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Using Light to Treat Sleep Disorders

Light box therapy can treat circadian rhythm disorders and winter depression or seasonal affective disorder (SAD). Learn about the most effective phototherapy options.

Light Box Therapy Options
Sleep Spotlight10

How Long Does a CPAP Prescription Last?

Wednesday March 26, 2014

CPAP machines

If you use continuous positive airway pressure (CPAP) or bilevel to treat your sleep apnea, you may wonder: how long does a CPAP prescription last? Though the answer may vary somewhat based on your insurance, there are a few rules of thumb that can be followed.

In most cases, the prescription your sleep specialist gives you for CPAP and the associated equipment will be good for 1 year from the time it is issued. This ensures that you are regularly checking in with your physician to ensure that your treatment is optimized. Your doctor can help you address any problems and update you on new masks, comfort features, or other developments. This face-to-face encounter also allows your medical history and physical examination to be reviewed. The prescription will allow you to replace your supplies as often as you should.

Medicare patients are required to have these visits every 6 months. Therefore, the prescription for equipment only lasts for this period.

The requirements may vary with some insurers, and your durable medical equipment provider should be able to inform you of any special circumstances that may apply to you.

Keep in mind that most CPAP machines are completely replaced at 5-year intervals. Therefore, if you are using an older machine, you may be eligible for a full upgrade of your unit.

All CPAP supplies are considered to be medical equipment and this is why they are controlled with the issuance of a prescription from a sleep specialist. If you are due to get new supplies, but your prescription has expired, you should start by checking in with your doctor.

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Why Periodic Limb Movements Are Not Restless Legs Syndrome

Saturday March 22, 2014

This is an issue that confuses patients and sleep specialists alike: what is the difference between periodic limb movements of sleep and restless legs syndrome? And why does it matter?

Movements of the legs at night can disturb sleep and lead to insomnia. However, not all movements are alike. In order to understand the difference between overlapping disorders, it is important to get back to the basics.

Restless legs syndrome (RLS) is a condition that leads to discomfort in the legs and may even be associated with intentional, conscious movements. It consists of four key features:

  • An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.
  • The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting.
  • Sensations that are relieved by movement, such as walking or stretching, as long as the activity continues.
  • Sensations that are worse during the evening or night.

RLS is a clinical diagnosis. It is based on the symptoms that a patient complains of and no testing is required. The prevalence of RLS is estimated to be 5% to 10% of people. It is often treated with iron replacement and prescription medications.

Interestingly, RLS is commonly associated with unconscious periodic limb movements of sleep (PLMS). This is a separate diagnosis, and one that is made based on the results of a polysomnogram. When a sleep study occurs, wires are placed on the front of the legs that measure movements. If leg movements occur frequently or intensely, they may disturb sleep. In general, the PLM index is considered to be abnormal when more than 15 events occur per hour in adults.

PLMS can occur secondary to other sleep disorders. For instance, someone with sleep apnea may kick his or her legs as part of opening the airway to resume breathing. Moreover, no matter the trigger, these movements are not thought to contribute to significant sleep disruption in isolation. Therefore, they are usually not treated when they are observed on a sleep study without any corresponding RLS symptoms.

In summary, RLS is a condition that is based on symptoms and not testing. PLMS is observed on a test, and may not have associated RLS symptoms because it can also occur in other disorders like sleep apnea. Most sleep specialists do not treat PLMS with medications for RLS if no RLS symptoms are reported. If the movements are disruptive to a bed partner, treatments may be pursued to quiet the movements at night.

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Sleep Apnea and the Effects on Your Health

Friday March 21, 2014

Sleep is not always a benign state. Snoring may not be harmless. In fact, a related condition that affects breathing during sleep may have important consequences. This disorder, sleep apnea, can have significant effects on your overall health.

There are certain symptoms and signs associated with obstructive sleep apnea that can affect day-to-day life. Excessive daytime sleepiness, mood complaints like anxiety or depression, or difficulty with thinking may undermine concentration or memory. However, untreated sleep apnea can have other unwanted side effects.

Sleep apnea may increase blood pressure, lead to insulin resistance and diabetes, worsen heart failure, provoke heart arrhythmias like atrial fibrillation, and even lead to heart attack, stroke, and sudden death. These risks occur over the long term. Just like one cigarette likely won't kill you, but smoking over many years just might, sleep apnea may increase your health risks over decades of exposure.

Review some information about how sleep apnea may contribute to heart health problems, stroke, sudden death, and even have specific consequences in children.

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Battling the Bed Bugs

Thursday March 20, 2014

Photo of actual bed bugs

It is a perennial headline that appears in the news: "Bed Bugs Are Back!" You may wonder about these little critters and why they seem to bedevil us everywhere these days. Take a moment to review some information on what bed bugs are, what harm they may (or may not) be, the symptoms associated with bed bug exposure, and the treatment options available if you face an infestation. You don't have to let these creepy, crawly nuisances bother you. Sleep tight - and don't let the bed bugs bite!

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