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Breast Cancer and Sleep Apnea

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.

 

Safer Sleep Apnea Treatment During COVID-19

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, ArlingtonBethesdaChantillyDumfriesGermantownLansdowneManassas, 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 CSCCOA@LMGDoctors.com. Call today to find a better and safer CPAP alternative treatment!

Sleep Study FAQ

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

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!

CPAP and COVID-19

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!

 

 

Sleep Study FAQ

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 common questions 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.

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!

 

Having Surgery? Why you need to be screened for Sleep Apnea.

Having Surgery?

Why you need to be screened for Sleep Apnea.

Sleep Apnea is a potentially serious sleep disorder that occurs when breathing is interrupted during sleep. People with untreated sleep apnea can stop breathing up to hundreds of times each night while sleeping. As many as 18 million Americans have obstructive sleep apnea. But over half of those experiencing obstructive sleep apnea (OSA) are unaware that they have the condition.

It is important for surgical patients to be pre-screened for sleep apnea. Patients with sleep apnea who are undergoing any type of surgery or invasive procedures under general anesthesia are at an increased risk for developing respiratory and cardiovascular complications. Complications can include irregular heart rhythms, oxygen deficiency, high blood pressure, diabetes, stroke, heart attack and even death. This holds true for both surgeries related to obstructive sleep apnea and unrelated surgery such as orthopedic or bariatric procedures.

SCREENING FOR SLEEP APNEA BEFORE SURGERY

Screening patients prior to surgery can be very simple. Patients fill out a short Patient Sleep Apnea Questionnaire, which helps their physician determine who is at high risk for sleep apnea. Based on your responses you may need to do a sleep study to confirm or rule out sleep apnea. This test can be done in a sleep laboratory or, in some cases, it can be done with an at-home kit.

PREPARING FOR SURGERY IF YOU HAVE SLEEP APNEA

If you test positive for sleep apnea you should receive treatment prior to scheduling any non-emergency surgery. The gold standard of treatment for OSA is Positive Airway Pressure (PAP). It is important to be compliant with your treatment (wearing the device for 6-8 hours a night) for two to four weeks before the surgery takes place.

DURING AND AFTER SURGERY

Those patients on PAP should bring their own equipment to the hospital. You will receive PAP once your surgery is completed and you are in the recovery area. You should continue to use the unit if admitted to the hospital. It is extremely important to remain compliant with use of PAP therapy after surgery in order to help decrease complications.

 TALK TO YOUR DOCTOR

Whether or not you are having surgery, sleep apnea can be dangerous if not diagnosed and adequately treated. The most common symptoms of sleep apnea are:

  • Snoring, chocking, or gasping during sleep
  • Daytime sleepiness
  • Morning headaches
  • Trouble concentrating, memory problems
  • Mood swings, depression

If you experience any of these symptoms you should speak to your doctor or call Comprehensive Sleep Care Center at 703-729-3420 to see one of our sleep medicine specialists.

Traveling with Sleep Apnea

TRAVELING WITH SLEEP APNEA

THE NEW MINI CPAP MAKES LIFE EASIER

As CPAP users we all know how beneficial our treatment is and how much better we feel after a good night’s sleep. The issue we face isn’t when we are home, but when we travel. Traveling with sleep apnea means dragging along your CPAP machine. If you’re like me you ask the question- do I pack my CPAP or not? To travel with a CPAP, we have to pull out the power cord that we have hidden behind the bed, find our CPAP travel bag, make sure that we pack every component we need (mask, tubing, filters). Even worse when we fly we must make sure to list the medical device as an extra carry on. Then sleep without our CPAP (keeping everyone awake with our snoring) while on the plane. Even thought I know better I tend to say “what a hassle, I will be fine without my machine for a few days” and leave it at home. Only to find that while I am on my trip, my daytime sleepiness and other sleep apnea symptoms start to show themselves. So why isn’t there a better solution? Well there is!

The new mini travel CPAP’s offer the same great therapy in a much smaller size. They even offer some great added benefits. Like USB charging ports, overnight battery options, FAA compliance for in-flight use, waterless humidification and continued insurance compliance with your CPAP machine.

MINI TRAVEL CPAP    resmed mini cpap

Comprehensive Sleep Care Center is now offering the opportunity for our patients to call in and schedule a free consultation to learn about our mini travel CPAP’s. We have two new models available from the best CPAP manufactures in the world. Come check out the small, lightweight, and inconspicuous device that allows patients to get the CPAP therapy they need while making traveling with sleep apnea easier.

Call Today 703-679-0598! To learn more about the Mini CPAP & how it can change the way you travel! For more information email Richard at RBaldridge@lmgdoctors.com

4 Important Facts About Sleep Apnea and Heart Disease in Women

4 Important Facts About Sleep Apnea and Heart Disease in Women

While Sleep Apnea is often thought of as a men’s health issue, here are some important facts about sleep apnea and heart disease in women that you need to know.

  • Obstructive sleep apnea is thought to be more prevalent than both asthma and adult diabetes, possibly affecting more than 18 million Americans.
  • Public health advocates think it may be as big a public health hazard as smoking.
  • The National Commission on Sleep Disorders Research estimated that sleep apnea is probably responsible for 38,000 cardiovascular deaths yearly.
  • Obstructive sleep apnea increases the risk of heart failure by 140%, the risk of stroke by 60%, and the risk of coronary heart disease by 30%.

What is Sleep Apnea?

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times. This means the brain — and the rest of the body — may not get enough oxygen.

  1. Women’s Hearts are More Affected by Sleep Apnea Then Men’s.

A study found that women with moderate to severe sleep apnea had more than a 30 percent higher risk of heart problems than women without sleep apnea. The study found no significant link between sleep apnea and heart problems in men. The researchers also found that, compared to women without sleep apnea, women with the disorder had higher blood levels of troponin, a chemical signal of early heart damage.

  1. Menopause Increases the Risk of Sleep Apnea and Heart Disease in Women

Higher levels of estrogen and progesterone protect women prior to the onset of menopause. These hormones maintain the airway’s muscle tone and keep it from collapsing. However, as these levels decline during perimenopause and drop to their lowest levels as part of menopause, the incidence of sleep apnea climbs. This suggest that older women may be at greater risk for sleep apnea-related heart disease than men.

Data from the 2007 Sleep in America Poll of the National Sleep Foundation demonstrated evidence that 35 percent of women entering menopause could expect to face a higher risk for developing the most serious form of sleep-disordered breathing—obstructive sleep apnea (OSA)—by the post-menopause phase, compared to younger women.

  1. Women’s Sleep Apnea Symptoms can be Different from Men’s

Sleep apnea symptoms in women may or may not mimic those in men. Often, the classic symptoms that men with OSA present, do not show up in the same way in women. Women are more likely to have complaints of restless legs, fatigue, insomnia, morning headaches, or mood swings, rather than the loud snoring and choking that men experience.

  1. Women and Untreated Sleep Apnea are not a Healthy Combination.

Untreated OSA leads to a host of other problems that can plague women: gastroesophageal reflux disease (GERD), diabetes, depression, hypertension, and obesity

Sleep Apnea Complications


If you are struggling with any of the issues discussed in this article, contact Comprehensive Sleep Care Center for a consultation and say hello to sleep again.

Think you are caring for your CPAP correctly?

Think you are caring for your CPAP correctly?

Take this quiz to find out.

One of the most important factors in maintaining CPAP compliance is taking care of your CPAP equipment. Fortunately, caring for your CPAP equipment can be easy. By making it part of your morning routine you will keep your device and accessories working properly. And say hello to sleep again…

1. The water in the humidification chamber needs to be cleaned out daily?

         Yes      No

The answer is a resounding yes. Emptying out the water helps prevents bacteria and calcification build up.

  • Remove chamber from humidifier carefully so water doesn’t enter your CPAP machine.
  • Open chamber and wash with warm, soapy water.
  • Rinse well with water and allow to dry on a clean cloth or paper towel out of direct sunlight.

2. Once a week, the humidification chamber needs to be completely washed?

Yes      No

Again, the answer is YES.

  • Once a week the humidifier chamber should be soaked in a solution of 1-part white vinegar, 3-parts water for approximately 15-20 minutes before rinsing thoroughly.
  • Some humidifier chambers are dishwasher safe, but make sure to check your CPAP machine’s manual before cleaning in a dishwasher.
  • Humidifier chambers should be replaced every 6 months or as needed.

3. CPAP masks need to be washed daily?

Yes      No

The answer is Yes, (do you see a theme here?)

Most CPAP mask cushions are made of silicone. While silicone is a very comfortable material for masks, it doesn’t have a very long lifespan, and without proper care can breakdown even faster than expected. Therefore, cleaning your CPAP mask is crucial in making it efficient as possible. Here are some tips on CPAP mask cleaning and replacement:

  • Wash mask daily with warm water and mild, non-fragrant, soap or use unscented baby wipes. You can also purchase CPAP mask wipes.
  • Rinse with water and allow to air dry on a clean cloth or paper towel out of direct sunlight.
  • Before using mask at night, wash your face thoroughly and don’t use facial moisturizers. Facial oils and moisturizers can breakdown the silicone faster.
  • Once a week, soak mask in solution of 1-part white vinegar, 3-parts water before rinsing.
  • Headgear and chinstraps should be washed as needed by hand using warm soapy water, rinsed well, and air dried. Do not place headgear or chinstraps in washing machine or dryer.
  • When caring for your CPAP masks check both your manufacturer’s recommendations and your insurance allowance. However, for most masks it is recommended that you replace the cushions 1-2 times per month, and the mask every 3-6 months.
  • CPAP tubing should be cleaned weekly in a sink of warm, soapy water, rinsed well, and left to hang-dry out of direct sunlight.

4. Should you clean the non-disposable filter weekly? More if you have pets or smoke?

Yes      No

I think you know what the answer is.

Your filters are located near the back of the CPAP machine where the device draws air. Nearly all CPAP machines have a disposable filter and some have an additional non-disposable filter as well. Here are some cleaning tips for your CPAP filters:

  • Rinse non-disposable filters with water and allow to dry before placing back into your machine.
  • The re-usable filters should be replaced when it begins to look worn or after 6 months.
  • Replace disposable filters every 2 weeks or more frequently if it appears dingy or dirty.
  • Once a week, unplug device from outlet and wipe with a damp cloth.

Cleaning CPAP

IMPORTANT TIPS

  • Make caring for your CPAP equipment part of your morning routine.
  • Keep machine and accessories out of direct sunlight to avoid damaging them.
  • Never use bleach to clean accessories.
  • Place machine on a level surface and away from curtains that may interfere with the air intake.
  • Keep track of when you should order replacement parts for your mask and accessories so that you always get the most out of your CPAP.

If you have a CPAP, but are struggling with compliance, check out our no mask oral appliance, ApneaGuard, for mild to moderate sleep apnea.  Call and schedule a consultation with one of our sleep medicine physicians, or ask your doctor about a sleep referral to the Comprehensive Sleep Care Center.


If you are struggling with your CPAP or have sleep issues, contact Comprehensive Sleep Care Center for a consultation and Say Hello to Sleep Again…