VOLUME 3, ISSUE 4
BETTER
BETTER
4TH
SLEEP
HEALTH
QUARTER 2009
DO YOU SNORE? IMPORTANT FACTS YOU
SHOULD KNOW
INSIDE THIS
ISSUE:
Almost everyone knows someone who snores at night. Maybe you have a parent or spouse that
“shakes the walls” when asleep. Or maybe you are the one being told you “saw logs” or “wake the
dead”. However you describe snoring, it never sounds good. But is snoring dangerous or just a lot of
noise? And what can be done to get rid of snoring?
EXCLUSIVE
CONTINUING
SERIES:
GETTING THE
MOST OUT OF
CPAP
2
NAPPING
SURVEY
RESULTS
3
DRINKING
ALCOHOL MAY
AFFECT SLEEP/
WAKE CYCLE
3
SPOTLIGHT ON
OSA: JENNIFER
KIM MD
4
THINGS TO
CONSIDER:
• Snoring is often a
sign of Obstructive
Sleep Apnea but
can also cause
excessive daytime
sleepiness on its
own.
• Over 40% of the
population snores.
Snoring is so common we often think of it as normal. In fact, roughly 40% of the population reports
snoring. But snoring is more than just loud noise, it is actually a symptom of a much more serious
condition. Snoring results from the vibration of tissue in a person’s airway. When one sleeps, the
muscles and tissues relax and start to partially obstruct the airway. The obstructing tissue moves with
airflow and leads to loud noise, but it can also actually obstruct breathing. When breathing is
obstructed the resulting condition is known as Obstructive Sleep Apnea. These obstructive events can
be a partial closing of the airway, called a Hypopnea, or a full blocking, called an Apnea. In both cases
the person is struggling to get more air into their lungs. When the amount of fresh air entering the
body is restricted, the oxygen level in the bloodstream falls and
the body starts to panic. The brain arouses or wakes the person,
temporarily restoring airway muscle tone and opening the throat.
Even though theses events can happen hundreds of times a
night, since these awakenings or arousals are so brief, the
person usually doesn’t even know they have this condition. They
think that they are sleeping all night but have actually been
fighting to breathe. Of course, for the person next to them
Not only is snoring annoying, it can be
witnessing the struggle, it’s all too real.
dangerous too.
Also real are the effects Sleep Apnea has on your body. The lack of oxygen stresses the heart, leading
to a much higher risk of heart attack, stroke, and high blood pressure. Other conditions related to
Sleep Apnea include migraines, impotence, memory loss, and daytime sleepiness.
Even if the problem hasn’t progressed to the point of full blown Apnea, the physical effects of snoring
can be felt. A recent study conducted by Swedish researchers concluded that “snoring is an
independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea”. (Chest, Nov.
2008) Many people try to pass snoring off as normal and do not realize the impact it may have on their
lives and on those around them.
So if snoring is such a problem, what can you do to fix it? The first step is to contact a sleep specialist.
They can evaluate your symptoms and schedule you for a sleep study to determine the severity of the
problem. Treatments depend on how serious the problem is. The doctor may recommend using an
dental appliance made by a dentist to move your jaw forward and open your airway. If the problem is
more severe, surgery or use of a CPAP machine may be the best methods of treatment. If you or
someone you know snores loudly on a regular basis, contact a Oregon Sleep Associates at 503-2885201 for more information.
BETTER SLEEP BETTER HEALTH
Page 2
GETTING THE MOST OUT OF CPAP: TIPS FOR
COMPLIANCE
There are many new treatments for Obstructive Sleep Apnea on the market today. But none of them
match the efficacy of Continuous Positive Airway Pressure, or CPAP. In this ongoing series, we will
explore different aspects of CPAP usage through the eyes of patients.
In the previous segment of this series, we explored the changing perception of CPAP therapy and how
today’s CPAPs differ greatly from those of the past. In this segment we delve into the ins and outs of
beginning CPAP therapy and offer some helpful tips for success.
CPAP therapy can be an intimidating prospect to many people. The thought of having to wear a mask to
sleep every night is not the most appealing. But when first starting on CPAP, there are simple methods to
reduce the discomfort or anxiety that you may be experiencing. “First off, it’s important for people to
know there’s someone looking out for them,” says Jason Cowlishaw, Oregon Sleep Associates’ Durable
Medical Equipment Specialist. “Sometimes places will give a patient a CPAP and say ‘here’s your
machine, go home and use it’ and it’s basically like the patient is on their own.” Instead, Jason educates
the patient the morning after their study, giving them the details of their equipment and fitting them with
the most comfortable mask possible. “I usually send people home with at least two options for CPAP
masks, that way they can find out what works best for them. We also swap masks out any time, so the
patient doesn’t have to worry if one doesn’t fit correctly.”
Once the proper mask fit is found, the process of easing into using CPAP begins. “When someone comes
in my office for a CPAP I always tell them not to run home and expect to use the machine all night right
off the bat,” Cowlishaw explains. “People will sometimes stress out about that, so I let them know it’s
better to use the CPAP for naps or for just a few hours a night in the beginning. After a month or so, they
can transition into using it for longer periods. All I ask is for the patient to put the mask on each night.”
It’s important that the DME office also stays in contact with the patients on a regular basis. “Usually I’ll
call them within a week of getting the CPAP just to see if everything is working properly. After a month,
we do a follow-up with the doctor and download the data from the machine. We’re also here to answer
any questions or help anytime, just give us a call.” Patients can also mail in their CPAP cards for
downloads to make sure their machines are functioning at optimal levels.
Successful CPAP use can improve your
mood, energy, and overall health.
“We have over an
80% compliance
rate on CPAP. That
is really a
testament to how
well this therapy
works when people
are introduced to it
correctly.”
- Jason Cowlishaw,
DME Specialist
Here are some helpful tips to make it easier to start using a CPAP:
•
Remember that this therapy is to help improve your health and make you feel better. Nothing bad or
dangerous will happen to you as a result of CPAP.
•
Try a distracting activity such as watching television or reading while wearing just the mask without
the pressure. This will let you get used to having the mask on your face.
•
At first, ease yourself into using the CPAP for naps, then move on to a few hours a night, slowly
working up to wearing it all night.
•
Educate your bed partner about your CPAP so they can be aware of any problems such as a mouth
leak or a loose mask.
•
If one mask is not comfortable, contact your DME provider to try a different style. If they are not
helpful, don’t hesitate to ask for a different DME service.
With a little patience and an open mind, many people soon find out that CPAP can be very comfortable
and easy to use. “We have over an 80% compliance rate on CPAP”, says Jason. “That is really a
testament to how well this therapy works when people are introduced to it correctly. It can definitely
change people’s lives for the better.”
If you’d like to talk to Jason Cowlishaw about CPAP, feel free to call him at 503-972-4692.
With literally dozens of mask designs
on the market, one can always be
found to fit your needs.
VOLUME 3, ISSUE 4
Page 3
NAPPING IS COMMON, BUT MAY BE A SIGN OF OSA
It’s afternoon and you are sitting at work. Your eyelids suddenly feel extra heavy and start to droop.
Your head starts to nod, and you can feel sleep pulling you in. Your body is telling you it’s time for a
nap and you’re not alone in that feeling.
Recently, a survey was performed by the Pew Research Center to learn more about people’s napping
habits. The results are surprising; roughly one third of Americans take a nap every day.
The survey looked at people of many different backgrounds and demographics but found napping was
widespread across all of them. Not surprisingly, there was a strong correlation found between napping
and trouble sleeping at night. The respondents that had trouble sleeping the previous night or who
didn’t usually get the normal 7-8 hours a night were much more likely to nap.
While napping itself may not necessarily be harmful, it can be a sign of something more serious.
Excessive daytime sleepiness is a common problem and one that can have many causes. If fatigue is
making it hard to function during the daytime, it could be the result of a sleep disorder.
Napping is normal, but it can be a
sign of a sleep problem if done too
often.
One of the most common sleep disorders is Obstructive Sleep Apnea. This condition is characterized by
obstructions in breathing which disrupt sleep to the point that the patient is not rested. One of the
major symptoms of Apnea is excessive daytime sleepiness, especially in the afternoon.
If you find that you cannot make it through the day without napping, it may be prudent to get screened
for sleep disorders. Talk to your doctor or contact Oregon Sleep Associates at 503-288-5201 for more
information.
DRINKING ALCOHOL MAY DISRUPT YOUR
CIRCADIAN RHYTHM
Roughly 1/3 of
Americans take
a nap every
day.
Benjamin Franklin famously said, “Beer is living proof God loves us and wants us to be happy.”
Maybe so, but he also said “Early to bed, early to rise makes a man healthy, wealthy, and wise.” Now
new research shows that alcohol and sleep make lousy bedfellows.
In fact, scientists now say that too much alcohol affects the body’s circadian rhythm. The Circadian
rhythm is the 24 hour cycle that synchronizes sleep and wake times depending on exposure to light.
Researchers at Kent State University recently conducted a study on the effects of alcohol on sleep.
They found that even low levels of alcohol intake can affect your sleep cycle.
The researchers used hamsters as test subjects because their sleep cycles are set by exposure to
light, just like humans. The hamsters were given different levels of alcohol and then were exposed to
bright and dim lights. The hamsters that were inebriated had the hardest time shifting their sleep/
wake rhythms after the exposure to dim light. The more they drank, the harder it was to adjust.
Professor David Glass, who worked on the study, says: “Hamsters’ circadian rhythms are very clear
and predictable and they’re easy to maintain in the lab. They also love to drink alcohol.” The rodents
reactions act as a model for how humans’ body clocks are affected by excessive drinking.
“Part of the reason for problems in an alcoholic’s life is the impact alcohol has on the circadian
clock. We think alcohol prevents light information necessary for proper clock activity from reaching
the brain. This information is critical for daily activity.” Alcohol blocks sensory information from
stimulating the brain’s control centers. “Because the body has trouble determining what time of day
it is, it can’t function properly”, explains Professor Glass. (Telegraph 2009)
To help avoid alcohol’s negative effects on sleep, abstain from drinking within 3-4 hours of bedtime
and always use moderation.
Excessive alcohol intake can
negatively affect your sleep/wake
cycle.
2228 NW PETTYGROVE
SUITE 150
PORTLAND, OR 97210
PHONE: 503-288-5201
FAX: 503-288-0151
E-MAIL:
[email protected]
We’re on the Web!
WWW.OREGONSLEEPASSOCIATES.COM
2009
B E T T E R
S L E E P
F O R
B E T T E R
H E A L T H . . .
OREGON SLEEP ASSOCIATES WELCOMES JENNIFER KIM, MD
Dr. Daniel Root and Oregon Sleep Associates are pleased to welcome Dr. Jennifer Kim to our
sleep center. Dr. Kim comes to Portland from Philadelphia, where she practiced as an Internist
for three years before pursuing Sleep Medicine. “I started noticing that my patients with the
best outcomes were those in whom I’d treated for sleep disorders,” She explains, “This led me
to go into sleep medicine.”
Dr. Kim has already started seeing patients at Oregon Sleep Associates. She has a special
interest in women with sleep disorders. “It’s amazing the number of women that have trouble
sleeping. Over 60% of women have Insomnia during and after Menopause.” Kim says, “Plus the
number of women out there with undiagnosed Sleep Apnea is staggering. I want to help all
those people get treated.” She is also interested in working with other under-diagnosed patient
groups. “I’m excited to work with children, their parents, and pediatricians to advance care in
pediatric sleep disorders.”
Dr. Kim came out to Portland to find a nice place to raise a family. “It’s such a beautiful city,”
she says, “But it will be interesting to get used to all the rain in the winter!” She says she is
looking forward to exploring the surrounding areas, hiking, and spending time with her husband
and daughter. Additionally, Dr. Kim is proficient in medical Spanish and conversational in
Korean.
Oregon Sleep Associates newest
doctor, Jennifer Kim MD.