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.

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).

We’ve covered REM behavior disorder and it’s strange effects before, but this story shows how this odd condition can affect an entire family’s well-being.

As reported on ABC’s Good Morning America and KATU News, Adam Kearns of Keizer, Oregon and his wife of ten years were recently ordered by the court to have no contact with one another after he was arrested on assault charges. The charges stem from an incident earlier this year in which Adam punched his wife in the face three times while in bed. The twist is that Kearns was actually asleep during the incident and after hitting her, he laid back down and continued snoring.

His wife went to the hospital and police were called. The law makes no provision for REM Behavior Disorder and requires police to make an arrest if a domestic assault occurs within the home. Kearns’ wife, Randi, says he was never violent towards her in any way and the law is keeping their family, including two young children, apart. Adam has undergone testing at a local sleep center and been diagnosed as having REM Behavior Disorder. Despite the fact that this is a documented sleep disorder and patients cannot control their actions when asleep, the courts are pursuing prosecution. He said it’s frustrating that authorities don’t believe him when it comes to this newly-diagnosed condition. “You can only tell somebody something so many times,” he told KATU news.

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.

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.

The National Sleep Foundation recently conducted a bedroom poll to determine what environmental factors influence Americans sleep the most. The NSF Bedroom Poll looked at different areas such as temperature, romance, sleep habits, and bed condition and polled 1500 people from all walks of life to get the results.

Respondents were asked to rate the level of impact each factor has on their ability to get a good night’s sleep. Some of the more interesting results:

• Pillows and bedroom temperature were the two areas that have the most impact on sleep (70% and 69% impact respectively). Professionals recommend a cool environment as being the most conducive for sleep.

• Bedroom darkness and sheets were also considered important factors with 57% and 53% of participants rating them as being of high importance. These are common factors impacting good sleep hygiene, along with bedroom temperature.

• Snoring from a bed partner is a common reason for people to lose sleep with 41% of respondents saying it impacts their night. This shows that there are still millions of people being affected by untreated Obstructive Sleep Apnea and its most common symptom, snoring.

For more on good sleep hygiene visit the NSF or Oregon Sleep Associates.

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!

As 2010 gets put to bed, it is time to look at the stories about sleep that were most talked about this year:

• More Children Are Medicated for Insomnia -  Illustrating a disturbing trend in medicine, many children are given prescription sleep aids for Insomnia.

• US Military Finds Bright Light Can Improve Alertness, Reduce Post Traumatic Stress - Another link between exposure to light and our circadian rhythms.

• Tired Teenagers At Risk For Depression – Teens’ schedules are causing increased rates of depression in today’s youth.

• Shift Work Hurts Productivity – Important news for businesses with employees on late shifts.

• Sudden Infant Death Syndrome Linked to Low Levels of Serotonin – New research sheds light on the possible causes of SIDS, a scourge that continues to puzzle scientists.

• Sleep Suffers During Wartime Deployment – The stress of war is affecting our troop’s sleep and peace of mind, making it harder to adjust upon their return home.

• Insomnia And Sleep Duration Linked to Early Death – Startling news on the connection between lack of sleep and mortality.

• Percy Harvin’s Trouble With Sleep Apnea – The Viking’s receiver’s continued woes with his sleep disorder.

• Biggest Loser Contestant on CPAP – Contestant Sherry Johnston talks about sleep apnea and continuous positive airway pressure.

• Obstructive Sleep Apnea Linked to Heart Disease – A recent study finds that the common sleep disorder is even more serious than previously thought.