Better Sleep Better Health

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 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.

Philips Respironics ComfortGel Blue™ Nasal Mask

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.

At Oregon Sleep Associates we have many years experience helping people choose the right CPAP mask for success with their sleep apnea treatment. We will be occasionally reviewing products we feel may help new or experienced CPAP users.

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).

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.

Every March the National Sleep Foundation endorses National Sleep Awareness Week, a country-wide campaign to bring awareness and education about sleep and sleep disorders to the public. The event coincides with the beginning of daylight savings time, when Americans lose an hour of sleep.

An estimated 50 to 70 million Americans have a sleep disorder, yet many are unaware they suffer from an impairment in their sleep. If you feel tired during the daytime, have medical issues such as Type II Diabetes or high blood pressure, or can’t sleep well at night, it is important to address the possibility of a sleep disorder. Speaking with a Board Certified Sleep Specialist is the first step towards treatment. They can review your symptoms, test for disorders, and formulate an effective treatment plan.

So this National Sleep Week, take the time to improve your health and well-being by getting screened for sleep disorders!

Obstructive Sleep Apnea is widely known as a danger because of its association with increased cardiovascular complications, stroke risk, diabetes, and other health problems. But not many people are aware that OSA can lead to problems with vision as well.

Obstructive Sleep Apnea is a condition in which a person’s airway collapses during sleep, leading to lowered blood oxygen levels and disruptions from sleep. Many complications can ensue from untreated sleep apnea. Several conditions which affect vision may be connected with the disease:

• Floppy Eyelid Syndrome occurs when a person’s eyelids become exerted, or turned inside out. The patient may awaken with their eyelids flipped inside out and can experience watering, stickiness, discomfort, blurred vision, downward pointing eyelashes, and eyelid droop or inversion. These events can lead to conjunctivitis and corneal injury. Most of the time this condition is benign, but it could indicate the presence of OSA.

• Glaucoma is a serious condition that can lead to blindness. It’s caused by damage to the optic nerve and is often associated with increased pressure in the fluid of the eye. OSA is associated with both primary open-angle Glaucoma and normal-tension Glaucoma. The constant variability of blood pressure and oxygen levels caused by OSA may contribute to this disease. In fact, one study found that 20% of patients with Glaucoma may have Obstructive Sleep Apnea.

• Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) occurs when vision is suddenly and painlessly lost in one eye upon awakening. It has been associated with OSA and can cause irreversible vision loss.

• Papilledema is swelling of the optic nerve in both eyes. It typically occurs due to increased pressure within the skull and can lead to progressively worsening vision and, in some cases, blindness.

These and other conditions may be brought on by OSA. It is prudent for everyone to visit an eye doctor every 2 years and if any signs of these conditions arise, get screened for Obstructive Sleep Apnea by a sleep specialist.

Drowsy driving is a very dangerous and under addressed problem facing our population. Each year thousands of accidents are caused by momentary fatigue-related lapses in attention and drivers simply falling asleep behind the wheel. Now companies are taking a proactive approach to keeping drivers awake.

Long hours on the road increase the risk for falling asleep whether you’re a trucker or just an average driver. A vehicle moving at 60 miles an hour can travel hundreds of feet in just seconds so nodding off momentarily can be fatal. According to the National Highway Traffic Safety Administration more than 100,000 police-reported crashes, resulting in 1,550 deaths and another 71,000 injuries each year are caused by drowsy driving.

Mercedes Benz recently developed a system to be integrated into their cars which can sense steering angle trends and corrections made by the driver. By analyzing these trends, the system can recognize variations that may indicate drowsiness and alert the driver. Other companies such as Saab are developing similar systems.

For those of us without Mercedes, there are aftermarket solutions available. Devices like the NoNap or DozeAlert can be worn over a person’s ear. These device monitors the angle of the driver’s head and sounds a buzzer when the person nods off.

The Anti Sleep Pilot requires more interaction with the driver. The hockey puck sized device is programed and placed on the dashboard. The driver must respond to cues by touching the device when prompted. It determines reaction time and cross-references this information with risk factors for falling asleep. Then a recommendation to take a break is given.

These are all novel ways to address the problem of drowsy driving, however the root cause is not being fixed. People are too fatigued and distracted in the car. Often there can be an underlying sleep disorder causing excessive fatigue. People with Sleep Apnea have double the risk of being involved in a car crash than those who don’t suffer from the condition. Before you get behind the wheel, make sure you get tested for sleep disorders. You might save a life.

For more information check out the National Sleep Foundation’s drowsy driving website.

The new year is upon us and it’s time to make that list of resolutions, most of which we never keep. But for 2011, improving your health and quality of life can be easily accomplished by addressing two common problems people have with their sleep:

Kick the bad habits: Poor Sleep Hygiene is a leading reason for sleep deprivation and Insomnia, but it is avoidable. Simple steps to improve Sleep Hygiene include eliminating the television from the bedroom, avoiding TV and computer use within 2 hours of bedtime, and avoiding caffeine within 8-10 hours of bedtime. Also don’t overdo the evening  alcohol intake and if you do find yourself unable to sleep, go to a separate dimly lit room and engage in a calming activity such as reading until you feel tired again. Taking these simple actions can help your mind associate the bedroom with sleep and can break the cycle of Insomnia.

Stop rattling the windows: Snoring is not only annoying for others around you, it is a major symptom of Obstructive Sleep Apnea. Sleep Apnea can be a dangerous condition leading to increased risk of heart attacks, strokes, and high blood pressure. Treatments are available for sleep apnea but diagnosis requires an overnight sleep study at an AASM accredited sleep center. If you have been told you snore, schedule an appointment to speak to a sleep specialist. It’s covered by insurance and treatment of apnea has been proven to help lower blood pressure, improve cognition, and decrease daytime fatigue.

Have a safe and happy New Year!