Tag Obstructive sleep apnea

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

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.

Starting CPAP Therapy? You Should See a Sleep Specialist – a Study.


A recent study published in Journal of Clinical Sleep Medicine  looked at various cues that the CPAP users found important from treatment initiation and adherence standpoint.

Obstructive Sleep Apnea (OSA) is a common sleep
disorder for which continuous positive airway pressure
(CPAP) therapy is the standard treatment for most patients with
moderate to severe disease. Although this treatment is effective
in reducing airway obstruction to nonclinical levels, CPAP
acceptance (commencement) and adherence is suboptimal.

In this study by The University of Queensland, Australia, 63 adult patients diagnosed with OSA who had never tried CPAP were asked at 1 month as to why they started and persisted with CPAP use.

My sleep physician said that I should 

My sleep physician was worried about my OSA

I was worried about the health consequences of my sleep problem 

I was so tired all of the time

I was worried about my heart 

Partner encouraged me to start using CPAP 

My partner couldn’t sleep because of my snoring 

I was worried that I would have a car accident 

These findings suggest that patients rate advice from
health professionals (specifically their sleep physician) as very
important in their decision to commence on CPAP.

More than 80% of patients indicated that sleep physician-prompting to use
CPAP and a perception of sleep-physician concern regarding
the patient’s OSA were crucial cues to commence on CPAP.

The study suggests that a clear communication by the health professional is vital to patients in supporting treatment uptake.

In summary, consulting a sleep physician regarding your sleep apnea treatment will help your CPAP initiation and adherence. Hence, pick up the phone, make an appointment and talk to your sleep physician.

An Alert Life is a Full Life.

Sleep Well, Live Well.

God Bless You.

New Research Links Insomnia to Sleep Apnea

Photo Credit: Pop Catalin

Photo Credit: Pop Catalin


We do not associate insomnia with obstructive sleep apnea, but a recent study by Dr. Barry Krakow (Mayo Clinic Proceedings) showed the role of OSA in causing and perpetuating insomnia.

Krakow investigated 1,210 insomnia patients who were unable to fall asleep or stay asleep using sleep aids. Subsequently, 942 patients underwent overnight sleep studies, and 91 percent of those who completed a sleep study actually suffered from previously undiagnosed obstructive sleep apnea, a critical factor aggravating their insomnia.

If you suffer from insomnia, please talk to us or your doctor about a simple home sleep test to diagnose and treat obstructive sleep apnea.

To read more about this article, please click New research links insomnia to sleep apnea.


Sleep apnea poses risk of complications for pregnant women | Tampa Bay Times

Pregnant woman lying in bed sleeping

Sleep apnea poses risk of complications for pregnant women | Tampa Bay Times.

New research from the University of South Florida has found that pregnant women with obstructive sleep apnea are five times more likely to die in the hospital during and shortly after pregnancy, compared with women without the disorder. The study also found that pregnant women with apnea also were more likely to suffer the severe complications of pregnancy, including severe high blood pressure, an enlarged heart and pulmonary blood clots.

To read more, click on the link above. If you snore, please talk to your doctor about sleep apnea.


FDA Approves a Novel Sleep Apnea Treatment


Photo Credit: Filip Schneider

Photo Credit: Filip Schneider


The US Food and Drug Administration (FDA) has approved the first fully implantable neurostimulator to treat obstructive sleep apnea (OSA), but only as a second-line therapy.

The device, called Inspire Upper Airway Stimulation therapy, is manufactured by Inspire Medical Systems, which announced the FDA’s decision today.

The implant helps keep a patient’s airway open by stimulating the hypoglossal nerve during sleep in tandem with a patient’s inspiration. The stimulation contracts upper airway muscles to pull the base of the tongue forward.

The FDA has approved Inspire Upper Airway Stimulation therapy specifically for patients with moderate to severe OSA who cannot use continuous positive airway pressure.

Adverse events reported in a clinical trial of the device included tongue weakness, dry mouth, pain, and numbness. The device is incompatible with having a magnetic resonance imaging scan.

(From Medscape)

Undiscovered sleep apnea may contribute to your child’s hyperactivity | Dr. Rich – Auburn Reporter

Photo Credit: Sanja Gjenero

Photo Credit: Sanja Gjenero


“What does sleep apnea have to do with ADHD? Isn’t sleep apnea basically a middle-aged obese guy’s issue?” Those readers would be correct. By far the most common person with obstructive sleep apnea is in fact an overweight male over 40. However, at least 30 percent of those eventually diagnosed with the condition do not fit that profile. Patients of all ages, gender and size can have sleep apnea, including young children.

“How does that work? Aren’t kids with ADHD by definition hyperactive, not sleepy?” That is true. However, adults and kids react differently sometimes. When adults don’t get enough sleep, they are tired the next day. Kids don’t always respond that way. They often get hyperactive during the day and exhibit symptoms like poor behavior or performance in school, crankiness, lack of focus and daydreaming. These are very similar to the symptoms used to diagnose ADHD.

The next logical question would be, “So what types of things should a parent look for? How do you tell the difference between true ADHD and symptoms that may be caused by a lack of oxygen during sleep?”

There are things to look for, that your pediatrician or a properly trained dentist should be able to see and share with you. Tell them if your child snores, or has been diagnosed with ADHD previously as part of their medical history review. Ask them to look for enlarged tonsils, a high palate, a small lower jaw or crooked teeth.

Other signs may include sweating heavily at night and bedwetting in younger children or at least frequent trips to the bathroom. These all point toward the need for evaluation for Obstructive Sleep Apnea.

Poor sleep also affects growth and development, including a tendency toward obesity, which only makes the sleep apnea problem worse due to increased fat deposits around the neck.

Please click on the link below to learn more.

Undiscovered sleep apnea may cause, contribute to your child’s hyperactivity | Dr. Rich – Auburn Reporter.

A New Sleep Apnea Treatment Could Help Millions | CBS News

In Thursday’s New England Journal of Medicine, researchers unveiled a new treatment that utilizes a sensor to stimulate nerves, allowing the body to breathe when otherwise it would not.

“I am so excited about this new device,” Dr. Ash told the co-hosts of “CBS This Morning.” She said the device, known as a “pulse generator” is surgically implanted, requiring a two hour procedure.

“It senses your effort to breathe. So it senses that you’re trying to take a breath,” she said. “It sends a pulse stimulation to the hypoglossal nerve — the nerve in your neck that controls those muscles that keep the airway open, and stimulates them, so the airway doesn’t collapse.”

Current standard treatment for sleep apnea is a device called a CPAP. It is a machine that applies air pressure through a mask, which, if worn while sleeping, keeps the airway open. Many people find the masks bulky and uncomfortable, choosing instead to leave their apnea untreated.

“For people that cannot use (the CPAP), that cannot tolerate it, it will make all the difference,” Ash said about the new device.

The new device is still in preliminary stages awaiting FDA approval, but Dr. Ash says she looks forward to the day when it is available to the general public. 

Please click on the link to watch a video clip on CBS News http://www.cbsnews.com/video/new-sleep-apnea-treatment-uses-nerve-stimulation

Sleep Apnea & Claustrophobia? Here is the Answer.

My patients with obstructive sleep apnea and severe claustrophobia are petrified at just the thought of wearing a bulky mask for use with their CPAP (Continuous Positive Airway Pressure) machine. Well, here is the answer to their prayers; a small, flexible, open, and wearable nasal interface from Respironics – Nuance Nasal Gel Pillows. Take a look.

Like it?  Talk to us or your home medical provider.

Sleep Well, Live Well.

Sleep-Disordered Breathing May Worsen Pregnancy Outcomes – MPR

Sleep-Disordered Breathing May Worsen Pregnancy Outcomes – MPR.

Evidence from published observational studies suggests that maternal sleep-disordered breathing is associated with increased risk of gestational hypertension and gestational diabetes, according to research published in the January issue of the American Journal of Obstetrics & Gynecology.

Sushmita Pamidi, MD, of McGill University in Montreal, and colleagues conducted a systematic review of the literature and meta-analysis of selected studies to assess the association between sleep-disordered breathing and risk of adverse pregnancy outcomes, including gestational hypertension/preeclampsia, gestational diabetes, and low-birth-weight infants.

Please click on the link above to read more.