Better Sleep Better Health

As the summer months approach and thoughts drift to vacation plans around the country and abroad, many people who have been treated for Obstructive Sleep Apnea with continuous positive airway pressure, or CPAP, may wonder how to maintain a healthy night’s sleep away from home.

Traveling by airline with a CPAP

Since 9/11 many restrictions have been put in place to increase security on airlines. One inconvenient measure has been the reduction of the number of bags allowed as carry-ons. This is one instance where having a CPAP machine and knowing your rights can come in very handy. The FAA classifies CPAP as a medically necessary device. This means that passengers are allowed to bring the machine and its bag on board as an extra carry-on. Savvy travelers can will find that CPAP bags, when well packed, can provide much needed valuable real estate in these times of $50 checked luggage. TSA handlers are generally well versed with CPAPs but may ask you to remove the machine from it’s bag for additionally screening, including swabbing for explosive residue, at the security checkpoints. If you happen to encounter an overzealous TSA agent that tries to make you check your CPAP, present them with this document issued by the Department of Transportation stating the machine is to be allowed through. An official note from your doctor showing medical necessity doesn’t hurt either, especially in foreign lands.

International Travel

Most currently produced PAP machines from major manufacturers utilize international power supplies. This means they can automatically adjust for different voltages, such as 240, without the need for special equipment. This eliminates the danger of burning out a PAP while on vacation. However, travelers will still have to bring plug adapters along to fit into different sized wall outlets. And it is prudent to look up contact information for your CPAP manufacturer in the destination country. If something goes wrong with your machine, having a certified repair center nearby can mean the difference between a memorable vacation and a ruined trip.

Camping with CPAP

Many people think that having a CPAP will stop them enjoying outdoor trips such as camping , hunting, and hiking. But newer CPAP machines are very portable and easy to use without a constant power source. There are now reliable battery powered CPAP units that can be recharged on the road via car adapters. Depending on the pressure level used, these units can provide overnight power for several nights before needing a recharge. Don’t want to spring for another machine? No worries, universal battery packs are also available for most major CPAP machine models on the market. These batteries are small, long lasting, and utilize the latest in battery advances. And most major companies, such as Resmed and Respironics offer car cigarette lighter adapters which make RV or car camping with CPAP easy.

For more information about traveling with CPAP, contact a qualified DME provider like the ones at Oregon Sleep Associates.

Recently two stories of overly tired air traffic controllers have made headlines. First, an air traffic controller inadvertently dozed off at Ronald Reagan Washington National Airport, leaving two cargo planes to land themselves. Then reports came out detailing a Nashville controller purposely sleeping during a busy shift. These incidents are frightening considering the important responsibilities these individuals are given every day.

One would expect sweeping changes to the follow such revelations about air traffic security, yet as an open letter from the chairman of the National Sleep Foundation to the FAA shows, the changes needed are not happening:

“Americans are justifiably concerned by the recent spate of incidents involving air traffic controllers who fell asleep on duty.  But now that the FAA/DoT has outlined the steps it intends to take to address this problem – minor tweaking of the controllers’ work/rest schedules combined with a threat of stricter disciplinary action against offending controllers in the future – the public’s response ought to escalate from concern to alarm.

This is because the announced changes amount to tokenism – gestures more likely to assuage public anxiety than to meaningfully reduce fatigue in air traffic controllers.  For example, although it is true that extending the time off between shifts (from 8 to 9 hours) will probably result in more sleep (which is good) it will not result in adequate sleep (the amount of sleep necessary to sustain normal alertness during the night shift).  Prior research shows (and common sense dictates) that a significant portion of the 9 hour break will be devoted to commuting, eating, personal hygiene, socializing with family, etc.  If the FAA was truly serious about optimizing alertness in air traffic controllers, and if the policy makers based their decisions on scientific evidence, the time off between shifts would have been extended to at least 12 hours – and scheduled napping would now be encouraged during work shifts, rather than prohibited. Likewise, prior sleep research (and, again, common sense) suggest that the threat of more severe punishment will have no beneficial effect on alertness.  Those air traffic controllers who fell asleep did not do so because they were not properly motivated to maintain wakefulness.  They fell asleep because they had a significant, physiological need for sleep.  And they probably didn’t even realize they were falling asleep – sleep onset can be insidious. (Think about it. If sleep onset was not insidious, would anyone ever fall asleep while driving an automobile?)

Also, it should be pointed out that both the airline industry and the FAA have known about this problem for decades.  In 1981 the National Transportation Safety Board (NTSB) published a special investigative report on air traffic controller fatigue. However, the recommendations outlined in that report were essentially ignored – and classified as “Closed—Unacceptable Action” in 1989.  Since then, the NTSB (which is the congressionally-mandated special investigative body charged with determining causes of transportation accidents) has issued more than 80 new fatigue-related safety recommendations.  Care to guess how many of these recommendations have been implemented?

History is replete with accidents resulting in human death and injury caused by sleepy transportation workers, and the NTSB routinely cites air traffic controller fatigue in its findings. One tragic example is the August 2006 accident involving Comair flight 5191 in Lexington, Kentucky, in which the air traffic controller cleared the plane for take-off on the wrong runway, resulting in a crash that killed 49 people. Unfortunately, given the inadequate response to the recent incidents, we can expect more sleep and sleepiness-related errors and accidents involving air traffic controllers in the future.”

The hectic schedule of an NBA team can wreck havoc on players’ performance and well-being. Constant traveling leads to sleep deprivation which increases recovery time from injuries, lowers judgement and reaction times, and leads to losses on the court. One team has found a way to gain the edge over the competition with sleep medicine.

The Boston Celtics coaching staff realized the impact constant traveling and a lack of sleep were having on their players, so they enlisted the help of Harvard’s Sleep Medicine director, Dr. Charles Czeisler. Czeisler detailed the detrimental effects of sleep loss to Celtics coach Doc Rivers and they took action to ensure a rested team. Paul Flannery of Boston Magazine recounts the changes on his blog:

The Celtics soon eliminated morning practices and instituted the “2 a.m. rule,” which holds that if the players can’t get to their hotel rooms in the next city by that time, then they stay where they are for an extra night and get their eight hours. Sound rest is all the more important for a veteran team like the Celtics, who have struggled playing games on consecutive nights. “Trying to create a window of 8 to 10 hours of sleep — it’s almost impossible during an NBA season,” Rivers says. “The way we were doing it made it completely impossible.”

The lessons learned from the Celtics sleep hygiene practices can be applied to everyone’s daily life. Allowing oneself plenty of time for sleep and eliminating distractions such as TV and computers from the bedroom are good steps to maintaining a balanced sleep schedule.

It’s that time of year again. The airports are crowded with people traveling home, the store shelves are packed with gravy and stuffing, and turkeys everywhere are looking around nervously.  After the feast is over, we’ll all loosen our belts and relax for a nap. Invariably, some Uncle or Aunt will repeat what they say every year, “Did you know that it’s the Tryptophan in the Turkey that makes you tired?” And everyone will nod and then drift off. But this year, you can amaze your family by jumping up and exclaiming, “Not true!”

Your startled relatives will be surprised to learn that despite popular belief, the Tryptophan in the Thanksgiving turkey is not a strong sleep inducing factor. Tryptophan is a essential amino acid for humans derived from our diets. In it’s purified form it can be a mild sleep inducing substance. However, to get large levels of Typtophan to the brain, it must be taken on an empty stomach. When consumed with other foods, Tryptophan loses it’s effectiveness because it has to compete with other substances trying to cross the blood brain barrier.

“Tryptophan is taken to the brain by an active transport system shared by a number of other amino acids, and there’s competition among them—like a crowd of people trying to get through a revolving door,” said Simon Young, a neurochemist at McGill University in Montreal, Canada in National Geographic.

Not enough of the Tryptophan from Thanksgiving turkey reaches the brain to cause drowsiness. In fact, though turkey contains a fair amount of the amino acid, many other foods such as beef contain more. Yet we never hear about a “post steak” nap.

So what does make us nod off every year after the meal?

Well, Thanksgiving usually involves eating thousands of calories which we normally wouldn’t ingest all at once. This amplifies the normal post lunch tiredness as your body tries to digest and metabolize this massive amount of food and leads to nap time. So this year after you munch away, try going out for a nice walk to burn off some of those excess calories.

Happy Thanksgiving!

It’s a common scenario for millions of Americans: Get up early, work a nine-to-five job, stay up late, and make up for lost time on the weekends. But this cycle takes its toll on people’s bodies and minds, and eventually it will catch up to you.

A study released in the August 2010 issue of SLEEP details the extent to which repetitive sleep deprivation can affect cognitive performance. Participants were assigned a reduced sleep schedule for five consecutive nights then randomly assigned different lengths of recovery sleep to simulate weekend rest after a workweek. The subjects were then tested  on their cognition, motor skills, and sleepiness.

The researchers found that those who have their sleep time reduced on a regular basis, such as when someone has to rise early for a job, accrue significant sleep debt. Sleep debt is the result of sleep deprivation in which an individual does not experience a feeling of being rested or refreshed. The drive for rest becomes increasingly strong and affects peoples’ daytime functioning. The subjects who had longer recovery periods scored slightly higher on tests but their performance was still impaired. The evidence suggests that most people cannot sleep long enough on the weekends to compensate for lack of sleep throughout the week. Worse still, trying to sleep in or make up for lost sleep time on weekends often disrupts a person’s normal sleep cycle, further complicating matters when Monday arrives.

If you find yourself trying to compensate for a lack of sleep by catching up on the weekends, it may be a sign that you need to improve your sleep hygiene. Try to cut out caffeine and alcohol before bed, eliminate distractions such as television from the bedroom, and try going to bed earlier and at the same time each night. You may not be able to change your work schedule, but adopting a better sleep schedule will make it that much easier to deal with. For more information on sleep hygiene, visit www.oregonsleepassociates.com.

Every year, especially during the summer months, millions of people take trips all across the globe. After meticulous planning , packing, and preparation they board planes towards their destinations, hoping for an enjoyable vacation away.But unfortunately, many of these travelers will experience something unexpected that can disrupt and even ruin their time off:  Jet Lag

Travelers experience “Jet Lag” because of a disruption of their Circadian Rhythm. The Circadian Rhythm is the 24 hour cycle that helps regulate the body’s sleep and wake times. This cycle uses light to essentially “set its clock”. As a person travels between time zones, their body has trouble adapting to the different environment. For example, if you are normally in the Pacific time zone and travel east to New York, your bedtime is now 3 hours ahead of when you would normally go to sleep. Conversely, if you travel west 3 hours, you may find it very hard to stay up since you are staying awake 3 hours past your bedtime.

Jet lag can make people tired and angry, sometimes ruining what is supposed to be a good vacation. Fortunately, there are some things one can do to combat the effects of Jet Lag. Here are some tips to help you deal with this problem:

• Select a flight that arrives in the early evening and go to bed at 10 PM local time.

• Anticipate the time change by getting up and going to bed at times closer to your destination’s  time zone for several days before your trip.

• Avoid alcohol, caffeine, and heavy exercise around bedtime.

• Bring earplugs and blindfolds to help dampen noise and light during sleep.

• Get outdoors and into the sunlight. Daylight will help regulate your biological clock.