CPAP Apnea Devices Help Control Blood Sugar in Diabetics

The study, published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine, tracked 50 patients with both OSA and uncontrolled Type 2 diabetes. Some were asked to use CPAP masks, while the others were not.

After six months, the researchers found CPAP users had lower levels of insulin resistance and hemoglobin (HbA1c) levels — key markers of diabetes — than nonusers. In addition, the CPAP group had fewer inflammatory proteins and other biomarkers associated with Type 2 diabetes blood sugar control.

Read more: CPAP Apnea Devices Help Control Blood Sugar in Diabetics

Help Your Child Sleep Well


Forming good sleep habits early on in life is vital. Here, are a few tips from Sarah Helm.

  • Avoiding late-in-the-day foods or drinks that have sugar and/or caffeine
  • Not providing attention if the child does awake from bed, and then quietly putting him or her back
  • Using a high quality, digital noisemaker that makes “white noise”
  • Keeping the bedroom at a cooler temperature
  • Eliminating the availability of fun toys.

Next, create a schedule prior to bedtime that goes from more active to less active, more fun to less fun, and lighter to less light.

For example, activities involving screens (iPad, TV) should be earliest on the schedule and should end an hour before bedtime. Children can do their evening/bedtime chores as the light fades (putting away toys, getting into PJs, brushing teeth). Reading a book in bed or engaging in some other passive activity (fun, but not too stimulating) is great for winding down at the very end of the night.

Your son or daughter should be able to fall asleep by himself or herself, so don’t stay in the bedroom and wait for him or her to fall asleep.

If your child is still waking and getting up in the night, you have a number of options. One is offering a “bedtime pass” that can be used once per night for something within reason (a glass of milk, a hug), or can be turned in the next morning for something better (a favorite breakfast, a special activity, etc.). You can also conduct periodic check-ins and fade those out (check in one minute after bedtime, two minutes later, four minutes after that, etc., until your child is asleep).

To read more, click here.

Sarah Helm, BCBA, can be contacted at

Why Change Liners for Your CPAP Mask?

Why Change Mask Liners?.

“Don’t fix it if ain’t broken!” A patient reluctantly shared with me when I asked him about CPAP supplies renewal.

Supplies renewal recommendations from the manufacturers and DME companies appeared to me to be motivated by personal gain. Now, I have become more and more religious about advocating and even insisting that all my patients change them as recommended.

To make my point, I just saw an Amish patient in his 50s on CPAP. He felt better, but not all the way. His pretreatment apnea hypopnea index was 43/hr. On his CPAP compliance report, it was 13.5/hr, which is abnormal. We like it less than 5/hr and preferably close to 0/hr!

Why was he having residual apnea? At least, in part it was the air leak from not changing his mask liner! Take a look at the following compliance report in the right half of the image.


So, get your supplies refilled in a timely manner.

Sleep Well, Live Well.

Sleep 7+ Hours to Live a Long, Healthy, & Happy Life


Consensus Statement (published in June 2015 issue) from American Academy of Sleep Medicine and Sleep Research Society recommends 7 or more hours of sleep every night.

1. Sleeping less than 7 hours per night on a regular basis is associated with adverse health outcomes, including weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death. Sleeping less than 7 hours per night is also associated with impaired immune function, increased pain, impaired performance, increased errors, and greater risk of accidents.

2. Sleeping more than 9 hours per night on a regular basis may be appropriate for young adults, individuals recovering from sleep debt, and individuals with illnesses. For others, it is uncertain whether sleeping more than 9 hours per night is associated with health risk.
3. People concerned they are sleeping too little or too much should consult their healthcare provider.

Sweet Dreams! God Bless!

– Yatin J. Patel

Class time or sleep time for students? – South Bend Tribune: Local


Photo Credit: Mokra from Brazil

Photo Credit: Mokra from Brazil

Jessica Payne, director of the Sleep Stress and Memory Lab at the University of Notre Dame and a chair for the nonprofit organization “Start School Later,” said the vast majority of teenagers are incapable of going to bed early. It’s not just that they choose to be up late using electronic devices, she said, their brains are wired for sleep in a way that’s different from the brains of adults and children.

And that starts with melatonin, which signals to the body that it’s time to sleep. In teens, melatonin isn’t released until around 11 p.m.

“The problem is,” Payne said, “we have them in a school schedule that’s counter to the ways their brains work. They’re not getting the sleep they need.”

Kyla Wahlstrom, director of the University of Minnesota’s Center for Applied Research and Educational Improvement, is a former school administrator and expert on the effects of later high school start times on teen health and academic performance.

Last week, Wahlstrom, who was involved in a CDC-funded study on the topic last year, said by phone that years ago she was skeptical of the positive findings of the long-term effects of later school starts for older students.

But when Minneapolis schools made the change in the late ’90s an increase in graduation rates by 3 percentage points for five consecutive years confirmed what other research was showing.

“There’s really no downside,” she said, “whether it’s social and emotional well-being and health (of teens), academic performance, academic indicators, such as tardiness, attendance and so on.”

To read more, click Class time or sleep time for students? – South Bend Tribune: Local.

High pollen count wreaking havoc on seasonal allergy sufferers | Local –

Talk to us about allergy testing and shots.

Talk to us about allergy testing and shots.

Worst Allergy Season in Recent Times?

Seasonal allergies are especially bad this year because there’s more overlap among trees, flowers and grasses as far as their blooming time this year than in normal years, and this is taking a toll on allergy sufferers.

“I don’t normally have any allergies really and then this year it just suddenly came to me,” says Carol Quinn.

Carol has noticed her allergies acting up more this year than in years past.

“I’ve had watery eyes, itchy eyes, sneezing, coughing,” says Quinn.

But she’s not the only one; experts say conditions are right this year to make allergies bad on everyone.

To read more, click on the link below.

High pollen count wreaking havoc on seasonal allergy sufferers | Local –

High-Fiber Diet May Help Prevent Allergies |

Several new studies suggest that dietary fiber could play a role in food allergies.

This notion is based on the idea that bacteria in the gut have the enzymes needed to digest dietary fiber, and when these bacteria break down fiber, they produce substances that help to prevent an allergic response to foods, said Charles Mackay, an immunologist at Monash University in Melbourne, Australia.

So far, the research related to this idea has been done mainly in mice, and dietary factors are unlikely to be the sole explanation for why allergy rates have skyrocketed, researchers say. But if the results were to be replicated in human studies, they would suggest that promoting the growth of good gut bacteria could be one way to protect against, and possibly even reverse, certain allergies, researchers say.

To read more, click on High-Fiber Diet May Help Prevent Allergies.

Will the Noise from CPAP Bother My Spouse?

“My spouse already has sleep difficulties, Will my CPAP machine make the insomnia worse?” I reassure such patients that all the new models of CPAP devices are almost silent producing only 24 to 29 decibels. 

How loud is 29 decibels? Here is a list of common noises and their decibel levels:

Normal conversation (60)
Refrigerator humming (40)
Whisper at 6 feet (29)
Whisper (20)
Calm breathing (10)

I further explain that most spouses find the soft, continuous, humming noise beneficial in helping them fall asleep, just like white noise would. Spouses have also shared with me that they sleep soundly knowing that CPAP is taking care of those dangerous episodes of cessation of respirations. They prefer this soft hum over stentorian snoring as the former represents continued breathing.

If you find a device’s noise is bothersome, first check to make sure the CPAP’s air filter is clean and unblocked.

If this doesn’t help, have your CPAP supplier check the device to ensure it’s working properly.

Also make sure that the CPAP mask is fitting properly as a large air leak from an ill-fitting mask can exacerbate the noise.

If the noise is still bothersome, try earplugs or a white noise sound machine to mask the noise.

Go through above checklist diligently.

Please continue to use CPAP as untreated sleep apnea affects your quality of life besides increasing your risk of hypertension, cardiovascular diseases, stroke, and drowsy driving.


Can’t Use CPAP Because of Dust Allergy? Try These.

Dust allergy can cause nasal congestion, drainage, irritation, itching, and the blockage. This, according to several studies, is one of the common causes of discontinuation of Continuous Positive Airway Pressure (CPAP) therapy.

Dust mites are ubiquitous in regions with high humidity. Mites need moisture and human dander for survival. High levels of mites can be found in dust from mattresses, pillows, carpets, bed covers, clothes, and soft toys.

Here, are my tips to help you minimize dust mite exposure and hence allergy symptoms.

1. Empty and clean all closets. Keep clothing in zippered plastic bags and shoes in boxes off the floor.

2. Remove carpeting, if possible.

3. Clean and scrub the woodwork and floors thoroughly to remove all traces of dust. Wipe wood, tile, or linoleum floors with water, wax, or oil.

4. Wear a filter mask when cleaning.

5. Clean the room thoroughly and completely once a week. Clean floors, furniture, tops of doors, window frames and sills, etc., with a damp cloth or oil mop. Carefully vacuum carpet and upholstery regularly. Use a special filter in the vacuum. Wear an N95 filter mask while dusting, sweeping or vacuuming.

6. Wash curtains often at 130 degrees Fahrenheit.

7. Carpeting makes dust control impossible. Therefore, health care experts recommend hardwood, tile, or linoleum floors. Treating carpets with tannic acid eliminates some dust mite allergen.

8. Encase box springs and mattress in a zippered dust-proof or allergen-proof cover.

9. Use only washable materials on the bed. Sheets, blankets, and other bedclothes should be washed frequently in water that is at least 130 degrees Fahrenheit.

10. Avoid fuzzy wool blankets or feather- or wool-stuffed comforters and mattress pads.

11. Keep furniture and furnishings to a minimum. Avoid upholstered furniture and blinds. Use only a wooden or metal chair that can be scrubbed.

12. High-efficiency particulate absorption (HEPA) filters can effectively remove many allergens from the air. Install a high-efficiency media filter with a MERV rating of 11 or 12 in the furnace and the air conditioning unit.

13. Keep the humidity level below 55 percent because house mites need high humidity to live and grow.

14. Keep toys that will accumulate dust out of the child’s bedroom. Avoid stuffed toys. Use only washable toys of wood, rubber, metal, or plastic. Store toys in a closed toy box or chest.

Although these steps may seem difficult at first, experience plus habit will make them easier. The results-better breathing, fewer medicines, and greater freedom from allergy and asthma attacks-will be well worth the effort.

Sleep Well, Breathe Well.

Why Should I Worry About Allergies? #CPAPproblems

When I inquire about their nasal allergy symptoms, patients often wonder and ask, ” I came here for sleep apnea treatment. What does that have to do with allergies?”

Studies (Respir Med 2000, Sleep 2003) have also suggested that nasal congestion and symptoms are important reasons for abandoning PAP therapy or at least lead to poor adherence to PAP therapy.

The most scientific way to evaluate the allergy symptoms is to find out what you are allergic to by doing a simple and painless allergy skin testing using plastic bristles instead of needles. Once we determine the cause of your allergy symptoms then, we can discuss how you can minimize the exposure and thereby the symptoms.

You may have residual symptoms especially if you are allergic to dust, mold, or pet dander as these can be difficult to completely avoid. For these, taking allergy medications (Zyrtec or Claritin tablet, Fluticasone Nasal Spray, and Montelukast Tablet) can help.

For allergy symptoms refractory to the above treatment, immunotherapy (injecting dilute allergens into the skin on a weekly basis) can help.

If you alleviate your allergy symptoms, then it will be easier for you to use CPAP all night long, every night. Discuss these with your doctor or call us for an appointment.

Sleep Well, Live Well.

God Bless You.