Stop Sleep Apnea Naturally
Nonprofit organization founded in 1990 by persons with apnea and concerned health care providers and researchers. The ASAA is dedicated to reducing injury, disability, and death from sleep apnea and enhancing the well-being of patients. The ASAA promotes education and awareness, research, and the A.W.A.K.E. network of voluntary mutual support groups. As part of its endeavors to increase understanding of sleep apnea, the ASAA fulfills thousands of requests for information from the public each year and answers a multitude of questions about diagnosis and treatment options. The ASAA also works with other nonprofit organizations and societies for health care professionals to reach the undiagnosed. In addition, the ASAA serves as an advocate for people with sleep apnea and helps them live with this disorder. The A.W.A.K.E. Network plays a crucial role in the ASAA's educational and advocacy efforts. A.W.A.K.E. is an acronym for Alert, Well, And Keeping Energetic, characteristics that are...
OSA is another disorder that degrades sleep quality and leads to impairment in daytime cognitive function. Obstructive sleep apnea refers to frequent interruptions of breathing caused by blockage of the upper airway. Respiratory interruptions result in transient lowering of blood oxygen levels, causing reflexive partial awakening in order to reestablish respiration. There are several treatments for OSA. Weight loss can eliminate the disorder. Some patients respond well to inhalers, which can open breathing passages. When these measures are not effective, doctors often recommend use of a c-pap (continuous positive airway pressure) device to keep the airways open during sleep. Although c-pap is an unequivocally effective treatment for OSA, many patients have difficulty tolerating the face mask, which is part of the device. An increasingly popular treatment alternative is upper airway laser surgery, which reshapes the tissues of the breathing passages. However, because surgery is less...
Obstructive sleep apnea affects approximately eighteen million adults in the United States and is most frequently seen in overweight men. It was once considered uncommon and often remained undiagnosed. Physicians rarely checked for it except in the stereotypical patient a sleepy, overweight, middle-aged man who snored. But in 1993, researchers at the University of Wisconsin School of Medicine learned that apnea is more common in both men and women than previously thought. They looked for sleep apnea in six hundred state employees, ages thirty to sixty, as part of a larger sleep study, and were surprised to find that 9 percent of women and 24 percent of men had at least five episodes of airway obstruction per hour. About 4 percent of men and 2 percent of women were estimated to have the full sleep apnea syndrome, which includes abnormal breathing events and daytime sleepiness. Untreated, OSA can have serious consequences. The relentless daytime fatigue that often results may lead to...
Summary (provided by applicant) Epilepsy affects approximately 2.5 million Americans, resulting in substantial disability. Because up to 30 of patients with epilepsy continue to have seizures despite appropriate treatment with antiepileptic medications, additional interventions to improve seizure control are needed. One approach to improving seizure control is to treat coexisting sleep disorders, such as obstructive sleep apnea. Obstructive sleep apnea (OSA) may exacerbate seizures via sleep fragmentation, sleep deprivation, or other pathophysiological processes that have not yet been determined. The investigators recently documented that OSA is common in epilepsy patients with seizures refractory to medical treatment. In addition, preliminary data in the form of retrospective case series by the investigators and others have suggested that treatment of OSA may improve seizure control. However, no prospective studies have been done to verify these findings. Proof that treating OSA is...
Central sleep apnea occurs when respiratory centers in the brain fail to send the necessary messages to initiate breathing. Although the airway isn't blocked, the diaphragm and chest muscles stop moving. Falling blood oxygen and rising carbon dioxide levels soon set off an internal alarm, prompting resumption of breathing and often waking the person. Therapy for central sleep apnea usually involves treating the underlying medical condition that has disrupted breathing. For example, if the CSA is caused by heart failure, medications to treat the heart failure may eliminate the CSA. Sometimes CPAP is used, and patients may receive added oxygen. For patients who Before deciding on treatment for CSA, it is important to establish the cause. A thorough evaluation, including a sleep study, is warranted. Fortunately, this form of sleep apnea is not common.
There's no doubt that snoring is annoying. In some cases it is harmless, but in others it's a sign of obstructive sleep apnea, a sleep disorder characterized by pauses in breathing that prevent air from flowing into or out of a sleeping person's airways. As we will see in Chapter 11, sleep apnea increases a person's risk of heart disease and causes severe daytime sleepiness. Snorers who temporarily stop breathing during the night or experience severe daytime sleepiness should consult a physician.
The air pressure delivered through the mask keeps the airway open, preventing collapse when the muscles relax during sleep and allowing the person to breathe regularly without interruption and sleep normally. The most common form of PAP is continuous positive airway pressure, in which the air pressure stays the same while breathing in and out. Continuous positive airway pressure was once very cumbersome but has become more comfortable in recent years. Newer models are lighter and quieter, and many offer options such as warmed humidified air (which alleviates nasal congestion, skin dryness, and dry mouth) and a timer that slowly builds up pressure to give you time to adapt and fall asleep more easily. There are also a variety of mask styles, allowing users to find the one that best fits their face and is most comfortable. People usually try CPAP for the first time in a sleep laboratory, 136, so a technician can adjust the pressure during sleep. Many people Continuous...
While surgical procedures on many body parts have strong success rates, this is not the case with most surgery for sleep apnea. Although some patients improve, a sizable percentage experience no reduction in symptoms, and some patients' symptoms actually worsen they have more episodes of apnea after the surgery than 138, they had before. Uvulopalatopharyngoplasty. When used to treat OSA, UPPP helps about 40 to 45 percent of patients. The rest may need to have further upper airway surgery or use CPAP. Somnoplasty. Somnoplasty is sometimes used to treat mild sleep apnea when other treatments have not helped. There is limited data supporting its use. Tracheostomy. Tracheostomy, the first surgical treatment used for sleep apnea, is rarely used today due to the success of CPAP and other treatments. The surgeon makes a small , 139
To this point, we've focused mostly on problems with sleep and wakefulness that result from primary sleep disorders such as insomnia, sleep apnea, and narcolepsy. However, many sleep-related problems result from nonsleep illnesses such as heart failure, diabetes, and Alzheimer's disease or from medications used to treat these illnesses. In most cases, treating the underlying disorder is the key to improving sleep. In this chapter, we'll review the common health conditions and medications that can make it hard to sleep at night or stay awake during the day.
Heart failure patients also can be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a form of central sleep apnea in which a series of increasingly deep breaths is followed by a brief cessation of breathing. Treating the heart failure and improving the effectiveness of the heart is the best treatment. Some people may need to use supplementary oxygen, a positive airway pressure device, or a diuretic medicine called acetazolamide to help them breathe and sleep more normally. In mild cases, benzodiazepine sleep medications can help some people sleep through these episodes. In addition, congestive heart failure raises an individual's risk for obstructive sleep apnea, which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. Chapter 11 discusses sleep apnea treatments.
Circadian factors affect the timing of heart attacks, with the highest frequency occurring between 6 a.m. and noon. Obstructive sleep apnea changes the timing of them, with more heart attacks and death occurring between midnight and 6 a.m. in OSA patients.
The devices used to treat sleep disorders are more effective now because of better materials and improved designs. For example, positive airway pressure (PAP), the primary treatment for sleep apnea, can now be tailored to a particular patient's facial shape, and the new equipment is smaller, lighter, and designed to make travel easier. Oral appliances for snoring have also improved. Surgery, a last resort for sleep apnea and snoring, has advanced with the use of lasers, radio frequency waves, and plastic stents. Many procedures can now be done in an office setting with only local anesthesia. Light, focused on the back of the eye, can be used to reset the internal clock and treat circadian rhythm disorders such as jet lag. As sleep disorders receive more attention, treatments will continue to advance, improving both comfort and success.
Sleeping during the day is a sign of sleep deprivation. This can be self-induced (that is, from staying up late), or it may result from poor sleep hygiene insomnia sleep apnea, narcolepsy, or another sleep disorder or an underlying illness. It can also be a side effect of a medication.
Antidepressants are the second medications to consider. I prescribe these if benzodiazepines don't work or have unacceptable side effects. In addition, I sometimes use antidepressants in special situations, such as for people who have respiratory disease or untreated sleep apnea, a history of substance abuse, or a coexisting emotional problem.
Secondary insomnia results from another cause. Chronic secondary insomnia is often caused by an illness or disease it may be a sleep disorder (such as sleep apnea or narcolepsy), a nonsleep condition (such as angina, heartburn, or depression), or a medication taken for such a condition. Substances taken for reasons other than sleep or health such as alcohol, caffeine, or recreational drugs can also lead to the development of insomnia.
Eventually the increasing effort required to breathe, along with the lack of oxygen and buildup of carbon dioxide, causes the sleeper to awaken and gasp loudly for air. After several large breaths, the blood oxygen and carbon dioxide levels return to normal and the person falls back to sleep, only to repeat the cycle again. Some people with sleep apnea repeat this cycle hundreds of times a night without being fully aware of what is happening. a. Air flows easily through an open airway during normal breathing. b. In obstructive sleep apnea, the airway collapses and blocks airflow. c. Positive airway pressure (PAP) devices keep the airway open, allowing normal airflow. A six-question screening test can help you determine if you need to be tested for sleep apnea. Symptoms and signs include the following Snoring. The hallmark of OSA is extremely loud snoring. Bed partners often liken it to a chainsaw or a foghorn, and they notice a pattern of snoring interrupted by periods of silence that...
Sleep-Related Breathing Disorders Snoring and Sleep Apnea Snoring that occurs when the airway is slightly narrowed but still open is referred to as simple, or primary, snoring. While not life-threatening, simple snoring may still be worth treating, since it can severely disrupt your partner's sleep. Complete or near-complete blockage of the airway during sleep is known as obstructive sleep apnea (OSA) a serious disorder with potentially serious effects on a person's health and quality of life. , 123 In this chapter, we'll look at the causes of and treatments for simple snoring and OSA, as well as a rarer form of sleep apnea known as central sleep apnea (CSA).
In other instances, levels of thyroid hormones can be abnormally low, a condition known as hypothyroidism. Feeling cold and sleepy during the daytime is a hallmark of this disorder. People with low thyroid levels tend to gain weight and their muscles don't work as well as they should both situations can bring about obstructive sleep apnea. Hypothyroidism can be treated with replacement doses of synthetic thyroid hormones. diabetes), other medical conditions (such as urinary tract infection, enlarged prostate, liver failure, multiple sclerosis, and sleep apnea), and medication (especially diuretics). Some cases are caused or exacerbated by excessive fluid intake after dinner, especially drinks containing alcohol or caffeine.
American Narcolepsy Association A support group for those suffering from narcolepsy, sleep apnea, or both, plus physicians, researchers, and other interested people. The association helps to improve through education and information programs, the quality of life for those who have narcolepsy. The group also supports and conducts research on the detection, prevention, treatment, and cure for these illnesses. It also works to reduce average time between onset of symptoms and diagnosis and to assist patients with personal, community, and business problems arising from their
The first clinical applications of this technology have aimed to prevent or reverse disuse atrophy of paretic muscles (Dupont et al., 2004). One clinical trial now under way involves stimulation of the middle deltoid and supraspinatus muscles of stroke patients to prevent chronically painful subluxation of the flaccid shoulder. Another involves strengthening the quadriceps muscles to protect an osteoarthritic knee from further stress and deterioration. Other applications in the planning phase include prevention of venous stasis and osteoporosis in patients with spinal cord injuries, reversal of equinus contractures of the ankle in cerebral palsy patients, and correction of footdrop in stroke patients. Still other clinical problems that may be candidates for such intramuscular stimulation include sleep apnea, disorders of gastrointestinal motility, and fecal and urinary incontinence. For most of these applications, clinical utility is as yet uncertain, morbidity would be unacceptable,...
A genetic component for narcolepsy was first suggested by Westphal (1877). In this first report of narcolepsy, both the proband and his mother were affected. Further evaluation of the transmission of the disease indicated that narcolepsy-cataplexy is, however, rarely a familial disorder when other causes of daytime sleepiness, most notably sleep apnea, are excluded. Most cases are sporadic and only 25-31 of monozygotic twin pairs are concordant for the disorder, suggesting a role for environmental triggers (1). Although only 1-2 of first-degree relatives develop the disorder, this corresponds to a 20-40-fold increase over the prevalence in the general population (0.05 ) (1).
Common problems seen in infants, children and teenagers include chronic pharyngitis, sinusitis, and otitis media, hearing loss, congenital cysts and masses, aspiration and swallowing disorders, and upper airway obstruction sleep apnea. Common surgical cases in pediatric otolaryngology include tonsillectomies and adenoidectomies, myringotomy and pressure-equalization tube placement, endoscopic sinus surgery, removal of foreign bodies of the upper aerodigestive tract and ear canals, upper airway endoscopy and surgery (including tracheotomies and tracheal reconstruction), resection of branchial cleft or other congenital cysts masses, otologic surgery such as tympanoplasties and mastoidectomies, and occasionally, cochlear implants.
Symptoms of narcolepsy can be sometime seen during the course of a neurological disease process. In such instances, the term symptomatic narcolepsy is used, implying that narcolepsy is a symptom of the underlying process rather than an idiopathic condition. In this case, the signs and symptoms of narcolepsy should be temporally associated with an underlying neurological process. Many authors use symptomatic narcolepsy and secondary narcolepsy indiscriminately, even though they have apparently different meanings. We suggest the use of symptomatic narcolepsy EDS, since secondary EDS has also been used for EDS associated with sleep apnea and restless leg syndrome. Symptomatic narcolepsy EDS must be distinguished from the category of associated narcolepsy EDS, i.e., cases in which narcolepsy EDS is associated with epileptic seizure and in which the two conditions may be secondary to a common process (such as brain tumor and injury).
Bariatric surgery has received much recent attention, and though the intervention itself has been challenged by many, some data and guidelines have emerged for prophylactic VCF use with this operation. Open gastric bypass for morbid obesity carries a 1 to 4 PE risk in spite of other methods of prophylaxis including IC, LMW heparin, and a push for early ambulation. Using retrievable VCFs, Gargiulo22 reported a reduced PE rate in open gastric bypass for patients with a BMI 55, but there was 14 complication rate. Factors associated with a high risk of VTE have been identi-fied23 to include BMI 60, truncal obesity, venous stasis dermatitis, and hypoventilation sleep apnea syndrome. Logically, one would add those with a history of VTE and a known or probable hypercoagulable state. It has been said that this operation has a short, defined period of risk for VTE that is ideal for retrievable VCFs. On the other hand, VCF placement can be challenging in morbidly obese patients, especially the...
They need, most adults require an average of approximately seven and a half hours per night. Research suggests that six hours of sleep at night is the minimum that most people need in order to be sufficiently alert the next day to maintain optimal memory. As important as the amount of sleep you get is the quality of your sleep. If you have sleep-related breathing problems, such as obstructive sleep apnea, you can sleep for ten hours a night and still not feel refreshed in the morning. If you think that you have sleep apnea (perhaps because your partner complains that you snore), it's essential that you see your doctor and have it treated. sleep, such as obstructive sleep apnea or depression. Sleeping medications should be used as sparingly as possible and always under your doctor's guidance.
Scammell et al. (100) subsequently reported on a 23-yr-old man who developed narcolepsy-cataplexy owing to a large hypothalamic stroke following resection of a cranio-pharyngioma. This lesion included two-third of the caudal hypothalamus, except for the most lateral component on the right, and extended into the mediodorsal thalamus bilaterally, the left amygdala, and parts of the basal forebrain and rostral midbrain. His postoperative course was complicated by panhypopituitarism, staphylococcal meningitis and hydrocephalus. He experienced HH. He became obese, with a BMI of 31.7. Sleep latency (SL) by MSLT was 0.5 min, and REM latency was 3.5 min. An overnight polysomnography showed 1 min and 1.5 min of SL and REM latency, respectively, without significant sleep apnea. His HLA was negative for DQB1*0602, and his CSF hypocretin level was 167 pg mL. EDS is a common symptom in PWS (101-103). Sleep-disordered breathing (SDB) and narcoleptic traits such as SOREMPs and cataplexy have also...
Snow et al. reported that five patients (11-19 yr, mean 15 yr) with EDS (53). The mean sleep latency by MSLT in the five patients was 10.3 min, but no detailed sleep data were reported for each case. Three patients underwent surgeries for craniopharyngioma, one for germ cell tumor, and one for a thalamic arachnoid cyst. The craniopharyngiomas and germ cell tumor were located in the hypothalamus-hypophysis region, and the arachnoid cyst was in the thalamic region. All patients received relatively extensive surgeries involving the hypophysis and hypothalamus and hormone replacement therapies. Patients had significantly higher BMI (mean 28), and this was primarily attributable to two morbidly obese patients associated with obstructive sleep apnea. Although treatment with continuous positive airway pressure resulted in complete resolution of their sleep-disordered breathing in these two cases, no changes in daytime somnolence occurred. affecting the hypothalamic region or brainstem,...
Lumbar cerebrospinal fluid (CSF) hypocretin-1 concentrations in controls, narcoleptics, and other pathologies. Each point is the concentration of hypocretin-1 in the crude (unfiltered) lumbar CSF of a single individual. Represented are controls (samples taken during night and day) and narcoleptics, including those with typical cataplexy, with atypical cataplexy, with cataplexy but who are HLA negative, and without cataplexy, as well as narcolepsy family probands. Individuals with hypersomnia owing to idiopathic hypersomnia, periodic hypersomnia, or hypersomnia caused by secondary etiology are also shown, as are those with other diagnostically described sleep disorders (obstructive sleep apnea n 17 , restless legs syndrome n 12 , insomnia n 12 ) and those with a variety of neurologic disorders. Specific pathologies are described for individuals with low (
A tracheostomy is a permanent opening of the trachea to outside air. It most often requires a surgical procedure for closure. The primary reason for performing a surgical tracheostomy is for long-term airway management in cases of chronic upper airway obstruction or central or obstructive sleep apnea, or to provide long-term mechanical ventilatory support. The use of assisted ventilation for more than 1 month in the first year of life has been considered to constitute a chronic tracheostomy (Bleile, 1993). Most of the estimated 900-2,000 infants and children per year who need a tracheostomy, a ventilator, or both for a month or more are, in fact, less than a year old (Singer et al., 1989). Although the mortality associated with a chronic tracheostomy in young children is twice that in adults, the procedure is invaluable for acute and long-term airway management (Fry et al., 1985).
Secondary polycythemia represents a true increase in erythrocyte volume. Causes include chronic exposure to carbon monoxide as is seen in long-term smokers, chronic hypoxia due to cardiopulmonary diseases, obstructive sleep apnea or living at high altitudes, erythropoietin (EPO)-producing tumors, and congenital high-oxygen-affinity hemoglobins, to name only a few.
Global and persistent cholinergic monoaminergic imbalance, owing to impaired hypocre-tin neurotransmission, may be required for the occurrence of cataplexy. This could not be induced only by an increase in REM sleep propensity and or vigilance state instability that occurs in various disease conditions (such as depression) (59) or in some physiological conditions (such as REM sleep deprivation). REM sleep abnormalities and sleep fragmentation are often seen in other sleep disorders (such as narcolepsy without cataplexy, sleep apnea), and even in healthy subjects when their sleep patterns are disturbed. The fact that these subjects never develop cataplexy also supports this hypothesis.
The metabolic syndrome is associated with increased risk of a variety of disease outcomes, including diabetes, peripheral arterial disease (the association with cardiovascular disease is discussed in Chapter 10), fatty liver and non-alcoholic steatohepatosis (discussed in Chapter 11), polycystic ovary syndrome (discussed in Chapter 12), gallstones, asthma, sleep apnoea and selected malignant diseases.
There is considerable controversy as to the usefulness of hypocretin measures in the blood. As stated earlier, we could not detect any hypocretin signals in human blood. (From 20 mL of plasma, the estimated level was less than 2.5 pg mL). Similarly, reported findings based on blood measures are very controversial. In a typical example, a significant positive correlation between plasma hypocretin levels and apnea hypoxia index (AHI) was reported in obstructive sleep apnea patients (16). Another group reported a completely opposite result (i.e., significant negative correlations between AHI and blood hypocretin levels) (15) (see also ref. 24), whereas two other studies demonstrated no changes in CSF hypocretin levels in obstructive sleep apnea patients (7,25).
Symptoms Snoring is the most common symptom other signs include color changes, labored breathing or gasping for air during sleep or sleeping in unusual positions. Because obstructive sleep apnea may disturb sleep patterns, these children may wake up sleepy and continue to complain of fatigue and attention problems throughout the day that may affect school performance. One recent study suggests that some children diagnosed with attention deficit hyperactivity disorder (ADHD) actually have attention problems in school because of disrupted sleep patterns caused by obstructive sleep apnea. Treatment Obstructive apnea can be cured by keeping the child's throat open to improve airflow. This may be done by surgically removing the tonsils and adenoids, or by providing continuous positive airway pressure (CPAP). CPAP is provided by having the child wear a nose mask while sleeping.
Sleep apnea Episodes of failure to breathe during sleep that may last for 10 seconds or longer may be caused either by a failure of the brain's regulation of breathing during sleep or by excessive muscular relaxation. in central sleep apnea, the patient's airway stays open, but the diaphragm and chest muscles do not work because of a disturbance in the brain's regulation of breathing during sleep. obstructive sleep apnea, on the other hand, is more common and is caused by excessive relaxation during sleep of the muscles of the sort palate at the base of the throat and the uvula. These muscles block the airway, making breathing labored and causing loud snoring. A complete blockage will halt breathing, making the sleeper stop snoring. As the pressure to breathe makes muscles of the diaphragm and chest work harder, the blockage is opened and the patient gasps and briefly wakes. This type of sleep apnea may also be caused by enlarged tonsils and adenoids, a large tongue, or a small...
Problems in staying awake are the usual reasons that drive people to seek help at one of the more than 200 sleep-disorder centers in this country. These problems are usually the result of sleep apnea (a potentially fatal disorder in which breathing stops intermittently during sleep) and narcolepsy (a disorder causing daytime sleep attacks).
Almost every disease process can affect a child's breathing and lung function, making pulmonology a very busy and exciting field. With infants, the pulmonologist helps to determine whether repeated wheezing episodes are from environmental triggers or due to aspiration from a swallowing dysfunction or gas-troesophageal reflux. For toddlers, they get to use bronchoscopes to remove small Lego pieces that have been aspirated and polysomnograms to diagnose sleep apnea. Children of any age acquire complicated pneumonias that may form loculated pleural effusions needing a chest tube for drainage. When a child has asthma severe enough to cause more than one admission to a hospital, a pulmonologist is consulted and continues to see them as an outpatient, providing important education and treatment that will help save the patient's life.
Of the soft palate, but researchers and clinicians disagree as to their effectiveness. Kuehn and Wachtel (1994) suggest the use of continuous positive airway pressure in a resistance exercise program to strengthen the velopha-ryngeal muscles. A common prosthetic approach is to use a palatal lift, which is a rigid appliance that covers the hard palate and extends along the surface of the soft palate, raising it to the pharyngeal wall. Palatal lifts should be considered for patients who are consistently unable to achieve velopharyngeal closure and who have relatively isolated velopharyngeal impairment.
In general, EDS in narcolepsy is considered to be more severe than in other sleep disorders, such as obstructive sleep apnea (OSA). It is present both as a chronic continuous daily sleepiness and as intermittent sleep attacks and is often the first symptom of developing narcolepsy. The chronic component of EDS leads to difficulty concentrating, decreased vigilance, and automatic behaviors. The term sleep attack is somewhat of a misnomer in that the episodes are not so much attacks as unavoidable naps. They are not as abrupt as the word attack implies but rather an irresistible desire to sleep that usually occurs at inopportune times throughout the day. The EDS of narcolepsy can be quite disabling, leading to difficulties in concentration and poor performance at work. Usually the daytime sleepiness can be temporarily relieved by a brief nap, but it returns quickly. This can distinguish narcolep-tics from patients with idiopathic hypersomnia, who usually take long, unrefreshing naps....
Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?