Welcome, Dr. Park.

Welcome Dr. Parker.

I hope you can find time in your busy schedule to post occasionally.

Hi Dr Parker... What is the most current equipment available for sleep apnea and can I buy it directly or must I deal with insurance? Thanks, Felicia Gervais

Felicia, Don't want to get out in front of Dr. Park, and I'm sure he'll chime in too, but I wanted to let you know that as long as you have your prescription on you, you can buy direct from whomever you'd like. The most current face mask available is the "Swift LT for Her," a nasal pillows-type mask from ResMed. One of the most current machines available is the The Fisher & Paykel Sleepstyle 200 Auto Series HC254 -- I wrote about it in this article. By the way, I have no interest in any of these companies -- I'm just telling you what I know.

Dr. York,

I've been reading your posts and you impress me as a very compassionate practitioner...and committed...posting as much a you do with a newborn at home. Are you familiar with the work of Larry Wolford in Texas and Bill Hang in Los Angeles. If not, I would encourage you to check out their web-sites. They are having a lot of success in treating Sleep Apnea and TMD related chronic pain syndromes. They may be good resources for you. I don't know Wolford personally, but work closely with Hang and would be happy to write a letter of introduction if you would like me to.

Keep up the good work

Peter Beckwith

Dr. York,

I am composing an e-mail now. Could you please provide me with an e-mail address to copy you at. You can do that here at the forum or contact me direct at Peterbeckwith1@mac.com. Also, do you have a web-site that I can look at?

Thanks

Peter

Dr. Park,

My apologies. I am preparing notes for a Dr. York this morning and have been addressing you as such in my recent posts. I'm sorry for that. I have the letter ready. Let me know how you would like to handle cc's and the like.

Thanks

Peter Beckwith

I spent some time on your website the other day and was very impressed. Then I found you here. It says a lot that you would be here in the trenches with the people who actually have to deal with apnea and use the equipment in real life. Glad to have you here.

I also spent a number of hours on your site last night and look to get your book soon (need to wait till my check comes in) I also sent a link to my daughter who is having her first baby. I really like the reports that were made about your wife and what she went though and what you learned, it will help her right now. Thanks for being a part of our group and look forward in hearing and learning more from you and others in our group.

I have been recently diagnosed with mild sleep apnea, I am still struggling with my nose pillows mask. I use a chin strap to help keep my mouth closed, if this doesn't work then I have to switch to a full mask....My question is I was doing fine sleeping with my mask then suddenly I am having trouble sleeping with it, this happened before I had my air levels increased. Is this a common problem that happens why all of a sudden am I having difficulty sleeping with my mask.

I am getting impatient and feeling like I have no place to turn, I have been off work for several months now due to my sleep apnea, at first I was diagnosed with severe depression due to lack of sleep now with this diagnosis I was doing fine with the mask then now I am not.....

If you could help me to understand this maybe I wouldn't be so impatient......I just want to sleep get better and get back to work, I hope you can help me :)

Belinda

Sandra gave you a name of a physician on this post: http://www.sleepguide.com/forum/topics/5year-old-who-snores

Hi- I am an allergist in Chicago. I have had multiple surgeries for sleep apnea, including bimaxillary advancement. I have had decent but certainly not complete improvement in my subjective symptoms. My RDI has decreased from about 45 to 8 or so. I think that the base of my tongue at the level of the epiglottis maybe causing persistent obstruction. I was wondering what kind of success you have had in refractory patients with the base of tongue coblation procedure and whether you think this would be a good option.

Thank you for your time.

Brian

Hi Dr. Park:
I am new on this forum today. After reading some of your posts, I bought your book and look forward to reading it. I have a CPAP that I used for about 3 or 4 days. Didnt work so I thought (with nose pillow but had my mouth open as it seemed like it would work better). I am going to try it again as I want to not be tired anymore (or health Issues). I have Ankylosing Spondylitis which could have been brought on by sleep apnea. I do think I want to try the dental appliance as a CPAP is not very sexy for my wife!

Chip

Dear Dr. Park,
I am a 42 yr old female that was diagnosed with SA 6 yrs. ago. I am not over weight, nor have I ever been. I could not tolerate the cpap and got rid of it. I still have excessive daytime sleepiness, migraines ( which I thought were sinus headaches) acid reflux and I even sometimes have numbness in my toes.
I went back for a new sleep study at a new center and they said I don't have SA, but they want me to come back and speak to the doctor because something might be wrong with my sinuses.
Does it sound like UARS to you? What should I ask them when I go? Everything I read points to UARS. I am desperate to feel better, this is ruining my whole life. Sincerely, Beth

FYI--I deleted that original website I put up on Discussion. No sense confusing people unnecessarily.
I'm interested in hearing what you think about the chin strap thing though, at your convenience. Looks like your line's hoppin' today!!

Susan McCord

Dr. Park--there's an active discussion going on re: CPAP/safety/monitoring as it relates to medical procedures, i.e., colonoscopy, endoscopy, etc. People, including me, are worried about being sedated without CPAP and proper monitoring of apnea during and after sedation.
When you have time, would you mind weighing in on this? It's a big concern...

Thanks!! Susan McCord :-)

Good Morning Dr. Park,
I am on my 13th day of CPAP therapy. I'm using a Respironics Elite II with a Mirage Quattro full-face mask. For the last 3-4 days now I have woke up with bags under my eyes that look like blisters. It feels like I'm in the middle hay season. My eyes are pinkish, weepy and a little sticky. I don't have any of the "crustys" that I would associate with an allergy. Typically, it takes 2-3 hours to "normalize" my appearance but I still carry dark circles and some puffiness throughout the day.
Is this, in your opinion, a normal reaction to the equipment I'm using? Is there something I can do to mitigate waking up with my eyes swollen semi-shut?

Thank you for the information about Iron for my RLS. I will mention it to my doctor. I first went to a neurologist for balance problems. He diagnosed Peripheral Neuropahy and ordered extensive laboratory tests. Everything was in the normal range. A lung function test and a fancy nuclear heart test showed no abnormalities. It was only when I mentioned that I get up frequently at night to urinate, that he sent me for tests for Sleep Apnea. Diagnosis: severe sleep apnea. I am in great shape for my age - 80. Normal blood pressure, etc. All of the neurological problems surfaced about two years ago. I am now taking Mirapex for the RLS. Not sure if it is helping as I wake up with severe leg pain, which goes away when I get up. Again, thank you for the information about Iron.

Dear Dr. Park,
Thank you for your response. My Dr. said he doesn't feel it is UARS from the study. He finds nothing abnormal and is thinking it might be narcolepsy. I have no symptoms of that except for the sleepiness. He said I need to change my Paxil for a different type of SSRI because he wants to do another study to r/o narcolepsy. He said he can't do it while I'm on Paxil and my Psychiatrist said no. I am frustrated and ready to just give up and keep napping everyday. I could just cry. What should I do? Throw in the towel?

Thanks for your response. I'll be talking to them soon about that.

FYI mark beds is a salesman and not interested in apnea

i have withdrawn my friendship with him

Hi Steve!

Susan McCord :-)

Wonder what you think of this new treatment in clinical trials: http://www.sleepguide.com/forum/topics/imthera-tongue-implant-sleep

Hello Dr. Park,

I very much appreciate your many postings of advice and support on SG and I would like to ask for your thoughts on a particular issue, that is, lack of S-3 and REM.

I was diagnosed with OSA and have been using CPAP since 12-09 and I am now using CPAP 7 nights a week.

My pressure has been increased from 9 to 12 and my OSA is improving.
Recent 6 wks at pressure of 12 – Per Hr – AI - .8; HI – 3.0; AHI – 3.8
1st 5 wks at the pressure of 9 – Per Hr – AI – 1.5; HI – 4.3; AHI – 5.8

However, I also have alpha intrusion and very little S-3 and REM.

S-3 & REM – % Of Sleep
2nd Titration – 1st Titration – 1st Sleep Study

S-1 – 42.9% – 68.2% – 35.6%
S-2 – 50.2% – 18.6% – 35.9%
S-3 – 6.3% – 6.5% – 20.2%
REM – 0.6% – 6.7% – 8.4%

After a 3rd titration on 2-23, I asked the tech in the morning and found that I, again, did not have REM sleep. I expect to go soon for a consultation to go over my latest titration results. However, on the morning after the titration, the doctor asked me to begin taking Gabapentin (Neurontin) 100mg at bedtime and I have been doing that for the past 10 days. (Although 100mg is a very low dosage, I also take Topomax 25mg daily for benign intention tremor and so that also needs to be taken into account.)

I was hoping that once I found out I had sleep apnea and used CPAP that it would be the answer I needed and, although I had a really difficult time adjusting to CPAP, I have persisted. But, with alpha intrusion and lack of S-3 and REM, I am not getting restorative sleep and so I remain incapacitatingly tired. And so I thought to ask if you have any thoughts or suggestions re: info / testing / treatment – any ideas regarding lack of S-3 and REM and related alpha intrusion.

Thank you very much for considering this long message on an individual issue and for any / all thoughts, suggestions or recommendations that you might have – as well as for all your on-going support and advise to SG members.

Best Regards,
Renee

Hello Dr. Park

As I mentioned to you in my previous note, I am trying to get information on lack of S-3 and 4 (SWS), REM along with alpha intrusion - the possible causes, etc. I just got the report of my most recent (3rd) titration which took place on 2-23 and my S-3 went down further from 6.3% to 2.8% and my REM went down from 0.6% to 0.0%.

This evening I received a posting from Judy on SG suggesting I get a copy of the presentation by Dr. Bhola: "How To Read Your Sleep Study Report" since she discussed the lack of Stage 3 and REM.

And, so, following up on Judy's suggestion, I would like to know how I might be able to get a copy of the presentation from your interview.

Thank you,
Renee

Dr Park, I THOROUGHLY ENJOYED Dr Bhola's presentation last night. THANK YOU!

It didn't go too long for my taste at all!!! The scheduling of this presentation was great for me as I have a CD of two of my titrations PSGs. Her slides and explanations helped me go back thru the first one and better understand which "squiggly" line was which lead. The CD of the other study is an EAS file which I haven't been able to access yet. It was done on Resmed equipment w/Cadwell. I was told Cadwell would allow me access online but then was given the CD instead.

I'm not sure yet just what other subjects I'd like to see covered. By the way, I think I made a mistake last night or missed something. Doggone cat was buggig me to go out. I purchased the pdf but didn't get or download the mp3. Is the mp3 a separate purchase or did I just mess up?

I take that back! But it might not have enough "mass appeal". I'm interested in the challenges of titrating and treating COPD patients w/CPAP and more importantly to me w/bi-level. I have a Resmed VPAP Auto (January 2008 release, not the Juy 2008 released VPAP Auto 25).

I thought of another!!! One of more "general interest", I'm sure. How about a good RRT explaing the features of the various brand and models of xPAPs? Or maybe a manufacturer's Rep from the "majors" such as Resmed, Respironics, DeVilbiss, Puritan Bennet and Fisher & Paykel.

New xPAP users are almost never given any choice in xPAP they receive nor any choice of brand nor even aware that they can "shop" their local DME provider options their insurance is contracted with.

Hello Dr. Park,

I went to: http://doctorstevenpark.com/ - and I am not able to find a link for the PDF file. I looked under: Home, Sleep Apnea, Articles, Expert Interviews, Press Room, Resources and Contact Us. Am I going to the right website?

Thank you,
Renee
__________________________________________________

At 9:13am on March 24, 2010, Steven Y. Park, MD said… Go to this website and there should be a link for the PDF file of Dr. Bhola's talk.
She gave a number of god reasons for deep sleep inefficiency.

Hello Dr. Park,

I got to the pdf with the link you provided and I'll get going on investigating all the info.

Thank you,
Renee
_________________________________________________________

At 12:38pm on March 24, 2010, Steven Y. Park, MD said… Sorry, I gave you the wrong link. Here's the right one: http://AttendThisEvent.com/?eventid=11869860.

On the upper left hand corner, you'll see a PDF link.

I so hope they will!!!! I've been absolutely enthralled w/DeVilbiss and F&P finally coming out w/fully data capable xPAPs! And delighted that PB has come out w/the new Sandman and would love to know more about them. Even tho I'm on bi-level. *sigh* I really LOVE my Resmeds and the ease of acess to so much data via the LCD screen. I really didin't lke the fussy access to the limited data on the Respironics. And I really HATED the power brick and platform of the Respironics too. The Resmed S8s have been such a CONVENIENT style, especially when traveling and changing motels each night. I was so sorely disappointed to see the S9s have the doggone extra cord and the power brick - two of the things I've hated most about the Respironics. I've got my fingers crossed that they will do a presentation for us!!!

And by the way - you sounded so YOUNG during the telecast!!!

And thank you re: the mp3 file. That was the first telecast I've really taken part in. I've never had much interest in youtube, twitter, myface and telecasts and online videos due to being a victim of slow speed dial up as our only available option in our rural area.

Thanks Dr Park. I did decide my attitude was out of line. Please blame it on chronic irritability (just lately) and sticker shock. Still I would be interested in what your consult consists of.
I did delete the comment as unnecessarily antagonistic. My humble apologies.

Mary Z.

Thanks Dr. Park. Well worth the time, energy and expense.

Mary Z.

Thanks Dr. Park, I did get that and am looking forward to reviewing it.

Dr. Parks.
Would we see any changes with OSA or Central apnea when treating cardiac patients with ionotropic, chronotropic medications?