief periods.<br />
<br />
Central sleep apnea often occurs with obstructive sleep apnea, but it can occur alone. Snoring doesn't typically happen with central sleep apnea.<br />
<br />
<b>Outlook</b><br />
<br />
Untreated, sleep apnea can:<br />
<br />
* Increase the risk for high blood pressure, heart attack, stroke, obesity, and diabetes<br />
* Increase the risk for or worsen heart failure<br />
* Make irregular heartbeats more likely<br />
* Increase the chance of having work-related or driving accidents and/or cause sexual dysfunction<br />
<br />
CPAP machines, sleep apnea dental devices and sleep apnea surgery are all treatments for sleep apnea.HIPAA Privacy Rule Must Dietag:www.sleepguide.com,2009-03-15:2549090:BlogPost:117792009-03-15T20:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<b>The Problem</b><br />
The HIPAA Privacy Rule must die. Since its inception in 2003, the HIPAA Privacy Rule has been invoked by health care providers not to protect us patients as Congress originally intended, but rather as a crutch for health care providers to fall back on when they have an interest, be it laziness, financial, incompetence or whatever, in making it more difficult for patients to gain control over our own health care decisions.<br />
<br />
<b>A Personal Anecdote</b><br />
The absolute absurdity of…
<b>The Problem</b><br />
The HIPAA Privacy Rule must die. Since its inception in 2003, the HIPAA Privacy Rule has been invoked by health care providers not to protect us patients as Congress originally intended, but rather as a crutch for health care providers to fall back on when they have an interest, be it laziness, financial, incompetence or whatever, in making it more difficult for patients to gain control over our own health care decisions.<br />
<br />
<b>A Personal Anecdote</b><br />
The absolute absurdity of this law was brought home to me recently when visiting a friend in the hospital who had suffered from a debilitating stroke. My friend Laura was uninsured at the time of the stroke and wanted my help when the public hospital she was at abruptly decided to discharge her without any notice or treatment plan. The hospital administrator in charge of Laura's case refused to speak to me, citing HIPAA. This despite the fact that my friend Laura was literally seated in her wheelchair beside me as I broached the topic of Laura's health. Fortunately, I am an Ivy-League educated attorney who happens to know a thing or two about HIPAA. "Laura," I then asked, "do you make me your agent to discuss every aspect of your health, without limitation, with any and all agents or representatives of this hospital?" She responded that she did. The hospital administrator was then trapped, and reluctantly began to talk to me.<br />
<br />
<b>The Legislation Itself</b><br />
But should we really need a lawyer beside us to access our own health records? The drafters of HIPAA certainly didn't think so. Which is why if you check the applicable law, 45 CFR 164.502, <u><i>one of the very first things is makes crystal clear is that although this is a privacy law, it is of course not to be used against the very individual whose privacy it is meant to protect:<br />
<br />
Sec. 164.502 Uses and disclosures of protected health information: general rules.<br />
<br />
(a) Standard. A covered entity may not use or disclose protected<br />
health information, except as permitted or required by this subpart or<br />
by subpart C of part 160 of this subchapter.<br />
(1) Permitted uses and disclosures. A covered entity is permitted to<br />
use or disclose protected health information as follows:<br />
(i) To the individual;</i></u><br />
<br />
<b>Purpose of the HIPAA Privacy Rule</b><br />
The HIPAA Privacy Rule is there to protect us patients from others who would do evil, nefarious things with our health care information. As the U.S. Department of Health and Human Services states on its website: "without the Privacy Rule patient information held by a health plan could, without the patient’s permission, be passed on to a lender who could then deny the patient's application for a home mortgage or a credit card, or to an employer who could use it in personnel decisions."<br />
<br />
<b>Conclusion</b><br />
Ask yourself this: what are you more worried about: being denied for a mortgage on account of health information leaking out somehow to the bank underwriting your mortgage, or spending hours and days on the phone with your doctors' receptionists and administrators trying to figure out what is going on with your health so that you can make an informed decision about the next step? I know where I stand on the answer to that question. And that's why I repeat: the HIPAA Privacy Rule must die.Old Sleep Apnea Suppliestag:www.sleepguide.com,2009-03-09:2549090:BlogPost:11432009-03-09T07:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417674?profile=original" target="_blank"><img alt="" height="274" src="http://storage.ning.com/topology/rest/1.0/file/get/73417674?profile=RESIZE_320x320" style="float: left;" width="300"></img></a> Unlike a fine wine, CPAP supplies don't get better with age. In fact, they tend to deteriorate and become less effective over time, and be replaced by ever more comfortable and innovative CPAP technologies. So we're often taken aback to hear that someone's been using the same mask for years, not having even replaced the cushions. Ditto for the machines…
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417674?profile=original" target="_blank"><img width="300" src="http://storage.ning.com/topology/rest/1.0/file/get/73417674?profile=RESIZE_320x320" alt="" width="300" height="274" style="float: left;"/></a>Unlike a fine wine, CPAP supplies don't get better with age. In fact, they tend to deteriorate and become less effective over time, and be replaced by ever more comfortable and innovative CPAP technologies. So we're often taken aback to hear that someone's been using the same mask for years, not having even replaced the cushions. Ditto for the machines themselves. If you haven't replaced your machine in years, you're working with outdated technology and probably could breathe a lot easier at night were you to update to something fresh. Now, we certainly understand that this stuff isn't cheap -- especially when you go through your brick and mortar local medical equipment supplier. But dd you know that Medicare and almost all insurers will pay for replacement equipment on a regular, fairly generous replacement schedule? It's true. They'll often pay out on the following replacement schedule:<br />
<br />
Mask -- 1 every 3 months<br />
Mask cushions -- 2 per month<br />
Tubing -- 1 every 3 months<br />
Disposable Filters -- 2 per month<br />
Humidifier Chamber -- 1 every 6 months<br />
Machine -- 1 every 5 years<br />
<br />
Beats me why people aren't told more about this up-front. Perhaps the insurance companies are trying to keep it on the down-low to keep costs down. But that's shortsighted, because these guidelines are there for a reason -- because this stuff degrades over time and becomes ineffective. If people replaced them regularly, they'd have more success getting well with Sleep Apnea and be less likely to cost the insurance companies tons more money with the really bad, costly stuff like Heart Attack, Stroke, Diabetes, and more...<br />
<br />
So if your CPAP equipment is older than your cell phone or computer, chances are there's a problem. Talk to your doctor or DME about replacements.Moderate Sleep Apneatag:www.sleepguide.com,2009-03-01:2549090:BlogPost:102612009-03-01T22:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<p>Having Moderate Sleep Apnea is like having had a moderate heart attack: while better than "Severe," it's still dead serious. Mistakenly, my first reaction when getting the diagnosis of Moderate Sleep Apnea was relief. "Well, at least I'm not too far gone," I thought, as I let my guard down and didn't get serious about my Sleep Apnea treatment.<br></br> <br></br> Then I did some research and found out what Moderate Sleep Apnea means.<br></br> <img alt="" height="123" src="http://storage.ning.com/topology/rest/1.0/file/get/73418033?profile=RESIZE_180x180" style="float: right;" width="150"></img> <br></br> The American Academy of Sleep Medicine (AASM)…</p>
<p>Having Moderate Sleep Apnea is like having had a moderate heart attack: while better than "Severe," it's still dead serious. Mistakenly, my first reaction when getting the diagnosis of Moderate Sleep Apnea was relief. "Well, at least I'm not too far gone," I thought, as I let my guard down and didn't get serious about my Sleep Apnea treatment.<br/> <br/> Then I did some research and found out what Moderate Sleep Apnea means.<br/> <img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73418033?profile=RESIZE_180x180" alt="" style="float: right;" height="123" width="150"/><br/> The American Academy of Sleep Medicine (AASM) defines Moderate Sleep Apnea as having an AHI of greater than 15 but less than 30. AHI, in turn, stands for "Apnea-Hypopnea Index," and is a measure of the total number of times you stop breathing or have shallow breathing during sleep divided by the total number of hours you were asleep. For an an episode of interrupted breathing or shallow breathing to count as a true event, it must last 10 seconds or longer. The bottom line: a "moderate" case of Sleep Apnea means a person stops breathing or has dangerously shallow breathing for more than 10 seconds at a time, on average, 15 to 30 times PER HOUR! Certainly not something to be taken lightly, as this magnitude of Sleep Apnea will usually adversely impact daytime functioning and cardiovascular health.<br/> <br/> An AHI of greater than 5 but less than 15 is deemed "mild" sleep apnea; an AHI of greater than 30 indicates "severe" sleep apnea.<br/> <br/> If you don't know what your AHI is, find out. Your life might depend on it.</p>
<p>Do you still have questions about Moderate Sleep Apnea? Post your questions here and we will answer them as best we can: <a href="http://www.sleepguide.com/forum/topic/new">http://www.sleepguide.com/forum/topic/new</a></p>Blasting the Sleep Apnea Stereotypetag:www.sleepguide.com,2009-02-25:2549090:BlogPost:96372009-02-25T00:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73418084?profile=original" target="_blank"><img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73418084?profile=RESIZE_180x180" style="float: left;" width="94"></img></a> Awareness is not yet widespread that Sleep Apnea is a disorder that doesn't just touch the lives of overweight, middle-aged men. But Sleep Apnea doesn't discriminate. Take James Simmons. He's 6 feet 3 inches tall, weighs 190 pounds and is only 23 years old. He's a top prospect to pitch in the Major Leagues for the Oakland A's, and can throw a 90 mph fastball. The…
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73418084?profile=original" target="_blank"><img width="94" src="http://storage.ning.com/topology/rest/1.0/file/get/73418084?profile=RESIZE_180x180" alt="" width="94" height="150" style="float: left;"/></a>Awareness is not yet widespread that Sleep Apnea is a disorder that doesn't just touch the lives of overweight, middle-aged men. But Sleep Apnea doesn't discriminate. Take James Simmons. He's 6 feet 3 inches tall, weighs 190 pounds and is only 23 years old. He's a top prospect to pitch in the Major Leagues for the Oakland A's, and can throw a 90 mph fastball. The kicker? He has Sleep Apnea. Last season he became so fatigued that the A's flew him into the Bay Area for a sleep study. Simmons was diagnosed with Sleep Apnea. Over the winter, he had Sleep Apnea surgery.<br />
<br />
"Now I wake up in the morning and I feel like I actually slept," Simmons said. "I notice it more when I'm running and when I work out. I feel like I can get through workouts a lot better."<br />
<br />
Although many of us are in fact overweight, male and middle-aged, the stereotype is far too common and blithely bought into by physicians, the media and lay persons alike, much to the disservice of all those who will not be properly diagnosed with Sleep Apnea because they don't fit the stereotype.<br />
<br />
So if you find out about any other celebrities who have Sleep Apnea but who don't fit the stereotype, or you yourself don't fit the mold, speak out and let us know. Maybe even post your picture to drive the point home. Together, we can raise awareness of the many different faces of Sleep Apnea.Apnea Diagnosistag:www.sleepguide.com,2009-02-24:2549090:BlogPost:95872009-02-24T03:23:10.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
New scientific research indicates that an individual's anatomy might be critical in an apnea diagnosis. Researchers at the prestigious Seoul National University College of Medicine in South Korea have concluded that people with obstructive sleep apnea have soft palates that are more elongated and angled than those of people without the condition. The finding was made using sleep videofluoroscopy (a combination of X-ray images and video recording).<br />
<br />
"Sleep videofluoroscopy quantitatively showed…
New scientific research indicates that an individual's anatomy might be critical in an apnea diagnosis. Researchers at the prestigious Seoul National University College of Medicine in South Korea have concluded that people with obstructive sleep apnea have soft palates that are more elongated and angled than those of people without the condition. The finding was made using sleep videofluoroscopy (a combination of X-ray images and video recording).<br />
<br />
"Sleep videofluoroscopy quantitatively showed that the soft palate was considerably elongated and angulated in patients with obstructive sleep apnea even in an awake state," wrote Dr. Chul Hee Lee and colleagues in a news release. "It is an easy way to measure the soft palate changes and may be a useful technique to differentiate obstructive sleep apnea from simple snoring with short examination time."<br />
<br />
The finding will also inform whether a particular patient might respond favorably to a surgical approach to obstructive sleep apnea. A full copy of the study is published in the February issue of the journal <i>Archives of Otolaryngology -- Head & Neck Surgery</i>.Sleep Apnea Cure?tag:www.sleepguide.com,2009-02-22:2549090:BlogPost:93662009-02-22T21:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="99" src="http://storage.ning.com/topology/rest/1.0/file/get/73418178?profile=RESIZE_180x180" style="float: left;" width="150"></img> Is it possible that a pill will turn out to be a Sleep Apnea cure? Hard to fathom, but that's exactly what Cortex Pharaceuticals, Inc. of Irvine, Calif. has its sights set on with its new AMPAKINE CX1739 drug compound. Cortex says that animal studies have demonstrated that the AMPAKINE compound can stimulate the regions of the brain responsible for regulating breathing and muscle tone in the upper airway. The notion is that an increase in breathing and an improvement in upper airway…
<img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73418178?profile=RESIZE_180x180" alt="" width="150" height="99" style="float: left;"/>Is it possible that a pill will turn out to be a Sleep Apnea cure? Hard to fathom, but that's exactly what Cortex Pharaceuticals, Inc. of Irvine, Calif. has its sights set on with its new AMPAKINE CX1739 drug compound. Cortex says that animal studies have demonstrated that the AMPAKINE compound can stimulate the regions of the brain responsible for regulating breathing and muscle tone in the upper airway. The notion is that an increase in breathing and an improvement in upper airway muscle tone would reduce or eliminate apnea and hypopnea events.<br />
<br />
In a huge win for the company, in January the UK's equivalent of the FDA gave Cortex permission to move forward with the clinical development of CX1739 in subjects with moderate to severe sleep apnea. The study will be conducted in a UK sleep lab, and will be double-blind and placebo-controlled with 20 participants.<br />
<br />
Are the days of CPAP use numbered? Perhaps so. But I'm not holding my breath (pun intended).Sleep Studiestag:www.sleepguide.com,2009-02-20:2549090:BlogPost:91872009-02-20T21:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
In a recent <a href="http://www.sleepguide.com/profiles/blogs/sleep-study">Sleep Study</a> article, I wrote from a personal experience about the difficulty many people have coming to grips with a diagnosis of Sleep Apnea. A member of this forum then started a discussion about <a href="http://www.sleepguide.com/forum/topics/interest-in-home-testing-poll">sleep studies</a>, and about the prospect of a home sleep test conducted with the assistance and oversight of a registered respiratory…
In a recent <a href="http://www.sleepguide.com/profiles/blogs/sleep-study">Sleep Study</a> article, I wrote from a personal experience about the difficulty many people have coming to grips with a diagnosis of Sleep Apnea. A member of this forum then started a discussion about <a href="http://www.sleepguide.com/forum/topics/interest-in-home-testing-poll">sleep studies</a>, and about the prospect of a home sleep test conducted with the assistance and oversight of a registered respiratory therapist, or some other qualified professional. I brought it to the attention of my wife, and lo and behold, she's now 100% behind the idea of a "do-over" sleep study to confirm or deny that she has Sleep Apnea. If my wife can be convinced to undergo this type of test, anyone can. This may very well be the future of Sleep Apnea diagnosis.Sleep Studytag:www.sleepguide.com,2009-02-19:2549090:BlogPost:90032009-02-19T03:56:35.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
My wife's Sleep Study confirmed what I had suspected all along: my wife has Sleep Apnea. What I didn't bargain for is that this Sleep Study has landed me squarely within the four corners of the proverbial dog house. Here's why:<br />
<br />
My wife has snored all night, every night since I've met her. It's so bad that I wear Macks earplugs just so I can get to sleep with all the ruckus. She's seen me go through all the stations of Sleep Apnea: the sleep study, the titration, the missteps, and the…
My wife's Sleep Study confirmed what I had suspected all along: my wife has Sleep Apnea. What I didn't bargain for is that this Sleep Study has landed me squarely within the four corners of the proverbial dog house. Here's why:<br />
<br />
My wife has snored all night, every night since I've met her. It's so bad that I wear Macks earplugs just so I can get to sleep with all the ruckus. She's seen me go through all the stations of Sleep Apnea: the sleep study, the titration, the missteps, and the successes, and knows how much it has improved my quality of life, and how important it is to my health. Knowing all this, one would think she would be eager to evaluate whether her own snoring was a symptom of Sleep Apnea. One might think that, but in my wife's case, one would be wrong. She's delayed and denied and refused to go in for a Sleep Study, despite my suggestions that it would be good for her to do so. Until yesterday. Yesterday Stanford Sleep Clinic opened the doors to its spanking new, very appealing new Sleep Clinic. It is the Four Seasons to the Motel Six I myself was tested at. We knew that this "Four Star" hotel-like clinic would open its doors to the public on February 17th, which is the reason my wife reluctantly agreed to have the Sleep Study done. But once she was admitted to the sleep lab, she became strangely hostile, complaining bitterly to me and the poor lab technician about every aspect of the process.<br />
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When the Sleep Study was over and I picked her up at the clinic, I thought the worst had passed. I was wrong: she was convinced she hadn't slept well during the test and that it had failed, and persuaded the doctor at the clinic to give her a call later in the day to confirm or deny her suspicion. When the doctor called this afternoon, he told her that they weren't finished scoring the test, but that they had enough data, and that she probably has a moderate case of Sleep Apnea, with an RDI of between twenty and thirty.<br />
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"I don't buy it," she snapped at me as soon as she hung up with the doctor. "That test sets you up for failure. How can you judge the quality of my sleep based on the worst night of sleep of my life? It's a B.S. test, and I don't believe in the test results at all."<br />
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She knows I do believe in the test results, and that she has a bona fide case of OSA, which sets me up as the bad guy. I write this article not to vent about my personal life, but because I think this dynamic is very common, although usually reversed: a wife getting tired of her husband's snoring, and encouraging him to get a Sleep Test, then when he gets diagnosed with OSA, denial and refusal to do anything about it.<br />
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If anyone has any advice, I'd like to hear it. It would help not only me, but I'm sure a lot of other people out there in the same boat.Sleep Apnea Depressiontag:www.sleepguide.com,2009-02-17:2549090:BlogPost:87862009-02-17T20:04:48.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73418172?profile=RESIZE_180x180" style="float: left;" width="117"></img> <b>Sleep Apnea Depression.</b> If you're asking which one it is, sleep apnea or depression, you're in good company: unfortunately, primary care physicians, psychiatrists, psychologists and patients often confuse sleep apnea and depression. Understandably so. Loss of energy, loss of interest in once enjoyable things, difficulty concentrating and fatigue are common symptoms of depression. But they are also common symptoms of sleep apnea, and new research is continually emerging to show…
<img width="117" src="http://storage.ning.com/topology/rest/1.0/file/get/73418172?profile=RESIZE_180x180" alt="" width="117" height="150" style="float: left;"/><b>Sleep Apnea Depression.</b> If you're asking which one it is, sleep apnea or depression, you're in good company: unfortunately, primary care physicians, psychiatrists, psychologists and patients often confuse sleep apnea and depression. Understandably so. Loss of energy, loss of interest in once enjoyable things, difficulty concentrating and fatigue are common symptoms of depression. But they are also common symptoms of sleep apnea, and new research is continually emerging to show the connection between the two. An article published in the September 2005 issue of the journal Chest concluded that many patients with depression symptoms improved markedly when treated with CPAP. The study showed that of those being treated with CPAP, 40 of the 41 participants taking antidepressants and those not taking them showed decreases in their depression scores.<br />
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But if you're relying solely on the opinion of your psychiatrist to treat your depression, a referral to a sleep physician is not likely. Why? Pharmaceutical companies spend tens of millions of dollars in advertising each year to convince psychiatrists and the general public that antidepressants are the way to treat depression. What about when antidepressants don't work? MORE antidepressants! The pharmaceuticals have created a new category of antidepressants which they call "Add-On" antidepressants. By its own admission, one pharmaceutical company that puts out the "Add-On" medication Abilify (aripiprazole) acknowledges that "studies show that approximately two-thirds of those diagnosed with depression did not achieve adequate symptom relief after taking an antidepressant alone."<br />
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The bottom line is that if you suffer from depression, and have one or more of the signs of sleep apnea, such as snoring, you'd do yourself a favor by getting evaluated by a sleep physician and not just a psychiatrist. I can tell you from personal experience that this is a good idea. I did it and it changed my life.Sleep Apnea and President Teddy Roosevelttag:www.sleepguide.com,2009-02-16:2549090:BlogPost:86622009-02-16T23:39:12.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417861?profile=RESIZE_180x180" style="float: left;" width="113"></img> On President's Day, our thoughts naturally turn to those who have held the nation's highest office. Teddy Roosevelt, the 26th President of the United States, likely had Sleep Apnea. The reason? In 1912, there was an assassination attempt on his life which left him hospitalized for a week in Milwaukee, where the assassination attempt took place. The hospital reported that his snoring was so loud and erratic that other patients on his floor complained that they couldn't sleep and were…
<img width="113" src="http://storage.ning.com/topology/rest/1.0/file/get/73417861?profile=RESIZE_180x180" alt="" width="113" height="150" style="float: left;"/>On President's Day, our thoughts naturally turn to those who have held the nation's highest office. Teddy Roosevelt, the 26th President of the United States, likely had Sleep Apnea. The reason? In 1912, there was an assassination attempt on his life which left him hospitalized for a week in Milwaukee, where the assassination attempt took place. The hospital reported that his snoring was so loud and erratic that other patients on his floor complained that they couldn't sleep and were moved away from his room.<br />
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Roosevelt also died in his sleep of a coronary embolism, an event that untreated Sleep Apnea could have contributed to.COBRA and the Stimulus Billtag:www.sleepguide.com,2009-02-15:2549090:BlogPost:85342009-02-15T21:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417794?profile=RESIZE_180x180" style="float: left;" width="119"></img> On Tuesday, President Obama is expected to sign into law the Stimulus Bill that Congress approved last week. The 1,000 page bill is complex and multifaceted, but for the members of SleepGuide.com, I wanted to highlight that it contains a provision that may help some of our members get diagnosed and treated for Sleep Apnea. Basically, for those who are laid off from their jobs between September 1, 2008 and December 31, 2009, the federal government will pay 65 percent of your COBRA…
<img width="119" src="http://storage.ning.com/topology/rest/1.0/file/get/73417794?profile=RESIZE_180x180" alt="" width="119" height="150" style="float: left;"/>On Tuesday, President Obama is expected to sign into law the Stimulus Bill that Congress approved last week. The 1,000 page bill is complex and multifaceted, but for the members of SleepGuide.com, I wanted to highlight that it contains a provision that may help some of our members get diagnosed and treated for Sleep Apnea. Basically, for those who are laid off from their jobs between September 1, 2008 and December 31, 2009, the federal government will pay 65 percent of your COBRA premiums for up to nine months. Also, anyone who was laid off since September who had initially declined COBRA, but in light of the new rule making would like to elect it, will have an additional 60 day period to elect it. The subsidy isn't available to workers whose income in the year they would receive it exceeds $125,000 for individuals and $250,000 for families.<br />
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The average family's COBRA premium is about $1,000 a month without the subsidy; with the subsidy it would be reduced to $350 a month.<br />
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Something to consider as you make choices about how and whether to do something about your Sleep Apnea in light of current economic circumstances. . .Nocturia and Sleep Apneatag:www.sleepguide.com,2009-02-14:2549090:BlogPost:84202009-02-14T20:22:17.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Reprinted from a discussion on <a href="http://www.sleepguide.com/forum/topics/do-you-have-to-go-a-lot">nocturia</a> posted by Steven Park, M.D., a featured member.<br />
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If you’re one of the millions of men and women who have to go the the bathroom far too often, or have embarrassing leaks of urine once in a while, here’s some important information that you should know. The New York Times (Feb. 3) reported on an article from the New England Journal of Medicine which revealed that postmenopausal…
Reprinted from a discussion on <a href="http://www.sleepguide.com/forum/topics/do-you-have-to-go-a-lot">nocturia</a> posted by Steven Park, M.D., a featured member.<br />
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If you’re one of the millions of men and women who have to go the the bathroom far too often, or have embarrassing leaks of urine once in a while, here’s some important information that you should know. The New York Times (Feb. 3) reported on an article from the New England Journal of Medicine which revealed that postmenopausal women with urinary incontinence issues had significant improvement after losing weight. They also benefitted in other areas such as improvements in their blood pressure, lipids, sleep and libido.<br />
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Another article in this month’s Journal SLEEP reported that OSA is associated with overactive bladder in men with or without urinary incontinence. The worse the severity of OSA, the worse the level of urinary problems. Not too surprisingly, nocturia (getting up at night to go to the bathroom frequently at night) is a known complication of obstructive sleep apnea.<br />
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Most people with these issues end up seeing a urologist initially and are placed on various medications that work to various degrees. However, a recent study suggests why you should see a sleep doctor instead—people who wake up in the middle of the night to go to the bathroom do so not because their bladders were full, but rather because they stopped breathing and then realized that they had a full bladder. OSA has also been shown to increase atrial natriuretic peptide (ANP), which is produced by the heart when it gets too much blood due to the sudden rush of blood after a lack of blood flow during an apnea episode. ANP causes you to make more urine to get rid of the excess fluid.<br />
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Something new to think about for all our senior citizens (and young adults too).Celebrity CPAP Users: Andy Richtertag:www.sleepguide.com,2009-02-14:2549090:BlogPost:83612009-02-14T04:21:42.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Andy Richter made an appearance recently on Late Night with Conan O'Brien sporting the celebrity's CPAP mask, which appears to be the Respironics Comfort Fusion Nasal Mask. Looks like Conan is laughing at him, but Conan's brand of humor is generally good-natured, so I'm sure this raised awareness of OSA in a good way.<img src="http://storage.ning.com/topology/rest/1.0/file/get/73417785?profile=original" alt="" width="597" height="333" style="float: left;"/>
Andy Richter made an appearance recently on Late Night with Conan O'Brien sporting the celebrity's CPAP mask, which appears to be the Respironics Comfort Fusion Nasal Mask. Looks like Conan is laughing at him, but Conan's brand of humor is generally good-natured, so I'm sure this raised awareness of OSA in a good way.<img src="http://storage.ning.com/topology/rest/1.0/file/get/73417785?profile=original" alt="" width="597" height="333" style="float: left;"/>Sleep Apnea and Shametag:www.sleepguide.com,2009-02-12:2549090:BlogPost:81802009-02-12T20:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417867?profile=RESIZE_180x180" style="float: left;" width="117"></img> Are we ashamed of having Sleep Apnea? I know the answer for myself is a resounding "no." But for others, it's not so simple. To my way of thinking, Sleep Apnea is a common disorder to which no stigma is attached. Sure, sleeping with a hose attached to a breathing machine every night is inconvenient, but I don't feel as if it's something I need to hide. But for my friend Peter (name changed for sake of anonymity), it's a black mark that he feels compelled to hide from others. When he…
<img width="117" src="http://storage.ning.com/topology/rest/1.0/file/get/73417867?profile=RESIZE_180x180" alt="" width="117" height="150" style="float: left;"/>Are we ashamed of having Sleep Apnea? I know the answer for myself is a resounding "no." But for others, it's not so simple. To my way of thinking, Sleep Apnea is a common disorder to which no stigma is attached. Sure, sleeping with a hose attached to a breathing machine every night is inconvenient, but I don't feel as if it's something I need to hide. But for my friend Peter (name changed for sake of anonymity), it's a black mark that he feels compelled to hide from others. When he wakes up in the morning, he takes care to stash the machine, mask and other apparatus out of the view of anyone who might visit his home. When he travels, he will insist on staying in a room alone, even though others are pairing up and sleeping in the same hotel room. And if he has a lady friend over to spend the night, he most certainly will not sleep with the machine that night. In fact, he would keep it from a significant other for weeks, maybe months, until he felt extremely close with her.<br />
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Now, I'm married and he's single. I live in the 'burbs and he lives in the city. Perhaps these lifestyle differences account for some of the gap between how we feel about our Sleep Apnea. Until I meet someone with Sleep Apnea who's married and also feels that having the disorder is a stigma, this is the only hypothesis I have. . .Insomnia and Sleep Apneatag:www.sleepguide.com,2009-02-11:2549090:BlogPost:79822009-02-11T19:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<b><i>Contributed by Dr. Steven Park, a featured member of SleepGuide.com:</i></b> <a href="http://www.sleepguide.com/forum/topics/is-insomnia-really-a">http://www.sleepguide.com/forum/topics/is-insomnia-really-a</a><br />
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Sleep doctors have always thought of insomnia as a behavioral or stress aggravated issue, and the standard ways of treating this all-too-common condition is to either give sleeping pills or have the patient undergo cognitive behavioral therapy. However, a recent study directed by…
<b><i>Contributed by Dr. Steven Park, a featured member of SleepGuide.com:</i></b> <a href="http://www.sleepguide.com/forum/topics/is-insomnia-really-a">http://www.sleepguide.com/forum/topics/is-insomnia-really-a</a><br />
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Sleep doctors have always thought of insomnia as a behavioral or stress aggravated issue, and the standard ways of treating this all-too-common condition is to either give sleeping pills or have the patient undergo cognitive behavioral therapy. However, a recent study directed by Dr. Barry Krakow at the Sleep and Human Health Institute is looking at the possibility that insomnia may actually be caused by a sleep-breathing problem, such as obstructive sleep apnea.<br />
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If you’ve read my book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired, I stated my opinion that in my experience, almost all people with insomnia have narrowed upper air passageways, especially behind the tongue. Some will have undiagnosed sleep apnea, but many will have instead something called upper airway resistance syndrome. This is a variation or precursor to sleep apnea where the length of time of each breathing pause is not long enough to be called an apnea. Because of the multiple pauses in breathing in deep sleep, a low-grade stress response is created which causes the insomniac’s mind to race or think about stress-related issues before going to bed. Their nervous systems are edgy and en garde all the time. No wonder it’s hard to fall asleep, especially if you’ve had a stressful day.<br />
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I’ve also experienced multiple instances where treating an underlying sleep-breathing problem also significantly improves insomnia symptoms as well.<br />
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You may be asking by now, "why do sleeping pills or cognitive behavioral therapy work?" The older type sleep aids were generally tranquilizers and only helped to numb the nervous system so that you can fall asleep faster. But these medications did nothing to prevent the sleep-breathing pauses. The newer medications don’t have as much of the sedating properties, but it’s very controversial that they even make any significant difference. Although industry supported studies find significant improvements in sleep scores using sleeping pills, non-industry supported studies show that these same sleeping pills only increase total sleep time by only 5-10 minutes.<br />
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Cognitive behavioral therapy (CBT) is another underused option that has been shown to work much better than sleeping pills in general. CBT works by re-programming your thinking and behavior about sleep to promote good sleep hygiene and habits.<br />
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CBT will work to some degree even if you have an underlying sleep-breathing problem because you’re addressing the physiologic stress-aggravting end result of the breathing problems that occur during sleep. Multiple micro-arousals from deep sleep to light sleep due to tongue muscle relaxation can definitely aggravate stress and anxiety problems.<br />
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This process also confirms other recent findings that report increased rates of depression and heart disease later in life in people with insomnia earlier on in life.<br />
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The main purpose of Dr. Krakow’s study tries to determine what percent of insomniacs have undiagnosed obstructive sleep apnea. Although not part of the study, it would be interesting to perform upper airway endoscopic exams like what I describe, to confirm what I describe in this post.<br />
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Here’s my question to all insomniacs: Do you prefer to sleep on your back, side or stomach? If you prefer your side or stomach, there’s your answer.Sleep Apnea and Diabetestag:www.sleepguide.com,2009-02-08:2549090:BlogPost:74912009-02-08T02:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417782?profile=RESIZE_180x180" style="float: right;" width="105"></img> The connection between Sleep Apnea and Diabetes is real and scary. Studies published in the European Respiratory Journal and Journal of Internal Medicine tell us that up to 40% of people with Sleep Apnea will have Diabetes. Other studies show that up to 50% of those with type 2 Diabetes have Sleep Apnea. Essentially, Sleep Apnea causes intermittent shortages of oxygen in the body and fragmentation of sleep, which in turn causes physiologic stress which then wreaks havok on glucose…
<img width="105" src="http://storage.ning.com/topology/rest/1.0/file/get/73417782?profile=RESIZE_180x180" alt="" width="105" height="150" style="float: right;"/>The connection between Sleep Apnea and Diabetes is real and scary. Studies published in the European Respiratory Journal and Journal of Internal Medicine tell us that up to 40% of people with Sleep Apnea will have Diabetes. Other studies show that up to 50% of those with type 2 Diabetes have Sleep Apnea. Essentially, Sleep Apnea causes intermittent shortages of oxygen in the body and fragmentation of sleep, which in turn causes physiologic stress which then wreaks havok on glucose metabolism and the development of insulin resistance.<br/>
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I myself have recently been diagnosed with elevated fasting blood glucose levels, also known as pre-diabetes. Fortunately, CPAP can help. According to recent studies, after seven weeks of CPAP therapy, blood glucose levels in diabetic patients fall, on average, 20 mg/dl.<br/>
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If you haven't done so already, and you have Sleep Apnea, you should get your fasting blood glucose levels checked ASAP to determine whether the unfriendly hand of Diabetes has touched you yet. Screening tests are inexpensive and easy to conduct, and should be part of your routine physical examination.<br/>
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Stay tuned -- the research on Diabetes and Sleep Apnea is in its infancy and much more will be revealed and understood over time.<br />
<a href="http://partners.pantheranetwork.com/z/12661/CD11635/"><img src="http://partners.pantheranetwork.com/42/11635/12661/" alt="" border="0"/></a>Insurer Reimbursement: Could Less be More?tag:www.sleepguide.com,2009-02-06:2549090:BlogPost:73152009-02-06T21:50:02.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
If you haven't heard, Medicare and private insurers are putting the screws to the DMEs that provide our Sleep Apnea equipment in an effort to cut costs, much to the chagrin of DME providers. One aspect of the cost-cutting is to deny reimbursement to DMEs and other providers that cannot show that their patients are complying with CPAP treatment. While at first blush, this might seem like an adverse development for us patients, the problem for us might be that the insurers didn't do this sooner,…
If you haven't heard, Medicare and private insurers are putting the screws to the DMEs that provide our Sleep Apnea equipment in an effort to cut costs, much to the chagrin of DME providers. One aspect of the cost-cutting is to deny reimbursement to DMEs and other providers that cannot show that their patients are complying with CPAP treatment. While at first blush, this might seem like an adverse development for us patients, the problem for us might be that the insurers didn't do this sooner, and that they haven't yet gone far enough.<br />
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My thinking is this: for too long, DMEs could get away with giving out to patients the most basic, least effective and "dumbest" machines out there. These are the machines that cost the DMEs the least (and thus result in the greatest margins), but which also reduce the likelihood of us getting well with Sleep Apnea. With no feedback given to the patient on how the patient is doing, the patient quickly kicks aside the treatment altogether when something goes wrong, because there is no obvious path to fix the problem. As we know, data-capable machines provide this feedback so that we are not "flying blind," but rather can tweak our therapy if something is not working, and quantify the results of the tweak.<br />
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Now the reason the dumb machines were put out there in the first place was because the DMEs could get away with it. Not any longer. Insurers are saying you have to give out data capable machines, because there is no other way you can prove to us that the machines are being used and unless we have that proof, we're not going to reimburse you for it. And look what the result is: chances are slim that any newbie to this forum is being prescribed a machine that doesn't at least have some basic data capability.<br />
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But let's not rest on our laurels. That's a step in the right direction, but just a baby step. What we are really after with data monitoring isn't just knowing that the machine is on, but knowing that it is being <i>effective</i>. So I would advocate that the insurers make the DMEs reimbursement conditioned on <i>efficacy</i> data, and not just <i>compliance</i> data. My guess is after a little while with this regime in place, we'll see a big move forward in patient compliance rates, and in innovative technology designed to improve compliance.New Product Releasestag:www.sleepguide.com,2009-02-05:2549090:BlogPost:72192009-02-05T23:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="38" src="http://storage.ning.com/topology/rest/1.0/file/get/73417701?profile=RESIZE_180x180" style="float: left;" width="150"></img> I tuned into ResMed's quarterly earnings call this afternoon, and was generally impressed with RMD's performance over the quarter, along with the explanations for that strong performance put forth by senior management. One of the financial analysts on the call noted that the pace of new products ResMed is bringing to market seems to have picked up over the last year. ResMed's CEO, Kieran Gallahue, confirmed that this observation has some basis in fact, and spoke proudly of the…
<img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417701?profile=RESIZE_180x180" alt="" width="150" height="38" style="float: left;"/>I tuned into ResMed's quarterly earnings call this afternoon, and was generally impressed with RMD's performance over the quarter, along with the explanations for that strong performance put forth by senior management. One of the financial analysts on the call noted that the pace of new products ResMed is bringing to market seems to have picked up over the last year. ResMed's CEO, Kieran Gallahue, confirmed that this observation has some basis in fact, and spoke proudly of the products that await us in RMD's development pipeline. As a Sleep Apnea patient, I eagerly await the introduction of new products, and applaud the manufacturers for investing in innovative solutions to the problems that arise with Sleep Apnea therapy. I would voice one note of caution to ResMed and the other manufacturers: please don't introduce products for the sake of introducing products without bringing some real benefit to us, the patients. Often in the rush to increase market share and bring up profit margins, companies bring new products to market that don't need to be there, and that are actually worse than their predecessor products. Sometimes we users of the products are used as guinea pigs to test products that really aren't fully "baked" yet, and could use some additional R&D or technical improvements.<br />
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All that being said, I don't see this day as having come yet for Sleep Apnea products. At this point, the industry has so much progress to make that almost every new release represents a substantial improvement over its predecessor . I sincerely hope things stay that way.MD on MD Violence: Turf War in Sleep Medicinetag:www.sleepguide.com,2009-02-04:2549090:BlogPost:70422009-02-04T03:53:03.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Sleep specialists are ticked off that, looking for new revenue streams, an increasing number of primary care physicians and other non-Sleep certified MDs are hopping on the Sleep Medicine bandwagon. As patients, the question is whether we should care. The answer I think is yes.<br />
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The complaint of the Sleep specialists is that interpreting sleep studies and diagnosing sleep disorders takes a fair amount of skill and training. Now, if you've ever taken a gander at your raw sleep study data and…
Sleep specialists are ticked off that, looking for new revenue streams, an increasing number of primary care physicians and other non-Sleep certified MDs are hopping on the Sleep Medicine bandwagon. As patients, the question is whether we should care. The answer I think is yes.<br />
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The complaint of the Sleep specialists is that interpreting sleep studies and diagnosing sleep disorders takes a fair amount of skill and training. Now, if you've ever taken a gander at your raw sleep study data and tried to make sense of all those squiggly lines and chicken scratch, you'd appreciate that they probably have a point. The general practice MDs, they claim, don't know how to interpret the raw data, but rather simply rubber stamp whatever the sleep lab tech concluded about the sleep study in question. And sleep lab techs didn't go to medical school. The result, the specialists claim, is that unqualified doctors are being paid for doing nothing, and while the sleep lab and the unqualified physician win, the patient ultimately loses out. Now, I'm not close enough to any of this to know for sure whether this is just sour grapes on the part of sleep specialists facing increased competition, or if they truly have a point. But my hunch is that the sleep specialists are in the right on this one. Perhaps our industry insiders will be able to shed further light on the answer to this question.Primary Care Physicians and Sleep Apneatag:www.sleepguide.com,2009-02-03:2549090:BlogPost:69082009-02-03T03:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="100" src="http://storage.ning.com/topology/rest/1.0/file/get/73417821?profile=RESIZE_180x180" style="float: left;" width="150"></img> Primary care physicians are on the front lines of the War on Sleep Apnea. Unfortunately, nobody told them that they're on the front lines of the War on Sleep Apnea! Below is a typical list of tips for healthy living given to me by my primary care physician. Notice the glaring absence of anything Sleep-related:<br />
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1. Make sure appropriate screening tests and immunizations are up to date.<br />
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2. Complete an Advance Health Care Directive.<br />
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3. Exercise "aerobically," enough to raise your heart…
<img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417821?profile=RESIZE_180x180" alt="" width="150" height="100" style="float: left;"/>Primary care physicians are on the front lines of the War on Sleep Apnea. Unfortunately, nobody told them that they're on the front lines of the War on Sleep Apnea! Below is a typical list of tips for healthy living given to me by my primary care physician. Notice the glaring absence of anything Sleep-related:<br />
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1. Make sure appropriate screening tests and immunizations are up to date.<br />
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2. Complete an Advance Health Care Directive.<br />
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3. Exercise "aerobically," enough to raise your heart rate to about (220 - your age) x 70%. Your goal is at least 30 minutes every day.<br />
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4. Achieve and maintain normal body weight.<br />
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5. Eat foods low in saturated fat and trans fatty acids and high in calcium and fiber, with plenty of fruits and vegetables. Take a calcium supplement, if necessary.<br />
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6. Practice safe sex, use condoms and a reliable method of contraception.<br />
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7. Do not smoke, and avoid inhaling others' cigarette smoke. If you need help quitting, please ask.<br />
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8. "Safety-proof" your home to prevent falls, poisoning, accidental use of firearms and fire.<br />
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9. Do not drive or allow others to drive while under the influence of alcohol or other mind-altering substances. Use sport helmets appropriately, regardless of your age. Observe safety regulations for automobile airbags, seatbelts and car seats.<br />
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10. Seek help early for depression, mood changes, alcohol or drug abuse.<br />
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11. Perform regular skin self-examinations. Protect your skin from sun damage with sunblock and clothing.<br />
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12. Women should seek medical attention for breast changes.<br />
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13. Men should seek medical attention for testicular changes.<br />
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14. Find balance in your life between work, home and play time. Include stress reduction activities (fun!) every day.PAPer "Bill of Rights" -- Version 2tag:www.sleepguide.com,2009-02-02:2549090:BlogPost:68132009-02-02T03:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417853?profile=original" target="_blank"><img alt="" height="99" src="http://storage.ning.com/topology/rest/1.0/file/get/73417853?profile=RESIZE_180x180" style="float: right;" width="150"></img></a> The comment period is over, and the attached represents the revised version, based on your feedback so far. The original, along with the context surrounding it, is set forth in <a href="http://www.sleepguide.com/profiles/blogs/paper-bill-of-rights-your">this article</a>. Given the growth of the community over the past month, and the addition of many knowledgeable…
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417853?profile=original" target="_blank"><img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417853?profile=RESIZE_180x180" alt="" width="150" height="99" style="float: right;"/></a>The comment period is over, and the attached represents the revised version, based on your feedback so far. The original, along with the context surrounding it, is set forth in <a href="http://www.sleepguide.com/profiles/blogs/paper-bill-of-rights-your">this article</a>. Given the growth of the community over the past month, and the addition of many knowledgeable members who will probably want to weigh in on the PAPer Bill of Rights, I am recirculating this for your comment and feedback. If you think this is a bad idea in general, and not something we should pursue at all, please feel free to say so. But if you think we should go forward with publicizing this, even if only after substantial revision to this latest draft, please say that, too.<br />
<br />
<br />
<b>PAPer Bill of Rights</b><br />
<br />
<i>Article I</i><br />
The objective of physicians and clinicians should be more than to get their patients to use positive airway pressure devices; it should be to strive for the devices to be used <i>properly</i> so that the patient achieves an optimal AHI and a leak rate within manufacturers' established ranges for the mask being used<br />
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<i>Article II</i><br />
All new machines developed by manufacturers should (i) be data-capable so that patients have some objective measure of their treatment's success; (ii) be equipped with an adjustable and integrated heated humidifier; (iii) include wireless technology capable of transmitting detailed efficacy data to patients at their option<br />
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<i>Article III</i><br />
Positive airway pressure devices should not require a doctor's prescription unless a patient has a history of other respiratory problems or health conditions that would make use of a positive airway pressure device dangerous.<br />
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<i>Article IV</i><br />
A user must not have to settle for a mask until it is both comfortable and effective for that user, and should be permitted to switch up masks at the sole expense of the manufacturer up to a certain number of masks per year; old masks should be recovered by the manufacturer as a hedge against fraud, and distributed to needy individuals/families<br />
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<i>Article V</i><br />
Physicians should inform patients of the existence of out-of-pocket "comfort" features and accessories such as auto-adjusting machines; fleece sleeves for hoses and tubing; etc.<br />
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<i>Article VI</i><br />
Insurers and Medicare should inform patients of the need to replace masks, tubing, mask cushions and other equipment, and the fact that they will pay for the parts to be replaced, and on what schedule they will do soUsed CPAP Masks and CPAP Machinestag:www.sleepguide.com,2009-01-31:2549090:BlogPost:65982009-01-31T23:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417807?profile=original" target="_blank"><img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417807?profile=RESIZE_180x180" style="float: left;" width="120"></img></a> A substantial marketplace is developing online for pre-owned CPAP masks and machines. Sites like craigslist and ebay offer used CPAP masks and machines at heavily reduced prices, giving many access to CPAP supplies they otherwise would not be able to afford. The benefits are undeniable, and lots of good has come from this marketplace. But I was recently talking…
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417807?profile=original" target="_blank"><img width="120" src="http://storage.ning.com/topology/rest/1.0/file/get/73417807?profile=RESIZE_180x180" alt="" width="120" height="150" style="float: left;"/></a>A substantial marketplace is developing online for pre-owned CPAP masks and machines. Sites like craigslist and ebay offer used CPAP masks and machines at heavily reduced prices, giving many access to CPAP supplies they otherwise would not be able to afford. The benefits are undeniable, and lots of good has come from this marketplace. But I was recently talking to a good friend who is a bit of a germaphobe. You know the type --- the kind of guy who says "screw you" instead of "bless you" when you sneeze in his presence. But he raised an objection to the used CPAP equipment marketplace that I hadn't thought of, and couldn't quite rebut, at least not based on any facts at my own disposal. He thought there was a risk that Tuberculosis could be transmitted to a buyer of pre-owned CPAP equipment if the seller had contracted the disease. So I did a bit of investigation. There are a number of cleaning products for CPAP machines and masks on the market that a buyer would certainly be able to use. The Citrus II Wipes and the disinfectant Control III are among the most popular. However, my call to their manufacturers revealed that neither would kill tuberculosis. The Control III product is strong enough to kill HIV, but not strong enough to combat TB. Bleach was the solution suggested by one manufacturer. But as we all know, bleach would surely destroy the equipment.<br />
<br />
So I raise the question not to alarm people who have benefited from pre-owned equipment, but rather to get some sort of confirmation that the chances are so slim to not even need to worry about it. Please give me the ammunition I need to rebut my friend's objection to the free and open exchange of pre-owned CPAP equipment.Sleep Test in... a Hotel?tag:www.sleepguide.com,2009-01-31:2549090:BlogPost:64312009-01-31T00:30:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417697?profile=original" target="_blank"><img alt="" height="103" src="http://storage.ning.com/topology/rest/1.0/file/get/73417697?profile=RESIZE_180x180" style="float: right;" width="150"></img></a> If you're like me, you had your polysomnography sleep test done in a cold, clinical medical setting, devoid of any creature comforts whatsoever. Not so for those lucky enough to have their sleep study done at the Vanderbilt Sleep Disorders Center, which recently held its grand opening at a new location: the local Hyatt hotel. The Hyatt Place Cool Springs will be…
<a class="noborder" href="http://storage.ning.com/topology/rest/1.0/file/get/73417697?profile=original" target="_blank"><img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417697?profile=RESIZE_180x180" alt="" width="150" height="103" style="float: right;"/></a>If you're like me, you had your polysomnography sleep test done in a cold, clinical medical setting, devoid of any creature comforts whatsoever. Not so for those lucky enough to have their sleep study done at the Vanderbilt Sleep Disorders Center, which recently held its grand opening at a new location: the local Hyatt hotel. The Hyatt Place Cool Springs will be host to a new six bed center where patients can be tested for sleep disorders, and, as necessary, titrated for CPAP treatment.<br />
<br />
The move is part of a trend toward making the overnight sleep study more comfortable and, in so doing, more closely replicate a patient's usual home sleep environment. Some critics of current sleep lab protocol cite the unfamiliar hospital-like setting of a sleep study as a cause of anxiety in patients being studied, and question the accuracy of sleep study results obtained in such a setting.Sleep Apnea and Truckerstag:www.sleepguide.com,2009-01-28:2549090:BlogPost:60872009-01-28T19:18:58.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417692?profile=RESIZE_180x180" style="float: left;" width="102"></img> Sleep Apnea and Truckers. To the Respironics, Resmeds and Fisher Paykels of the world, the two go together like Love and Marriage. To truckers the combination is more like oil and water. Clearly, the manufacturers have the moral high ground. But whether they will be able to woo truckers remains to be seen.<br />
<br />
Truckers are disproportionately predisposed to having some form of Sleep Apnea, with one study pegging the number at 28% of all those holding commercial trucking licenses. And like…
<img width="102" src="http://storage.ning.com/topology/rest/1.0/file/get/73417692?profile=RESIZE_180x180" alt="" width="102" height="150" style="float: left;"/>Sleep Apnea and Truckers. To the Respironics, Resmeds and Fisher Paykels of the world, the two go together like Love and Marriage. To truckers the combination is more like oil and water. Clearly, the manufacturers have the moral high ground. But whether they will be able to woo truckers remains to be seen.<br />
<br />
Truckers are disproportionately predisposed to having some form of Sleep Apnea, with one study pegging the number at 28% of all those holding commercial trucking licenses. And like most people who have some form of Sleep Apnea, truckers aren't getting treated for it. Now pair those facts with truckers driving 18-wheelers on long hauls for hours on end without interruption, and the potential for disaster is alarming: of the small number of truckers who actually are being treated for Sleep Apnea, the study showed, there was a 73% reduction in preventable driving accidents.<br />
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Mention Sleep Apnea to a trucker, and the likely response will be denial. Which makes sense on a certain level, because they fear that if they admit it they will have their licenses, along with their livelihoods, revoked. And indeed, at the behest of the CPAP manufacturers, the Federal Department of Transportation is headed down that path, proposing that to be physically fit to hold a trucking license a driver must have "no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with his/her ability to control and drive a commercial motor vehicle safely." If such a dysfunction is detected, the driver must be evaluated and treated for the dysfunction. Easy enough to say, but as we all know, getting well with Sleep Apnea is about trial and error, and often takes time. How the D.O.T. and the manufacturers agitating for this change are going to deal with that hard fact remains to be seen. But this much is clear: their success in wooing their unwilling partner will depend on it.Advanced Member Search on SleepGuide.comtag:www.sleepguide.com,2009-01-28:2549090:BlogPost:60252009-01-28T00:31:54.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
Now you can find others on SleepGuide.com who are just like you. Check out our <a href="http://www.sleepguide.com/profiles/members/advancedSearch">Advanced Member Search</a>, and find other people with Sleep Apnea by region, by interest in Sleep Apnea, by type of machine or mask they use, and more. Let us know if you'd like to find people some other way and we can look into incorporating your suggestions into future releases of the site. Enjoy!<br />
<br />
…<p style="text-align: left;"><img alt="" height="653" src="http://storage.ning.com/topology/rest/1.0/file/get/73417776?profile=original" width="400"></img></p>
Now you can find others on SleepGuide.com who are just like you. Check out our <a href="http://www.sleepguide.com/profiles/members/advancedSearch">Advanced Member Search</a>, and find other people with Sleep Apnea by region, by interest in Sleep Apnea, by type of machine or mask they use, and more. Let us know if you'd like to find people some other way and we can look into incorporating your suggestions into future releases of the site. Enjoy!<br />
<br />
<p style="text-align: left;"><img src="http://storage.ning.com/topology/rest/1.0/file/get/73417776?profile=original" alt="" width="400" height="653"/></p>Apnea Sexy: Results are Intag:www.sleepguide.com,2009-01-27:2549090:BlogPost:59352009-01-27T02:00:00.000ZThe SleepGuide Crewhttps://www.sleepguide.com/profile/SleepGuideCrew
<img alt="" height="90" src="http://storage.ning.com/topology/rest/1.0/file/get/73417773?profile=RESIZE_180x180" style="float: right;" width="150"></img> In a prior post, we brought to your attention a personals ad we came across for a gentleman with OSA seeking a woman with the same. The ad read: "I am an intelligent, kind, and passionate man and I refuse to let the CPAP machine dampen my social life and passion for life and, hopefully, for someone like you! Are there any smart, cute women out there that have this condition too? I don't feel like I need to find someone else with this condition, since it is not all that bad and most…
<img width="150" src="http://storage.ning.com/topology/rest/1.0/file/get/73417773?profile=RESIZE_180x180" alt="" width="150" height="90" style="float: right;"/>In a prior post, we brought to your attention a personals ad we came across for a gentleman with OSA seeking a woman with the same. The ad read: "I am an intelligent, kind, and passionate man and I refuse to let the CPAP machine dampen my social life and passion for life and, hopefully, for someone like you! Are there any smart, cute women out there that have this condition too? I don't feel like I need to find someone else with this condition, since it is not all that bad and most women are understanding, but I thought it might interesting to try to meet someone else with this condition. It certainly would give us something to talk about and spark our first conversations!"<br />
<br />
I recently responded to the ad myself out of curiosity to ask whether a love connection was made. Not even close, according to the gentleman who posted it. Total number of responses he received: 0.