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There are as many nights as days, and the one is just as long as the other in the year's course. Even a happy life cannot be without a measure of darkness, and the word 'happy' would lose its meaning if it were not balanced by sadness.
 
Carl Jung

falling asleep everywhere I go!

You've studied about sleep...
You continue to have trouble sleeping....
 
Quit being sleep deprived & take charge of your life!

I can't sleep....

Sleep Studies

Sleep studies are tests that watch what happens to your body during sleep. The studies are done to find out what's causing your sleep problems.

Sleep problems include:

  • Sleep apnea, when an adult regularly stops breathing during sleep for 10 seconds or longer. This may be caused by blocked airflow during sleep, such as from narrowed airways. Or it may be caused by a problem with how the brain signals the breathing muscles to work.

  • Problems staying awake, such as narcolepsy.

  • Problems with nighttime behaviors, such as sleepwalking, night terrors, or bed-wetting.

  • Problems sleeping at night (insomnia). This may be caused by conditions such as periodic limb movement disorder, which is an intense urge to move the legs.

Sleep studies can also determine whether you have a problem with your stages of sleep. The two stages of sleep are non-rapid eye movement (NREM) & rapid eye movement (REM). Normally, NREM and REM alternate 4 to 5 times during a night's sleep. A change in this cycle may make it hard for you to sleep soundly.

The most common sleep studies are:

  • Polysomnogram. This test records several body functions during sleep, including brain activity, eye movement, oxygen & carbon dioxide blood levels, heart rate & rhythm, breathing rate & rhythm, the flow of air thru your mouth & nose, snoring, body muscle movements & chest & belly movement.

  • Multiple sleep latency test (MSLT). This test measures how long it takes you to fall asleep. A video camera is used to record movements during sleep.

  • Multiple wake test (MWT). This test measures whether you can stay awake during a time when you're normally awake.

Sleep studies usually are done in a sleep lab. Sleep labs are often located in hospitals.

source: WebMd

I can't sleep....

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision

The most common form of sleep apnea is obstructive sleep apnea (OSA). Although doctors use sleep studies to diagnose both obstructive sleep apnea and central sleep apnea, this Decision Point focuses on obstructive sleep apnea.

Consider the following when making your decision:

  • If you snore but do not have other symptoms of sleep apnea, you may not need a sleep study. Lifestyle changes, such as losing weight (if needed), sleeping on your side, and keeping a regular sleep schedule may reduce your snoring.

  • If you have symptoms of sleep apnea (particularly excessive snoring or daytime sleepiness), your doctor will probably suggest a polysomnography sleep study. Polysomnography is the only sure way to find out whether you have sleep apnea.

  • If you know that you have sleep apnea, you can treat it.

    • If you have mild sleep apnea, or more severe sleep apnea without daytime sleepiness, treatment may or may not reduce your symptoms, complications such as high blood pressure.

    • If you have moderate to severe sleep apnea, treatment generally reduces symptoms of sleep apnea and may reduce your risk of complications.

source: WebMd

I can't sleep....

Why should I have a sleep study?

A sleep study can give you a positive diagnosis of sleep apnea. This is important because if sleep apnea isn't diagnosed and treated, it can interfere with your quality of life. If you have sleep apnea, you may be at risk for excessive daytime sleepiness and complications such as high blood pressure, high blood pressure in the lungs (pulmonary hypertension), depression, irregular heart rhythms, heart failure, coronary artery disease & stroke.

Reasons to have a sleep study
  • You have symptoms of sleep apnea, particularly excessive snoring and daytime sleepiness.

  • A sleep study that is performed in a qualified sleep lab is the only sure way to diagnose sleep apnea.

  • Correct diagnosis leads to early treatment of sleep apnea that can reduce your symptoms and risk for complications such as high blood pressure and irregular heart rhythms.

  • A complete sleep test can rule out other sleep-related problems, such as Narcolepsy or periodic limb movement disorder.

  • No risks are involved in undergoing a sleep study.

Are there other reasons you might want to have a complete sleep study?

Reasons not to have a sleep study
  • You snore but do not have other symptoms of sleep apnea.
  • Treatment of mild sleep apnea may not reduce your symptoms or your risk of complications.
  • You are not comfortable with the treatment options for sleep apnea and may not seek treatment if you are diagnosed with it.
  • Sleep studies are expensive.
  • You are willing to try lifestyle changes (such as weight loss) to reduce your snoring and mild sleep apnea.
  • Sleep study results on older adults are more difficult to interpret than the results of younger people.

Are there other reasons you might not want to have a sleep study?

healthy sleep may mean giving up something....

10 Tips to Get Better Sleep

Set yourself up to get a good night's sleep.
 
By Michael J. Breus, PhD
WebMD Feature
Reviewed by Ann Edmundson, PhD, MD

Want to know how to sleep better? We all have trouble sleeping from time to time. But you can make it easier to get a good night's sleep every night with these simple steps. Here are 10 tips for better sleep:We all have trouble sleeping from time to time. But you can make it easier to get a good night's sleep every night with these simple steps.

  • Cut caffeine. Simply put, caffeine can keep you awake. It can stay in your body longer than you might think -- up to about 14 hours. So if you drink a cup of coffee at noon and are still awake at midnight, caffeine might be the reason. Cutting out caffeine at least four to six hours before bedtime can help you fall asleep easier. If you have already had too much caffeine, try eating some carbohydrates like bread or crackers to help reduce the effects.

  • Avoid alcohol as a sleep aid. Alcohol may initially help you fall asleep, but it also causes disturbances in sleep resulting in less restful sleep.

  • Relax before bedtime. Stress not only makes you miserable, it wreaks havoc on your sleep. Develop some kind of pre-sleep ritual to break the connection between all the day's stress & bedtime. These rituals can be as short as 10 minutes or as long as an hour.

    Some people find relief in making a list of all the stressors of the day, along with a plan to deal with them - this can act as "closure" to the day.

    Combining this with a period of relaxation - perhaps by reading something light, meditating, aromatherapy, light stretching, or taking a hot bath - can also help you get better sleep. And don't look at the clock! That "tick-tock" will just tick you off.

    healthy sleep may mean giving up something....

    • Exercise at the right time for you. Regular exercise can help you get a good night's sleep. The timing & intensity of exercise seems to play a key role in its effects on sleep. If you're the type of person who gets energized or becomes more alert after exercise, it may be best not to exercise in the evening. Regular exercise in the morning even can help relieve insomnia, according to a recent study.

    • Keep your bedroom quiet, dark & comfortable. For many people, even the slightest noise or light can disturb sleep - like the purring of a cat or the light from your laptop or TV. Use earplugs, window blinds or curtains & an electric blanket or air conditioner - everything possible to create an ideal sleep environment. And don't use the overhead light if you need to get up at night; use a small night-light instead. Ideal room temperatures for sleeping are between 68 & 72 degrees Fahrenheit. Temperatures above 75 or below about 54 can disrupt sleep.

    • Eat right, sleep tight. Try not to go to bed hungry, but avoid heavy meals before bedtime. An over-full belly can keep you up. Some foods can help, though. Milk contains tryptophan, which is a sleep-promoting substance. Other foods that help promote sleep include tuna, halibut, pumpkin, artichokes, avocados, almonds, eggs, bok choy, peaches, walnuts, apricots, oats, asparagus, potatoes, buckwheat & bananas.  Also, try not to drink anything after 8 p.m. This can keep you from having to get up to use the bathroom during the night.

    • Restrict nicotine. Having a smoke before bed - although it feels relaxing - actually puts a stimulant into your bloodstream. The effects of nicotine are similar to those of caffeine. Nicotine can keep you up & awaken you at night. It should be avoided particularly near bedtime & if you wake up in the middle of the night.

    • Avoid napping. Napping can only make matters worse if you usually have problems falling asleep. If you do nap, keep it short. A brief 15-20-minute snooze about 8 hours after you get up in the morning can actually be rejuvenating.

    • Keep pets off the bed. Does your pet sleep with you? This, too, may cause you to awaken during the night, either from allergies or pet movements. Fido & Fluffy might be better off on the floor than on your sheets.

    • Avoid watching TV, eating & discussing emotional issues in bed. The bed should be used for sleep & sex only. If not, you can end up associating the bed with distracting activities that could make it difficult for you to fall asleep.

        source: WebMd

      It is not what we take up, but what we give up, that makes us rich.
       
      Henry Ward Beecher

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      sleep disorders...

      Restless Legs Syndrome Sends Nocturnal Blood Pressure Up  By Neil Osterweil, Senior Associate Editor, MedPage Today
      April 10, 2007

      MONTRÉAL, April 10 - Restless legs syndrome may boost nocturnal blood pressure & exacerbate cardiovascular disease risks, particularly among older patients, investigators here suggested.

      Older adults with restless legs syndrome of long duration may be particularly at risk, reported Paola A. Lanfranchi, M.D., M.Sc., of the Hôpital du Sacré Coeur de Montréal & colleagues, in the April 10 issue of Neurology.

      Blood pressure surges related to periodic leg movements during sleep might affect the cardiovascular system of otherwise healthy patients, they wrote, citing several epidemiologic studies between those with restless legs syndrome & cardiovascular disease.

      Although restless legs syndrome has been associated in population-based studies with increased risk for coronary artery disease & hypertension, the mechanisms underlying the increased risk are unknown, the authors wrote.

      They enrolled 4 women & 6 men with the syndrome into a study assessing both heart rate & blood pressure changes associated with periodic leg movements during sleep, with or without EEG signs of arousal.

      The patients, mean age 47.3 + 13.5 years, spent one night in a sleep lab, during which they were monitored with polysomnography & noninvasive beat-to-beat blood pressure monitoring. For each participant, 10 periodic leg movements during sleep with microarousals & 10 periodic leg movements during sleep without microarousals were given cardiovascular analysis.

      Both systolic & diastolic blood pressures were measured within a 25-beat temporal window comprising 10 beats before the onset of each movement & 15 beats afterward.

      Blood pressure changes related to periodic leg movements during sleep were with repeated measure using one-way analysis of variance.

      Blood pressure changes associated with periodic leg movements during sleep with & without microarousals were compared by paired t-tests & the authors used Pearson correlation coefficients to assess the relationship between cardiovascular changes & clinical & polysomnographic variables.

      They found that blood pressure increased significantly in association with all periodic leg movements during sleep, with an average increase in systolic of 22 mm Hg, and increase in diastolic of 11 mm Hg.

      Changes in blood pressure during periodic leg movements during sleep were significantly greater when they were also associated with microarousals than when there were no microarousals (P<0.05).

      Leg movement without microarousals were significantly associated with one tachycardia, and one bradycardia, and leg movements with microarousals were associated with one tachycardia but no bradycardia.

      The authors also found that both the systolic and diastolic changes associated with periodic leg movements during sleep increased with the age of the participant and with the duration of restless legs syndrome.

      "Our results show a significant increase in systolic blood pressure and diastolic blood pressure in association with periodic leg movements during sleep without conventionally defined microarousals," they wrote. "However, the magnitude of blood pressure changes was greater when periodic leg movements during sleep were associated with microarousals and increased with duration of microarousals while appearing independent of periodic leg movements during sleep characteristics. This implies that the intensity of cardiovascular response might be related to the degree of central activation and less to the somatomotor response."

      They noted that there is a repetitive increase in cardiac afterload with periodic leg movements during sleep that could further affect cardiac function and contribute to disease progression in heart transplant recipients and patients with systolic heart failure.

      The investigators acknowledged that the study was limited by the small sample size, which limits the power or correlation analyses. They also noted that the patients in the study had untreated restless legs syndrome and periodic leg movements during sleep.

      source

      What is sleep apnea?

      Sleep apnea occurs when you regularly stop breathing for 10 seconds or longer during sleep. It can be mild, moderate, or severe, depending on the number of times per hour you stop breathing (apnea) or breathe very slowly (hypopnea). Apnea episodes may occur from 5 to 50 times an hour.

      What causes obstructive sleep apnea?

      A blockage or narrowing of the airways in your nose, mouth, or throat generally causes obstructive sleep apnea (OSA). This usually occurs when the throat muscles & tongue relax during sleep & partially block the airway.

      Sleep apnea can also occur if you have bone deformities or enlarged tissues in your nose, mouth, or throat. For example, you may have enlarged tonsils. During the day when you're awake & standing up, this may not cause problems. However, when you lie down at night, the tonsils can press down on your airway, narrowing it & causing sleep apnea.

      Other factors that make sleep apnea more likely include using certain medicines or alcohol before bed, sleeping on your back & being obese.

      source: WebMd

      Snoring

      This topic discusses simple snoring. If you stop breathing, choke, or gasp during sleep, you may have a potentially serious condition called sleep apnea. For more information, see the topic Sleep Apnea.

      What is snoring?

      Snoring occurs when the flow of air from the mouth or nose to the lungs is disturbed during sleep, usually by a blockage or narrowing in the nose, mouth, or throat (airway). This causes the tissues of the airway to vibrate and knock against the back of the throat, resulting in a noise that can be soft, loud, raspy, harsh, hoarse, or fluttering.

      You may not know that you snore. Your bed partner may notice the snoring and that you sleep with your mouth open. If snoring interferes with your or your bed partner's sleep, either or both of you may feel tired during the day.

      In the past, snoring was often considered no more than a nuisance that kept a bed partner awake at night. However, snoring may progress to upper respiratory resistance syndrome and obstructive sleep apnea, a potentially serious sleep disorder in which you periodically stop breathing during sleep. Because of this, it is important to see your health professional if you routinely snore.

      Snoring is common. About 25% to 50% of men and about 25% to 30% of women snore on a regular basis.1

      What causes snoring?

      You snore when the flow of air from your mouth or nose to your lungs makes the tissues of the airway vibrate. This usually is caused by a blockage (obstruction) or narrowing in the nose, mouth, or throat (airway).

      When you inhale during sleep, air enters the mouth or nose and passes across the soft palate (the back of the roof of the mouth) on its way to the lungs. The back of the mouth-where the tongue and upper throat meet the soft palate and uvula-is collapsible. If this area collapses enough, the airway becomes narrow or blocked. The narrowed or blocked passage disturbs the airflow, which causes the soft palate and uvula to vibrate and knock against the back of the throat, causing snoring. The tonsils and adenoids may also vibrate. The narrower the airway is, the more the tissue vibrates, and the louder the snoring is.

      See illustrations of the tonsils, adenoids, and uvula and the soft palate.

      How is it treated?

      You may be able to treat snoring through lifestyle modifications such as losing weight (if necessary), quitting smoking, changing sleep habits (such as sleeping on your side instead of your back), and avoiding the use of alcohol and sedatives before bed. If nasal congestion is disturbing airflow, nasal dilators (such as nasal strips), decongestants, or nasal corticosteroid sprays may be used. Oral breathing devices, which push the tongue and jaw forward to improve airflow, may also be an option. If these treatments do not work, continuous positive airway pressure (CPAP) or surgery may be tried.

      Snoring is not always considered a medical problem, so insurance may not cover treatment.

      source: WebMd

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