Types of sleep apnea

Notes from Dr. Norman Blumenstock

There are three types  of sleep apnea. 

There are three main types of sleep apnea: 

• Obstructive sleep apnea (OSA)
• Central sleep apnea (CSA)
• Mixed sleep apnea

• Obstructive sleep apnea (OSA)

  Obstructive sleep apnea is the most common type of sleep apnea, making up 84% of sleep apnea diagnoses.¹

  

  In most cases of obstructive sleep apnea, air stops flowing to the lungs because of a blockage (or obstruction) in the upper airway—that is, in the nose or throat.

  The upper airway could become blocked due to:

  • the muscles relaxing too much during sleep, which blocks sufficient air from getting through*
  • the weight of your neck narrowing the airway
  • inflamed tonsils, or other temporary reasons
  • structural reasons, like the shape of the nose, neck or jaw

  * This narrow airway causes a vibration in your throat, which creates the sound of snoring.

  Central sleep apnea (CSA)

  Central sleep apnea (CSA) is the least prevalent type of sleep apnea,¹ and can be caused by heart failure, or a disease or injury involving the brain, such as:

  • stroke
  • brain tumor
  • viral brain infection
  • chronic respiratory disease

  In some cases, the airway is actually open but air stops flowing to the lungs because no effort is made to breathe. This is basically because the communication between the brain and the body has been lost, so the automatic action of breathing stops.

  Those with CSA don’t often snore, so the condition sometimes goes unnoticed.

  Mixed sleep apnea

  This is a mixture of both obstructive sleep apnea OSA (where there is a blockage or obstruction in the upper airway) and CSA (where no effort is made to breathe), and is the least common type of sleep apnea. Your doctor can help you understand more about this if you need to.

  If you have any concerns that you may have any type of sleep apnea, please consult your doctor.

Dr. Norman Blumenstock talks at Sleep Conference

Notes from Dr. Norman Blumenstock

I will be giving two Dental Sleep Medicine talks at Sleep Conference tomorrow which will be held at Monmouth University's MAC Center (gymnasium) in West Long branch, NJ.

How a Lack of Sleep Can Hurt Your Finances

Notes from Dr. Norman Blumenstock

“The fact is that man-made disasters ranging from the explosion of the Space Shuttle Challenger to the spilling of Exxon Valdez, and the chemical disaster in Bhopal, India, all have sleepiness as a primary contributing factor,” Wickwire says.

Proud that you’re awake at all hours and still functioning normally? It may be costing you.

The arguments for a good night’s sleep are well-documented, with studies showing that people who get more sleep get fewer colds, tend to maintain a healthier weight and have a smaller chance of coming down with heart disease and diabetes.

But if you’re uninterested in the health benefits of sleep, you may want to consider what your sketchy sleep patterns are doing to your wallet.

You’re probably sleepwalking through your sleep problem.There are many reasons we don’t get enough sleep. Some people are workaholics or night owls. Others are kept up by chronic stress or insomnia, and still others have a disorder like sleep apnea. According to the National Sleep Foundation, more than 18 million Americans have sleep apnea, a condition that causes troubled breathing during sleep, and 75 percent of people with sleep apnea don’t know they have it.

Related: How Financial Stress Dramatically Lowers Your IQ

What’s unsettling is that the average person may not realize they’re sleep deprived due to the way the body works. ”We habituate to adenosine, a brain chemical that induces sleep. So even though judgment and performance are impaired, we think we’re performing just fine. The reality is, they are depriving their brains of a nutrient just as vital as food or water,” says Emerson Wickwire, sleep medicine program director at Howard County Center for Lung and Sleep Medicine in Columbia, Maryland. He also teaches non-drug treatment approaches to sleep disorders at The Johns Hopkins University School of Medicine and Walter Reed National Military Medical Center.

Wickwire continues: “The effects of sleep loss on cognitive processing, concentration and memory are striking and acute. Processing speed deteriorates dramatically with shortened sleep duration, and you can’t simply ‘catch up’ on the weekends.”

If you aren’t sleeping, you’re putting your career at risk.Nitun Verma, medical director for the Washington Township Center for Sleep Disorders in Fremont, California, sees this a lot. He works with many professionals in Silicon Valley and says there are two typical groups of patients who tend to come into his office.

"The first group is the professional at a larger, more established company, usually in their 40s to 50s," Verma says, adding that these people often feel sleepy at work, which worsens as the afternoon progresses. "They have a fear that some younger, more energetic person is going to take their job or their promotion."

People in their 20s and 30s suffer from sleepless nights, too, Verma says. They have a more active social and professional night life, advancing their lives and careers, and often only sleep four to five hours a night, he says.

"Adrenaline is carrying them during exciting times, but the sleepiness finds them during brainstorming and creative times," Verma says.

Of course, it’s easy to dismiss the problems. Occasionally falling asleep during a meeting, aside from the embarrassment, may not be so bad. But do it enough, and it can destroy your career.

Is there a best sleeping position?

Notes from Dr. Norman Blumenstock
Which sleeping position is best for you?

Mon, Jul 28, 2014 at 03:01 PM

What's the best sleeping position for you? Well, that depends. (Photo: Baranq/Shutterstock)

People are surprisingly feisty about their favorite sleeping positions; I'm a back-sleeper myself and I think it's definitely the most comfortable; I have never been able to sleep on my stomach for more than a few minutes, but my partner loves it. And since back-sleepers are known for snoring, I'm probably happier with him on his stomach too. 

It turns out that no matter what your personal opinion (or how strongly you hold it!) all sleeping positions have pros and cons. Since getting enough sleep is a problem for so many people, I'd say sleeping whichever way is most comfortable to you is likely what matters most, but if you are having trouble, or waking up in pain on a regular basis, you might want to look at changing the position you fall asleep in. For certain positions, you might even want or need an extra pillow specially designed for it (see ideas below). 

Back sleeping

Pros: This position is the best for reducing or minimizing face, neck and decolletage wrinkles, since there's no pressure on that skin as you sleep. It's also great for minimizing acid reflux, if you struggle with that issue (be sure to incline the body with the head higher than the stomach to have the most positive effect). As long as your neck is supported and in alignment with the rest of your spine, back sleeping is also considered the best for spine health.

 

Cons: The worst thing about sleeping on your back is the aforementioned snoring issue, which is even worse for those with sleep apnea or colds. 

Tips: For some people, sleeping on their backs can aggravate lower-back issues. Besides doing some stretches like this before bed, you might also consider using a pillow under your knees (there are some designed especially for this use, or you can jury-rig your own).

Side sleeping

Pros: Reduced or eliminated snoring, and it's good for blood circulation, so if you have an issue with that, side-sleeping could help. Pregnant women, especially, find it the most comfortable position. 

 

Cons: Side-sleeping will cause fine lines on the side of the face you most often sleep, as well as on the neck and chest. It can also cause shoulder or hip pain in some people. 

 

Tips: To keep the back aligned, and reduce torquing, a pillow like this one can help. When side-sleeping, you should always aim to have the neck in the same plane as the rest of your spine — it's easy to wake up with neck pain from sleeping on your side, specifically when your head is tipped up (forehead higher than the chin), so try to keep this from happening with a pillow of the correct thickness. "You need to fill the space above your shoulder so your head and neck are supported in a neutral position," Ken Shannon, a physical therapist at Brigham and Women's Hospital in Boston told CNN.

 

To reduce the effects of sleeping on your side on wrinkles, consider a silk pillowcase, which is less drying, pulls at skin less — and musses hair less — than cotton ones.

 

Stomach sleeping

Pros: Less snoring, as it keeps airways more open; can be fine for those without back issues. 

 

Cons: This position is the worst for wrinkles (as anyone who has woken up with their pillow's wrinkles imprinted on their face can attest). It can also put stress on the lower back, so those with back problems should avoid it. "Stomach-sleeping makes it difficult to maintain a neutral position with your spine," Shannon explained to CNN. 

 

Tips: Placing a thinner pillow under the hips can help keep the back on the same plane as the spine and be less stressful on the spine. Or, try sleeping on your stomach without a pillow at all. 

A good night's sleep is a matter of technicality.

Notes from Dr. Norman Blumenstock
Technology can possible help or hinder a good night's sleep.

Technology is a double-edged sword when it comes to sleep. It's been proven that one should shut off the "screens" — TV, computer, smartphones and beyond — well before hitting the sack, but sometimes, those future-forward devices hold the ticket to getting a good night's rest.

Sleep-related apps

IQ ALARM: Wakes people with an IQ test as an alarm; $.99

SLEEP CYCLE ALARM CLOCK: Tracks sleeping habits and quality, and awakens people with soothing tones; $.99

SLEEP: Sends people to sleep with soothing sounds, lullabies and relaxing music; $.99

DEEP SLEEP WITH ANDREW JOHNSON: Guided meditation; $2.99

INSOMNIA CURE: Hours of audio content and 40 pages of insomnia tips and learning tools; $2.99


Sleep time gadgets

These products are said to improve sleeping habits.

FitBit is a digital sleep tracker that analyzes sleep patterns and quality, similar to the SleepIQ Technology in Sleep Number beds. The One model tracks steps, distance, calories burned and stairs climbed during the day, but also measures sleep quality at night, according to FitBit.com. Sync the device to a computer or smartphone, and review the real-time progress. Various colors and styles are available. $99.95;www.fitbit.com.

The Snore Relief Wrist Band by Hammacher Schlemmer, though no longer available for purchase, reports that it did provide natural relief for snoring by stimulated the median nerves at the inner wrists.

"Snoring can be caused by loose soft tissues vibrating in the throat, and when the device detects snoring, it releases a signal that gently stimulates the body to shift position, stopping snoring," Hammacher Schlemmer states online.

Clinical trials for the product showed that 80 percent of participants' spouses observed a decrease in snoring after two weeks of use, leading to better sleep quality, according to the website.

Familiar with fumbling around in the dark? Senzo light switches are called "smart switches" and include infrared and radio frequency wireless communication for control. It features a built-in timer, wireless sensor, smartphone and Internet control, a remote control and a night light to easily find your way about in darkness. They can even be locked to prevent unauthorized users. For more information, visitwww.senzo.com.my.

Behind closed doors
Here's what's going on inside the bedroom, according to the 2013 Sleep Council Survey:

• 27 percent now use desktop computers/laptops to surf the Internet in the bedroom.

• 17 percent of respondents talk on the phone in the bedroom.

• 62 percent of 16 to 24 year olds like to eat in their bedrooms compared to only 22 percent of respondents overall. In fact 16 to 24 year olds like to do most things in their rooms: 28 percent do hobbies/crafts, 76 percent listen to music, and 28 percent exercise there.

• 65 percent of respondents read in the bedroom.




Source: Sleepcouncil.org

Man kicked out of bed for snoring ordered to pay woman £200 compensation after slashing her car tyres

Notes from Dr. Norman Blumenstock

Here is an example of one of the dangers of snoring. It may lead to a criminal act.

July 5, 2014    By Jamie Beatson

John Wade slashed the 31-year-old's tyres and set off her car alarm after she kicked him out of bed for snoring in the middle of the night.

John Wade set off woman's car alarm while slashing her tyres

A man who slashed a woman’s car tyres after she kicked him out of bed for snoring was yesterday ordered to pay her compensation.

John Wade took a knife to the woman’s car after she booted him out in the middle of the night.

Wade stormed out of the house in Dundee’s Grampian Close – stopping in the kitchen to pick up a knife.

He then went to the 31-year-old woman’s car and slashed two of her tyres and set off the car alarm as her daughter looked on at 10.30pm on March 11.

Fiscal depute Eilidh Robertson told Dundee Sheriff Court: “There was an argument about the accused’s snoring, during which time she asked him to leave.

“He went downstairs, leaving her in the bedroom, and she went downstairs to lock the door behind him.

“She saw he had walked into the area outside where the vehicle was parked and, with a knife, slashed the tyres of her vehicle, setting her car alarm off.

“Her young daughter, who was awoken during the disturbance, watched the accused slash her mother’s tyres with a knife.”

Wade, 26, of Findhorn Street, Dundee, was arrested at his home at 3am on March 12.

He pleaded guilty to a charge of vandalism.

The court was told Wade was not in a relationship with the woman but had been staying with her at her home for a few days before the incident.

Mike Short, defending, said: “He did vandalise two tyres and accepts that he should not have done this. It is a rather unsavoury incident.” He added: “The complainer has forgiven him.”

Sheriff Kenneth McGowan ordered Wade to pay £200 compensation to the woman.

OAT eases mild to moderate sleep apnea

Notes from Dr. Norman Blumenstock
Patients through out the United States are benefiting from oral appliance therapy for their snoring and sleep apnea.

Dental device helps patients breathe easier

Published On: Jul 01 2014 04:24:41 PM EDT

WESTERVILLE, Ohio

Ted Durkee is seeing his dentist. The 67-year-old doesn't have a toothache, he has sleep apnea.

"I always had problems with dozing off in the afternoon in the office, and people would joke about that," said Durkee.

Durkee suffered for years, until he finally decided to participate in a home sleep study. Tests revealed Durkee had low oxygen levels, which lead to his diagnosis of sleep apnea.

Experts say 22-million people in the United States suffer from sleep apnea. The most popular treatment is known as continuous positive airflow pressure - also called C-PAP. But if the condition is not severe enough, C-PAP may not be the best option. Some patients are trying a different approach that's found in their dentist's office.

That's what Durkee's doctor prescribed. It's called oral appliance therapy, or OAT. It's a mouth appliance that moves Durkee's jaw forward to help him breathe easier while sleeping.

"Mr. Durkee was the ideal patient," said Dr. Gretchen Zody, Durkee's dentist. "He's on the mild end of apnea."

Zody said she can see signs of sleep apnea just by looking in her patients' mouths.

"Their tongue can be scalloped along the edges, so you can actually see the indentations of the teeth," said Zody.

That's because patients push their tongue forward to clear their airway.

Other possible signs include grinding of the teeth, acid reflux or snoring.

OAT is only for mild to moderate cases of sleep apnea. Patients who are missing several teeth are not good candidates for the treatment, because the appliance must hook onto a solid row of teeth.

Without insurance, the OAT device will cost about $2,500. Some insurance companies will cover the treatment, but generally only after patients prove they cannot tolerate the C-PAP.

It took a few weeks for Durkee to notice a difference, but he says now his oxygen levels are back to normal, and he hasn't experienced any side effects.

"I have a lot more energy," Durkee said. "The bags under my eyes are not as severe as they have been in the past."

To learn more about OAT, go to:

http://www.aadsm.org/oralappliances.aspx

http://www.snoringisntsexy.com/learn/sleep-apnea-treatment-options/oral-appliance-treatment