How to Get a Good Night's Sleep
http://thedianerehmshow.org/shows/2010-04-19/how-get-good-nights-sleep
Insomnia, snoring, apnea and restless leg syndrome prevent millions of Americans from getting a good night's sleep. Why sleeping is so important to overall health and advice from experts on how best to battle mild to severe sleep disorders.
Guests
David Neubauer
associate professor in the department of psychiatry, Johns Hopkins University School of Medicine, and associate director, Johns Hopkins Sleep Disorders Center.
Helene Emsellem
director, Center for Sleep and Wake Disorders, and associate clinical professor of neurology, George Washington University; author of "Snooze ... Or Lose!"
Michael Twery
director of the National Center on Sleep Disorders Research at the National Institutes of Health.
![Image of Snooze... or Lose!: 10 "No-War" Ways to Improve Your Teen's Sleep Habits](http://ecx.images-amazon.com/images/I/51SQv4dnBjL._SL75_.jpg "Snooze... or Lose!: 10 "No-War" Ways to Improve Your Teen's Sleep Habits"){kind=small}
Comments
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
I was diagnosed as a classic insomanic last summer. I had two years of about three hours of sleep nightly. After a physician ruled out any physical reasons for the lack of sleep, a behavior specialist walked me through cognitive behavior therapy and I have had tremendous success. I do a muscle relaxation exercise nightly during the week and use melatonin to help me sleep. My life is much, much better ever since I sought help.
I havn't heard any discussion of surgery for sleep apnea. My father was diagnosed years ago with the condition and had surgery, which changed his life. Your guests almost sound like they have some financial interest in th c-pap machine. What about surgery?
Some people are afraid of CPAP, due to comfort or stigma or whatever reason. For many, if not most, who try it, it works. It works well. There is a huge variety of delivery systems available, and while some truly cannot tolerate the airflow, the mask/nasal pillow comfort can usually be addressed IF the patient/user is willing to give it a fair try. Even a few hours' use a night is better than none.
As far as UPPP surgery, it can be beneficial, but it can present horrible difficulties for many.
A good forum for peer-to-peer discussion, on Yahoo groups, http://health.groups.yahoo.com/group/cpapusers/
Steve
Ste Genevieve, MO
I work at a sleep disorders center in St. Louis. It does take most people a little bit of time to adjust to CPAP. It is important for the sleep center to provide good follow up care to help the patient adjust to this device. Our center has nurses specially trained to help people with CPAP. I encourage anyone who is going to a sleep disorders center for sleep apnea screening to make sure that center is accredited. It is also important for patients to ask what sort of follow up care the center provides if it is determined CPAP is needed.
I was tested and did not have sleep apnea...but I knew I had poor quality sleep because I was always tired and frequently work up with headaches.
Instead of waiting for professionals to provide a solution, I experimented with an oral appliance ordered over the internet for $30. When fitted properly, it made a huge difference for me.
Point being, depending on your problem, there may be solutions which do not rely on having sleep apnea diagnosed or your doctor actually helping you find a solution. (My doctor was useless.)
I have a cpap which works very well. My problem is that I would like to go back-packing and need a small, non-electric alternative which I can use where there is no power. Is there any such thing?
Diane,
It is a common misconception of the high cost of CPAP products. The cost is high if you are going through a local provider and using insurance. The rates are based on the Medicare reimbursable rate.
If you want to pay cash, you can get a brand new, top of the line CPAP machine for usually less than your deductible, if you purchase from a online retailer.
Online CPAP retailers are legitimate businesses that follow FDA regulations and require a valid prescription. They are able to offer a lower price because they do not have to pay the overhead of a retail location, and they also do not have to pay staff to bill and follow up with insurance companies.
Online retailers usually also have long phone support hours and focus on service. Service has to be a corner stone of any online medical provider retailer since customers are paying in cash and can take their business elsewhere with little switching costs.
Many people do not know of the online option. They only go with the local provider their doctor recommends.
Also most online retailers emphasize the need for a patient support group for a patient to take on the lifestyle change that comes with CPAP usage. There are many wonderful CPAP patient support forums online to help new CPAP users hear from real CPAP users who know what they are going through.
Regards,
Carolyn Goodman
My husband and I had twins 11 month ago and have not had a full night sleep since. We are going out of town for 7 nights (and leaving the girls with the grandparents) later this week. We joke that we are going to make up our lack of sleep in these 7 nights. Is there any possible way to make up so much lack of sleep? Is the interupted sleep that we've had any better or worse than only sleeping 4 hours in once chunk?
I am a very healthy 60+ female. I was diagnosed with sleep apanea but I don't feel tired in the day time nor feel like I lack of sleep. I exercise a lot and generally feel very healthy and energtic. Out of all the people who snore (there are a lot), just what percentage of people needs treatment?
Hsiao-Mei
Hi Diane,
Regarding Sleep APnea testing and treatment. There is a new FDA approved device for At-Home SLeep Apnea Testing. This can be done in the comfort of the patients own home. Statistically, this has increased patient compliance for treatment and diagnosis of up to 60%.
For CPAP patients who need treatment, there is auto-tritating CPAP for a much more comfortable nights sleep increasing the efficacy of CPAP therapy.
www.athomesleepapneatest.com or contact us at info@o2rd.com
This is in response to the caller who has been diagnosed with sleep apnea but does not wish to use a c-pap. My husband was diagnosed with chronic insomnia about 15 years ago. He has been to several doctors and tried almosts every medication out there without relief. He would give anything to have sleep apnea and cure his sleep problems with the c-pap. For your sake and the sanity of your wife, PLEASE use the c-pap. It may save you much unneeded stress and health disorders.
Ann
I did not snore but was having bp problems in the middle of the night. It turns out I have sleep apnea. No other symptoms. I sleep well, feel rested, do not snore and do not gasp. Yet I quit breathing 20 times an hour which makes an adrenelin rush which causes my bp to go up. I have had a hard time getting used to the mask and had to use ambien for a few nights but not I can stay under it longer without sleep aid. Has anyone else had problems with bp in the middle of the night?
I went through the sleep test and eventually had a procedure for a deviated septum. This worked wonders and i sleep so much better. I, too, rejected the CPAP. I knew I would not like it. I have so much more energy and I sleep so much better.
I credit my daughter, Jessica, for pushing me to go to the Dr. and for my Dr. listening to me about the problem. Most people do not want to admit that they snore but wake up and smell the coffee. It is a problem that will shorten your life and lessen the quality of your life.
Thanks to Diane and her crew for researching and airing this important problem in our lives.
Rita Duda, Avon Lake, Ohio WCPN member
I've heard that Dentists have a new device that holds the jaw in place while sleeping. Because the jaw doesn't fall back and cut off the air passage, patients can avoid CPAP devices all together. They are relatively comfortable and are supposed to "cure" snoring and apnea.
Have you heard of this and think that this is as affective as they say?
Hi Diane my name is Justin. I was diagnose with
a sleeping disorder about seven years ago.
My problem is I will like to use the machine
I was told to buy but I could not afford it. It is
getting worse every year but I just can't afford it.
Is there any organisation out there that accept payment
plan.
Justin Che
I must be one who needs hand holding. The cpac machine causes me to sneeze so I never really benefited from it. But I did buy it.
The process of being diagnosed is very weighted at the front end. Go to the doctor, call to make appt for sleep study. Go at 10pm to some area of town you don't know. People you don't know. Get hooked up and told to sleep for 5 hrs. Not an easy thing to expect of your self. Get diagnosis of sleep apnea. Referred to medical equipment place. Person sells you a machine.
The machine caused me to sneeze and that was not remedied. "hand holding" needed.
Big business, I guess, loaded on the front end. Every one paid, the hospital that bills for the sleep study [who are they], the doctor you don't know who that is that read the sleep study.
There is no hand holding. All of this was paid for and I am not sleeping.
Thank you for opportunity to listen to this discussion and forgive my sharpness on the subject.
I am so grateful for the Diane Rehm show - so stimulating, so entertaining. Thank you, Diane.
Susan
I use a TAP appliance prescribed by my doctor and fitted by a dentist for my sleep apnea and snoring. It is like a heavy duty retainer that clips top to bottom and prevents my lower jaw from dropping back. My doctor like most just said I had to use the cpap machine. I have an active outdoor lifestyle and enjoy camping backpacking rafting and hunting - and did not want to be tied to electricity - also did not want a hot uncomfortable mask so I looked into alternatives and easily found the TAP and a dentist competent to fit it in my relatively small town.
People should know that there is an excellent and more environmentally and active lifestyle compatible solution to sleep apnea.
I found out I had sleep apnea because I have attrial fibrilation - and the two can be related - something that also may help others.
Hi there,
My problem was as you said "I stop breathing and will
wake up about 15-20 times a night" My problem is I can't afford
the machine. Did the sleeping pils work?
justin che
Thank you for the show regarding sleep. I hope my question is relevant although not about apnia. In a 40-year marriage we have bought 2 new mattresses; it's time for another. Matresses no longer turn, I understand, which prolongs the life.
What is a good quality company, making firm mattresses that we can invest in? We are an odd couple, I've lost weight (123 lbs.) ; my husband has added (250lbs.)
Thanks for your help!!!
Carolee Howard
check out Ihatecpap.com
Several things seemed a bit odd to me as I listened to the show about apnea today.
First off, the the guests characterization of how many people are able to continue with the c-pap machines after the trial period. My doctor told me about HALF of his patients were able to use the c-pap while the other half could not. As he did with the rest of the patients, he had me try the machine for a whole month before he would discuss trying alternatives. I was given the latest, nasal pillow with humidifier, model. After a month with this one, I tried the mask for two wks.
At the end of the month and a half, he told me I could try a mouthpiece to sleep with that would gently push out my lower jaw enabling me to sleep with less apnea.
He also suggested a simple surgical procedure that could be done in day surgery. He said my anatomy made me a very good candidate and that the success rate has been the HIGHEST OF ALL the procedures. He also said that he waited to mention it because insurance wouldn't cover it unless I had first tried the c-pap and he had wanted me to make a real effort to use the c-pap.
I came to the program at roughly the midway point and I tried to call in with this question/concern but was too late. Did I miss the discussion of the surgical procedure or did the guests, who must surely be aware of it, omit it from their discussion for a reason?
I have witnessed prejudicial attitudes between surgical and non-surgical remedies in the past and there is plenty of blame to spread around. I am hoping this isn't an example of such.
Thanks.
I can't tell yo uhow many people have tried the cpap machine, covered and paid for by medicare and taxpayer dollars and threw it away after one time. These things don't work (for many reasons) and can't be reused on another patient. I think you need to study how many people are still using these machines after 1 year BEFORE medicare and health plans cover this expensive unit. Thank you for hearing my comment.
I can't tell yo uhow many people have tried the cpap machine, covered and paid for by medicare and taxpayer dollars and threw it away after one time. These things don't work (for many reasons) and can't be reused on another patient. I think you need to study how many people are still using these machines after 1 year BEFORE medicare and health plans cover this expensive unit. Thank you for hearing my comment.
My husband has suspected that he had Restless Leg Syndrome for several years.I have also suspected that he had Periodic Limb Movement Disorder as well. When he mentioned his symptoms to his Dr. they first offered sleep medication. (Which did not work.) They then put him on Requip which seemed to help, but did not completely alleviate his symptoms. No one referred him to a Specialist or offered him any alternatives to medication. He did read about relaxation exercises, heat and limiting caffeine and he has tried all of those things....still no relief. Recently, he did a sleep study at a local sleep clinic. The final diagnosis was Restless Leg Syndrome (which we already knew) and the Dr. basically told him he was doing all he could do....he is now taking Mirapex.
He rarely is rested, it is difficult to sleep in the same bed with him, the medication affects his sex drive, and he feels tired all the time. His health is good otherwise.....he exercises, eats well and is not overweight. The medication helps......but not completely and the problem is that he requires more and more in order to address his symptoms.
We are concerned about any long-term effects of this medication if this is his only option. He is 38 years old and is looking at taking this the rest of his life? Are there really no other options?
Very, very disappointed that really nothing was said about restless leg syndrome. This can be just as disruptive to sleep as apnea, etc. The description of the program was how best to battle these sleep disorders. I was hopeful, but again very disappointed in the end.
The title of this program was misleading. It was all about sleep apnea and it's various treatments. PLEASE a show dedicated to the multiple other causes of insomnia and where to find help.
Can lack of sleep during the night be made up by taking naps in the afternoon?
Despite being known for my energy and a thinner body, I was diagnosed via a sleep study (2 nights). What I want you to know is:
- although a lighter sleeper, I get along with my CPAP machine
- I never thought of myself as fatigued (I exercise regularly and with some intensity) so never thought I had the symptoms (my wife noted the stopping of breathing followed by the explosive breakthrough - I never awakened, ever)
- after being on the machine, when I arise, it is like getting out of a chair - no feeling of "starting" or dragging, even for a few steps - this is quite surprising - I thought all persons started slowly for a few steps and quickly shook off drowsiness - with the CPAP, I never awaken with even a tinge of drowsiness, even when awakening at night for other bio needs - I go down quickly, as quickly as before, when returning to bed - yes, I keep the mask on, but unplug and replug it to the air hose - then go right back down. I have been surprised by all of it. Think it might help to share.
Helene Emsellem briefly touched on this and I think this would be important to many listeners.
"New practice parameters published by the American Academy of Sleep Medicine (AASM) in the February issue of the medical journal SLEEP recommend oral appliances as a first-line treatment for snoring and mild to moderate OSA, but for patients with severe OSA, CPAP remains the recommended therapy. Potentially, the recommendations could alter sleep clinicians' initial approach to treating mild to moderate OSA."
There are inexpensive over the counter oral appliances sold in the US for the treatment of snoring. However, for treatment of sleep apnea one should consult a dentist who is trained in sleep disorders as well as a medical doctor specializing in sleep medicine. Together these two professional can help to ensure that you are getting the individual treatment you need. That may be a CPAP, oral appliance or some combination of both.
Hope this helps,
Robert
Dear Diane,
Thank you for covering this important topic. I have sleep apnea and appreciated much of the information from your expert guests. However, I was quite frustrated to hear the dismissive tone they took with patients who cannot tolerate a cpap. I struggled for years to use one and believe there are many people like me. The cpaps and sleeping pills are big business and it is unfortunate that the experts did not disclose their conflicts of interest. I did look up David Neubauer and found he is a paid speaker for Sanofi Aventis (and other sleeping pill companies), which makes one of the top selling sleeping pills, Ambien. For a show with such high standards as yours to not disclose these conflicts is highly disappointing. The only way we can trust physicians is if they get off the payroll of the medical device and pharmaceutical companies.
I would appreciate a response.
Thank you,
Fred