Sleep

Explore the latest in new sleep articles available from April. Learn how simple breathing exercises may help you to ease anxiety and improve your insomnia. Discover some of the serious consequences associated with sleep problems in pregnancy, including preeclampsia and gestational diabetes. What is ZzzQuil? Learn about this over-the-counter sleeping medication and how long it should be used to treat acute insomnia. Read about the Neupro patch, a medication that is delivered through the skin to treat restless legs syndrome (RLS) and Parkinson's disease. Finally, add to your understanding of nasal sprays that can be used to relieve allergies, nasal congestion, and snoring. You may be familiar with the over-the-counter option called Afrin, but learn why this should only be used briefly. Discover other prescription nasal sprays including Astelin, Nasonex, and Rhinocort. There is a lot to learn about in sleep, so get started on these topics!

Read More:

• How Can Breathing Exercises Help with Anxiety and Insomnia?
• Consequences of Sleep Problems in Pregnancy
• What Is ZzzQuil?
• Neupro Patch May Relieve Restless Legs Syndrome (RLS) Symptoms
• Afrin Nasal Spray Works as Short-Term Decongestant
• Astelin Nasal Spray Provides Relief from Allergies
• Nasonex Nasal Spray to Treat Allergies
• Rhinocort Nasal Spray Treats Allergies

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Explore the latest sleep articles published in March. You can learn ways to decrease your anxiety and relieve insomnia. Consider how to treat restless legs syndrome (RLS) with iron supplements. Finally discover why you feel so sleepy after lunch (hint: it's not the food). Review a detailed article describing how you can sleep better at night. Expand your understanding of anatomy by learning about adenoids, turbinates, and the nasal septum. Finally, read about the use of Flonase nasal spray to treat your allergies. There is always something new to learn about in the world of sleep!

Read More:

• Ways to Decrease Anxiety and Improve Sleep
• How to Treat Restless Legs with Iron Supplements
• Why Am I Sleepy After Lunch?
• How Can You Sleep at Night
• Definition of Adenoids
• Definition of Turbinates
• Definition of Nasal Septum
• Flonase Nasal Sprays for Allergies

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As an update to a prior blog on the availability of the Provent medical device, I had a chance to speak with Matt Williams who serves as the director of national sales for Ventus Medical, Inc. based in San Jose, California.

As previously reported, the company has initiated a bankruptcy process. Fortunately, they remain in operation while awaiting acquisition of their assets by another company. It is anticipated that the assets will be bought out and that business will continue with the Provent product, according to Mr. Williams.

For patients who currently use or who have an interest in using the Provent medical device, it remains available during this transition. There is sufficient inventory to meet the needs of suppliers for up to 1 year. The prescriber network has been notified that access to the product continues uninterrupted.

It is anticipated that this business transition will occur over the next 2-3 weeks as corporate trustees review the offers. The good news is that for those who use Provent to treat sleep apnea, the product remains on the market and will be available for the foreseeable future. Further updates will be provided as warranted during this period.

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For those who have sought treatment of obstructive sleep apnea with the Provent medical device, it seems that this therapy option will no longer be available as the company in San Jose, California has reportedly gone out of business, according to those familiar with its operations.

Provent consists of a small one-way valve that is secured at the nostril with an adhesive band. It allows a person to breathe in, but the valve closes with exhalation and retains some of the air. Gradually, pressure builds up within the airway. It was theorized that this would keep the airway from collapsing and prevent obstructive sleep apnea. Unfortunately, when the mouth comes open, this pressure gradient can be lost. Treatment effectiveness varied and, in general, Provent is not as successful as continuous positive airway pressure (CPAP), though the latter may be less tolerated.

Provent received widespread attention after a blog in The New York Times last year. It was an attractive option for overnight camping and travel in which electricity or a bulky device were less desirable. It also appealed to those who could not tolerate CPAP. Now that the product is unlikely to be available, a remaining alternative option may include the use of an oral appliance that is worn like a retainer at night and moves the lower jaw forward.

Ventus Medical, Inc., the parent company that produces Provent, was contacted directly for comment and to verify the discontinuation of Provent and the telephone line was repeatedly busy with no answer at a second customer service number. More information on this developing story will be provided as it is known.

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There has been an exciting new development in February: I am pleased to welcome and announce the contributions of a leading expert in surgeries to treat sleep apnea and snoring, Dr. Eric Kezirian. Highly regarded for his important work in this field, he will serve as a guest author and provide valuable insight and information for people interested in learning about the surgical options to improve sleep-disordered breathing. This month includes some of his initial articles on soft palate, tongue, and jaw surgery. In addition, there is an accompanying complement of anatomy terms that are integral to understanding the procedures: uvula, palate, and tonsils. Start exploring the role of surgery in treating these common sleep problems. For a change of pace, you can also read a new article about the various safety precautions to take for sleep-related behaviors such as sleepwalking, known as parasomnias. Check out the new articles on sleep for February and expand your knowledge of this fascinating subject.

Read More:

• Biography of Eric Kezirian, M.D., M.P.H.
• Soft Palate Surgery Options for Sleep Apnea
• Sleep Apnea Surgery Options Include Hypopharyngeal Procedures
• How Is Jaw Advancement Surgery Used to Treat Sleep Apnea?
• Definition of Uvula
• Definition of Palate
• Definition of Tonsils
• What Safety Precautions Should Be Taken in Parasomnias?

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There are many great new articles available from January. The largest is an extensive series of blogs that will give specific advice to help you to sleep better over the course of 30 days. This course can be a major pathway to finally ridding yourself of your sleep problem. You can also learn what may be causing you to wake up early in the morning. If you use continuous positive airway pressure (CPAP) to treat your sleep apnea, you may question whether you should use it when you have a cold. You can also learn how to avoid getting water in the tubing of your CPAP. Expand your vocabulary by learning some new words related to sleep: oxygen desaturation index (ODI) and pes. Finally, explore how two specific dementia conditions affect sleep: frontotemporal dementia and Creutzfeldt-Jakob disease. There are many great articles to read this month, so don't miss out on learning more about these topics.

Read More:

• How to Sleep Better in 30 Days
• What Causes Early Morning Awakenings?
• Should I Use CPAP with a Cold?
• How to Avoid Moisture in CPAP Tubing
• Definition of Oxygen Desaturation Index (ODI)
• Definition of Pes
• Frontotemporal Dementia and the Effects on Sleep
• Creutzfeldt-Jakob Disease and the Effects on Sleep

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At the conclusion of 30 days spent in an effort to sleep better, you may find yourself continuing to struggle. Through no fault of your own, restorative rest may still elude you. You may still struggle to sleep at night or wake feeling unrefreshed. What should you do now to improve your sleep? When should you see a sleep doctor?

There are many things that you can do to improve your sleep. As observed over the past month, you can sleep better by keeping a regular sleep schedule. You can improve your sleep environment by removing electronics, pets, and even the alarm clock. You can meet your sleep needs, pay off your sleep debt, and sleep at the right time for you. By recognizing sleepiness, you can create a relaxing buffer zone and go to bed only when sleepy. You can sleep better by cutting out caffeine, alcohol, and nicotine. You can exercise at the right time, avoid peeing frequently during sleep, and eliminate heartburn at night. By eliminating stress and addressing mood problems, you can limit wakefulness in bed and sleep more. Exposure to morning sunlight and prioritizing sleep can also be helpful. If after all these changes, and more, you continue to have difficulty sleeping, you may need additional professional assistance.

Persistent difficulty falling or staying asleep or sleep that is not refreshing should be evaluated by a physician. If you are too sleepy during the day, struggling with frequent naps and compromised function, you may need help. Problems that last more than a month should be further assessed. Although you might start by speaking with your primary care doctor, you may benefit from speaking with a specialist. Who should you see to discuss your problem?

Seek out a board-certified sleep specialist who is a medical doctor who has completed fellowship training in sleep medicine. A sleep medicine fellowship is 1 to 2 years of additional training after a primary residency has been completed. These doctors may have previously been trained in pulmonary medicine, neurology, or psychiatry. They then take a board examination that certifies their expertise in the discipline. The clinic or lab that you visit should be further certified by the American Academy of Sleep Medicine (AASM), a marker of the quality of care you should expect. Many professionals may express an interest or promote an expertise in sleep medicine, but you deserve to see someone who has the training and credentials necessary to help you. Not all "sleep experts" are created equal.

After speaking with a verified sleep specialist, it may be recommended that further testing be conducted. Most often, an overnight sleep study called a polysomnogram may be performed to identify a sleep disorder such as sleep apnea. Additional tests may be used to diagnose restless legs syndrome, narcolepsy, and other sleep disorders. There are many effective treatment options available once the condition has been properly identified.

You do not need to suffer from difficulty sleeping. There are sleeping pills as well as behavioral treatments, including: sleep restriction, stimulus control, and cognitive therapy. For these latter options, it can be helpful to work with someone who has training in these therapies, such as a certified psychologist. Surgical options and medical devices such as light boxes or CPAP may also have a role. A well-trained specialist will assess your individual needs and provide guidance for what therapy best suits your situation.

If after making a good-faith effort to improve your sleep, you still find yourself falling short, don't give up. Targeted advice and adjunctive treatments may be just what you need. Seek out some professional assistance and you will be able to finally sleep better, a goal that is most worthy of your efforts.

Check out the entire series, "How to Sleep Better in 30 Days."

Read More:

• What to Expect in a Sleep Study
• How to Choose a Sleep Doctor
• What Is a Sleep Clinic?
• Diagnostic Tests for Sleep Disorders
• 10 Common Symptoms of Sleep Disorders

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As the "30 Days to Better Sleep" blog series draws to a close, there are only a few finishing touches necessary to ensure a good night's sleep. One of the most important is completely within your control: it is the decision to make sleep a priority.

Sleep concludes our day. It is, quite literally, the last thing we get to, but it is a finish line that we tend to postpone when necessity or preference dictates. Work, family obligations, and hobbies may intrude on the amount of sleep that we obtain. A late night with friends, a few hours surfing the internet or watching a movie, a project for work; there are endless distractions and diversions that can intrude on our time for sleep.

The first task is to consider how much sleep you need and when you should be sleeping. Once these determinations are made, you can recognize an appropriate bedtime and wake time. It can be helpful to draw a line in the sand to conclude your day, a previously described artificial closure. From this point, a period of relaxation called a buffer zone before bedtime should be observed. Then, when it is time to go to bed, the transition to sleep will be eased with a decreased likelihood of suffering from insomnia.

The challenge presents in how to preserve your sleep period. How can you protect it from the innumerable intrusions? Enroll your family and friends in these efforts. By including your bed partner in these priorities, he or she can contribute to your adherence. Be kind but firm with others who may present opportunities for distraction. If you find consistent conflicts, you may decide to slightly shift your sleep schedule to accommodate these needs on a permanent basis.

Do your best to keep your sleep schedule consistent through the week and weekend. Avoid sleeping in or staying out too late on a handful of days. Instead, go to bed and wake up at the same time each day. You will be rewarded with a consistent ability to sleep well at night, wake feeling refreshed, and be rested during the rest of the day.

Sleep may seem like the least interesting part of your day. It may be viewed as an inconvenience, a waste of time, a hassle. Neglecting your sleep needs can lead to the ill effects of sleep deprivation. These can undermine your ability to function during the day, causing poor concentration or attention, loss of short-term memory, or a disagreeable mood. If you gain more of this compromised wakefulness at the expense of some shut-eye, what good is this?

Instead, now that you have made many changes and improved your ability to sleep, respect your newfound gains. Set aside the time you need to sleep, just like you make a priority to eat or exercise. It is as just an important part of your life. Give it the respect that it deserves. You will be glad that you did.

Check out the entire series, "How to Sleep Better in 30 Days."

Read More:

• Help Me Sleep Better
• The 10 Worst Ways to Ruin Your Sleep
• Better Sleep Guidelines
• Top 10 Ways to Get a Better Night's Sleep
• Improve Sleep Habits in Children

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In the grand scheme of improving your sleep, it is important to assess the gains and recognize if you are simply too sleepy during the day. The irony is that the sleepier you are, the less you might recognize the degree of impairment in yourself. What are the causes of persistent excessive daytime sleepiness? How might being too sleepy affect your daytime function in regards to memory, focus, and mood? Take a moment and consider whether you may still be too sleepy and why.

Remember the difference between sleepiness and fatigue. Sleepiness or drowsiness is a strong compulsion to fall asleep. When it occurs during the day, it is marked by the ability to take naps. It may contribute to accidents if coupled with driving. It may lead to cognitive performance issues, including poor concentration, attention, and short-term memory. It may contribute to mood complaints, including depression and irritability. Perhaps it is easy to recognize when you feel sleepy, but how do you know when you are too sleepy?

There are a few measures used to assess excessive daytime sleepiness. The most common is the Epworth sleepiness scale. It assesses your ability to fall asleep in passive situations. Scores higher than 10 are consider to be pathological and should prompt an evaluation for sleep disorders. You may be too sleepy if you take daily, especially prolonged naps. If you fall asleep in less than 5 minutes at night, you may also be too sleepy. In addition, there are other objective tests available to assess the degree of sleepiness, including multiple sleep latency testing (MSLT) and maintenance of wakefulness testing (MWT).

What causes excessive sleepiness? The most common reason for people to feel sleepy during the day is inadequate total sleep time. Sleep deprivation leads to an increasing desire to sleep, especially in the afternoon when the waking effects of the circadian rhythm naturally dip. It's a simple relationship: if you don't sleep enough at night, you will be too sleepy during the day.

Sleep that is of poor quality will also contribute to daytime sleepiness. This may be caused by conditions such as sleep apnea or insomnia, in which sleep overnight becomes greatly fragmented or disrupted. In addition, there are conditions that cause rapid transitions between sleep and wakefulness, leading to profound sleepiness in the day, such as may be seen as part of narcolepsy.

Sleep deprivation or sleep that is of poor quality can lead to great impairment. There may be physical signs and symptoms, including hallucinations and even death. One of the key tasks of sleep is to clear away a neurotransmitter in the brain called adenosine. This chemical contributes to the feeling of sleepiness, and if it is not removed, our thinking becomes muddled. We may not even recognize the degree to which we are actually impaired. Therefore, it is important to get the perspective of other observers in our lives, including our family, friends, and coworkers. Get a candid assessment of your performance and mood, and if there is room for improvement, consider what role your sleep may have in the situation.

Excessive daytime sleepiness does not have to be a familiar part of our day. It may suggest that our sleep at night is in need of our attention. With a little collaborative information in hand, you can discuss your situation with your doctor and pursue appropriate testing, including an overnight sleep study. Start by considering if you are too sleepy, and if you are, reach out and get the help that you need to wake feeling rested and function at your best throughout the day.

Check out the entire series, "How to Sleep Better in 30 Days."

Read More:

• Determine Your Sleep Needs
• What Are the Symptoms of Sleep Deprivation?
• How Much Sleep Is Too Much?
• Reasons Why You Feel Sleepy
• How Much Sleep Do I Need?

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For as long as you can remember, it has been the first thing you look at in the morning: the alarm clock. It is a symbol of obligation, intrusion of responsibility, and a marker of the modern working life. One of the highlights of retirement may be finally getting rid of it. What if you could hit the snooze for good? How is an alarm clock affecting your ability to sleep and wake feeling rested? Consider whether it may be time to get rid of the alarm clock.

What does it mean to use an alarm clock? At its foundation, the implication is that you need to wake up at a certain time, probably before you would naturally wake on your own, and that you wouldn't without a prompting. If you trusted that you would wake up with time to spare, you wouldn't set an alarm. Instead, if left to its own devices your body is likely to keep sleeping, making you late for work or other obligations. Therefore, by waking with an alarm, you are shortening your total sleep time.

The consequence of waking with an alarm is sleep deprivation. If you had your fill of sleep, you would be waking before your alarm even goes off. Instead, you are trying to continue sleeping when the alarm prompts you to arise with a buzz, blare, or musical interlude. How much longer would you have slept? You might get a glimpse of the answer by how many times you hit the snooze button. Better still would be the days that you turn it off completely or don't turn it on to begin with, such as a weekend on which you can sleep in. Initially, this extra sleep will pay off the accumulated sleep debt, and then you will approach your average sleep needs.

If you determine that you need 8 hours of sleep each night, why not allow yourself this time in bed? It is a matter of simple math to figure out when you should go to bed and when you will naturally wake up on your own. If you wish to wake at 6 AM, then a bedtime at 10 PM would let you get enough sleep without fear of oversleeping. This assumes, of course, that you will spend most of this block of time sleeping. If you suffer from insomnia or a circadian rhythm disorder, especially delayed sleep phase syndrome, you might need to correct this problem first before setting the alarm clock aside.

If you are interested in eliminating the alarm clock, it is also imperative to keep a regular sleep schedule. Go to bed and get up at the same time every day, including weekends. Your body will reward this regular pattern of sleep by waking you up at the right time. Prior to unplugging the alarm clock and trusting your ability to wake on time on your own, you should probably ease yourself into the new arrangement. Keep a very regular schedule for several weeks, getting a sufficient amount of sleep, and then set the alarm clock to a later time, a point at which you absolutely must get up -- or be late. You might also let your employer know that you are making this transition, in case you need a little extra forgiveness for tardiness. Then you can gradually phase out the alarm clock completely.

With a little planning and persistence, you can obtain the sleep that you need and get rid of the alarm clock for good. What could be better than that?

Check out the entire series, "How to Sleep Better in 30 Days."

Read More:

• Should I Use an Alarm Clock?
• Determine Your Sleep Needs
• The 10 Worst Ways to Ruin Your Sleep
• How Much Sleep Do I Need?
• The 10 Best Ways to Wake Up

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