Sleeping Pills Can Kill


Eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien) can cause automatic sleep behaviors leading to injuries from falls, car accidents, and accidental overdose. Talk to us (574-534-9911) and your family about preventing such accidents.

“Most people have talked or walked during sleep at some time in our lives. However, some people exhibit more unusual complex behaviors while asleep, including eating and driving. These types of behaviors, called parasomnias, come about when parts of our brain are asleep and other parts awake at the same time. Parasomnias, while generally considered normal in a healthy child, can be a cause for concern when they develop in adults. Earlier this year the FDA issued a “black box” warning for the sleep medications eszopiclone, zaleplon, and zolpidem, given reports of sleep behaviors that resulted in injuries from falls, car accidents, and accidental overdoses related to their use. The FDA also notes that all medications used to promote sleep reduce alertness and may cause drowsiness the following day, which may impair your ability to drive.” – Suzanne Bertisch, MD, MPH – Harvard Health.

What Can You Do?

1. Call us for an appointment at 574-534-9911 to discuss options.

2. Always take the lowest effective dose for the shortest possible time.

3. Get obstructive sleep apnea diagnosed and treated as it can cause insomnia. If you do suffer from sleep apnea, it can be dangerous to take sleeping pills or pain meds without using  CPAP.

4. Keep the door double locked.

5. Do not keep furniture in the middle of the room.

6. Have the bedroom on the ground floor.

7. Have heavy drapes in front of the windows.

8. Keep the door keys and car keys locked in a safe place.

9. Put the sharp objects away.

Consider Cognitive Behavior Therapy for Insomnia. CBT-I is the most effective long-term therapy for insomnia.

Thank you. Sleep Well. Be Safe.

After Train Crash, Transit Regulators Targeting Sleep Apnea – ABC News

Federal regulators are urging railroads across the country to test train operators for obstructive sleep apnea after the engineer in September’s deadly New Jersey commuter train crash was found to have the fatigue-inducing disorder.

The Federal Railroad Administration will issue a safety advisory this week stressing the importance of sleep apnea screening and treatment, Administrator Sarah Feinberg told The Associated Press. One railroad that already tests its engineers, Metro-North in the New York City suburbs, found that 1 in 9 suffers from sleep apnea.

The advisory, akin to a strong recommendation, is a stopgap measure while regulators draft rules that would require all railroads to screen engineers for sleep apnea. That process could take years, and Feinberg said railroads shouldn’t wait for the government to force action.

“At this point, it’s unacceptable to wait any longer,” Feinberg said.

Sleep apnea patients are repeatedly awakened and robbed of rest as their airway closes and their breathing stops, leading to dangerous daytime drowsiness.

“You end up with an engineer who is so fatigued they’re dosing off, they’re falling asleep in these micro bursts and they often have no memory of it, and they’re operating a locomotive at the time, so they’re putting hundreds of people in danger,” Feinberg said.

To read more, click here: After Train Crash, Transit Regulators Targeting Sleep Apnea – ABC News

Sleep Apnea May Boost Risk for Post-Op Problems

MONDAY, Oct. 17, 2016 (HealthDay News) — Sleep apnea may boost the odds of developing two serious health complications following surgery.

So, finding out if you have the sleep disorder beforehand — and seeking treatment — could boost your odds for good recovery from surgery, researchers say.

The two post-op complications are blood clots in the veins and an irregular heartbeat called atrial fibrillation, according to two new studies.

These problems occurred more often among surgical patients who had not yet been diagnosed — and therefore weren’t treated — with sleep apnea.

Obstructive sleep apnea is characterized by repeated breathing disruptions during sleep. Symptoms include excessive daytime sleepiness, restless sleep and loud snoring — often with periods of silence followed by gasps.

More than half of surgery patients who have sleep apnea don’t know it, the authors of one new study said. Identifying these patients ahead of time might spare them serious post-op complications, the findings suggest.

Read More: Sleep Apnea May Boost Risk for Post-Op Problems

Seven Benefits of a PAP Nap at Snooze Clinic

My wife and I visited the campus of Williams’ Brothers in Washington, IN to learn how we can serve our patients better. Williams brothers run their family business in a compassionate, caring, and efficient manner. Julie, their CPAP specialist, a pleasant young lady in her 30s gave us a 2-hour long tour of their flawless operation.

“Let me walk you both to the parking lot,” she said at the end of the trip. As we were walking through the large building, I noticed a room with a bed and stopped Julie, and asked her about the room.

“We do all our CPAP set-ups in this room!” she proudly announced. Wow! So simple and yet so helpful to the patients. We, like most providers, were setting CPAP up with patient sitting upright in the chair. How can one get an accurate idea of how the mask or the nasal cannula is going to feel when sleeping in bed?

Connie, our medical assistant, ordered a bed, mattress, bed covers, and other supplies from Amazon the very next Monday. Abbee assembled it right away in the examination room closest to the supplies room at our Goshen office, and the Nap Room was all set.

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“Doc, we did out first CPAP set-up today,” Connie called me excitedly when I was in our Mishawaka location. “He was euphoric. He told us he is just going to lay down, but won’t sleep with the CPAP on. Well, we had to wake him up after half an hour, Doc!”

So, here, are the benefits of the Nap Room.

  1.  You can try the small mask or even smaller nasal cannula and lie down and see how it feels before taking it home.
  2. You can also see if the PAPillow, the pillow with a cut-out to accommodate the mask or the cannula to minimize the air leak, feels right.
  3. The interface may fit well sitting in the chair, but does it fit well when you toss and turn? You can learn that in the PAP Nap room.
  4. The nap also allows you to check the Hose Suspension system to see if you need that or just want to use the headboard of the bed. This suspension system is very helpful especially if you toss and turn a lot. It prevents you from getting tangled up.
  5. The PAP Nap also allows you to see how the humidifier and the control panel work.
  6. The nap helps you gain the confidence that the CPAP, the tube, and the nasal interface works well. It reduces the anxiety associated with CPAP initiation.
  7. The Nap Room also comes in handy during the follow-up visit if you are having difficulties with persistent snoring, apnea, or an air leak.


Well, we are excited about our Nap Room. Check it out when you visit us either in Goshen or in Mishawaka.

Sleep Well, Live Well.


Extra sleep can help cut women’s risk of diabetes – but unfortunately not for men – Miriam Stoppard – Mirror Online

A Dutch-led team of researchers has studied almost 800 healthy middle-aged men and women to learn more about the link between sleep and diabetes

Source: Extra sleep can help cut women’s risk of diabetes – but unfortunately not for men – Miriam Stoppard – Mirror Online

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.