http://www.weightwatchers.com/util/art/index_art.aspx?tabnum=1&art_id=69971&sc=3053

 http://www.weightwatchers.com/util/art/index_art.aspx?tabnum=1&art_id=58391&sc=3405

Laboratory research, much of which was done at University of Chicago, points to the explanation for this. When your sleep is disrupted or restricted, then your metabolic rate is slowed, your appetite hormones are not functioning properly(making you hungrier) and your ability to regulate your glucose and insulin is impaired, not to mention that you just have no energy to exercise or take the time to prepare nutritious food.  So any sleep disorder that affects the quality or quantity of your sleep, especially insomnia and sleep apnea, can lead to weight gain and obesity.

 http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/myths-facts?src=RSS_PUBLIC

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.

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!

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.

The reporter, Robert Mitchum (rmitchum@tribune.com) brings up concerns that are shared by many sleep physicians, namely that hospitals and businessmen are opening sleep apnea mills.  Sleep Medicine just became a bonified sub-specialty in 2006 and the first official board exam, overseen by the American Board of Medical Specialities (www.abms.org), was given in 2007.  Until recently, any doctor could claim to be a sleep specialist.  It is important to go to a board-certified sleep specialist who treats all sleep disorders, not just sleep apnea, because people often have more than one problem with their sleep. It is also very important to go to a sleep center that is accredited by the American Academy of Sleep Medicine (www.aasmnet.org). If you go to their website, it is very easy to find an accredited center near you.

Now I know that I have a bias since I am a physician who owns and operates her own comprehensive sleep center, but I do feel strongly that this is the best way to do sleep medicine. When businessmen own the sleep lab and hire the doctor, you are not going to get the same level of care. The other week, a patient called my cell phone on a Saturday morning to say that his wife’s CPAP broke the night before and because she had one stroke already, she is afraid to sleep without it. I met them at my sleep center an hour later to give her a new CPAP. Only when a sleep center is being run like a doctor’s practice are you going to get that kind of service.

As for home sleep tests, I do some work with a company called Snap Diagnostics that provides a user-friendly, fairly reliable home sleep test that you pick up in a doctor’s office. Usually a sleep technician or nurse shows you in the office how to hook yourself to the few wires involved and then you bring the kit back the next day.

(CPAP is an acronym for Continuous Positive Airway Pressure and is the gold standard treatment for obstructive sleep apnea AKA OSA)