High-Fiber Diet May Help Prevent Allergies | LiveScience.com

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.

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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.

Why do I Pull Off my CPAP Mask in Sleep?

mask

“Doc, I put the CPAP mask on every night, but wake up with the mask on the bed. I don’t remember pulling it off,” frustrated patients often share with me. 

In my experience, nasal obstruction is the commonest cause of such occurrences. Studies have indeed shown that avoiding allergen exposure,  and using nasal steroid spray at bedtime help keep the nasal passages open.

For such patients, we first do allergy skin testing followed by an intensive allergen avoidance education. We prescribe allergy medications like Zyrtec (Cetirizine) at bedtime along with fluticasone nasal spray to be used 2 sprays each nostril prior to putting the CPAP mask on.

If you still suffer from nasal obstruction, adding singular (montelukast) tablet as a maintenance medicine can help. Allergy shots (injecting measured dosage of allergens in your skin on a weekly basis) can alleviate your allergy symptoms and the need for allergy medicines.

Talk to your doctor about these interventions and follow them. Be patient and persistent. Put on the CPAP mask every night and ultimately, one day, you shall wake with the mask on your face as opposed to your bed!

Best wishes.

Sleep Well, Lead Well.

Do call us if we can be of any help.

microsleep

Loved this beautiful poem about microsleep and naps.

I Sleep with my Face Buried in Pillow. Can I Still Use CPAP?

PhotoCreditFilipSchneider

We get that question often. “I sleep on stomach with face buried in a pillow. How can I use CPAP?” I reassure them that we do have quite a few patients, who use CPAP religiously despite their habit of sleeping prone.

We also remind them that the CPAP masks and cannula are stiff enough that the weight of your head will not cause collapse and obstruction to airflow. Most patients do however prefer a nasal cannula as opposed to a mask as the later can be difficult to sleep with the face down.

My patients with sensitive skin love this Nuance interface.

Our patients find this Nuance interface easy to sleep face down.

You may also find the ResMed interface shown below comfortable.

Air Fit P10 can also work even if you sleep face down in the pillow.

Air Fit P10 can also work even if you sleep face down in the pillow.

These interfaces work the best provided you do not have nasal allergies leading to nasal obstruction, in which case allergy skin testing followed by allergen avoidance, allergy medication, and allergy shots can help.

What if I breathe through the mouth? Well, we can prescribe a chin strap to keep your mouth closed during sleep.

Please do not let your sleep position scare you from getting treated for Obstructive Sleep Apnea. Untreated sleep apnea increases your risk of stroke, heart attack, high blood pressure, drowsy driving, and sudden death.

Sleep Well, Live Well.

Can CPAP Improve my Sexual Function?

PhotoCreditTallia

“I don’t have any sleep problem. My wife forced me to come here,” a young man in his forties vented out his irritation. I explain that the treatment of sleep apnea does reduce the risk of stroke, heart attack, and early death. Now, he got even more irritated, “I am not going to wear that CPAP.” I continued to make my case, “Studies have shown that the CPAP also improves intimacy and sexual function.” All of a sudden his eyes became big, he straightened up in the chair and asked hurriedly, “How soon Can I get that CPAP machine, Doc?”

Indeed, the studies have shown that up to 68% of men with Obstructive Sleep Apnea report sexual dysfunction and loss of interest in sex.

In a study published in Journal of Clinical Sleep Medicine, Judith L. Reishtein, Ph.D. and colleagues evaluated the sexual function of 176 patients with sleep apnea before and after the treatment with CPAP for 3 months.

Intimate and sexual relationships were assessed using the Intimate and Sexual Relationships subscale of the Functional Outcomes of Sleep Questionnaire (FOSQ). This disease-specific, self-administered instrument contains 30 questions and 5 stand-alone subscales.

As shown in the following table, difficulty with sexual desire, arousal, and orgasm decreased remarkably after 3 months of treatment with CPAP.

 

CPAPsex

 

How does CPAP improve sexual function?

Those who are sleepier, as the researcher found, may be less interested and more impaired in sexual activity. Indeed, Barnes and colleagues also found among a group of 98 men with OSA, those with Erectile Dysfunction were significantly sleepier in the daytime than those without ED.

Margel and colleagues reported that morning tiredness was predictive of sexual satisfaction and the ability to have a morning erection.

In addition to excessive sleepiness, other potential mechanisms have been considered, including hormone levels as well as hypoxic-induced neural dysfunction affecting the erectile process. Comparing 10 men who had OSA with 5 healthy controls, Luboshitzky and others found that the OSA patients had lower mean luteinizing hormone (LH) and testosterone levels, secreting less LH and testosterone during sleep.

In a study of 1312 men, Barrett-Connor and colleagues found that men with the lowest testosterone levels had more severe apnea than those with normal levels. They also spent more of their sleep time with oxygen saturation less than 90%.

Soukhova-O’Hare found that chronically low oxygen level in rodents decreased levels of the endothelial nitric oxide, which mediates penile erection. This team also documented that chronic intermittent hypoxemia produced a 55% decrease in the number of daily spontaneous erections that were reversed after 6 weeks of recovery in normoxia. They also found reduced sexual drive and mating activity.

Thus, the findings from these studies suggest that the effect of OSA on intimate and sexual behaviors may be multifactorial.

How Quickly Sexual Function can Improve?

Bradshaw and associates demonstrated a significant increase in the Intimate and Sexual Relationships score in participants who received just 2 weeks of CPAP treatment.

Goncalves and colleagues reported Erectile Dysfunction resolved in 13 of 17 OSA patients treated for one month with CPAP.

Akashiba and colleagues reported that in patients with severe OSA, following 6 weeks CPAP treatment, Intimacy and Sexual Relationships scores improved 2.59 points.

In conclusion, treatment of sleep apnea with CPAP improves intimacy and sexual function besides reducing your risk of stroke, heart attack, high blood pressure, high blood sugar, and drowsy driving. So, listen to your spouse and talk to us.

God Bless You.

Sleep Well, Live Well.

 

 

 

CPAP Mask is Irritating my Skin!

I recently saw a young lady with red, irritated skin around the nose and mouth, where the CPAP (Continuous Pressure Airway Pressure) mask comes in contact with the face. Such irritation commonly occurs in patients with sensitive skin, environmental allergy, excessive sweating, and higher pressure requirement.

This can be frustrating, but there are things you can do to minimize and reverse this.

1. Do not put the mask too tight. CPAP machines can compensate for the small amount of air leak. When we review your CPAP compliance report, we can make sure this air leak is not causing apnea (cessation of respirations) or hypopnea (shallow respirations).

2. Apply talc powder before you put the mask on if you have oily skin. You may already have done this. Baby powder works the best in absorbing excess moisture and sweat.

3. Get tested for allergies especially the indoor allergies like dust, mold, and pets. Skin testing is safe, quick, and painless.

4. Switch to a different interface; try a nasal cannula shown below as it would minimize the contact with skin or a smaller mask from a different manufacturer.

My patients with sensitive skin love this Nuance interface.

My patients with sensitive skin love this Nuance interface.

 

5. Use a moisturizer cream if your skin is dry. We have also used Elocon, a non-steroidal skin ointment to reduce the inflammation.

Work with us through this irritation, but do not ever stop using the CPAP as untreated sleep apnea increases the risk of stroke, heart attack, high blood pressure, diabetes, and drowsy driving death.

Sleep Well, Live Well.

God Bless You.

PTSD and CPAP Intolerance? These 5 Tips can Help.

PhotoCreditVinciusSgarbe

Treatment of Obstructive Sleep Apnea has been shown to improve anxiety, depression, and other symptoms of Post-Traumatic Sleep Disorder but compliance with Continuous Positive Airway Pressure (CPAP) has been worse in these patients. My patients suffering from anxiety, depression, insomnia and similar symptoms do find it difficult to sleep with the CPAP.

If you or someone you know is suffering from PTSD and OSA, the following tips can help.

1. Get treated for PTSD. The treatment by your therapist or psychiatrist will improve your sleep quality and thereby your CPAP adherence, which in turn will help alleviate your PTSD symptoms. We request that you regroup and see them regularly.

2. Try a mild anxiety or sedative medicine. Talk to your physician about this. This will help you adjust to CPAP.

3. Practice Self-relaxation, meditation, and yoga. This can help reduce your anxiety about CPAP initiation. In our experience, these interventions are far more effective in the long run than the medications for anxiety or insomnia.

4. Use a small, non-intrusive nasal cannula instead of a large, bulky, suffocating mask. This will minimize claustrophobia and resultant anxiety panic feeling.

5. Attend a local CPAP support group. Studies have shown that such participation improves CPAP experience and adherence.

It can be difficult to get used to CPAP, but it is worth the pain. It not only improves your psychiatric symptoms, but would also improve your energy level and alertness. It will also reduce your risk of stroke, heart attack, high blood pressure, and drowsy driving death.

So, start using CPAP. Stay with it. Don’t quit on it. Call us if we can help.

Sleep Well, Live Well.