Mar 3rd, 2010
by Dr. Lisa Shives.
I was interviewed by Web MD for this piece on natural sleep remedies. This will give useful information to those who struggle with insomnia and especially those who wish to avoid prescription hypnotics and sedatives. We need more research into the effectiveness of these herbal and natural sleep aids, but most can’t hurt you if you buy a reputable brand and if you are not taking other medications. Still, I always advise my patients to take seriously anything they ingest. Please ask your primary care or sleep doctor before you use any over the counter or “natural” sleep aid.
http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/sleep-supplements-herbs?page=2
Posted in: Dr. Shives in the News, Natural Sleep Remedies, Sleep Disorders, Sleep Medicine News, Your Health and Sleep.
Tagged: alternative therapies for sleep problems · herbal sleep aids · hypnotic medications · insomnia · insomnia treatment · Natural sleep aids · Natural Sleep Remedies · north suburban sleep center · northshore sleep center · sedatives · sleep center chicago · sleep center northshore chicago · Sleep Disorders · sleep doctor chicago · sleep specialist northshore chicago · Sleep Tips
Mar 2nd, 2010
by Dr. Lisa Shives.
If you hate CPAP, then you need to check out my blog every Tuesday for the Tuesday Tips for CPAP Strugglers. If you can’t get use to the CPAP, the most common reason is that you have not found the right mask, so you think that you hate the CPAP when in fact you hate the mask.
Today’s Tuesday Tip is to find a comprehensive sleep center that handles their own CPAP machines and masks because that way you have medical professionals working together to treat your sleep apnea and help solve the problems that you are having with the CPAP therapy. Employees of medical supply companies who, by the way, are usually not health professionals, simply cannot deliver the same quality of care. Such a sleep center should do what we do at Northshore Sleep Medicine: we let you take home and try many different masks without repeatedly billing you or your insurance company. We guide you toward the best masks and then let you take home as many as you need until you find the perfect fit and comfort for your face and your sleeping patterns.
And remember CPAP is the gold standard therapy for obstructive sleep apnea and the only proven first-line therapy for severe sleep apnea. It is in your own best interest to make a good effort to use the CPAP if that is what your doctor prescribes. So don’t be fooled by the advertisements from dentists who encourage you to “hate CPAP” and to give up on it and switch to their expensive oral appliances that often do not adequately treat the sleep apnea. There is an appropriate use for the oral appliances, but only a physician should be making that recommendation, not a dentist.
Sleep apnea is a serious medical disorder that, if left untreated, increases your risk for high blood pressure, heart disease, stroke, diabetes, obesity and dementia. It goes without saying that the treatment is best guided by a sleep physician. If you snore, have excessive daytime sleepiness or for some other reason suspect that you have sleep apnea, do not start by going to a dentist who advertises that he treats snoring. Start by going to a reputable sleep doctor, preferabably at a comprehensive sleep center, who will then refer you to a trustworthy, experienced dentist if the oral appliance ( AKA: mandibular advancing device) is an appropriate therapy for you.
Posted in: About Northshore Sleep Medicine, CPAP, CPAP Problems, Sleep, Sleep Apnea, Sleep Disorders, Sleep and Heart Health Facts, Uncategorized, Your Health and Sleep.
Tagged: CPAP · CPAP Tips · I hate CPAP · mandibular advancing device · north suburban sleep center · northshore sleep center · Obstructive sleep apnea · oral appliance · OSA · sleep and health · sleep apnea · sleep center · sleep center chicago · sleep center northshore chicago · Sleep Disorders · sleep doctor chicago · sleep labs chicago · sleep specialist northshore chicago · Sleep Tips · snoring
Feb 26th, 2010
by Dr. Lisa Shives.
More than once, the question has come up from one of my Jewish patients: Can I use my CPAP on the Sabbath?
Most Rabbis agree that it is alright to use medical equipment such as CPAP (Continuous Positive Airway Pressure) that your doctor has determined is medically necessary for treatment of your obstructive sleep apnea. By using your CPAP every night, you are lowering your risk of developing hypertension (high blood pressure), heart disease, cardiac arrhythmias, stroke, obesity, diabetes and dementia.
Many CPAP machines now turn on automatically when you put on the mask and turn off when you take it off so there are no on/off switches to use. One example is manufactured by Res Med. Ask your sleep doctor about prescribing this type of CPAP machine if that makes you feel better.
Also, another way to be observant is to use a timer such as the type people use to turn lamps on and off- when they are away from home. Rabbi Kreisman of Skokie, Illinois recommends this to members of his temple.
One of our staff sleep physicians at Northshore Sleep Medicine, Dr Irina Trosman, is Jewish and she feels strongly that her Jewish patients should feel comfortable using their CPAPs on the sabbath and high holidays and that they should not feel that they have gone against their traditional religious beliefs.
Mazel tov!
Posted in: About Northshore Sleep Medicine, Sleep Apnea, Sleep Disorders, Sleep and Heart Health Facts, Your Health and Sleep.
Tagged: CPAP · cpap and jewish patients · CPAP for orthodox jews · CPAP use on the sabbath · health risks of untreated sleep apnea · heart disease · north suburban sleep center · northshore sleep center · Obstructive sleep apnea · OSA · preventive medicine · sleep and health · sleep apnea · sleep center · sleep center chicago · sleep center northshore chicago · Sleep Disorders · sleep doctor chicago · sleep labs chicago · sleep specialist northshore chicago
Jan 18th, 2010
by Dr. Lisa Shives.
My patient, Tom, recently emailed me to say that since he started using his CPAP regularly, he has had no episodes of atrial fibrillation (a condition marked by an irregular heartbeat and one that greatly increases your chance of stroke). He is delighted to have a reprieve from this troublesome disorder and he attributes his success to the treatment of this sleep apnea with the CPAP machine.
Studies have shown that 80% of patients with atrial fibrillation have obstructive sleep apnea and a growing body of observational studies show that treating the sleep apnea with either CPAP or the oral appliance can keep the a.fib (atrial fibrillation) under control. Many electro-physiologists (the cardiologists who do cardio-ablations) will not do the ablation until a patient has a sleep study to investigate the presence of sleep apnea.
Posted in: About Northshore Sleep Medicine, Sleep Apnea, Sleep Disorders, Sleep and Heart Health Facts, Your Health and Sleep.
Tagged: a.fib · atrial fibrillation · cardiac arrhythmia · CPAP · heart disease · Obstructive sleep apnea · oral appliance · OSA · sleep center · sleep center chicago · Sleep Disorders · sleep doctor chicago · sleep labs chicago · sleep specialist northshore chicago
Dec 4th, 2009
by Dr. Lisa Shives.
If there is one piece of wisdom that doctors have gained over the past 20 years, it is: that the slower the heart beats, the better. Whenever someone has a heart attack or is diagnosed with coronary heart disease, then a good doctor puts the patient on medications that lower the heart rate (usually drugs that are classified as high blood pressure medications).
Conditions that disrupt the sleep such as sleep apnea or insomnia can lead to arousals (many of which are not remembered) and this in turn leads to over-stimulation which increases the firing of the sympathetic nervous system (i.e. a rush of adrenalin). This is all a fancy way to say: when you don’t have good sleep, your heart is not resting as it should. You can have an increase in your blood pressure and an increase in your heart rate that over many years can increase your risk for high blood pressure, heart disease, congestive heart failure, stroke and cardiac arrhythmias such as atrial fibrillation or ventricular tachycardia (as well as many other conditions such as diabetes, obesity, dementia and impotence).
If you treat sleep disorders such as sleep apnea, it can dramatically benefit your heart. For example, I saw a patient this week, Richard, who had an initial, diagnostic sleep study that found significant sleep apnea and showed that his maximum heart rate while asleep was 122 bpm (beats per minute) with a mean pulse rate of 80. This was much higher than expected for this extremely fit, 69 year old man who has a resting heart rate in the daytime of 65 bpm. When he returned to the sleep lab and was started on CPAP (Continuous Positive Airway Pressure) to treat his sleep apnea, then his maximum heart rate dropped to 67 bpm and his mean was 52 bpm! He had a nearly 50% reduction in his heart rate because we were able to eliminate the pauses in his breathing and all the stress on the body that apnea induces. Plus keep in mind that this was his first night on CPAP and it was in a sleep lab with wires attached to him. It will surely be even better when he is sleeping in his own bed and he becomes more accustomed to CPAP.
Sleep disorders are still one of the most overlooked causes of cardio-vascular disease. Yet, there are more and more sleep centers and sleep physicians who can work with your internist and cardiologist to help find the optimal treatment plan. To find the best sleep center near you, go the American Academy of Sleep Medicine’s website (aasmnet.org). They list all accredited sleep centers in the US. Be sure to ask if they are a comprehensive sleep center that has a board-certified sleep specialist and which treats all sleep disorders because your problem may involve more than one sleep disorder.
Posted in: Sleep and Heart Health Facts.
Tagged: atrial fibrillation · cardiac arrhythmia · congestive heart failure · coronary artery disease · CPAP · health risks of poor sleep · heart attack · heart disease · high blood pressure · hypertension · insomnia · north suburban sleep center · northshore sleep center · Obstructive sleep apnea · OSA · sleep and health · sleep center chicago · Sleep Disorders · sleep doctor chicago · sleep labs chicago · sleep specialist northshore chicago · stroke · ventricular tachycardia
Oct 21st, 2009
by Dr. Lisa Shives.
The US National Transportation Safety Board has made a recommendation to the Federal Motor Carrier Safety Administration and to the Coast Guard that they begin to screen drivers and ship navigators for sleep apnea. See the report at: http://www.ajc.com/health/content/shared-auto/healthnews/prss/632222.html. This is has been a long time coming and will be welcomed news in the sleep community. Health care professionals who treat people with sleep disorders know just how dangerous sleepiness can be. The question remains: How will they screen drivers, ship captains, pilots etc? Will it be a questionnaire? Will people try to avoid the diagnosis?
I feel very strongly that school bus drivers should be screened for sleep apnea. I know of no initiatives aimed at such a measure and would appreciate any information about this topic.
Posted in: Sleep Apnea, Sleep Disorders, Uncategorized.
Tagged: central sleep apnea · Drowsy Driving · northshore sleep center · Obstructive sleep apnea · school bus drivers · school bus drivers and sleep disorders · Sleep and Airline Pilots · sleep center · sleep center chicago · sleep center northshore chicago · Sleep Disorders · sleep labs chicago · sleep specialist northshore chicago
Sep 16th, 2009
by Dr. Lisa Shives.
A recent study published in the medical journal, Pediatrics, in July 2009 found that one third of the 194 study subjects (who were age 4-10 years and had asthma) had Sleep Apnea (AKA Sleep Disordered Breathing). And these children also had significant behavioral problems when compared to those kids who did not have Sleep Apnea.
The authors suggest that pediatricians be “particularly diligent about screening all children with asthma for Sleep Disordered Breathing (Sleep Apnea) and also consider sleep disorders as a possible risk factor for behavior problems.”
There is a growing body of evidence that sleep disturbances can cause and exacerbate behavior and learning problems and may mimic the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). It is important for pediatricians, psychiatrists and psychologists to consider sleep disorders early in the work up of ADHD (or other learning or psychiatric problems). Indeed, I maintain that no child should receive a diagnosis of ADHD without having an overnight sleep study to rule out sleep apnea.
Parents with children diagnosed with ADHD can think that their children “sleep just fine” because they go to bed and seem to sleep for 10 hours before emerging from their bedrooms, but few parents sit and watch their children sleep for hours so they don’t really know about their quality of sleep. Too many children are being put on stimulates, and many at such a young age.
These drugs were never tested in children and this usage is a recent enough phenomenon that we are only starting to see how people fare who have been taking stimulants (e.g. methylphenidate (Ritalin or Concerta); dextroamphetamine + amphetamine (Adderall); lisdexamfetamine (Vyvance) for many years. I know that I see teens and young adults every day in my sleep practice who suffer from intractable insomnia likely connected to lifelong use of prescription stimulants.
Posted in: Child Sleep Problems, Sleep, Sleep Apnea.
Tagged: ADD · ADHD · Attention Deficit Disorder · Attention Deficit Hyperactivity Disorder · Behavior problems · chicago sleep center · Child Sleep Problems · learning and academic problems · north suburban sleep center · northshore sleep center · Obstructive sleep apnea · Pediatric sleep apnea · sleep and school performance · sleep labs chicago · sleep specialist chicago · sleep specialist northshore chicago
