Archive for the ‘Sleep Issues’ Category

Sleep Apnea.. Did you know?

Wednesday, November 21st, 2012

Snoring. Fatigue. Long pauses in breathing. These are just a couple of symptoms and warning signs of sleep apnea. Similar to seeing smoke alerting you of a fire, daytime sleepiness or gasping for air during your sleep can alert you to sleep apnea and should be mentioned to your doctor. If left untreated it could lead to diabetes, heart failure or stroke. Possible treatments of sleep apnea include therapies, surgeries and even an implant that shocks you every time the airways in your lungs close. Each of these possible treatments does include a list of pros and cons.

Therapies for sleep apnea include CPAP (Continuous Positive Airway Pressure) or BiPAP (Bilevel Positive Airway Pressure) machines designed to continuously deliver various pressure of air into the nose or mouth in order to keep the airway passages open for the free flow of air into your lungs. The pro to this treatment is not having to get surgery. If going under the knife doesn’t please you, then wearing a mask over your nose or mouth during slumber is your best bet. However, the con to this treatment is wearing the mask at night. Many PAP users feel the masks can be quite obtrusive and uncomfortable during slumber. If you’re a stomach sleeper then you would certainly need to adjust your sleeping habit in order to wear a PAP mask. Another con, of course, would have to be constantly replacing your PAP supplies every 3 to 6 months. Bacteria build-up and deterioration is common when using these machines on a daily basis. Make sure you have insurance that will cover durable medical equipment.

If wearing a mask on a nightly basis doesn’t necessarily tickle your fancy, you might want a more permanent treatment to your restless night’s sleep. The most commonly performed surgeries to combat sleep apnea include nasal surgery (correction of nasal problems such as a deviated septum), Uvulopalatopharyngoplasty – UPPP (surgically removing the soft tissue in the back of your throat and palate in order to increase the width of the airway at the opening of the throat) and Mandibular maxillar advancement surgery (constructive surgery to improve a birth defect in your face or throat that may contribute to sleep apnea). The pro to this treatment is that it is permanent. The con would be having to go under the knife which might scare a lot of OSA sufferers.

In some cases especially with only mild cases, weight loss or cutting cigarettes and alcohol out of your diet can improve your night’s slumber. Therapies and surgeries are suggested by your doctor only in moderate or severe cases. If either of these does not sound pleasing to you, you can always look into shock treatment like a Wisconsin man did earlier this year. Dan Gutzman, husband and father of two in Milwaukee, tried a CPAP and could not get used to it. He thought surgery was far too drastic. His doctor explained the shock treatment to him as a nerve stimulator that sends an electric shock wave to his lungs and tongue when his airway is blocked and snoring occurs. If you’d rather not sleep with probes in your mouth and lungs and think an electric shock is just scary, keep to a CPAP therapy treatment.

Wellness Flowchart

Tuesday, March 1st, 2011

Why Aeroflow Industrial?

Tuesday, January 11th, 2011

Why Areoflow Industrial?
• Driver consults with an Aeroflow specialist to determine the need for an Aeroflow Sleep Apnea Test Kit.
• The Driver wears the easy to use testing device for one night. Then the unit is shipped back to Aeroflow health Care for secure downloading.
• Aeroflow Diagnostic testing specialist downloads the device for interpretation by an Aeroflow Board Certified Sleep Doctor.
• Aeroflow notifies the driver of their results and Doctors recommendations within 24 hours of receiving back the testing kit.
• If the recommendation indicates the need for therapy Aeroflow Clinician will contact the driver for consultation and treatment options. Aeroflow will arrange and follow the driver through treatment.
• 24 hour support from Aeroflow staff.
• Aeroflow works with the Trucking company and Occupational Doctors to prove compliance and virtually eliminate any downtime.
• Aeroflow provides any documentation needed for CDL license requirements and Company policies related to sleep disorders.
• Aeroflow can bill your current health insurance providers. Also, offer easy monthly payment plans with a small down payment for those who need a little help.

info@aeroflowindustrialclinics.com
1.866.650.7508

Are You Familiar With Sleep Apnea?

Thursday, November 18th, 2010

Are You Familiar With Sleep Apnea?
In case you are not familiar with “obstructive sleep apnea” (OSA), here’s a brief explanation. OSA occurs when one is asleep and the soft palate and/or tongue falls against the back of the throat to the point that it partially or completely obstructs the airway. The person is trying to breathe but their airway is obstructed. During this time the oxygen level in the blood is dropping, which is of course very disturbing to the body and causes one to begin to awaken. Most patients with OSA don’t wake up completely, but they are aroused enough that the muscle tone returns to the back of their throat and their airway opens up and they breathe again. This cycle repeats itself throughout the night. The obstruction of the airway and drop in oxygen disturbs the body enough that the individual never gets into the deeper phases of sleep where effective rest occurs. As a result they are not as alert the next day.

The section in the Federal Regulations that addresses sleep apnea and drivers of commercial motor vehicles follows:

“CFR 391.41(b)(5)
A person is physically qualified to drive a commercial motor vehicle if that person has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely. Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. If the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy.”

Our Nurses Care

Thursday, November 18th, 2010

“Our Respiratory Therapists are the best at developing and maintaining a relationship with the patients that ultimately provides the patients with the comfort level needed to have a successful outcome. After a patient feels the benefit’s of treating their sleep disordered breathing they will typically wish they had treated it long ago.”

Quote by Josh Hill “ AEROFLOW HEALTHCARE” Our nurses care!

Home Sleep Testing

Friday, October 22nd, 2010

Dear Healthcare Provider,

With the emergence of home sleep testing, there has been some confusion regarding the
indications for home sleep testing. This letter is an attempt to provide clarity on the use
of home sleep testing.

Patients should be pre-screened for sleep apnea before using any home sleep testing
program. It is important to use a validated screening tool. The Berlin questionnaire is
the most validated screening tool, but unfortunately it is not easy to use or score. I prefer
the Stop-Bang questionnaire (see attached) because it is extremely simple. If the patient
answers yes to any 3 of the questions – they are at high risk for sleep apnea.

Home sleep testing should only be used in patients who are at high risk for sleep apnea.
Anyone who screens positive to the Stop-Bang questionnaire is high risk. I use
the Watermark Ares home testing device which performs level 2 sleep studies. Level 2
studies measure indices of both sleep and breathing. These studies have proven to be
equivalent to laboratory testing for the assessment of sleep apnea. Most home testing
equipment performs level 3 sleep studies which only record indices of breathing. Level 3
studies are also appropriate for testing for sleep apnea. A positive level 3 study is
sufficient for the diagnosis of sleep apnea. However a negative level 3 study in a high
risk patient does not rule out sleep apnea and necessitates a laboratory study.

Home sleep testing is not appropriate for patients who are not at high risk for
obstructive sleep apnea. It is also contraindicated in circumstances in which the accuracy
of the testing equipment may be altered. The most common scenario that will decrease
the accuracy of a home sleep testing device is the use of nasal oxygen. This is because
nasal airflow is usually measured by monitoring nasal pressure changes at the nose. The
slightly positive pressure of nasal oxygen can alter the signal.

Continuous positive airway pressure (CPAP) is the preferred therapy for sleep apnea.
There are 2 big categories of CPAP: traditional fixed pressure CPAP machines and autotitrating
CPAP machines. These have been shown to be equivalent in the treatment of
obstructive sleep apnea in multiple clinical trials. They are both recognized as an
acceptable treatment for sleep apnea by the American Academy of Sleep Medicine.
Fixed pressure CPAP machines require a laboratory based sleep study to determine the
best pressure for treatment. Auto-titrating CPAP machines are equipped with a
microprocessor that constantly monitors the patient’s breathing. If an increase in airway
resistance is noted, CPAP pressure is slowly increased. Therapy with an auto-titrating
CPAP machine can be initiated in the home.

Cost and convenience are the two areas that differ greatly between laboratory and
home based testing and treatment. Home sleep testing is roughly one-fourth the cost
of laboratory testing. The use of an auto-titrating CPAP machine can eliminate the need
for a second sleep study.

In summary, it is no longer necessary to send your routine sleep apnea patients to a sleep
laboratory. High quality, more cost effective care can be provided in the comfort and
convenience of the home.

Please contact me if I can be of assistance in managing your patients.

Sincerely,

Thomas P. Stern, M.D., M.S.
Pulmonary, Critical Care, and Sleep Medicine
tomstern@mdadvisor.org

Additional Links

Validation of a Self-Applied Unattended Monitor for Sleep Disordered Breathing

Clinical Guidelines for the Use of Unattended Portable Monitors

Practice Parameters for the Use of Autotitrating CPAP

Outcomes of Home-Based Diagnosis and Treatment of Obstructive Sleep Apnea

CPAP Patient testimonial

Monday, October 18th, 2010

Hi Tammy, (Aeroflow Nurse)

I’m sorry I took so long to email you but work has kept me going and I’ve been a little under the weather lately. Anyway I wanted to let you know that you were 110% right about the CPAP machine changing my life because:

1. I feel so much better and more well rested in the morning.
2. I no longer need energy drinks to keep me awake in the morning.
3. I no longer snore at night which is making my wife very happy.
4. I had a slight pain in my left knee that would come and go from time to time…gone!

The mask still takes some getting used to because sometimes I feel I worry too much about air escaping so I adjust it a little more than I probably should but I’m getting better at that. Overall I think this has helped me a great deal and life is good again!

Thank you again for getting me setup on my CPAP and especially with the follow-up phone calls you made to check on me. I don’t know many doctors or nurses that would do that and my wife and I appreciate it very much. I have Aeroflow’s address so you’ll be happy to know that you are now “officially” on our Christmas card list!

Take care and thanks again,
Mike Downing