Roughly 3 million people worldwide suffer from Narcolepsy. The condition is characterized by excessive daytime sleepiness, sleep paralysis, cataplexy (loss of muscle control in response to emotional stimuli), and hypnogogic hallucinations. New information suggests onset of the disease correlates with exposure to Influenza and other upper airway infections.

Scientists from Stanford University, including narcolepsy expert Emmanuel Mignot, MD, drew upon patient populations in China for a recent Narcolepsy study conducted in conjunction with Chinese researchers. The findings, published in the Annals of Neurology, show Narcolepsy cases peak five to seven months after a peak in flu/cold or H1N1 infections in the country.  “Together with recent findings, these results strongly suggest that winter airway infections such as Influenza A (including H1N1), and/or Streptococcus pyogenes are triggers for narcolepsy,” Mignot wrote in the paper. 

The currently held theory is that Narcolepsy may be an autoimmune disease which occurs when patients’ immune systems kill the neurons that produce the protein Hypocretin. Hypocretin, also known as Orexin, is believed to be the hormone which produces wakefulness. If an infection such as H1N1 causes the body to overreact and destroy Hypocretin-producing neurons, the result could be Narcolepsy. This correlation may lead to a better understanding of the disease and a better potential treatments.

Current treatments for Narcolepsy include using wake-promoting agents such as the drug Modafinil to keep patients awake during the daytime and/or administration of medications at night to encourage deep sleep with the hope of increased daytime wakefulness.

Hypnotics such as Ambien, Sonata, and Lunesta are among the most prescribed medications in the country. It was estimated that in 2010 alone, prescription drug companies made $5 billion on these types of medications. Hypnotics are widely used to treat insomnia but a new study calls attention to the detrimental effects of these medications.

The study was carried out by researchers from the Scripps Clinic Viterbi Family Sleep Center and the Jackson Hole Center for Preventive Medicine and published in the peer-reviewed medical journal BMJ Open. The research consisted of a large cohort study comparing death and cancer rates between two groups of patients: hypnotics users and people who had never taken the medications.

The results do imply that sleeping pills directly cause death or cancer, but rather suggest there could be a correlation between the medication and increased risks. As outlined by the NIH, the basic results of the study suggest that patients prescribed any hypnotic had increased risk of dying compared with patients who had never been prescribed hypnotics. The risk of dying increased in line with the amount of hypnotics they were prescribed:

• Patients who were prescribed 1-18 pills of any hypnotic a year were 3.6 times more likely to die than matched patients not using the drugs.
• Patients who were prescribed 18-132 pills a year were almost 4.5 times more likely to die.
• Patients who were prescribed more than 132 pills a year were 5.3 times more likely to die.

These results support the idea that sleeping pills should be used only as temporary measure to address symptoms of insomnia, not as a long term treatment. The medications are still a viable option prescribed properly and used in conjunction with a comprehensive approach to treating sleep concerns. The sleep specialists at Oregon Sleep Associates use this approach to addressing your sleep issues. If you are having trouble sleeping, contact them today at 503-288-5201.

Almost everyone knows someone who snores at night. Maybe you have a parent or spouse that “shakes the walls” when asleep. Or maybe you are the one being told you “saw logs” or “wake the dead”. However you describe snoring, it never sounds good. But is snoring dangerous or just a lot of noise? And what can be done to get rid of snoring?

Snoring is so common we often think of it as normal. In fact, roughly 40% of the population reports snoring. But snoring is more than just loud noise, it can actually be a symptom of a much more serious condition. Snoring results from the vibration of tissue in a person’s airway. When one sleeps, the muscles and tissues can relax and start to partially obstruct the airway. The obstructing tissue moves with airflow and creates noise, but it can also actually obstruct breathing. When breathing is obstructed, the resulting condition is known as Obstructive Sleep Apnea. These obstructive events can be a partial closing of the airway, called a Hypopnea, or a full blocking, called an Apnea. In both cases the person is struggling to get more air into their lungs. When the amount of fresh air entering the body is restricted, the oxygen level in the bloodstream falls and the body starts to panic. The brain arouses or wakes the person, temporarily restoring airway muscle tone and opening the throat. Though theses events can happen hundreds of times a night, since these awakenings or arousals are so brief, the person usually doesn’t even know they have this condition. They think that they are sleeping all night but have actually been fighting to breathe. Of course, for the person next to them witnessing the struggle, it’s all too real.

Also real are the effects Obstructive Sleep Apnea has on your body. The lack of oxygen stresses the heart, leading to a much higher risk of heart attack, stroke, and high blood pressure. Other conditions related to Sleep Apnea include migraines, impotence, memory loss, and daytime sleepiness.

Even if the problem hasn’t progressed to the point of full blown apnea, the physical effects of snoring can be felt. A study conducted by Swedish researchers concluded that “snoring is an independent cause of excess daytime sleepiness and not merely a proxy for sleep apnea”. Many people try to pass snoring off as normal and do not realize the impact it may have on their lives and on those around them.

So if snoring is such a problem, what can you do to fix it? The first step is to contact a sleep specialist. They can review your symptoms and determine a plan to evaluate the severity of the problem. Treatment options depend on the severity of the problems found. Use of a CPAP machine may be the best method of treatment. The doctor may also recommend using an oral appliance made by a dentist to move your jaw forward and open your airway. Other options may include surgery. If you or someone you know snores loudly on a regular basis, contact Oregon Sleep Associates at 503-288-5201 for more information.

Saturday, February 11th, 2012 at the Oregon Convention Center.

Dr Daniel Root will be speaking at 12:30 about Sleep Disorders and Type II Diabetes.

Drop by our booth to learn more about sleep and schedule a consultation.

It’s true that in today’s market there are literally dozens of masks available to the CPAP user. But this doesn’t mean that the choosing a mask needs to be difficult. Let’s look at some different types of masks and their features, uses, and pros and cons:

Part 2: FULL FACE CPAP MASKS

Patient sleeping using a Full Face style mask.

Full Face Masks (FFM), or oral/nasal masks, are larger than nasal masks but operate in a similar manner. These masks extend below the bottom lip to create seal that encompasses the user’s mouth as well as the nose. These masks are used when a person demonstrates a “mouth leak” when asleep. A mouth leak occurs when the jaw relaxes and air escapes through the mouth. Mouth leaks can also happen when the therapy pressure is high enough to force the mouth open even when wearing a chinstrap. If the pressure is escaping through the mouth, the CPAP can’t do its job and keep the airway open. The full-face style masks allow a user to breathe through either their nose or mouth without worrying about loosing pressure. Because of the larger surface area the FFM cushion must cover, these masks can sometimes have trouble sealing well. Fortunately, new designs and seals have been created to counteract these problems.

Here are some examples of Full Face CPAP Masks:

The ComfortGel Full FFM from Philips Respironics feature soft gel cushioning like the nasal ComfortGel Blue but works stops mouth leaks as well.

The Forma FFM by Fisher & Paykel offers a soft foam cushion and silicone seal that extends below the user’s chin to keep the mouth leaks in check.

ResMed’s Mirage Quattro FFM features a double walled silicone interface to ensure a complete seal.

General Pros And Cons of Full Face CPAP Masks:

Pros:

• Allows patients to breathe through nose or mouth
• Corrects mouth leak without need for chinstrap
• Available in a variety of sizes and cushions like the nasal masks
• Works well even at higher pressures
• Disperses pressure over a larger surface area, reducing sensation of high pressure

Cons:

• Larger surface area to seal can lead to mask leaks
• Larger mask size may look intimidating to new/claustrophobic users
• Generally louder than other masks
• Line of sight often obscured by forehead connection

If you’re in the Portland, OR area swing by our DME office where you can find these and many more masks. Or if you’re not in the Northwest check out the deals at BuyPAP.com. Also check out our facebook page and follow us on twitter for more updates.

Police officers have a difficult and sometimes dangerous job. The public relies upon police forces to protect our lives, solve crimes, and be role models for our communities. But unfortunately, there is one threat to cops’ safety that can’t be locked up. 

A new study published in the Journal of the American Medical Association involving 4,957 municipal, state, county and other law enforcement officers across North America revealed that 40 percent of participants screened positive for a sleep disorder and most were undiagnosed and untreated. The most common sleep disorder found was Obstructive Sleep Apnea (OSA). Moderate to severe insomnia affected 6.5 percent, and 28.5 percent of police officers showed excessive sleepiness.

These numbers are especially alarming considering the sensitive nature of police work and the long hours spent behind the wheel. “Sleep disorders expose individuals to increased sleepiness, which elevates the risk of motor vehicle crashes.  We found that excessive sleepiness is common in police officers and that almost half report having fallen asleep while driving and about 25 percent report that it occurs at least monthly,” said Shantha Rajaratnam, PhD, co-lead author of the research paper. “Positive screening for a sleep disorder increased the risk of falling asleep while driving after work, depression and burnout by more than two-fold.”

But the results of the study yielded some optimistic insights as well. Massachusetts State Police (MSP) were found to have a  significantly lower risk for OSA than the municipal or nationwide police officers, who were nearly 60 to 80 percent more likely to screen positive for OSA. The researchers hypothesize that the comprehensive on-the-job physical fitness program implemented years ago by the MSP may account for the lower rates of both OSA and obesity (a major risk factor for OSA) observed among this group. Recognition and identification of sleep disorders as health risks can help other departments across the country to develop similar programs and keep our civil servants safe.

The Philips Respironics ComfortGel Blue mask is one of the most popular CPAP nasal masks on the market today.  The ComfortGel Blue is a redesign of the original Respironics Comfort Gel mask, which for many people is the perfect answer to uncomfortable and hard CPAP masks.

Highlights:

• The ComfortGel Blue has the same dual cushion technology as the original ComfortGel but a new gel material has been added that contours to the face better than the original Comfort Gel. The beauty of this cushion is that the user can tighten the mask down to reduce leaks but not wake up with pain or marks on their face.

The pliable blue gel create a comfortable cushion while the silicone flap seals against leaks.

• Philips also changed the forehead pad on the Gel Blue to a softer, more forgiving material thus preventing some of the skin irritation patients ran into the original Comfort Gel.
• The exhalation ports were also redesigned to redirected exhalation airflow away from the bed partner as well as reduce noise.
• The “StabilitySelector” has been retained on this mask as well, a great feature that allows adjustment of the angle at the bridge of the nose to fine tune the seal for each user.

• This is an especially important improvement: The frame on the ComfortGel Blue has been strengthened so there is no longer an issue of breaking the frame when removing the headgear. In the past removing the mask too forcefully could stress the “ball and cup” attachment points these reinforced cups on the frame still offer the convenience of this type of quick detachment system without worries of a late night CPAP mask crisis.
• As with the previous generation, this mask is available in Petite, Small, Medium, Large to fit users of every size.
• Along with Philips Premium Headgear the ComfortGel Blue mask continues to be one of the go to masks on the market today.

Summary:

We’ve had a lot of experience with the previous generation of ComfortGel masks both in the sleep center and with patients at home. The mask has proven itself to be one of the most reliable and consistently used masks out there. With all the new improvements Philips Respironics has made, the ComfortGel Blue is sure to be a patient favorite for years to come.

If you are in the market for a new CPAP mask or just looking for something different you can find the lowest prices on the ComfortGel Blue Nasal Mask here.

Nasal CPAP Mask, notice the seal around the nose and four attachment points to the headgear.

One of the questions we often are asked at Oregon Sleep Associates is “how do I know which CPAP mask to choose?“ It’s true that in today’s market there are literally dozens of masks available to the CPAP user. But this doesn’t mean that the choosing a mask needs to be difficult. Let’s look at some different types of masks and their features, uses, and pros and cons:

Part 1: Nasal CPAP Masks

Nasal CPAP Masks are the traditional style of CPAP mask. They are generally triangular shaped to cover the user’s nose and create a seal to the face. Most connect to the headgear at four locations, 2 on the mask body and 2 on the forehead support. Nasal CPAP masks are suitable for most patients without a severe mouth leak and come with a variety of seals depending on the manufacturer and model. These seal options as well as multiple size cushions for each mask allow for a more customized experience for all users.

Here are some examples of Nasal CPAP masks:

 The ComfortGel Blue Nasal Mask seals to the face using a soft blue gel, forming a comfortable interface.

The Zest from Fisher & Paykel offers a foam cushion with silicone flap to ensure a good seal.

General Pros and Cons of Nasal CPAP Masks

Pros:

• Works for most users
• Many cushion and seal types
• Low surface area to seal
• Tried and true designs

Cons:

• Possible irritation of bridge of nose
• May require more fittings to find appropriate size
• Dependent on Chin Strap to correct any mouth leaks
• Line of sight obscured by forehead connection

As always, you can find these and many more masks in our DME office, or if you’re not in the Portland OR area buy them online at BuyPAP.com. Also check out our facebook page and follow us on twitter for more updates.

The Mirage™ FX nasal mask series is a recent addition to ResMed’s venerable line up of CPAP interfaces. The design focuses on providing a lightweight and simple alternative to traditional CPAP masks.

Highlights:

• Consisting of only four parts including the headgear, the Mirage™ FX weighs in at only 2.5 ounces. This makes it one of the lightest masks on the market today.  ResMed achieved weight reduction by paring down the rigid plastic frame inherent in most nasal masks.

  

• The soft silicone cushion of the Mirage™ FX forms the body of the mask, and the 44 integrated exhalation vents have been positioned in circular pattern around the interface elbow. Having this many vents in this configuration seems to help with noise, making the Mirage™ FX one of the quietest masks we’ve encountered.
• The cushion material is soft and forgiving, which is a nice feature for those who find nasal masks to be irritating or painful to wear all night. The cushion only comes in two sizes, standard and wide, which both fit in the same frame. ResMed claims that the cushions are “one size fits all” but in our experience “one size fits most” may be more accurate. Some people with large or long noses may not find this mask to work well for them but the majority of users will be fine.

• The forehead piece seems to be more of an attachment point for the headgear rather than a stabilizing pad seen on some masks. This may help in giving the user a feeling of having less equipment anchored to their face.
• Headgear on the Mirage™ FX features ResMed’s SoftEdge™ design and is nicely cushioned at the back of the head. The headgear is attached to the frame at the standard four points with hook and loop fasteners and seems very easy and intuitive to adjust. For those wishing to look stylish in their CPAP, this mask is also available as the ResMed Mirage™ FX for Her, which comes with a smaller pink headgear.

Summary:

Overall we’ve found the Mirage™ FX from ResMed is a great option for both new and experienced CPAP users. Its lightweight and open design create a feeling of “less mask” and a more natural therapy experience. The custom options are a nice touch and ease of use makes this a great choice. If you are a patient at Oregon Sleep Associates and would like to check out the FX contact our DME or if you are not in the Portland area,  you can always find the lowest prices on the Mirage™ FX here.

Are you looking for CPAP devices, masks, and accessories? Dr Daniel Root is proud to announce the grand opening of BuyPAP.com, your new online source for PAP equipment at the lowest prices around.

BuyPAP carries devices and accessories from the industry leading manufacturers such as ResMed, Philips Respironics, and Fisher & Paykel. Whether you need a whole new machine, a new mask, or just some replacement supplies you can easily find it on our site and get it to you’re door quickly without any hassle. Rely on our staff’s 20+ years combined experience in the sleep medicine field to help guide you to a better night’s sleep. Check out BuyPAP.com here or call 1-855-NOAPNEA (1-855-662-7632).