I have been using the Respironics Full Face Quattro Mask since I started CPAP. I believe I made a good choice for a fist mask thanks to the help of the sleep lab letting me try on many masks during my study. This mask has not been perfect, but many of the lessons I learned can apply to all masks and all types. These are the tips that helped me with 90% of my mask troubles. If you are struggling try these some of these simple fixes that could make things better.

1.) How clean is your mask? Do you clean it every day? Mine gets slippery and won’t even hold even my wimpy 9cm of pressure if it isn’t 100% free of facial oils. Also even if you mask is 100% clean, wash your face before you go to bed. This helped me with my seal, but I have heard some others claiming that using a moisturizing cream helped them. I think these people have abnormally dry skin, so try at each end of the spectrum. I know my Father-In-Law swears by using Bart’s Bees Wax on his nasal pillows. Try each of these depends on your skin type and preference, but give them a try.

2.) When you first adjust your mask, if you have CPAP equipped with a “Ramp” feature do not use this feature when adjusting your mask. Put you mask on, start the machine at “Full Prescribed Pressure.” If you adjust it for the smallest pressure, it will just blow out when it reaches the maximum.

3.) Being a normal man I never read the instructions, but every mask has a prescribed order for tightening the straps; use it! After struggling, reading the directions helped me a ton! It sounds so simple, but some “pointy-head” put them together in that order for a reason.

4.) Are you having trouble getting used to the fit and feel of your mask, or your prescribed pressure? You need to make friends with your mask and CAPA! IT IS your friend, not your enemy; it will lead you to better health, if you learn to work together!

To make friends with your mask, talk to it. No, I’m, just kidding. Start by getting used to it by wearing it around the house during your normal waking hours. Watch TV, read, knit or do some activity while wearing your mask. You will NEVER get comfortable enough to sleep with your CPAP and mask it can’t be comfortable with it during the daytime. I know I can’t wear my mask with glasses, so I can’t see the TV, but I can still cruse the internet with my iPhone at close range. Make friends with your equipment! (Unless you have small children like I do, then it is a good way to have them stop coming into your room at all hours of the night, as they are more scared of you than the monsters under their beds!)

It hasn’t been easy, but I have made it to week three. I have learned a lot about sleep apnea and have been thru a lot of experiences that I still cannot explain. I am sleeping thru the night and my seven day average for hours of sleep is now up to an exact nine hours and my thirty day average is at an exact eight hours. Only three weeks ago I was only sleeping four to six hours; what a change! My energy is up, my mood is up, I shoveled snow for only the second time since I started CPAP and only the second time in three years. My life is being restored in the night! I have become sleep addicted, spending most of my day thinking about sleeping. I get into bed as quickly as possible and stay sleeping as long as I can.

I have had some noteworthy mask difficulties. I have had to really clamp it down the past few nights and so tight it has left marks on my face for a few hours in the morning. My mask was leaking in the same place every night and blowing air right into my eye. I believe it to be a seal failure because there is a slight deformity in the seal when I examined it. Almost like it melted, stretched and then cooled. I might have used water that was to hot when I washed it, but it was below the temp I thought it would melt at.

My DME supplier said that “You need to expect leaks to happen, just go back to sleep,” “No, I expect this to be 100%.” This is medical equipment and being the cost is so high I don’t think it is beyond asking for superior results. What if I paid my bill to them in the same manner, you know, deduct 25% for leaks in my wallet. When they called about the balance I could just say, “You need to expect that sometimes people won’t pay their bills, just go back to your paperwork.” This is the same rep that gave my wife an auto-PAP for a titration study and didn’t bracket the pressure settings around her current prescription.

I want to try the Respironics Comfort Gel Full-Face Mask, but I confess it might end up as a Christmas gift because of tight finances. At over $150 even from discount internet suppliers these masks are a little too costly for just trying on a whim. I have heard great things about the Gel Masks fit and I am now desperate to try one. At my sleep study she had me try on a few, but they made my face feel like it was as long as a horse. Given the tradeoff between feeling big and not leaking, leaving unsightly lines or pressure sores on your face, I’d take the horse mask if it is comfortable.

I called the sleep lab to see about setting up a mask fit appointment, but was told the person who normally does the appointments left and has no expected return date. It sounds like they were fired, furloughed, or had a health or family issue. The person I spoke with said they would speak with their boss to see if someone was available to do an appointment and then return my call. That was several days ago and I have not heard a response. I hope this does not signal the end of their mask fit program, as it is a valuable service. At the end of the appointment they basically give you a loner mask to try out of their inventory. At a cost of several hundred dollars apiece, it is a rather expensive chore to test masks. Being that you cannot sell discarded masks on the used market, there is no way to recover the cost of a bad choice. Even using your insurance that only covers masks every six months or once per year, means you will be stuck with your failures for the same amount of time.

Personal Changes

I need a life! For the past three years all of my activities have been sedentary, to protect and save my body for the future, but now I have all this energy and limited places to spend it. I can put the effort into the house and as it is winter it is a good place to start, but by no means is it the end. I need more. Things have been changing: as I have gotten stronger I have begun to reclaim the household chores I once pushed over onto our teen age son Tyler; snow shoveling, grass cutting, grocery carrying and such a like. I haven’t been reading as much as I had been, haven’t been blogging or writing in my Personal Log as much as I had been. This has all been a great blessing and is not being met with complaint by me, but only observation.

I have had one major setback in one of my areas of personal change; I have relapsed to using tobacco. I have had precious few breaks from this habit since age thirteen, but I am gaining ground. I have been taking Zyban and I have made two attempts to quit in the past few weeks. The most successful was 5 days, but a life and death issue within my extended family threw me off the wagon and out of personal balance. I will make a fresh effort this weekend.
I have been checking by blood pressure and sugar very regularly and have watched it rise and fall with my tobacco use. I believe that I was trying to stimulate my metabolism with nicotine and coffee so fight the effects of sleep apnea. My hope is that because I am getting proper rest I can now back away from the stimulants. I have begun to cut my normal morning coffee with decaf. Starting first with a ratio of five to one and progressing to a full fifty-fifty. I don’t know how far I will progress, as I have noticed my consumption reach new heights in an effort to boost my caffeine intake. I think I will hold here until I see my volume decrease.

Improving Health?

I think I might be looking at my insulin resistance going away! Yesterday I was craving sugar bad, all day! After I had eaten a full dinner, two PayDay bars and thirty whoppers (the small malted milk balls not Burger King) I was still hunting for more sweets. I was a little apprehensive to check my blood sugar before bed, as it should have been thru the roof. Less than two hours after a full meal and with all that quick sugar, I thought it would be an out of sight reading, but it was only 106. I was not expecting it to be below 200, but what is this? No wonder I was craving sugar, I wonder how low it was before I consumed all that stuff? How accurate is this type of observation, as it is not a very scientific in method. Watching changes in me has become another sedentary hobby I will have to break. I think the observation is valid, but the conclusions in questionable. Yet, if I keep it general by saying my sugar was lower than I expected, the observation can remain valid.

As my RA symptoms have been resolving I have noticed that not all of my pain is gone. The ugly truth is that I still have the pain from damage done by the RA: I still have shoulder trouble from blowing out my shoulders lifting weights, still have a trigger finger and still have some nerve pain in my feet; it would be disingenuous of me to say otherwise. Yet, the inflammation and swelling is gone from it familiar places, the fatigue is nonexistent and there is zero morning stiffness. That is at least progress especially when accounting that I have not taken a Humira injection in 3 weeks.

I now face the challenge of explaining all of this to my Physicians in a way that is coherent and factual. I actually want to scream “God showed me how to get better!” but I haven’t even posted that on this Blog yet. Maybe that is my next step, to tell the whole story and what a story it is too! The story that stretches from my writing of “The Longest Day” until today, but I feel it is missing a dramatic climax. Telling the tale of “The Third Day” could be the ending I am looking for, but I don’t feel I can exclude the recovery process though it stretches before still. I might have to leave that out of the story, as those pages are not written in the days of the book of my life yet and I need not consider them as they will arrive in due time and Lord willing be less dramatic.

ManLoosed@Home

Traveling with CAPA

There is a lot of things that go into making our CPAP function. We might have mastered this art at home, but on the road can be a little more difficult. As I said in the second installment of CPAP tips; one of the things you need to obtain is a letter from your prescribing physician stated that this is necessary medical equipment. This becomes important when traveling especially internationally and passing thru customs. For me, I would will be packing your CPAP in checked baggage, but for those who desire to “breeze” thru the airport without stopping at the luggage carousel, there is a steep learning curve! Below is a basic checklist for whatever you carry choice might be.

CPAP Travel Checklist:

 
-Travel letter from you prescribing Dr. certifying your need for CPAP treatment.

-A plastic bag large enough to fit your CPAP in. (See TSA link below)

-Make sure you have the right power adapter for your destination, especially internationally.

- Bring an extension cord, just in case an outlet is not close enough to your bed.(Very hard if you’re traveling internationally, to get the right one!)

-Check to make sure that all your CPAP equipment and accessories are packed.

-Make arrangements to get distilled water at your destination. (More on this below.)

Hotels and CPAP:

I have heard of cases in which the lamps and alarm clocks in hotel rooms are hard wired to the wall and there was no outlet by the bed. Outlets were supplied for laptops and cell phone chargers, but these are sometimes a great distance away, be prepared with an extension cord or be prepared to ask for one at the front desk.

Do hotels have distilled water available? I wanted to give you a good report that hotels are so concerned their service and our comfort that they would, but alas, service truly is dead. After calling a few hotels today to see if they had distilled water for their guests, EVERY phone call was negative. One lady seemed not to know what distilled water was, asking me, “Are you sure you don’t mean bottled water?” What a disappointment this is! I am not a business traveler, so I have never need to iron clothing while in a hotel; on vacation I don’t care if my shorts have a few creases in them. I understand no supplying waster for a CPAP, but so many people need a clothes iron I was sure they would have it! To be fair these were average hotels, not 5 start locations, which I suspect might go to the store for you if you needed distilled water.

In the TSA’s Own Words:

TSA’s Page on CPAP

TSA on Medical Liquids (Our Distilled Water)

It might be worth is to print this page, so you can give it to them in the event you carry on your CAPA. If the people at the security screening even know what a CPAP is I will be surprised, let alone to know THEIR OWN handling procedures. Do I expect this of them? Frankly yes, not only do I have OSA, but I am also on immune-suppressive therapy for RA; this makes me vulnerable to germs! With how many people pass thru security checkpoints in a day, I might as well attach the CPAP to the hose and drag the whole assembly thru the restroom floor!

CPAP and the Airlines:

Because a CPAP is considered necessary medical equipment, it supersedes any airline directive to allow only one carry on. Unless I am starved for space in my checked baggage I won’t be carrying my CPAP on the plane with me, as I said before. If it was an international flight lasting for >8 hours, I would consider carrying it on, but not wearing it. I would rather snore at everyone on the plane! Just looking at the amount of regulation and hoops for O2 is enough to make me buggy! Looking at the list of approved oxygen concentrators, it seems as if the flight attendants might not allow you to use it anyway. Here is what one airline has about “Medical Equipment” and specifically O2 concentrators.

United: Worst Explination! No Specific CPAP Statement.
Southwest One CPAP: SW On CPAP
Continental: On CPAP and Vents
Delta: Look under “Assisted Devices”
JetBlue: Best Policy So Far!

It seems that I must notify the airline two days in advance if I want to use it, not if I just carry it on. There is a loop hole there, but the thought of getting to the plane door only to be told I MUST check my CPAP in that flimsy bag, is horrifying! Print these policies out, so you have a chance to fight back if they try to break or ignore their own rules.

Summary:

I would check it. When I travel it usually isn’t just for an overnight, but an extended stay on a vacation. Normally I am traveling with my family and we have a ton of luggage anyway, so a little extra for my CPAP is worth it. If you still want to take your CPAP as a carry-on you are entitled to! Just make sure you are prepared. Even if it was OK on your flight to your destination, it doesn’t mean it will be just as OK going the other way! Prepare to be challenged, be ready to give an answer and hopefully you won’t have to teach the TSA and the Airlines about their own policies. Have a nice trip and sleep well on it!

CPAP Tips #2: The Best Advice I Got!

The Best Advice- Starting off Right

The best advice I have ever gotten is to get a copy of your “Sleep Test” results AND a copy of your prescription for yourself and if you are a traveler a letter stating that this is  a prescription and medically necessary device. The test results from ANY medical test are your property! They are your results and your prescription and you by law have access to your medical records! You most likely will not understand all of the results, especially the raw data, but I will point you in the right direction for some help with this in a minute.

Results: Can Tell You More

A copy of your test results can tell you a lot more than just pass or fail! (Going into my sleep study it was my sincere hope to failed with grace!) This can tell you the average number of events you had every hour, the length and types of events, your lowest O2 readings during the night and what type of sleep they observed you to have. There are two parts of the sleep study you might need; the first is a summery page, written by the sleep Physician and the second is a graph of the whole sleep study and titration (if you had a split study.)

Useful information is not always communicated by your physician, but still can be very important. On my sleep study summery page there was a note, which my physicians never discussed with me: “No supine (on back) or REM sleep was observed during the test or titration. Titration pressure might not be adequate.” An important detail, as the most sever events occur on your back in REM sleep, don’t you think! That led me to request a data capable machine from the DME supplier so I could monitor if my AHI number increased to a place that I might need re-titrated. I can also use this one piece of information to convince my insurance company to pay for a titration study or home titration study sooner than they want to. I’ll just show them that note!

For help understanding this information I recommend seeking help from the American Sleep Apnea Association on their FORUM page. There is a section specifically for understanding your sleep study. Reading thru the information on others studies can help you understand yours. Feel free to ask any questions that remain, as their moderators are very knowable and ready to help you. These are great people who I can brag on enough for their role in educating me. (You can also find me there from time to time, but under a different name.)

Here is a link: ASAA FORUM

 Rx’s: Suppliers Need Them!

 A copy of your prescription is also vital! While your “sleep specialist” or GP might send your Rx to DME supplier of your or their choice; you can use this piece of paper (Rx) to SAVE MONEY! I have found that you local home medical companies cannot beat the prices that you can find from reputable suppliers on the internet. So if you are paying for this equipment out of pocket, this is a way to save major cash! Even on the internet a xPAP machine is still a prescription item, so you need your script! Some internet suppliers don’t require “proof” of a script for a mask, but some do.

This in a time saving piece of paper, as the other way for a supplier to obtain your Rx is to call the Physician’s Office and asks them to send them a copy of it. This can take a great deal of time, depending on how organized you Dr. Office is or is not. By having the script in hand, you can simply email them a photocopy. Most will keep your script on file and you will not need to send them a copy every time you place an order.

If your Doctor is to specific or not specific enough on the Rx, both could lead to later problems. The Sleep Lab I went to made a recommendation to the Dr. based on what mask I chose for the titration portion of the sleep study; if specified a specific mask. If your Dr. puts the specific mask on your prescription, all the suppliers must supply you with  that exact mask and can’t not change it; which can be good or bad. If a week after you start using this mask at home and begin to have difficulties, you need to get the physician to write a new script for the next exact mask you want to try. All this can be avoided if you ask the prescriber to write “a mask of their choice” when writing the Rx. There might be times that a DME supplied refused to give you a specific mask you request. Don’t be fooled they can order anything they want from any company, but at times just don’t want to. As with fixed $$ for machines, some don’t want to carry the more expensive masks because it cuts into their money. In this case get your prescriber to be specific and force their hand. The “interface” or mask is the most important thing that is “of your choosing”, so get it done right and don’t stop until you are satisfied! Most internet suppliers will also bill your insurance if they are not excluded, so don’t be afraid to go off and try new mask types. Just know your insurance might not cover another mask for 6-12 months.

My DME supplier has a  mask return program. If I am not satisfied with the mask in the first 30 days I can return it and choose another. This is excellent as masks are normally $150 and up. Some internet suppliers have similar programs that go out to 90 days, but usually you sign up and pay for this service. You must ask your DME supplier if they have a program such as this, they might not tell you up front and it is a pity to find out after that time has expired!

It is also important to know your titrated pressure as you might need this from time to time. Being admitted to a hospital on an emergency basis is one such time that is critical to know this information. Being that you have been admitted for something serious, you could make your situation worse by having apneas events while trying to recover. They can find this information, but usually it will be kept at you GP’s Office which isn’t open 24hrs a day.

( A note about outpatient surgeries: There are special procedures that need to be followed for outpatient surgery if you suffer from sleep apnea. The anesthesia used in “outpatient surgeries” can cause sleep apnea to become life threateningly. Even for a day surgery this might win you a tube down the throat or even an extra night in the hospital to monitor your breathing.)

Links to a Internet CPAP Suppliers:

CPAP Supply USA
CPAP Wholesale
CPAP Plus/Direct
(*These are only examples, I do not endorse one over the other, or guarantee your satisfaction with any of them.)

Dr. Letter: Medically Rx’d and Necessary Device

I will cover this later in the travel section, but this is an invaluable letter to have if you are business or international traveler. To get off to a great start, get a letter on the Dr. stationary and make plenty of copies. This letter is also useful to give to your electric company. Why your electric company? I’m glad you asked!

In the event that you have your electricity disconnected for non-payment or an outage occurs in your area, because you have “Durable Medical Equipment” as a medical necessity, your electric can not be turned off and must be at the top of the list to be restored in the event of a power failure. Before you need it, communicate with your electric company and give them the letter from your Dr. In the event that they lose your payment or there is a natural disaster, your lights will be first back on!

ManLoosed@Home

Not all CPAP machines are created equal! BUT Medicare and most insurance companies only have one billing code for them and pay a fixed amount to the equipment supplier for that code, not the specific machine. This means that DME (durable medical equipment) supplier can make more money by giving you the cheapest machine they can find and collecting the standard reimbursement from your insurance company. It is up to you to find what is the best machine for the money that you insurance will pay out! Some machines can be very expensive , but it might be worth a little out of pocket expense for the right equipment for you.

Some insurance companies, sleep labs or your sleep doctor sometimes contract and set the brands and quality levels of machines that the DME will supply to their patients. My insurance company, for instance, has specified the brand of machine they are to deliver, but not the exact model. My wife and I, who got our CPAPs only 30 days apart and with the same insurance, recieved 2 different machines. I negotiated with the DME supplier for a data capable machine because I am a technical guy and am interested in a machine that was able to measure my nightly AHI (Apnea Hypopnea Index).

My insurance company bought the humidifier, but, by contract, leases the CPAP from the DME. If I ever change insurance companies I can keep the humidifier but must return the CPAP unit. Some other insurance carries do a lease to purchase arrangement; this begins as a lease, but after they verify you have been using the machine (called a compliance check) they will purchase it for you.

Compliance checks are done via a smart card that slips into your CPAP, some transmit data over the internet or via a modem. On some CPAP machines only the hours of usage and number of sessions (CPAP use >4hrs) are recorded. On fully data capable machines enough information is recorded that your DME supplier, Sleep Doctor or even yourself can monitor your treatment by examining the data recorded on the card. For about $200 you can purchase the software and card reader to do this, but only if you have gotten the right machine.

If you are doing this all out of pocket and not insurance is involved, you can save a great deal of money by dealing with reputable dealers on the internet. These are dealers that offer warranties, have a return policy (especially on masks) and have great customer service. Because these are prescription items, especially CPAP machines, most will call you prescribing Physician and request a copy of your Rx. The best way streamline this I will talk about next time!

There are many sleep apnea dangers that most people don’t know exist. While some people may think of it as common snoring, sleep apnea is something that needs to be taken very seriously. In fact, if left untreated, the sleeping disorder can cause death via congestive heart failure. Sleep apnea, (apnea literally meaning without breath) is something that affects men, women, adults and children. It is characterized by a minimum of 10 second intervals between breaths, which result in either a neurological arousal or a blood oxygen desaturation of at least three or four percent. No group of people is immune from the disastrous consequences of the disorder, which makes it extremely scary. Since it’s something at occurs when you sleep, many people who sleep alone don’t know that they suffer from it until it’s too late.

Some of the sleep apnea dangers that can act as symptoms include loud snoring (with periods of breathlessness immediately followed by gasps for air), morning headaches and esophageal reflux. Because of the lack of sleep that many sleep apnea patients suffer from, there are often side effects that can be just as troubling as the disorder itself. For example, many people who have sleep apnea also experience depression, irritability and anxiety. These three things can combine to really mess with a persons head. Imagine feeling depressed and angry all of the time, not knowing that something like sleep apnea is causing your troubles. Many times the side effects can get treated with pharmaceutical drugs, but these do nothing to combat the apnea itself. – Sleep Apnea Symptoms –
What is sleep apnea
What is sleep apnea

Una muestra de la capacidad de superación humana. William Trubridge establece el récord de buceo libre (en apnea) y sin aletas al alcanzar los 88 metros. La gesta le lleva tres minutos y medio.

El video transmite una especie de paz sobrecogedora. Emocionante.

(si no carga el video, está aquí: http://vimeo.com/4802703)

apnea extreme

stephane mifsud is a freediver from france.

he holds a number of freediving world records for both static and dynamic apnea.

most recently, he set a new world-record for holding his breath for 11 minutes 35 seconds!

haven’t found too much information on him, and most of it is in french, but i reckon the video-clip below is worth a thousand words… the clip dates back to 2007 and is a demo of a documentary on him. since the video was made he has set a number of new records.

i n c r e d i b l e !

I think I’ve got it all down; I hope. It seems that learning to sleep with a mask on is easy when compared to the things the body needs to relearn. After having been sleep deprived and oxygen starved for years, there might have to be some retraining. I started sleeping thru the night for the most part, but there was still one thing waking me up; the need to “GO”. Yes I said, “GO.” When I first started to learn about the symptoms of sleep apnea the one that seemed like it had an obvious reason was “GO-ing several time during the night.”

I figured it was because I was wakening so many times during the night that the “super-hold-it” response during sleep was not being activated. I never thought I had hurt my body this badly by not getting my sleep apnea treated. Here is what the American Sleep Apnea Association says about “GO”-ing:

Nocturia, or nocturnal urination, is sometimes a symptom of sleep apnea. In fact, nocturia among younger individuals–who are less likely to have other medical causes of nocturia–is a strong indicator of sleep apnea. While the precise relationship has not been thoroughly studied, it appears that the most likely reason patients with untreated sleep apnea have more frequent urination at night is related to the increased pressure in the right side of the heart. This increased pressure is usually the result of low oxygen levels in the bloodstream caused by the apnea events: when oxygen levels fall, the heart works harder to get oxygen to the brain.

An increased pressure in the heart is a sign that there is too much liquid in the body: when the heart receives the stimulus of the increased pressure, higher levels of a hormone called atrial natriuretic peptide (ANP) are secreted. ANP is a diuretic that is associated with the increased need to urinate.

When sleep apnea is effectively treated, nighttime urination is also reduced. Studies have shown that ANP levels in patients with untreated sleep apnea are increased and levels reduced in patients using CPAP effectively. Remember, not all causes of frequent urination are related to untreated sleep apnea; prostrate problems, for example, may cause increased need for urination. Discuss any concerns you may have with your doctor.

To much pressure on the right side of my heart?! Good grief, that’s a little more serious than just not sleeping well! That blows my idea of just being “to awake to hold it” right out the window! I wonder if this also wasn’t the reason for my excessive sweating. How badly could this have screwed up my body?

It has taken me a full 2 weeks on CPAP for this to go away! After the first 7 days my body learned I wasn’t going to die in the night, but it took another 7 days for my heart to learn I wasn’t drowning and I could stop trying to “GO” my way to better sleep.

I have been sleeping thru the night! No waking up to GO! Just sleep from 10:30PM-5:45AM, yahoo.

From the FMS Global News Desk of Jeanne Hambleton

Courtesy of the National Sleep Foundation  November 23, 2009

Sleep deprivation can have an enormous impact on your health and happiness. Apparently, it can also affect your ability to make split-second decisions, according to a recent study in the journal SLEEP. Researchers at the University of Texas at Austin split 49 West Point cadets into two groups, 21 of whom were deprived of sleep and 28 of whom were well-rested, and tested them on tasks that require quick decisions. According to the study, participants in each group performed the tasks twice, separated by a 24-hour period. Cadets who were sleep-deprived between testing periods saw their accuracy decline by 2.4 percent, and cadets who were well-rested between testing periods improved by 4.3 percent. W. Todd Maddox, one of the researchers, told HealthDay that the type of thinking tested in this study is “critical in situations when soldiers need to make split-second decisions based about whether a potential target is an enemy soldier, a civilian or one of their own.” While people vary in their need for sleep, experts agree that for most adults the amount needed to feel one’s best is somewhere between seven and nine hours per night.

SLEEP STEALERS

More often than not, you have a pretty good idea of what is keeping you awake at night — from the cat scratching at your bedroom door to the snoring partner next to you. But not all “sleep stealers” are obvious. Here are some big sleep stealers that could be keeping you up at night and you may not know it.

Psychological Factors Stress is considered by most sleep experts to be the number one cause of short-term sleeping difficulties. You are not going to solve all your problems while sitting in bed at night, so give it a rest and get some rest.

Lifestyle Stressors Without realizing it, you may be doing things during the day or night that can work against getting a good night’s sleep. These include drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and night time schedule, and working or doing other mentally intense activities right before or after getting into bed.

Medications In addition, certain medications such as decongestants, steroids and some medicines for high blood pressure, asthma, or depression can cause sleeping difficulties as a side effect.

FATIGUE & EXCESSIVE SLEEPINESS

Do you find it difficult to get out of bed in the morning? Do you sometimes feel sleepy while watching television or driving? If so, you may be one of the millions of Americans who suffer from excessive sleepiness, a condition that can significantly reduce quality of life, decrease productivity and interfere with relationships. Most people feel tired occasionally, but excessive sleepiness that persists is neither normal nor healthy.

CAUSES:

One of the primary causes of excessive sleepiness is self-imposed sleep deprivation. In the U.S. and many other parts of the world, sleep loss may occur as a result of economic or societal pressures. People may skimp on sleep in hopes of getting more done, and widespread access to technology makes it possible to stay busy (at the computer, for example) around the clock. By some estimates, people now sleep about 20 percent less than they did a century ago.

Working at night and sleeping during the day can also cause excessive sleepiness. Some people are able to adjust to such a schedule. However, others may never overcome the body’s natural tendency to be awake during the day and asleep at night. A similar phenomenon occurs with jet lag, in which the body is “out of sync” with the natural environment. In general, symptoms of jet lag increase with the number of time zones crossed. That is, someone flying from Beijing to San Francisco is more likely to suffer worse jet lag than someone flying from San Francisco to New York.

Excessive sleepiness is also linked with a number of primary sleep disorders. For example, sleep disordered breathing (SDB), which includes snoring and obstructive sleep apnea (OSA), is often associated with excessive sleepiness. Because SDB may result in frequent interruptions during sleep, it can lead to abnormal sleepiness during waking hours no matter how many hours a person actually spent in bed.

Insomnia is another main cause of perceived daytime sleepiness or fatigue. Insomnia symptoms may include difficulty falling asleep, difficulty staying asleep, and/or waking up still tired as well as daytime impairments such as excessive sleepiness, cognitive deficits (e.g., concentration and memory problems), fatigue, and irritability.

Narcolepsy is a neurological disorder characterized by disabling sleepiness. Most patients begin to experience symptoms in their teens or 20s, but symptoms may appear in younger children or older adults. Narcolepsy is also recognized by insomnia at bedtime, sudden sleep attacks, cataplexy (sudden muscular weakness), hallucinations, and sleep paralysis.

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and a strong urge to move them.  People who suffer from RLS may mistake the problem for insomnia since RLS symptoms are usually worse at night, leading to insomnia at night and excessive sleepiness during the day.

The good news is that these sleep disorders can be easily diagnosed and effectively treated. If you have excessive daytime sleepiness and/or feel you may suffer from a sleep disorder, talk to a healthcare professional about the problem as soon as possible.

Excessive sleepiness may also be caused by a variety of physical and mental illnesses as well as some medications.  If you suffer from a medical condition and you are experiencing excessive sleepiness, talk to your healthcare professional about the problem.  In many cases, properly treating the medical condition may alleviate sleepiness. In other cases, sleepiness must be treated independently.

POLL DATA:

Excessive sleepiness is not just a matter of feeling lousy – it can also affect mood, relationships, work, and quality of life.  According to the results of NSF’s 2008 Sleep in America poll:

36 percent of American drive drowsy or fall asleep while driving

29 percent of Americans fall asleep or become very sleepy at work

20 percent have lost interest in sex because they are too sleepy

14  percent report having to miss family events, work functions, and leisure activities in the past month due to sleepiness.

Each of these consequences can have an enormous impact on an individual’s health and happiness.

One of the most serious risks associated with excessive sleepiness is drowsy driving.  NSF’s 2008 poll revealed that a whopping 36 percent of American adults have nodded off or fallen asleep while driving.  Sleepiness and driving do not mix.  If you feel sleepy, you should not drive. Visit drowsydriving.org. to learn how to prevent a drowsy driving-related crash.

There are several tools used to evaluate a person for excessive sleepiness.  An individual’s personal report of how they feel is also important in characterizing a sleepiness problem.  Interviewing a person’s bed partner or those sleeping nearby is also helpful in identifying things that occur during sleep (e.g., snoring and breathing pauses during sleep).

Special questionnaires developed specifically to provide insight regarding daytime sleepiness (these include the Epworth Sleepiness Scale and Stanford Sleepiness Scale). Sleep diaries may also be helpful in assessing and evaluating sleepiness as well as any underlying factors.

Additionally, there are several tests that may be employed when a sleep disorder such as SDB or narcolepsy is suspected.  Such tests may include an overnight sleep study or “polysomnogram,” and the Multiple Sleep Latency Test (MSLT).

TREATMENT:

Once a cause for excessive sleepiness is determined, there are generally a range of treatment options available to patients, including behavioral and pharmacological (drug) therapies.  For example, if the primary cause of sleepiness is OSA, continuous positive airway pressure (CPAP) or an oral appliance may be prescribed. If excessive sleepiness persists in OSA patients using CPAP or is the result of narcolepsy, approved medications may be appropriate. For sleepiness caused by voluntary sleep deprivation or poor sleep habits, treatment will center on adopting behavioral measures to make getting adequate sleep a top priority.

COPING:

Although everyone should employ all the elements of good sleep hygiene, this is particularly important for anyone with excessive sleepiness.  These are behaviors and habits that can promote healthy sleep, which helps improve alertness during the day.  They include:

Maintaining a consistent sleep schedule, even on the weekends

Developing a regular, relaxing bedtime routine

Using your bedroom only for sleep and sex; if you do this, you will strengthen the  association between bed and sleep

Create a sleep environment that is dark, quiet, comfortable and slightly cool

Removing all work materials, televisions, phones, and other distractions from the bedroom

Avoiding caffeine in the second half of the day

Limiting alcohol – it can disturb sleep

For some people with excessive sleepiness, adopting healthy sleep habits is enough to resolve the problem.

People vary in their need for sleep, but experts agree that for most adults the amount needed to feel one’s best is somewhere between seven and nine hours per night.  Teens and young adults usually need nine hours of sleep or more per night.  If you suffer from excessive sleepiness that persists for more than three weeks despite allowing adequate time for sleep, discuss the problem with your healthcare professional.

GERD AND SLEEP

GERD, also known as acid reflux, is an acronym that stands for gastroesophageal reflux disease. It is a chronic illness that affects 5-7% of the world population and is associated with serious medical complications if untreated. GERD is the 3rd most common gastrointestinal disorder in the U.S. Most patients with GERD also experience nighttime heartburn, which is more bothersome. And according to the 2001 NSF Sleep in America poll, adults in America who experience nighttime heartburn are more likely to report having symptoms of sleep problems/disorders such as insomnia, sleep apnea, daytime sleepiness and restless legs syndrome than those who don’t have night time heartburn.

GERD describes a backflow of acid from the stomach into the esophagus. Most patients with GERD experience an increase in the severity of symptoms (usually heartburn or coughing and choking) while sleeping or attempting to sleep. If the acid backs up as far as the throat and larynx, the sleeper will wake up coughing and choking. If the acid only backs up as far as the esophagus the symptom is usually experienced as heartburn.

Most people refer to GERD as heartburn, although you can have it without heartburn. Sometimes GERD can cause serious complications including inflammation of the esophagus from stomach acid that causes bleeding or ulcers. In a relatively small number of patients, GERD has been reported to result in a condition called Barrett’s esophagus, which over time can lead to cancer. Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

GERD is common and may be frequently overlooked in children. It can cause repeated vomiting, coughing, and other respiratory problems. Talk to your child’s doctor if the problem occurs regularly and causes discomfort.

No one knows why people get GERD but factors that may contribute to it include:

age, diet, alcohol use, obesity, pregnancy, smoking.

Also, certain foods can be associated with reflux events, including:

citrus fruits, chocolate, drinks with caffeine, fatty and fried foods, garlic and onions,

mint flavorings, spicy foods, tomato-based foods, like spaghetti sauce, chili, and pizza.

GERD affects people of all ages, ethnicities and cultures and tends to run in families.

SYMPTOMS:

The most frequently reported symptoms of GERD are:

Heartburn

Acid regurgitation

Inflammation of the gums

Erosion of the enamel of the teeth

Bad breath

Belching

Chronic sore throat

Some patients with GERD experience no symptoms at all. Because of the wide range of symptoms associated with GERD and the need to distinguish it from heart-related problems, the number of medical visits and tests needed to diagnose or rule out the disease tends to be quite high.

TREATMENT:

GERD is a recurrent and chronic disease that does not resolve itself. If you are diagnosed with GERD, there are several methods of treatment which your doctor will discuss with you including behavioral modifications, medications, surgery, or a combination of methods. Over-the-counter medications may provide temporary relief but will not prevent symptoms from recurring.

The lifestyle changes you can make to minimize GERD include avoiding fats, onions, chocolate and alcohol. Losing weight may also help alleviate GERD symptoms.

Because of the association between GERD and sleep apnea, people with nighttime GERD symptoms should be screening for sleep apnea.

COPING:

These lifestyle modifications should help minimize reflux:

Avoid lying down after a large meal

Eat smaller meals and maintain an upright, relaxed posture

Avoid fats, onions, chocolate and alcohol

Avoid potassium supplements

Always swallow medication in the upright position and wash it down with lots of water.

POLL DATA:

GERD is the 3rd most common gastrointestinal disorder in the US and one of the leading causes of disturbed sleep among people between the ages of 45 and 64, according to the 2002 NSF Sleep in America poll. Reviewed by William C. Orr, Ph.D.

CAFFEINE AND SLEEP

Caffeine has been called the most popular drug in the world. It is found naturally in over 60 plants including the coffee bean, tea leaf, kola nut and cacao pod. All over the world people consume caffeine on a daily basis in coffee, tea, cocoa, chocolate, some soft drinks, and some drugs.

Because caffeine is a stimulant, most people use it after waking up in the morning or to remain alert during the day. While it is important to note that caffeine cannot replace sleep, it can temporarily make us feel more alert by blocking sleep-inducing chemicals in the brain and increasing adrenaline production.

There is no nutritional need for caffeine in the diet. Moderate caffeine intake, however, is not associated with any recognized health risk. Three 8 oz. cups of coffee (250 milligrams of caffeine) per day is considered a moderate amount of caffeine. Six or more 8 oz. cups of coffee per day is considered excessive intake of caffeine.

Caffeine enters the bloodstream through the stomach and small intestine and can have a stimulating effect as soon as 15 minutes after it is consumed. Once in the body, caffeine will persist for several hours: it takes about 6 hours for one half of the caffeine to be eliminated. There are numerous studies to support the idea that caffeine causes physical dependence. If you suspect that you or someone you know is dependent on to caffeine, the best test is to eliminate it and look for signs of withdrawal, such as headache, fatigue and muscle pain.

Although caffeine is safe to consume in moderation, it is not recommended for children. It may negatively affect a child’s nutrition by replacing nutrient-dense foods such as milk. A child may also eat less because caffeine acts as an appetite suppressant. Caffeine can be safely eliminated from a child’s diet since there is no nutritional requirement for it.

Although the FDA does not advise against women who are pregnant or nursing to eliminate caffeine from the diet, many experts recommend limiting the amount consumed during that time to one or two 8 oz. servings per day.

SYMPTOMS:

Caffeine is a stimulant. In moderate doses, it can:

Increase alertness

Reduce fine motor coordination

Cause insomnia

Cause headaches, nervousness and dizziness

It has also been known to result in:

Anxiety

Irritability

Rapid heartbeat

Excessive urination

Sleep disturbance

A “caffeine crash” once the effects wear off.

TREATMENT:

If the conditions listed under “symptoms” occur, discontinue the use of caffeine. These effects are more likely to occur if caffeine is consumed in large doses. Children and women who are nursing or pregnant should avoid caffeine. People who are taking any prescription medication should talk to their doctors before consuming caffeine.

Knowing the caffeine content of your food and drinks can help you keep caffeine intake at a healthy level so you can still reap the benefits of a good night’s sleep.

COPING:

In order to sleep better at night and reduce daytime sleepiness, try practicing the following sleep tips:

Maintain a regular bed and wake time schedule including weekends

Establish a regular, relaxing bedtime routine such as taking a bath or listening to music

Create a sleep-conducive environment that is dark, quiet, comfortable and cool

Sleep on a comfortable mattress and pillows

Use your bedroom only for sleep and sex

Finish eating at least 2-3 hours before your regular bedtime

Exercise regularly but avoid it a few hours before bedtime

Avoid caffeine (e.g. coffee, tea, soft drinks, chocolate) close to bedtime

Don’t smoke — not only is it a major health risk it can lead to poor sleep

Avoid alcohol close to bedtime; it can lead to disrupted sleep later in the night.

POLL DATA:

According to the 2001 Sleep in America poll, 43% of Americans are “very likely” to use caffeinated beverages to combat daytime sleepiness.

Reviewed by: Greg Belenky, M.D.

DIET, EXERCISE AND SLEEP

For years your doctor, your mom and your friend who goes to the gym multiple times a week have probably been telling you to eat better and exercise more. It is all you hear on television, in the newspapers and on talk radio. New doctors and dieticians usher in new diets, new fads, and so you’ve made some lifestyle changes – cutting back on your fat and sweets intake, and doing some cardiovascular exercise a few days a week. Despite all this, you still feel burned out, can’t drop those extra pounds, and don’t have the energy to greet each day with enthusiasm. What are you missing?

THE THIRD PIECE OF THE PUZZLE: SLEEP

Though the exact mechanisms of how sleep works, how sleep rejuvenates the body and mind is still mysterious, one thing sleep specialists and scientists do know is that adequate sleep is necessary for healthy functioning. Research shows that all mammals need sleep, and that sleep regulates mood and is related to learning and memory functions. Not only will getting your zzzs help you perform on a test, learn a new skill or help you stay on task, but it may also be a critical factor in your health, weight and energy level.

SLEEP PROBLEMS AND OBESITY: INTERACTING EPIDEMICS

An estimated 18 million Americans have sleep apnea, a sleep-related breathing disorder that leads individuals to repeatedly stop breathing during sleep. Not only does sleep apnea seriously affect one’s quality of sleep, but it can also lead to health risks such as stroke, heart attack, congestive heart failure and excessive daytime sleepiness. Sleep apnea is often associated with people who are overweight – weight gain leads to compromised respiratory function when an individual’s trunk and neck area increase from weight gain.

These interacting problems of weight gain and sleep apnea make it difficult to help oneself off the slippery slope of health problems. From a behavioral perspective, those suffering from sleep apnea may be less motivated to diet or exercise – daytime sleepiness lowers their energy levels and makes it difficult to commit to an exercise and/or diet program which would improve both their weight and sleep apnea.

Unfortunately, losing a significant amount of weight in a healthy manner can be very difficult, so Richard Simon, MD recommends treating sleep apnea first: “Unfortunately, we do not have great treatments for obesity that have long-term success rates of much greater than 5–10%,” Simon says. “Thus I prefer to start therapy with [continue positive airway pressure] (70% success rate) and then add exercise (probably less than a 50% success rate). People feel restored when they are effectively treated for sleep apnea and are more willing to start exercising then.”

Sleep deprivation may also inhibit one’s ability to lose weight – even while exercising and eating well! A 1999 study at the University of Chicago showed that restricting sleep to just 4 hours per night for a week brought healthy young adults to the point that some had the glucose and insulin characteristics of diabetics. Such sleep restriction may have been a bit extreme, but it is also not altogether uncommon in our society and is a pattern deemed the “royal route to obesity” by Eve Van Cauter, PhD, who conducted the Chicago study.

GETTING IN SHAPE: HOW SLEEP AND EXERCISE DO A BODY GOOD

Though research shows that exercise is certainly good for one’s body and health, properly timing exercise is necessary to maximize the beneficial effects. For example, a good workout can make you more alert, speed up your metabolism and energize you for the day ahead, but exercise right before bedtime can lead to a poor night’s sleep.

All the jumping jacks in the world would not make up for a night of tossing and turning! Sleep experts recommend exercising at least three hours before bedtime, and the best time is usually late afternoon. Exercising at this time is beneficial because body temperature is related to sleep. Body temperatures rise during exercise and take as long as 6 hours to begin to drop. Because cooler body temperatures are associated with sleep onset, it’s important to allow the body time to cool off before sleep.

DIET AND SLEEP: A HEALTHY HELPING OF THE RIGHT STUFF

Are you someone who needs a fresh cup of java to coax you out of bed in the morning? Or perhaps you prefer an afternoon jolt from the cola vending machine? Or maybe you are more the candy bar type – in any case, you are not alone. In a 24/7 culture, cups of coffee, cans of soda and candy bars are staples of everyday consumers. For some, the day cannot begin without a cup of Starbucks and for many students today no study break is complete without a can of Coke. How did caffeine become the drug (and food) of choice?

In fact, lack of sleep creates a vicious cycle – the more tired you are, the more caffeine you will consume to stay awake during the day; but the more caffeine you consume, the harder it will be to fall asleep at night. Not only are foods and drinks high in caffeine likely to keep you up at night, but they are also usually replete with sugar or artificial sugar and not much else. When a healthy snack such as a carrot or granola bar is replaced with a can of Mountain Dew, you are at higher risk for putting on weight and it becomes harder to sustain energy for a longer period of time.

Food is also related to sleep by appetite and metabolism. Research by Dr. Van Cauter shows that people who do not get enough sleep are more likely to have bigger appetites due to the fact that their leptin levels (leptin is an appetite regulating hormone) fall, promoting appetite increase. This link between appetite and sleep provides further evidence that sleep and obesity are linked. To top it off, the psychological manifestations of fatigue, sleep and hunger are similar. Thus, when you are feeling sleepy you might feel like you need to head for the fridge instead of bed.

WHAT IT ALL MEANS: HOW DIET, SLEEP AND EXERCISE AFFECT YOU

By now you probably realize that health is complex – if one part of the body system suffers, you are likely to see consequences in other areas of your life. Though diet and exercise are critical components of healthy lifestyles, it is also important to remember that sleep is inherently linked with how we eat (and how much), how we exercise (and whether or not we lose weight), and how we function on a daily basis. Getting the proper amount of sleep each night is necessary to face the world with your best foot forward. Sleep will help you on the road to good fitness, good eating and good health.

NAPPING

More than 85% of mammalian species are polyphasic sleepers, meaning that they sleep for short periods throughout the day. Humans are part of the minority of monophasic sleepers, meaning that our days are divided into two distinct periods, one for sleep and one for wakefulness. It is not clear that this is the natural sleep pattern of humans. Young children and elderly persons nap, for example, and napping is a very important aspect of many cultures.

As a nation, the United States appears to be becoming more and more sleep deprived. And it may be our busy lifestyle that keeps us from napping. While naps do not necessarily make up for inadequate or poor quality nighttime sleep, a short nap of 20-30 minutes can help to improve mood, alertness and performance. Nappers are in good company: Winston Churchill, John F. Kennedy, Ronald Reagan, Napoleon, Albert Einstein, Thomas Edison and George W. Bush are known to have valued an afternoon nap.

TYPES:

Naps can be typed in three different ways:

Planned napping (also called preparatory napping) involves taking a nap before you actually get sleepy. You may use this technique when you know that you will be up later than your normal bed time or as a mechanism to ward off getting tired earlier.

Emergency napping occurs when you are suddenly very tired and cannot continue with the activity you were originally engaged in. This type of nap can be used to combat drowsy driving or fatigue while using heavy and dangerous machinery.

Habitual napping is practiced when a person takes a nap at the same time each day. Young children may fall asleep at about the same time each afternoon or an adult might take a short nap after lunch each day.

TIPS:

A short nap is usually recommended (20-30 minutes) for short-term alertness. This type of nap provides significant benefit for improved alertness and performance without leaving you feeling groggy or interfering with nighttime sleep.

Your surroundings can greatly impact your ability to fall asleep. Make sure that you have a restful place to lie down and that the temperature in the room is comfortable. Try to limit the amount of noise heard and the extent of the light filtering in. While some studies have shown that just spending time in bed can be beneficial, it is better to try to catch some zzz’s.

If you take a nap too late in the day, it might affect your nighttime sleep patterns and make it difficult to fall asleep at your regular bedtime. If you try to take it too early in the day, your body may not be ready for more sleep.

BENEFITS:

Naps can restore alertness, enhance performance, and reduce mistakes and accidents. A study at NASA on sleepy military pilots and astronauts found that a 40-minute nap improved performance by 34% and alertness 100%.

Naps can increase alertness in the period directly following the nap and may extend alertness a few hours later in the day. Scheduled napping has also been prescribed for those who are affected by narcolepsy. Napping has psychological benefits. A nap can be a pleasant luxury, a mini-vacation. It can provide an easy way to get some relaxation and rejuvenation.

Most people are aware that driving while sleepy is extremely dangerous. Still, many drivers press on when they feel drowsy in spite of the risks, putting themselves and others in harm’s way. While getting a full night’s sleep before driving is the ideal, taking a short nap before driving can reduce a person’s risk of having a drowsy driving crash. Sleep experts also recommend that if you feel drowsy when driving, you should immediately pull over to a rest area, drink a caffeinated beverage and take a 20-minute nap.

Shift work, which means working a schedule that deviates from the typical “9 to 5″ hours, may cause fatigue and performance impairments, especially for night shift workers. In a 2006 study, researchers at the Sleep Medicine and Research Center affiliated with St. John’s Mercy Medical Center and St. Luke’s Hospital in suburban St. Louis, MO, looked at the effectiveness of taking naps and consuming caffeine to cope with sleepiness during the night shift. They found that both naps and caffeine improved alertness and performance among night shift workers and that the combination of naps and caffeine had the most beneficial effect.

James K. Walsh, PhD, one of the researchers who conducted the study, explains, “Because of the body’s propensity for sleep at night, being alert and productive on the night shift can be challenging, even if you’ve had enough daytime sleep.” “Napping before work combined with consuming caffeine while on the job is an effective strategy for remaining alert on the night shift.”

NEGATIVE EFFECTS:

In spite of these benefits, napping is not always the best option for everyone. For example, some people have trouble sleeping any place other than their own bed, making a nap at the office or anywhere else unlikely. Other people simply have trouble sleeping in the daytime; it could be that certain individuals are more sensitive to the midday dip than others – those who are may feel sleepier and have an easier time napping. Here are some other negative effects:

Naps can leave people with sleep inertia, especially when they last more than 10-20 minutes. Sleep inertia is defined as the feeling of grogginess and disorientation that can come with awakening from a deep sleep. While this state usually only lasts for a few minutes to a half-hour, it can be detrimental to those who must perform immediately after waking from a napping period. Post-nap impairment and disorientation is more severe, and can last longer, in people who are sleep deprived or nap for longer periods.

Napping can also have a negative effect on other sleeping periods. A long nap or a nap taken too late in the day may adversely affect the length and quality of night time sleep. If you have trouble sleeping at night, a nap will only amplify problems.

One study has indicated that napping is associated with increased risk of heart failure in people already at risk.

STIGMAS:

While research has shown that napping is a beneficial way to relieve tiredness, it still has stigmas associated with it. Napping indicates laziness, a lack of ambition, and low standards. Napping is only for children, the sick and the elderly. Though the above statements are false, many segments of the public may still need to be educated on the benefits of napping.

A recent study in the research journal Sleep examined the benefits of naps of various lengths and no naps. The results showed that a 10-minute nap produced the most benefit in terms of reduced sleepiness and improved cognitive performance. A nap lasting 30 minutes or longer is more likely to be accompanied by sleep inertia, which is the period of grogginess that sometimes follows sleep.

By now you are probably thinking about ways to incorporate naps into your daily routine. Keep in mind that getting enough sleep on regular basis is the best way to stay alert and feel your best. But when fatigue sets in, a quick nap can do wonders for your mental and physical stamina.

…ends…

I’ve definitely been enjoying reading Apnea’s Blog and after posting about it and discussing it with Ms Justine and seeing the most recent photo sets she’s published, I’m more interested in working with her. There’s something about her that I find appealing, outside of the obvious fact that she’s beautiful. I see pretty things all the time, so there has to be something more appealing than just beauty to make me want to work with someone. I’ve been a fan of her work since the earlier days, but seeing her grow into her modeling work has given me more respect for her as time goes on.

How can you not adore someone that goes out of their way to create something interesting with every new set?

111809

           After the first 3 days I would have said “Awesome.” The last 2 days I was thinking that it wasn’t going well, but after some reflection and seeing what my real stats were I’m back to saying it is going “very well.” The machine stats say that my average night of sleep with the machine on is 7h 45min; I know that only 6.5-7hrs of that is sleep, but the sleep seems to be redemptive sleep so I am not concerned.

                I have heard that for a time you fight “the instinct to survive,” as your mind has learned that sleeping is a brush with death and it refuses to “go gently into that goodnight.” I think that is why it takes an hour or better to get to sleep. I am not dragging into bed ready to pass out any longer; it is more gentile now, like a nudge that tells me I am tired. I reminds me of the Dylan Thomas a poem,  

“Do not go gentle into that good night.
Rage, rage against the dying of the light.”

As if this isn’t the very feeling from deep within me. Set at odds against these words is the promise of the scriptures:

Pr 3:24                   

When thou liest down, thou shalt not be afraid: yea, thou shalt lie down, and thy sleep shall be sweet.

And again,

Jer 31:26             

Upon this I awaked, and beheld; and my sleep was sweet unto me.

                The next day this is what I find, “my sleep was sweet unto me.” How long oho heart will you not remember the lessons of the last night? How long will you choose to remember the nine years before, of the war in the night? Be comforted and take rest oho heart, fear not, for the Lord had removed your terror in the night, he has brought life in the hours that death once reigned and he shall turn back the clock, He shall not hold back the sun as in times past, but he shall return unto you the years that the locusts and cankerworm have eaten, and you shall delight yourself in the abundance of peace.

                At righting this I am in tears. Yesterday, as I read testimonials of successful CPAP treatments it was the same. How did something so simple and quiet sap my strength, throw me into depression and threaten my life.

Surely it is the “little foxes that spoil the vine.” (Song 2:15)

                I want to yell, but will they think I am crazy if I scream, “I’m alive!!!” That is what I feel, but I have no one to share it with. I want to write about it, but who is there to read it? Can I tell this story well? Can I tell this story with all my heart? Should I take an aside to tell this story? Or is this the big story? I am alive…

            Nine years ago my newly-wed wife April were just getting comfortable in married life. We had not been spending the night together before we were married, so there were a few surprises. The first observation was I was a bad snorer, but the second would become more important; I would stop breathing at night. I had never heard of sleep apnea before, but my wife, an RN was fully versed in what it was. Breathing sussation is common for people with sleep apnea, but it was news to me.

            We were newly-weds, our family was growing from 3-4 and didn’t have good insurance, so money was tight.  After discussing the options, the testing and treatments we discovered that after insurance our cost would still be over a $1000, plus a monthly charge for equipment. How could I take money from the household just to get a good night’s sleep? This seemed outrageous and absurd! April was insistent that if I needed it, it would happen. We were newlyweds and the thought of introducing such an unsightly piece of equipment into our bedroom was out of the question.

            I learned to sleep on my side, and for the next nine years this worked well for us. I was hopelessly addicted to sleeping in a stone cold room with no covers because I was sweating the bed so frequently. Two years ago I developed Rheumatoid Arthritis and this condition would change everything. I began to have shoulder pain and in order to sleep I was taking pain killers. I started waking up on my back a lot, having snored myself awake and most mornings feeling like someone had scrubbed my throat with something the size of a chimney sweeping brush. With all this you would think I would be begging for change and a good night’s sleep, but ironically it would not be me who would take the first step.

Hard Lessons

                April began having difficulty with sleep apnea; typical daytime sleepiness, bad snoring at night and during the night I would hear her stop breathing (because I was awake). She went to the Dr. Office to make some life changes; one of the things he ordered was a sleep study for her. She went and found that she had sever sleep apnea; with over 50 events per hour. Yet, there was one more thing that was going to push me toward a sleep study of my own.

                The same week my wife’s CPAP arrived, my Rheumatologist who was treating me for RA, put me on yet another new medication in attempt to get control of this disease. I experienced every side effect listed; including the most horrific, insomnia. I went for nearly five days with sleeping only two to three hours a night after only taking the medication for two days. My insides turned to goop; personality changes, moodiness and nervousness are only a few side effects from a very long list. I only took the medication for two days and I could not sleep for five. 

            A week after being off the medication the insomnia had passed, but still was not sleeping well. I just was not able to catch my sleep up. It began to get worse: I was waking up multiple times during the night drenched in sweat worse than it had ever been, my heart pounding out of my chest and feeling as if I had just run a mile and jumped into bed with no memory. I was trying to sleep, but I was being scared to death at what was happening. I wondered if I would wake up the next morning and if I would ever be right again.

               After several weeks of not being able to ketch up on sleep, I made an appointment with my family doctor and requested that he send me to a sleep study; after taking some history he agreed. I went home to do some research of my own on the topic and it soon became obvious to me that I had been dealing with sleep apnea for quite some time. The insomnia was what threw me past the point of no return without intervention and revealed just how poorly I had been sleeping.

I discovered that many of my unexplained health difficulties, which we assumed were part of RA could actually be caused by untreated apnea. I had dealt with unexplained heart arrhythmia, a deadly sign of sleep apnea! I also learned that some studies have found that 50% of people with RA also have sleep apnea; why wasn’t I warned of this by my RD and Family Dr?

            After several weeks I was only marginally better, I wasn’t having the horrible symptoms of sever night sweats, but I was so tired during the day that I was rapidly becoming dysfunctional. Even after getting back to a normal sleep cycle, I was still becoming extremely tired during the day. I was barely living; my emotions were all over the place. In the weeks ahead I fell asleep driving twice and started limiting my driving, I stopped doing homeschool with the kids as I was falling asleep at 10AM and the house was rapidly becoming a disaster. My life was grinding to a halt. I can fully understand why sleep deprivation is a primary method of interrogation, it shatters every aspect of your soul; mind, will and emotions. 

Sleeping Away from Home

            It took 4 weeks for my appointment at the sleep lab to come. I had been warned by April and Tom, my father in law, that a sleep study was actually an anti-sleep study. My experience was not quite what I was expecting; I slept as well, if not better than I had been doing at home. They did a split study night during the test; a procedure that is enacted when it becomes obvious that apnea is present and they go ahead with titration of the CPAP machine. It would still take another week for the “official results” to be given to my family Dr. When they were in, the result was as expected; moderate sleep apnea. (I am going to get re-titrated soon, as no REM was observed and I was only titrated on my side.) If that was only moderate I hate to see severe! Granted, mine was exacerbated by sleep deprivation and from insomnia, but what would happen next I didn’t expect.

Getting Results

            The day that my GP called with the results I called the DME office requesting that they move my appointment to the desperate pile. They made a same day appointment with me, but it still wasn’t fast enough, so I showed up 45 minutes early. I was successful in negotiating for a RemStar M Pro, which was data capable, so I could see if my AHI went up later after I got into REM sleep one I had adjusted.

I started off very well, the first night sleeping nine and a half hours without waking up. The next day I felt as if I was not longer getting worse, but only marginally better. I began to fall asleep in the chair at 3PM, rather than 10AM or on a good day 1PM. The second night I slept seven and a half hours and felt better rested. I didn’t even begin to feel the slightest bit sleepy until 10PM. I had a busy day and I didn’t feel tired? This was strange! I wondered if I was tired enough to go to sleep? Usually I waited until I could barely walk up the staircase to get to bed, but now I still felt like I could go all night, compared to the normal. This third night I slept seven and half hour’s strait again. Considering I hadn’t slept more than six hours a night for years, I was amazed that I could stay in bed that long. This third morning after was radically different and I was forever changed.

            When I woke up I didn’t feel my normal morning stiffness from RA. I noticed I was full of energy, my thoughts were clear and my emotions were under control. I was shocked; I had energy and strength, real changes! I had to make an AM run to the grocery store for coffee creamer and I discovered how radically different this was. I was walking full stride, something I hadn’t been able to do for nearly three years; I was also pain free and I had the biggest and most genuine smile on my face I could remember. When I recognized this I almost wept.  What happened to me? Could this really be the difference the CPAP had made? I felt as if I had been dead before and suddenly been made alive! In my best estimation and this is no exaggeration, I felt as if I had three times the physical strength I had only the day before. In the three days since this happened the entire house had been cleaned, the laundry is caught up and today I was able to shovel the snow from the driveway. I haven’t shoveled snow for three years.

Concluding Exhortation

            If you believe you have sleep apnea, get tested. If you are not sleeping well, if you snore loudly, feel tired during the day after a full night of sleep; get tested. Nine years after first hearing my wife say, “I think you quit breathing during the night,” I finally got treated. God only knows the things I have been unable or unwilling to do during that time that I could have done. The last six weeks before CPAP were the worst days of my life and the days since starting CPAP have been the best.

               Sleep apnea moves in slowly, like a dark cloud in the night, it gains ground while you are sleeping until this invisible killer makes a home in your bedroom. I let it stay thru apathy and fear and I never even realized this was choking the life out of me in the night and figured I would get it treated if it got any worse, but I never noticed it getting any worse until it was VERY BAD. I understand that the remedy of a CPAP machine and mask seem disproportionate to the problem. You are likely asking what I asked nine years ago, “How can I ever live with that?” I warn you, if you take nine years as I did, and survive; you will say, “How did I ever live without this?”

               It is approaching three weeks since starting CPAP; I have not had joint pain from the third day of CPAP until now. On Thanksgiving this year I was able to throw the football with my son, something else I haven’t been able to do in three years. I continue to adjust to the machine, learn new things and grow each day. I am considering approaching my Dr and asking him to back me off of the RA meds to see if I was misdiagnosed. Time will tell, but even if I cannot I still day say this had improved my quality of life considerably! My wife and I are now hose heads together; we help keep each other compliant and help one another thru the hard spots. We have thrown our yellow lab out of our bedroom because she was the last one in the room who still snored.

ManLoosed@Home

i’m in this strange emotional cycle where i fluctuate between being entirely too intense and full of feelings and being completely vacant and devoid of energy and passion. it’s such an all-or-nothing pattern. quite an exhausting one.

the reality of next year is impending. i have only a few more classes left to complete before i graduate from nyu – then i’m off to find my own jobs, gigs, whatever means of making a living i can with my limited but very specific skills.

maybe i should have chosen a different art concentration.
or maybe none of them are easy right now. i suppose artist and musicians are known for working really hard and living in cardboard boxes despite being the most brilliant individuals.

anyway, i insist upon having fun despite all this anxiety.

i was “cigarette girl” at trash this weekend. i walked around in my underwear and collected emails to promote the scene/parties.
then i fell asleep in the greenroom and realized that it’s a surprisingly soothing place to sleep, what with the reverberations from speakers and such. i had a nice nap until the security tool woke me.

i did some new art too. not gonna lie – it’s based on some alt model photography. anyone who follows the genre can probably figure out who the girls are.

apnea

zui

why yes, i do like drawing pale women with dark hair.
i always get jealous of photographers who create such beautiful pictures – i guess i want to do the same thing with drawing.

(note: i haven’t been drawing tattoos. whenever i attempt ink it comes out looking crude and awkward.)

i’ve been told my work has a bit of a “stiff outsider feel.” i’m trying to make my pieces less 2-dimensional. something about them just isn’t coming to life.

i’m off to orchestra. rehearsing some john adams and kodaly and brahms….nice lineup for the next concert.

Sleep apnoea does not have to have power over your life. In actuality, there are solutions available, you can obtain these days in order to put a stop to sleep apnoea from invading your night’s and ruining your life.

In order to prevent sleep disorder, you should first understand the sickness and what causes it. Sleep apnea is a sickness which causes
the sufferer to pause breathing on various situations all over the night. When this takes place, the muscles and tissue in the esophagus are relaxing and which leads to a obstruction in the airway. The results, that are often symptoms, together with heavy snoring, pauses in breathing and waking up with insufficient air or, in extreme situations, even desperate for air for air. At at the outset, the victim may perhaps not recognize what is happening, but in a little while will begin to comprehend a design and tiredness of exhaustion, touchiness and lack of concentration all through the day. If left unmanaged, sleep apnea might give rise to heart troubles, a bigger chance of a stroke or other grim therapeutic form.

What Is Sleep Apnea
What Is Sleep Apnea

The metabolic syndrome & smoking-related diseases

Snoring can disturb others and harm the snorer.

The apnea patients of Dr. Marc L. Benton, a New Jersey pulmonologist (airways doctor,) were fitted with nasal positive airway pressure masks and told to wear them every night. Find attached some great interviews with his patients.

Source: The New York Times -Health Guide

(por cortesía de Fernando Tricas; la información de este post ha sido publicada originalmente en: Fogonazos, asombros diarios; video colgado en: Vimeo)

El 10 de abril de 2009 el buceador neozelandés William Trubridge estableció un nuevo récord mundial de buceo en apnea al descender 88 metros sin aletas.  El descenso de Trubridge a las profundidades del Dean’s Blue Hole (en Bahamas) tuvo una duración de unos  3  minutos y 30 segundos.

Merece la pena ver el video de esta hazaña.

“Freediving World Record – 88m without…“, posted with vodpod

Mas información en: VerticalBlue.net

Una delle mie canzoni preferite dei Beatles è Norvegian Wood, titolo preso a prestito dallo scrittore Murakami Haruki (alla giapponese, cit.) per un libro incredibile regalatomi anni fa da una delle mie migliori amiche. Da allora è iniziata una dipendenza totale dalla sua prosa suggestiva, malinconica e surreale, che ho voluto poi trasmettere ad altri (peraltro con successo).

In uno dei suoi racconti, una volta, ho ritrovato descritto un personaggio, che mi ha spaventosamente ricordato un amico, altrettanto dipendente da Murakami. Ed è stato lui che, qualche giorno fa, mi ha raccontato di questo disco, Apnea, appena nato dalla collaborazione tra l’armonicista Max de Aloe ed il pianista Bill Carrothers, uno studio di alcuni racconti dello scrittore. Dodici brani, tutti originali, tranne una disarticolata Norvegian Wood, e Dear Heart di Henry Mancini. Chi ama Murakami lo ritroverà di sicuro.

A novembre il duo presenterà il disco a Castellanza (VA), il 13, e a Piacenza, il 14. Se non capitate da quelle parti, sempre sabato 14 saranno in diretta su radio 3, alle 17.

In 2004, 1.2 million Australians were recorded as suffering from sleep related pathologies.  Each year we spend over $10.3 billion dollars as a result of disturbances caused by a restless sleep.

Source: Hillman DR; Murphy AS; Antic R et al. The economic cost of sleep disorders. SLEEP 2006;29(3):299-305.

Author: Dr. Steven Y. Park

Sleep apnea surgery is one of the most controversial subjects in sleep medicine. There are heated debates within the sleep community as well as in online forums and support groups. Sleep apnea surgery is definitely not for everyone, for some, it can be a life-changing experience.

Here are 5 important issues that you must be aware of before considering any form of sleep apnea surgery:

1. Does sleep apnea surgery work?

Yes, but only when done properly. Just like with CPAP or dental devices, if you don’t use it properly or use it at all, it won’t work.

One of the most common misconceptions about sleep apnea surgery is the relatively low success rate of the uvulopalatopharyngoplasty (UPPP) procedure, which is often quoted at 40%. But performing this operation is like bypassing only one blocked heart vessel when you have 3 other vessels that are blocked. For some strange reason, ENTs are overly obsessed with the soft palate, since this is where snoring usually comes from and we have the most research and procedures for the soft palate.

We now know that if you address the entire upper airway together (nose, soft palate, tongue), then your success rates are much better, approaching 80%. Why only 80%? There’s only so much you can do with the soft tissues within the small space within smaller jaws (which is the main anatomic reason for sleep apnea). The more aggressive you are, the higher the success rate, but the more chance of pain and complications.

If you go to the next level and enlarge your jaws (upper and lower), then success rates can reach 90 to 95%.

To put things into perspective, if you bypassed everything with a tracheotomy (placing a breathing tube below your voice box), then you’ll have a 100% “cure”, but obviously, this is not a very practical option.

One question you must ask then, is, what’s the meaning of success? In surgery, one common definition is that the final AHI (apnea hypopnea index) on a formal sleep study drops greater than 50% of the original and the final number has to be less than 20. One of the main criticisms of sleep apnea surgery is that even if “successful”, you may still have mild sleep apnea. Surgeons will argue that it’s better than not using CPAP at all.

2. Not All Surgeries Are The Same

There are probably dozens of procedures for sleep apnea from various nasal, soft palate and tongue operations to skeletal framework procedures. These can range from minimally invasive to major surgery. The problem is that by definition, they’ll all work to a certain degree. For example, procedures for a stuffy nose have been shown to “cure” sleep apnea in 10% of patients. But for the most part, none of these options by themselves have very good success rates.

The key is to examine the upper airway for each individual and figure out where the obstruction is and take care of it simultaneously. Most people have more than one area of obstruction. Surgeons at Stanford have about a 75 to 80% success rate with soft palate and tongue base procedures. This is called multi-level surgery for sleep apnea. You have to look at the airway from the tip of the nose all the way to the voice box.

3. There’s No Cure for Sleep Apnea

Unless we all undergo tracheotomies, there’s no way to prevent breathing pauses at night. Modern humans’ upper airway anatomy is thought to be predisposed to breathing problems at night, which only gets worse as we age. I talk about why this problem has gotten much worse in recent years in my book, Sleep, Interrupted. All of us are on a continuum, where various factors (anatomy, age, weight, inflammation, etc.) contribute to forces that make our tongues and palates to collapse. The older we get, we’ll either gain weight, which narrows our breathing passageways, or our throat tissues will sag and collapse easier.

Surgery will shift the line of this continuum downwards, but it won’t bring it down completely. This is why it’s important to incorporate a healthy diet and lifestyle and exercise regimen into any sleep apnea treatment regimen.

For most people, lowering the numbers significantly will make you feel much better. But sometimes, the numbers will go down dramatically, but you may not feel any better. This just goes to show that there may be other issues besides sleep apnea that have to be addressed. You’ve had sleep apnea for years or decades. Just by fixing your sleep apnea won’t immediately fix problems that can arise from sleep apnea, such as hormonal problems, weight gain, or memory problems and brain fog.

4. Surgery is the Last Resort, But Don’t Rule It Out

Admittedly, there are many people who rush to surgery prematurely, but there are also many others that aren’t even offered surgery due to misconceptions by physicians. There are also many patients that are turned off by all the conflicting information that’s available on the internet.

Before you even think about surgery, make sure you’ve tried or considered all the other options thoroughly. Most people who fail CPAP do so because of poor counseling, support and followup by the medical system. Just like everything else with life, your chances of success depends on which doctors you see. The follow-up and support offered by your CPAP equipment vendor can also play an important role in whether or not you’ll benefit from CPAP. The same issues also apply with dental devices for sleep apnea.

This is why it’s important to educate yourself about all the treatment options, and not to give up too easily. Too many people give up at this point, and don’t consider any further treatments. Surround yourself with a group of trusted doctors and professionals that forms a team. Use their expertise and guidance to find a way to make things work. If nothing works for you, don’t rule out surgery just for the sake of avoiding surgery. Learn and educate yourself about surgery before rejecting it.

5. How to Find the Right Surgeon

Finding the right surgeon for your sleep apnea condition can be challenging. Everyone claims to specialize in snoring and sleep apnea surgery. Who are you to believe?

First of all, find someone who’s comfortable performing a wide range of procedures in all the three areas of the upper airway (nose, soft palate and tongue). Are they familiar with the minimally invasive procedures as well as the standard options? No everyone will be an expert at all the procedures, but it’s important to know about all the other options as well as well as to make appropriate referrals when necessary.

There are a variety of “minimally invasive” procedures out there, especially for the soft palate, but these procedures have to be offered very selectively. Even if successful initially, is your surgeon prepared for relapsed that are likely years later? Is the goal of surgery only to cover up the snoring, or will it treat the underlying anatomic causes?

If your surgeon recommends palatal surgery “just to see,” without addressing the entire upper airway from the nose to the tongue, go for a second opinion. If you do decide to undergo a palatal procedure (with or without tonsillectomy), be prepared for a 60% failure rate, which means that the tongue needed to be addressed as well. Sometimes, more needs to be done to the soft palate or the nose has to be addressed. Everyone is different, and the treatment recommendations have to be tailored to the individual.

Article Source: http://www.articlesbase.com/sleep-articles/5-things-you-must-know-about-sleep-apnea-surgery-1405130.html

About the Author:

For a more detailed, free report on The Truth About Sleep Apnea Surgery, go to: http://tinyurl.com/yl8hsk5. Steven Y. Park, M.D. http://www.doctorstevenpark.com

(CNN) — Instead of feeling crisp and refreshed, Jesse Wu wakes up sluggish after 12 hours of sleep.

"If I sleep the right amount, I feel really good," said the 25-year-old who lives in a suburb of Chicago, Illinois. "If I sleep too long, I feel groggy throughout the whole day."

Like Wu, some feel exhausted after long hours of rest.

"Many people will tell you, they sleep a little worse when they sleep a long time on weekends," said Dr. Daniel Kripke, co-director of Scripps Clinic Sleep Center in La Jolla, California. "Too much long sleep on weekends does not seem to make people feel better." But he acknowledged that the reasons haven’t been determined.

For years, doctors have warned about the dangers of not getting enough shuteye — traffic accidents, weight gain, decreased productivity and immune protection, but the effects of oversleeping are not well-understood. There isn’t medical evidence to recommend that people who sleep long hours should change their habits, Kripke said.

Daylight saving time ends this Sunday, giving sleepers a bonus hour of sleep.

Wu savors his sleep. "I really enjoy it," he said. In the morning, he needs five alarms — each with a different sound — that he smacks as he lumbers out of bed.

Like many professionals, Wu sleeps little on the weekdays (about five hours) and makes up for it on weekends, spending eight to 12 hours blissfully hibernating. Sometimes, after a long stretch, he wakes up too tired to function.

"After I’ve gotten so much sleep, the first situation is I fall asleep at 10 p.m., even though I’ve gotten 12 hours of sleep, because I feel so groggy," said Wu, who works as a membership coordinator for a professional association.

This is known as sleep drunkenness, when a person hovers between sleep and wakefulness, said Dr. Lisa Shives, medical director at Northshore Sleep Medicine in Evanston, Illinois. In one case, a patient who had sleep drunkenness came to the emergency room because his wife thought he had a stroke.

"They’ll wake up and be in this weird state of sleep drunkenness," Shives said. "If it’s really severe, you’re not going to be in any state to make decisions. If it’s just regular [case], a lot of us feel ‘blah,’ and most of us have to carry on and get going on a shower and cups of coffee."

Oversleeping once in a while doesn’t present serious health risks, experts say.

But if you habitually sleep excessively, it could be the result of an underlying health problem. And it could be cutting into your life span.

"There’s been at least two epidemiological studies to show that if people get less than five hours, or more than 10 hours of sleep, it increases their mortality," said Michael Breus, the clinical director of the sleep division at Southwest Spine and Sports in Scottsdale, Arizona.

A 2007 Finnish study found that the mortality risks increased by about 20 percent for people who slept more than eight hours. That same year, a British study found that people who slept five hours or less and those who slept more than eight hours also faced increased risks. Another study showed that people who routinely slept more than eight hours a night had a greater chance of stroke than others with less sleep.

Scientists say sleep and longevity are somehow associated, but there might be confounding factors.

"We don’t know if it’s the long sleep. It could be something else causing illness and the long sleep," said Kripke, who has researched the topic for 35 years.

Here are possible factors for habitually excessive sleep, known as hypersomnia:

• Problem: Poor-quality sleep

A person could sleep the recommended amount, but still feel tired because he or she got poor quality sleep.

"Oftentimes, we only think of sleep in terms of minutes — but that’s really the quantity of sleep. In fact, there’s a quality of sleep," said Breus, author of the book "Beauty Sleep."

The average sleep cycle takes 90 minutes to complete. It starts from stage 1, the lightest sleep, and progresses to deeper levels through stage 4. Then, it continues to rapid eye movement (REM) sleep when the person dreams.

"When you have poor quality sleep, you spend a lot of time in stage 1 sleep," said Shives, a spokesperson for the American Academy of Sleep Medicine. "You will tend to want to sleep longer to make up for the quality and increasing quantity."

• Problem: Other medical conditions

Too much long sleep on weekends does not seem to make people feel better
–Dr. Daniel Kripke

RELATED TOPICS

• Sleeping and Sleep Disorders
• Sleep Apnea
• Sleep Disorders

"If you find you’re sleeping a lot — like more than nine hours on a regular basis, you need to talk to your physician, because that probably means you got poor quality sleep and that could be sleep apnea, narcolepsy or restless legs form of sleep disorder," said Breus.

Sleep apnea is a major cause of problems, when breathing stops during sleep.

"If you have sleep apnea and you stop breathing through the night, you might feel really tired in the morning even though you’ve gotten eight hours. Those eight hours were horrible, light, crappy sleep," Breus said.

Another possibility is periodic limb movement disorder, which causes a person to jerk and twitch during sleep, causing disruptions. Depression has also been associated with excessive sleep.

• Problems: Genetics

Some people naturally thrive on little sleep. And then, there are others who flourish after nine hours.

"It’s only when you go less than six and a half hours of sleep, we call you a short sleeper; more than 9.5 hours, we call you a long sleeper," Shives said. "We think there’s something genetic."

A study published this year in the journal Science identified a mutated gene in a mother-daughter pair that allowed them to function on six hours of sleep. The research conducted by University of California, San Francisco scientists is believed to be the first to discover a gene, hDEC2 involved in regulating sleep length. This finding could someday lead to a better understanding of why some people require more sleep.

Story from CNN.COM