Breast Cancer and Sleep Apnea

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Breast Cancer and Obstructive Sleep Apnea

In a recent study, the incidence of breast cancer among patients with Obstructive Sleep Apnea was significantly higher than that of the control group. In particular, the incidence of breast cancer was higher among patients aged ≥65 years. The result suggests that OSA may be a risk factor for breast cancer in women.

Recent studies have shown that disturbed sleep and low blood oxygen levels during the night, which are common in obstructive sleep apnea, may play an important role in the biology of different types of cancers.

In people with the OSA, the airway closes completely or partially many times during sleep, reducing the levels of oxygen in the blood. Common symptoms are snoring, chocking or gasping for air, disrupted sleep and excessive daytime tiredness.

The study found that people who have more airway closures during sleep and whose blood oxygen saturation levels fall below 90%, are diagnosed with cancer more often than people without sleep apnea.

The researchers also found that cancer was more common among women than men.

The most common type of cancer among women was breast cancer, while prostate cancer was the most prevalent among men. While the study can’t prove that sleep disorders cause cancer, it does show that there’s an association between the two.

Women are under-diagnosed for sleep apnea at a rate of 6-to-1

So why are women so under diagnosed?

Some of the reason’s women aren’t diagnosed with sleep apnea may be:

  • Many women talk with their general practitioners about their sleep problems rather than a sleep specialist. Some these doctors have preconceived notions about what a typical sleep apnea patient looks like and may overlook the reported symptoms by women when they don’t fit the common portrait.
  • Women maybe be embarrassed and less likely to report loud, chronic snoring.
  • Women usually report different symptoms than men which may lead to a misdiagnosis.
  • Common symptoms of OSA seen in women-
  • Women are more likely to be prescribed prescription medications (such as anti-depressants) rather than be sent for a sleep study.
  • Men may be less likely to be observant to their bed-partner’s sleep disturbances than women are. Many men who seek treatment for OSA only do so because of concern by their bedpartner.

Getting a quality night’s sleep is more important than you may have realized. The American Academy of Sleep Medicine recommends 7 or more hours of quality sleep a night. If you or your bedpartner are having any issues with sleeping or daytime sleepiness, make an appointment with our sleep medicine professions to get evaluated today. We are offering Televisits for new and returning patients. Give us a call and Say Hello to Sleep Again.

 

Tips for Your Child’s Sleep Study

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Tips for Your Child’s Sleep Study

By Amanda Jones RPSGT- A Sleep Technician Mommy

An in-lab sleep study can be stressful for the adult patient. But bringing your child in for a sleep study can be nerve-wracking for the both of you. Our Sleep Technician Manager (and mommy of 2) is here to help give you some tips for your child’s sleep study and what to expect.

Pediatric Sleep Study Tips

  • To best prepare your child, keep napping to a minimum on the day of the study. Keeping your child from napping may help them fall asleep easier in the lab. Of course, it may be difficult to prevent your child from falling asleep, but do your best to minimize napping the day of the study.
  • You and your child will be greeted by a friendly, experienced licensed sleep technologist. You both will be shown to your private room for the night. Our rooms have a queen size bed, TV, and an overstuffed recliner for your comfort.
  • The sleep technologist will go over any questions you may have prior to starting the study. Your child will be asked to sit in a computer chair while the wires are applied. The hook up can take up to 30 minutes, so if your child has an iPad, book, or toy they like, feel free to bring it!
  • During the hook up, the sleep tech will politely explain why the wires are being applied. This, in turn, will make your child feel more comfortable. As an example: For some younger children, some techs will say the wires will test for superpowers! This set-up includes the following equipment:
    • A bandage-like sensor that measures your child’s oxygen will be placed on the toe or finger
    • Small plastic prongs at the nose will measure your child’s exhaled air
    • Elastic or cloth belts will be placed on your child’s chest and stomach, usually over their pajamas
    • Stick-on electrodes will be placed on your child’s face and chest to measure eye movements, heart rate, and muscle tone during sleep.
      • A few additional electrodes are applied with a washable paste on your child’s scalp to measure stages of sleep
  • We do recommend and ask that the parent sleep in the recliner and not in the bed with the child. This is so we get a clear recording of your child’s movements and sleep patterns. If the parent were to sleep in the bed with a child and simply just change positions, it could cause the child to wake up or make it look like the child was moving their leg.
    • We understand that this can be stressful and at times scary for your little one, and they may need your comfort while laying in bed. This is OK. We only ask that once the child is asleep, you exit the bed quietly and move to the recliner to sleep.
  • If your child has any comfort items (blanket, stuffed animal, etc.), we recommend and welcome them to come to the sleep over as well!
  • If your child likes to have a bedtime snack or a specific nighttime drink (ex: milk), make sure to bring those as well. The lab does have a refrigerator, a water cooler with hot and cold water and a microwave, if needed.
  • No need to worry if your child is a restless sleeper. The sleep technologist will be monitoring your child and the leads throughout the night. They might have to come into the room a few times to adjust or reattach wires that come loose.
  • If your child has a hard time tolerating the study, don’t worry. The sleep technologist is experienced working with children and will work hard to get the proper data for the doctors. The doctors are great and are equipped to read the data collected, even if its not perfect.
  • If your child has bed-wetting accidents at night, that is not a problem! Kindly let the tech know so they can lay down extra protection.
  • The wires are pain-free to attach, as well as remove. We have adhesive remover on hand for an easy removal in the morning with little irritation! There will be some paste residue on the face and head once the wires are removed. This residue is water soluble and will wash out with warm water. Using conditioner can help make the paste removal easier, as well as micellar water or rubbing alcohol.

Pediatric Sleep Disorders

Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance.

Our goal at Comprehensive Sleep Care Center is to make you and your child’s experience as comfortable and beneficial as possible.

Kids, Sleep and COVID-19

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Kids, Sleep and COVID-19
Boost your child’s immune system during COVID-19 Pandemic with quality sleep

Research shows that quality sleep is essential when it comes to health for both children and adults. Ensuring that your child gets an adequate amount of quality sleep can help boost their immune system and keep families healthy. This is a high priority during COVID-19, but also vital for health year-round.

Many kids today are struggling because of schooling issues, not being able to see their friends or play sports. They are not expending the same levels of energy as before COVID-19. Everyone’s routine has changed. Children may feel our stress or be anxious from listening to the news. All this can lead to poor sleep resulting in more meltdowns and unwanted behaviors.

A child’s poor sleep can be due to many issues like:

  • Lack of stimulation (physically and mentally)
  • Increased screen time with TV, computers, video games
  • Increased feelings of stress and anxiety

If your child is consistently not getting enough sleep,
they are three times more likely to get sick.

Sleep helps your body (adults and kids) produce immune-boosting cells to protect us.

That’s why, when we get sick, we also get tired. Your body is telling you that you need sleep to heal.
While more sleep won’t necessarily prevent you from getting sick, skimping on it could adversely affect your child’s immune system, leaving them more susceptible.

The National Sleep Foundation has these recommendations for children:

Under 1 year of age: 12 to 16 hours a day
1 to 2 years: 11 to 14 hours a day
3 to 5 years: 10 to 13 hours a day
6 to 12 years: 9 to 12 hours a day
13 to 18 years: 8 to 10 hours a day

5 TIPS TO PROTECT YOUR CHILD’S SLEEP

  1. Make a schedule for sleep and daily activities (for both you and your children) – and do your best to keep consistent.
  2. Stop screen time 60 minutes before bedtime- Intense, close-up light exposure in the evening will delay sleep by not allowing the body to produce melatonin, the good sleep hormone. This is especially important since our kids are using more screen time during the day.
  3. Get sunlight- Try and get outside. Open up your blinds, take a walk, or play outside. The sun controls our internal 24-hour clock that tells our body when to be awake and when to be asleep. If your child’s body doesn’t get enough sunlight, it will mix up their days and nights.
  4. Your child needs physical activity – Kids days have likely gone from active to sedentary. The harder they play, the more their body will need to recover, and the better they’ll sleep.
  5. Create a calming routine – This routine should be at least 30 minutes before bedtime. Things like a warm bath, a good book, (no screen time), do a puzzle or something quiet. The best sleep results come from a routine that’s calm and technology-free.

Of course, there’s more to boosting your immunity and guarding against illness than just getting ample sleep. It’s also important to practice stay-healthy strategies too.

Steps to Keep Children and Others Healthy

  1. Clean hands often using soap and water or alcohol-based hand sanitizer.
  2. Avoid people who are sick (coughing and sneezing).
  3. Put distance between your children and other people outside of your home. Keep children at least 6 feet from other people.Consider postponing visits or trips to see older family members and grandparents. Connect virtually or by writing letters.
  4. Children 2 years and older should wear a cloth face covering over their nose and mouth when in public settings where it’s difficult to practice social distancing. This is an additional public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) the other everyday preventive actions listed above.
  5. Clean and disinfect high-touch surfaces daily in household common areas (like tables, doorknobs, light switches, remotes, desks, toilets, and sinks).
  6. Launder items including washable plush toys, as needed. Follow the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting and dry items completely.
    Make sure your children are up to date on well-child visits and immunizations.

Following guidelines to prevent the spread of the COVID-19 virus can be particularly difficult for children. Stay patient. Be a good role model and your child will be more likely to follow your lead. And remember, you children will be able to bounce back faster if they get sick if their body is well rested.

If your child continues to have sleep issues, or if you are concerned that your child may have a sleep disorder, the pediatric sleep medicine physicians at Comprehensive Sleep Care Center are here to help. Give us a call today. We are offering in-office as well as virtual office visits.

10 Tips to Better Sleep

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10 Tips to Better Sleep

Healthy sleep habits can make a big difference in your quality of life. Better Sleep helps to strengthen your immune system. But sleep can be elusive, especially during COVID-19 (Coronasomnia).

Here are 10 tips for getting a better night’s sleep.

Try to keep the following sleep practices on a consistent basis:

  1. Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends.This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night. This is also important for kids during the pandemic upheaval.
  2. Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.
  3. If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.
  4. Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.
  5. Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 66 and 69 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner’s sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.
  6. Sleep on a comfortable mattress and  Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.
  7. Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime. Try a light snack 45 minutes before bed if you’re still hungry.
  8. Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.
  9. If you can’t sleep, go into another room and do something relaxing until you feel tired. It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine.
  10. If you’re still having trouble sleeping,  you may benefit from recording your sleep in a Sleep Diary to help you better evaluate common patterns or issues you may see with your sleep or sleeping habits.

If you’re still having trouble sleeping, don’t hesitate to speak with your doctor or to call one of our sleep medicine specialists here at Comprehensive Sleep Care Center. It could be a more serious sleep disorder like sleep apnea or chronic insomnia.

 

 

 

 

Safer Sleep Apnea Treatment During COVID-19

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A Safer Sleep Apnea Treatment During COVID-19

CPAP Alternative – Oral Appliance Therapy

 

CPAP Alternative

Over the years, we have heard it time and time again: I hate my CPAP, I’ve tried, but I really can’t tolerate it. I feel claustrophobic with the mask… isn’t there a CPAP alternative? Yes, there is! You can say Bye Bye CPAP and treat your sleep apnea and snoring without a mask with Oral Appliance Therapy (OAT). Oral Appliance is also a safe and CPAP alternative treatment option during these times of COVID 19

Position Statement

The American Academy of Sleep Medicine (AASM) recommends oral appliance therapy as a first-line treatment for mild to moderate obstructive sleep apnea, or in cases where patients are unable to tolerate CPAP therapy. In addition, the American Academy of Dental Sleep Medicine (AADSM) states that oral appliance therapy (OAT) should be prescribed as a first-line therapy for the treatment of obstructive sleep apnea (OSA) during the COVID-19 pandemic.

CPAP Non-Compliance

It is estimated that 30-50 percent of CPAP users don’t like their treatment; another survey discovered that about half of patients stop using CPAP within 1-3 weeks. Luckily, there is a better way to treat sleep apnea without a bulky CPAP or surgery.

A Better Treatment Option

Over 300,000 patients world-wide have found successful treatment with Oral Appliance Therapy (OAT), a custom-made oral device for the treatment of mild to moderate obstructive sleep apnea (OSA). Oral Appliance Therapy has been shown to be highly effective in treating sleep apnea and snoring. In fact, 91% of patients reported improvement in sleep quality while wearing it.

CPAP Alternative for Sleep Apnea

What is Oral Appliance Therapy?

Oral Appliance Therapy (OAT) is a no-mask CPAP alternative treatment for mild to moderate obstructive sleep apnea and snoring. It is similar in appearance to a retainer. The Oral appliance is custom fit by a qualified dentist. It works by holding the jaw slightly forward. This keeps the tongue and soft tissues from collapsing and blocking your airflow/breathing during sleep.

Obstructive Sleep Apnea

Millions suffer from the effects of snoring and obstructive sleep apnea (OSA), yet few are aware of the potential health hazards.

The warning signs of OSA include

  • Frequent and loud snoring
  • Daytime sleepiness
  • Waking during the night gasping for breath
  • Morning Headaches
  • Grinding Teeth

Obstructive sleep apnea can lead to the following health issues:

  • High blood pressure
  • Heart disease – including sudden cardiac death
  • Stroke
  • Type-2 Diabetes
  • Weight Gain
  • Greater risk of car accidents due to drowsiness
  • Depression/anxiety
  • Decreased Sex Drive

Pretty serious stuff if left untreated.

Treating snoring or obstructive sleep apnea with oral appliance therapy can help you feel like a new person. You will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use it nightly.

Benefits of Oral Appliance Therapy

  • No mask or machine needed
  • Comfortable & easy to wear
  • Easy to disinfect and clean
  • Discreet & silent
  • Portable and easy for travel
  • No electricity needed
  • Allows for talking and drinking
  • Less issues for claustrophobic patients
  • Most patients see improvement in the first few nights
  • Better compliance rates compared to CPAP
  • Less cumbersome & more attractive compared to a CPAP
  • Significantly improves sleep apnea symptoms, i.e. oxygen saturation and daytime sleepiness

 OAT may be the perfect CPAP alternative solution for ending snoring, treating Sleep Apnea, and improving your sleep quality. It is an ideal treatment for patients who have been diagnosed with mild to moderate obstructive sleep apnea or for those who have severe OSA yet are unable or unwilling to tolerate CPAP therapy and/or surgery.

Comprehensive Sleep Care Center

We have the area’s top sleep medicine specialists with 9 convenient locations in Alexandria, Arlington, Bethesda, Chantilly, Dumfries, Germantown, Lansdowne, Manassas, and Woodbridge.

We are the only sleep center in the Washington, DC Metro area to provide on-site oral appliance therapy with our own team of dentists experienced in treating sleep apnea. Because OSA is a medical condition, the claim is filed through your medical insurance provider. Most medical insurances cover the cost (after your deductible or co-insurance is met). We offer no-interest flexible payment plans for patients with higher deductibles.

If you are interested in learning more about Oral Appliance Therapy, visit our website today. You can also email our Patient Care Coordinator, Marvin, at [email protected]. Call today to find a better and safer CPAP alternative treatment!

Sleep Study FAQ

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SLEEP STUDY FAQ (ANSWERED BY A REGISTERED POLYSOMNOGRAPHIC TECHNOLOGIST)

By Amanda Jones RPSGT

If you have questions about undergoing a sleep study, you’re not alone. Here are some FAQ that I get asked while working at Comprehensive Sleep Care Center as a Sleep Technologist. They may be able to help you understand the process and put you more at ease.

A sleep study, known as a polysomnogram, is an overnight test done in a sleep lab. Prior to the study, a sleep technologist will place sensors on your scalp, face, chest and legs. These sensors will record brainwave activity (to assess sleep stage), eye movements, muscle activity, heart rhythm, body movements, nasal/oral airflow, respiratory effort and oxygenation. In addition, your body position will be observed on video camera. All this information will better assist your sleep physician in determining the cause of any sleep related problems.

Sleep Study FAQ

Q: WHY DO I NEED A SLEEP STUDY?

A: Sleep studies help doctors diagnose sleep disorders such as sleep apnea, periodic limb movement disorder, narcolepsy, restless legs syndrome, insomnia, and nighttime behaviors like sleepwalking and REM sleep behavior disorder.

Q: CAN MY SPOUSE OR SIGNIFICANT OTHER STAY WITH ME ON THE NIGHT OF MY STUDY?

A: Significant others may have helpful insight during the evaluation stage, but they are not usually permitted to stay with you on the night of your study. IF there is a reason they need to stay, please discuss it with your doctor during your consult.

Q: WHAT IF I CAN’T SLEEP?

A: Don’t stress, we don’t expect you to sleep as well as you would at home, and we take that into account. Nearly everyone can fall asleep during an in-lab study. In most cases, you do not need a full 6 hours of sleep for the doctor to make a diagnosis. There are several things you can do to help you sleep the night of your study. First consider waking a little earlier than usual on the day of your study. Do not take naps during the day. Avoid the consumption of all caffeine—skipping coffee, tea, soda pop, chocolate, energy drinks, and other caffeinated products.

Q: CAN I BRING MY OWN PILLOW?

A: Of course! We want you to be as comfortable as possible so you can sleep. Our sleep labs use My Pillows on each bed (one soft and one firm).  However, most people prefer their own pillow. In fact, if you have a special blanket or throw you sleep with, bring that as well! The more comfortable you feel the better you will sleep.

Q: WHAT ABOUT ALL THE WIRES? WILL THEY STAY ON ALL NIGHT?

A: After you arrive at the sleep center a technician will apply small sensors to your head and body with adhesive. The wires connecting the sensors to a headbox are usually gathered to the side with plenty of slack so you can move around during sleep. Elastic belts will be wrapped around your chest and abdomen to measure breathing. A clip will be placed on your finger or (in some cases your earlobe) to monitor oxygen levels in your bloodstream. Most people get used to it all very quickly. Everything is attached using medical tape and/or paste. The wires are attached to stay on all night. If anything does come loose the tech will enter the room to re-attach them during the night. We attempt to do this without waking the patient if possible. The sensors are attached to your body in a manner like electrocardiogram (EKG) electrodes and are not painful. In rare instances, some people with sensitive skin develop local irritation at the electrode sites. If you have experienced skin irritation due to EKG testing in the past, or have an adhesive allergy please notify the Sleep Center and the technologist prior to the study.

 Q: CAN I SLEEP ON MY SIDE? WHAT IF I MOVE AROUND IN MY SLEEP?

A: We want you to sleep in your natural position. Many people roll over and change positions multiple times during the night. While sleep apnea is more prevalent when sleeping on your back, the Technician may ask you to try sleeping on your back for a portion of the test. This allows us to check your breathing in multiple positions. IF you’re unable to, don’t worry! It may be very difficult to sleep on your stomach so the technician may ask you to use a pillow to keep you from rolling all the way onto your stomach.

Q: DURING MY SLEEP STUDY, WHAT IF I HAVE TO USE THE RESTROOM?

A: If you need to get up during your sleep study just notify your sleep technologist (by calling out or sitting up in the bed) and let them know that you need to use the restroom. They will unhook one or two central connections, which will enable you to get up and walk to the bathroom. The headbox even has a strap you can carry over your shoulder or around your neck. (The headbox is the device that all your wires connect into)

Q: MAY I SLEEP NAKED?

A: No. As a courtesy to our sleep techs we request that you sleep in pajamas or a t-shirt and shorts.

Q: HOW LONG IS THE SLEEP STUDY? WHAT IF I WAKE UP EARLY? CAN I SLEEP IN?

A: The wake-up time is 5 am, and unfortunately, we cannot allow patients to sleep in. Insurance requires a minimum of 6 hours of recording, and as long as we have reached that, you are free to leave before 5 am (some restrictions may apply depending on if the patient took a sleeping medication). Many people ask why they must get up so early. Our Sleep Technicians need to ensure all patients are up and checked out so they can upload all the data to be read and get home so they too can get some sleep.

Q: HOW HARD IS THE PASTE TO GET OUT OF MY HAIR?

A: The paste is water soluble! You can use a hairbrush, but some paste will remain. The best thing to do is wash your hair with very warm water. We recommend using conditioner first to loosen up the paste and then washing your hair. Rubbing alcohol is also an effective, quick way to remove paste but can be rough on the scalp. Also, Micellar water can be effective and less harsh.

Q: CAN THEY TELL ME THE RESULTS OF MY SLEEP STUDY IN THE MORNING?

A: Unfortunately, no. The sleep technologist is collecting data that will be interpreted by your sleep medicine physician. You will receive your results at your follow-up visit.

Whether you were a little nervous about your upcoming sleep study, or just curious about the process, we hope this cleared up a few questions and put your mind at ease! Remember, your Comprehensive Sleep Care Center sleep technologist is not only there to gather information, but they are there to make the process as comfortable as possible! We look forward to seeing you soon!

 

Six Tips to CPAP Success

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Six Tips to CPAP Success

Trouble getting comfortable with your CPAP machine? Here are some tricks and tips to being successful with your CPAP therapy at home!

PAP therapy – such as CPAP, BiPAP, ASV, etc. – can be challenging to use at first, but with the following tricks and tips, for CPAP success you’ll have yourself saying “Hello!” to sleep again before you know it.

  • Rid yourself of preconceived notions regarding the CPAP machine!

    • Most people know a family member or friend who is using a PAP machine, and he or she might love it, or hate it. Everyone goes through a very unique experience with his or her therapy, so keep your mind as open as possible, and do not let someone else’s experience influence your own.

  • Breathe naturally

    • When you first wear a PAP machine, you may be inclined to try to regulate your breathing and put in a conscious effort at inhaling and exhaling. But don’t! This can induce panic and may make you want to take the mask and machine off. Breathe naturally, and with time, typically the positive pressure becomes more comfortable.

  • Consistency of usage is key

    • “Practice makes perfect” applies to PAP therapy! The more you use the machine, the easier it becomes. On nights when you feel like you have had enough with your machine, try your best to push through. If you do need to take a brief break and step away from the therapy for a moment, do so, but plan to put the mask and machine back on before you fall back asleep for the rest of the night.

  • The mask can make or break the treatment

    • Work closely with our DME technicians to ensure that you have the best mask style and size suited for your mode of PAP therapy, your pressure settings, your facial structure, and your preferred body positioning during sleep, among other defining elements. A mask that does not fit well makes for a poor night’s rest with the machine, as the airflow can “leak” out, causing disruptive noise and discomfort.
    • Practice “mask desensitization” if you are having a hard time keeping your mask on, all night long. This involves wearing the mask and headgear for at least 45 minutes prior to bedtime, in an effort to “normalize” the apparatus and get your brain and body acquainted with the equipment before you attempt to sleep.

  • Take advantage of comfort features on your machine

    • Don’t forget about the features below for optimal comfort, and contact our DME team if you need additional assistance or further instructions on how to utilize or adjust the following:
      1. Humidifier settings – can help with dry mouth and dry mucosa
        1. Increase the level for more moisture
          1. If your tubing is “gurgling” due to water condensing in the tubing or mask when you increase the setting, ask a DME technician about a heated tube.
        2. Decrease the level for less moisture
      2. RAMP – can help you fall asleep with PAP therapy by lowering the pressure
        1. Hitting the RAMP button will drop the pressure to a lower setting (i.e. 4 cm H2O) and allow the pressure to gradually build up to your final prescribed pressure over a period of time (i.e. 30 minutes)
  • Flex – can provide extra relief when you inhale, exhale, or both, depending on your mode of PAP therapy and machine manufacturer

  • Keep your sleep medicine team involved

    • If you are having a problem using and/or tolerating your PAP therapy, let us know so we can help!

 The more you use your machine, the more you will get used to it. Give yourself time to adjust. So, stick with it and soon enough you’ll start to realize just how much treating your sleep apnea improves your sleep and your quality of life! And you can Say Hello to Sleep Again!

INSOMNIA -Why Can’t I Sleep?

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INSOMNIA-Why can’t I sleep?

Insomnia is a problem for many during normal times, but factor in a pandemic and global unrest and it has become much more widespread. Insomnia is a sleep disorder where a person has trouble falling asleep, staying asleep and/or they wake up too early in the morning. Insomnia can drain your energy level and mood, but also negatively impact your health, work performance and quality of life. How much sleep you need varies from person to person, but most adults need seven to eight hours a night.

Insomnia is characterized based on its duration. Acute Insomnia typically lasts short-term while Chronic Insomnia can last a long time.

Acute Insomnia

Lasts from one night to a few weeks and can come and go. It often happens due to life’s circumstances (Coronosomnia) or when you can’t fall asleep the night before an exam or after receiving stressful or bad news. Many people experience short term insomnia and it tends to resolve without any major treatment.

Chronic Insomnia

Happens at least 3 nights a week for 3 months or more. It can have many causes. Changes in the environment, unhealthy sleep habits, shift work, certain medications and medical disorders can lead to a long-term pattern of sleep deprivation.

Insomnia Symptoms may Include:

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested after a night’s sleep
  • Daytime tiredness or sleepiness
  • Irritability, depression or anxiety
  • Difficulty paying attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

Common Causes of Insomnia Include:

  • Stress-Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma also may lead to insomnia.
  • Travel or work schedule-Your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism and body temperature. Disrupting your body’s circadian rhythms can lead to insomnia. Causes include jet lag, working a late or early shift, or frequently changing shifts.
  • Poor sleep habits-Poor sleep habits include an irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watching TV. Computers, TVs, video games, smartphones or other screens just before bed can interfere with your sleep cycle.
  • Eating too much late in the evening-Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable. Many people also experience heartburn which may keep you awake.
  • Mental health issues–Anxiety disorders may disrupt your sleep. Insomnia often occurs with other mental health disorders as well.
  • Medications-Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many over-the-counter medications such as some allergy and cold medications, and weight-loss products can contain caffeine and other stimulants that can disrupt sleep.
  • Medical conditions- Examples of conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal reflux disease (GERD), overactive thyroid, Parkinson’s disease and Alzheimer’s disease.
  • Sleep-related disorders–Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
  • Caffeine, nicotine and alcohol- Coffee, tea, cola and other caffeinated drinks are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.
  • Changes in sleep patterns- With age, your internal clock often advances, so you get tired earlier in the evening and wake up earlier in the morning. But older people generally still need the same amount of sleep as younger people do.
  • Changes in health- Chronic pain from conditions such as arthritis or back problems, can interfere with sleep. Issues that increase the need to urinate during the night, such as prostate or bladder problems, can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.

 If you are experiencing insomnia symptoms you should speak to your doctor or call Comprehensive Sleep Care Center at 703-214-0318 to see one of our sleep medicine specialists. We are now offering TeleMedicine visits to new and returning patients. Comprehensive Sleep Care Center offers expert diagnosis, treatment, and care for sleep disorders with the goal of providing a better night’s sleep and a better day ahead.

CPAP and COVID-19

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10 Things You Need to Know CPAP and COVID-19

We are receiving a lot of questions about CPAP use during the COVID-19 Pandemic. Comprehensive Sleep Care Center is here to help you with this, and all your sleep care needs. That includes the use of CPAP (Continuous Positive Airway Pressure) as well as BiPAP and ASV Therapy during the COVID-19 Coronavirus Pandemic.

First and foremost, the most important thing we can tell you is DO NOT STOP USING YOUR CPAP without first speaking to your doctor! You were prescribed a CPAP for a medical reason and stopping can put your health at risk.

The information below is for educational use only. If you need specific medical advice, please call the office to speak to the physician or DME-Durable Medical Equipment representative.

Do I have a higher risk of getting coronavirus because I have sleep apnea?

  • There is no evidence linking sleep apnea with coronavirus risk.

 If I do have the coronavirus, will CPAP help me treat it?

  • Your CPAP is used to treat one thing, your obstructive sleep apnea.
  • The question becomes, if you Do Not use your CPAP, what could happen? We know that we want to stay healthy. Well good quality sleep is needed to do that. If you’re not using your CPAP, you’re going to further weaken your immune system. And if you do have coronavirus, or you’re worried about getting coronavirus or any virus, you’re going to be more susceptible if you stop using your device.

 What’s the Difference Between CPAP Machines and Ventilators?

  • CPAP machines and ventilators are both considered mechanical ventilation. They both assist with a patient’s breathing. But there is a big difference -CPAP machines deliver a steady stream of pressurized air to keep the airways open while sleeping, thus preventing the collapse of the passageway and episodes of interrupted breathing. A ventilator is necessary for more severe respiratory conditions in which a patient is unable to breath on their own. A ventilator requires a tube being medically inserted. If you’re using a CPAP machine because you’re in respiratory distress due to COVID-19 infection, you need to call talk to your primary care or go to the emergency room.

 If I have symptoms or have tested positive for Coronavirus, should I continue using my CPAP?

  • Coronavirus doesn’t change your sleep apnea diagnosis – or your need to continue using CPAP therapy. You should continue to use your CPAP machine because a full night’s sleep benefits your overall health.
  • If you have symptoms of the coronavirus, you should isolate yourself in a separate bedroom and use a separate bathroom, if available. In this “recovery room,” you can continue to use CPAP while you sleep alone.
  • In the event of COVID-19 diagnosis, it is important to continue the cleaning guidelines provided for your unit. Please refer to our web page for step-by-step instructions on cleaning your device and mask.
  • We recommend increasing the weekly cleaning to a minimum of bi-weekly during an active infection.
  • After you are free from the coronavirus, replace your CPAP filters and disposable accessories as soon as possible.

 Can my CPAP machine spread Coronavirus to my bed partner?

  • The latest information says non-invasive ventilation (delivered by a mask with air diffusers) has a low risk of aerosolization, provided that there is a good mask fit, and you follow patient isolation (recovery room) guidelines.

Will my insurance still request compliance while in the Pandemic?

  • This is a bit tricky. Insurance companies have not provided any information to indicate that there are any changes to the compliance requirements. If there are extenuating circumstances for a patient, inform your doctor immediately so they can document the information. But it will not ensure that if compliance is requested the extenuating circumstances will override the compliance requirements.

How often should I clean and disinfect my CPAP mask and hose?

  • It’s important to clean your equipment as specified in the instructions for use that came with your equipment.  Poor or inappropriate maintenance can make your sleep therapy ineffective and damage your equipment.
  • If you’ve been sick, it’s smart to wash your mask, tubing, humidifier and filter daily until your cold, flu or virus symptoms are gone. That can help reduce the amount of time you spend feeling under the weather.
  • To be cautious in this time of COVID-19, we recommend increasing the weekly cleaning to bi-weekly cleaning.
  • Keeping it clean: CPAP hygiene
  • Replace your mask and other equipment to keep your machine clean and functioning optimally. We recommend you replace your mask/supplies every 90 days as allowed by your insurance carrier.

Distilled water is unavailable in my area. What should I use in my CPAP humidifier?

  • Optimal humidifier performance requires distilled water. That’s because most or all its minerals have been removed, preventing mineral buildup in the humidifier tub. That said, bottled (purified) water may also be used. It will not harm the device or pose a risk to patients. It will, however, require more rigorous humidifier cleaning to prevent excess mineral buildup in the tub.

 Will a CPAP cleaning machine disinfect my CPAP device and mask?

  • No, CPAP cleaning machines are not FDA-approved and especially right now, I would say, soap and water are still your best option to effectively clean your device.

 Are there any additives or chemicals that I should use to clean a CPAP machine during the coronavirus outbreak?

  • The answer is NO!
  • During a time like this, people may be tempted to try different things like bleach or other chemicals in their CPAP machine. But remember these chemicals can get in your lungs and cause damage. Please, just stick to what’s recommended. Don’t add anything else.

CPAP Cleaning Instructions

 Daily Cleaning

**Do not use moisturizing soaps, bleach, scented oils, chlorine, or alcohol-based solutions to clean your supplies. These solutions may cause irritation to your skin and lungs and may reduce the life of your products.

**If you’ve been sick, it’s smart to wash your mask, tubing, humidifier and filter daily until your cold, flu or virus symptoms are gone. That can help reduce the amount of time you spend under the weather.

  • Before using your mask -wash your face daily with soap and water to remove excess facial oils.
  • Wipe down your mask (including areas that come in contact with your skin) using a damp towel with soap and warm water. This will remove any oils, dead skin cells, and sweat on the mask that can affect the quality of the seal. Gently rinse with a clean towel and let the mask air-dry out of direct sunlight.
  • **You can also use unscented baby wipes or pre-moistened towels designed specifically for cleaning CPAP masks, which are available on-line. DO NOT USE CLOROX OR DISINFECTING WIPES.
  • If your unit has a humidifier, empty any leftover water instead of letting in sit in the unit all day. Refill the humidifier with clean, distilled water right before bedtime for optimal use

Weekly (more more frequent) Cleaning

  • Your mask and tubing need a full bath at once a week to keep it free of dust, bacteria, and germs. (During COVID-19 or any other virus we recommend more frequent cleaning)
  • Clean the CPAP tubing, nasal mask, and headgear in a bathroom sink filled with warm water and a few drops of ammonia-free, mild dish detergent. Avoid using stronger cleaning products, including dish detergents, as they may damage the mask or leave harmful residue. Swirl all parts around for about five minutes, rinse well and let air dry during the day. Hang the tubing over the shower rod, on a towel rack or in the laundry room to ensure all the water drips out.
  • The mask and headgear can be air-dried on a towel or hung on a hook or hanger.
  • You should also wipe down your CPAP machine with a damp cloth. Ensure the unit is unplugged. The towel shouldn’t be too damp or wet, as water could get into the machine.
  • Clean the filter by removing it and rinsing it in warm tap water. Run it under the water and squeeze to make sure there is no dust. Then blot down the filter with a towel.
  • Do not wash your machine’s white filter, if one is present—those are disposable and should be replaced every two weeks. If you are recovering from being sick, we recommend changing the filter sooner.
  • If your CPAP has a humidifier, that also needs to be cleaned weekly.
  • Empty any remaining water and then wash the water chamber in the sink with warm soapy water. Rinse well and drain out as much of the water as possible. Let the chamber air-dry before placing it back into the CPAP unit.
  • Every other week you should disinfect the humidifier. Do that by soaking it in a solution of one-part vinegar to five parts water for 30 minutes, thoroughly rinsing and then placing in your dishwasher’s top rack for washing. And keep it clean by using only distilled water to prevent mineral deposits that can build up and cause damage to your machine.

**The following are examples of soap that may be used: Johnson & Johnson baby soap, Ivory soap (plain).

With a little upkeep, your CPAP can continue to help you breathe better for a long time. Just a few minutes a day can help keep your CPAP running efficiently for years to come.

Stay Healthy and Stay Strong!

 

 

Coronasomnia

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It’s not Insomnia. It’s CORONASOMNIA

Yes, it is a real thing

 

Are you quarantined alone or with a houseful of kids? Are you working full-time or searching for a new job? The stresses caused by Coronavirus are real and it is causing us to lose sleep. It’s called Coronasomnia and yes, it is a real thing.

I do my best to keep a regular schedule. I try to go to bed and wake up at the same time every day like the experts recommend. But on many nights (especially if I watch the news before bed), as soon as my head hits the pillow, my mind goes into overdrive. I am wide awake wracked with anxiety about  Coronavirus. I worry about my family. Those that live far away, those that live close by, but I can’t visit. I worry about my job. I worry about my friends that own small businesses and restaurants. What is going to happen? What can I do to help? What if I get sick? When is this ever going to end?

I thought it was just insomnia but it’s not. It’s Coronasomnia!

Clearly, I am not alone in this. Everyone I know is having sleep issues. They ask me for my advice because I work at a sleep center. I tell them it is Coronasomnia; an epidemic inside of a pandemic! Even children are starting to feel the stress and it is causing sleep issues for them. Try getting a teenager to adhere to a sleep schedule, or any schedule, when there is no school or sports.

Although the pandemic has only been around for a few months, experts are already seeing an impact. A poll released by the American Psychiatric Association (APA) found that nearly half of Americans (48%) are anxious about the possibility of getting Coronavirus (COVID-19), and nearly four in ten Americans (40%) are anxious about becoming seriously ill or dying from Coronavirus. But far more Americans (62%) are anxious about the possibility of family and loved ones getting Coronavirus.

More than one-third of Americans (36%) say Coronavirus is having a serious impact on their mental health and most (59%) feel Coronavirus is having a serious impact on their day-to-day lives.

Lack of sleep can affect your immune system

It is a never-ending cycle. Stress causes sleep deprivation and insomnia which makes you more stressed. Then the news and life’s uncertainties add to that stress. Here is an even bigger problem; lack of sleep can affect your immune system. Studies show that people who don’t get quality sleep or enough sleep are more likely to get sick after being exposed to a virus. Lack of sleep can also affect how fast you recover if you do get sick. Great double the trouble!

There are several key factors that are likely contributing to Coronasomnia sleep issues

  • Information overload from news sources and other media
  • Excessive exposure to screens; blue light from screen inhibits your body’s natural release of melatonin, which can make it harder to fall asleep
  • Loss of daytime routines and structure; less consistent bedtimes and wake times
  • Depressed mood and daytime napping can make it more difficult to fall asleep at night

I know many of us feel like there is nothing we can do but just deal with it and hope it goes away when things finally get better. The problem is that insomnia can have a significant impact on our health. So, what can we do to try and get the 7-8 hours of quality sleep we need?

Here are some tips that may help you get a better night’s sleep:

  • Stick to a sleep schedule – the same bedtime and wake up time. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.
  • Limit your exposure to the news especially right before bed
  • Decrease screen time before bed – blue light from screens can interfere with your circadian rhythms and decrease your melatonin levels.
  • Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as taking a bath or reading. Try practicing a relaxing bedtime ritual.A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep.
  • Avoid naps- Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.
  • Exercise daily- Vigorous exercise is best, but even light exercise is better than no activity.
  • Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 65 and 68 degrees. Check your room for noises or other distractions. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.

If you’re still having trouble sleeping, don’t hesitate to speak with your doctor or to call one of my sleep medicine specialists here at Comprehensive Sleep Care Center. As much as Coronavirus related sleep issues are common and understandable, we all need to get a decent night’s sleep to stay healthy.

Written by Sharon Goldman, Marketing Manager at Comprehensive Sleep Care Center