Remember the Time Change This Sunday!

Millions of Americans will roll their clocks back one hour this weekend for the return to Standard Time. But as clocks move back and we wake on Sunday morning, after “gaining” an extra hour of the day, will Americans use that extra hour to catch up on their sleep? Probably not. According to the National Sleep Foundation’s 2009 Sleep in America™ poll, two out of every ten Americans sleep less than six hours a night. Even with an extra hour, that’s less than necessary for a full night’s rest. The National Sleep Foundation recommends the following tips to help ease the adjustment to standard time:

* Maintain your regular bedtime Saturday night, when clocks move back, and awaken at your regular time on Sunday morning. This can give you an “extra” hour of sleep the next morning and help reduce your sleep debt;
* Block out light and keep your sleeping area dark. Standard time causes the sun to rise about an hour earlier. This can impact sleep, especially for people accustomed to awakening before or around sunrise. The light itself can disturb sleep, so it is always best to sleep in a darkened room;
* Increase the light when you wake up. Light has an alerting affect that may help you wake up. It will also help adjust your biological clock to the “new” sleep schedule;
* Difficulty adjusting to the time change? Staying awake at night or sleeping until your desired wake-up time may be helped by gradually moving bedtime and awakening later by 15 minutes every one to two days.

Somebody’s in Denial

A recent visitor to our blog came here after doing an internet search for “you can’t die from sleep apnea.”

WRONG!

38,000 Americans die from complications of sleep apnea every year.  For those who think you can’t, I have two words:  Reggie White.

I also recently saw someone on Twitter who said “Sleep is for the weak.”

WRONG!

If you don’t get sufficient sleep, your body builds a “sleep debt” and can actually enter a pre-diabetic state.  So if you’re one of those who think sleep is for the weak, please enjoy your shortened, sleep-deprived life.

Steve Gardner

New CPAP2GO Store to Open in West Allis, Wis.

The Sleep Wellness Institute, Inc., will open its third CPAP2GO store  on Thursday, Oct. 1, in West Allis.  CPAP2GO specializes in continuous positive airway pressure (CPAP) machines, masks and supplies used to help many people with obstructive sleep apnea.  The CPAP2GO stores are the only retail CPAP stores in Wisconsin operated by a sleep disorders center.  The first store opened in Franklin last year, and a Waukesha location opened in April.

The newest store, at 2931 S. 108^th Street, will be open Monday through Saturday, with evening hours Monday through Friday.  It will be staffed by specially trained employees and will feature the “30/30 Advantage” – an in-stock supply of more than 30 masks and a free 30-night comfort and fit guarantee.  Much of the equipment will be covered by most health insurance plans.

The store will be managed by Cody Glorioso, who is the director of the Sleep Wellness Institute’s durable medical equipment department.  The store’s telephone number will be 414-761-CPAP (2727). A website, www.cpap2go.net, provides more information for customers.

The Sleep Wellness Institute is Wisconsin’s largest independent sleep disorders laboratory.  It is fully accredited to diagnose and treat sleep disorders among adults and children by the American Academy of Sleep Medicine.

We’re Convinced! Billy Mays Died of Sleep Apnea

Billy Mays may have used cocaine and pain killers, but I guarantee you that he died of sleep apnea. If you want to confirm this find out what the time of death was. People who die in their sleep during the latter half of the night (4 to 6 am) typically die of sleep apnea (other notables, Reggie White, John Candy and Divine (from John Waters fame)).

Sleep apnea is a condition marked by snoring. Snoring is caused when the tissue in a person’s neck area begins to collapse around their airway and the tissue in the upper airway begins to flap. To picture this, did you ever blow up a balloon and partially pinch the end of it while letting out the air? It makes a sound similar to snoring. This is the first sign that a person may have sleep apnea. If a person snores, there may be likelihood that they are experiencing pauses in their breathing due to their airway collapsing. This is apnea. To picture this, did you ever drink a thick shake and the straw kept collapsing? The same thing happens when someone experiences sleep apnea. The tissue around their neck (the shake) collapses around their airway (the straw) when they try to inhale during sleep. When the airway collapses, air does not get in, when air doesn’t get in oxygen doesn’t get in. Oxygen levels in the body will decrease and the heart slows down sending a signal to the brain to arouse the body out of sleep (or in a lighter stage of sleep) to open up the airway and begin breathing. This is equivalent to getting poked in the shoulder. This process repeats itself over and over again throughout the night. We have patients who literally stop breathing up to 100 times an hour. Imagine getting poked in the shoulder 100 times an hour 7 nights a week 365 nights a year. No matter how long you sleep, you are forever tired throughout the day.

Combine the prospect of sleep apnea with REM (Rapid Eye Movement) sleep and you have the perfect recipe for dying in your sleep. When we sleep we go into different stages of sleep,  some light some deep, and then there is the stage of sleep where we dream, REM sleep. REM sleep occurs in 90 minute cycles. Each night a person will go through 4 to 5 REM cycles. Each cycle will be longer than the last. The first REM period is typically 5 to 15 minutes with last cycle lasting 30 to 45 minutes. It is during this last REM cycle where the complications from sleep apnea can become deadly. During REM sleep the muscle tone in our bodies in our body drops off. (Some say this is an evolutionary process to keep us from acting out our dreams.) When the muscle tone drops off the airway becomes more compromised making it harder for the brain to arouse the body out of an apnea event. Typical 15 to 20 second pauses in breathing now become 30, 40, 60 second events. (I have seen as long as 1min 45 sec.). As a result of these longer events, oxygen levels can decrease to 60% (on a 100% scale) while the heart rate significantly decreases. The good new is that the brain will typically arouse the person out of sleep pulling them back from the brink of death every night. The ones that aren’t so fortunate typically experience an irregular heartbeat; if the brain does not catch it in time it will lead to a heart attack while they sleep.

Billy Mays had the perfect body type of a person who suffers from sleep apnea, short neck, big shoulders and extra weight around the midsection. If you combine sleep apnea with his hectic schedule you might understand his need for something to keep him going. Because of his celebrity he probably had access to remedies that the general population would not have. Further evidence is that he had untreated hypertension and an enlarged heart. These are byproducts of living with sleep apnea year after year. The constant variability in a person’s heart rate due to sleep apnea is a main factor contributing to this.

Sleep apnea is easily treated by using a device called CPAP.  CPAP is an acronym for Continuous Positive Airway Pressure. The device is about the size of a toaster which is connected to a hose which attaches to a nasal mask. The machine delivers positive pressure that fights against the negative pressure that sucks in the airway. It is a wonderful device that helps people who have lived in a sleep deprived haze for 5 to 10 years and literally changes their lives around over night.

Sleep apnea affects approximately 18 million Americans (as many as diabetes) while only 2 to 3 million are diagnosed and treated. People treated for sleep apnea will also see their high blood pressure improve. Diabetics have seen better management in their blood glucose levels. I have also seen it save marriages, improve productivity and rescue people out of depression.

In conclusion, if you find out Billy Mays died in the early morning hours and he snored, I will guarantee you he met the same fate as those people I mentioned in the beginning of this post.

Mark Stoiber, President

The Sleep Wellness Institute

Sign Up Now for Reggie White Sleep Disorders Foundation Golf Outing

If you love golf and you’re in the southern Wisconsin/northern Illinois area, you don’t want to miss the 3rd Annual Reggie White Sleep Disorders Foundation Golf Outing and Charity Auction on Sept. 22.

This great event will be held at the Hawks View Golf Club in Lake Geneva, WI, a five-star rated championship course that is meticulously maintained and offers a great day for golfers of all talent levels.

The cost is $700 per foursome, which includes use of the driving range, cart, 18 holes of golf, attendance at a free trick shot and long drive exhibition by former Green Bay Packer Bill Schroeder, lunch, hors d’ouevres, and an outstanding dinner.  And each foursome will be matched with a sports or local media celebrity for the day.

All proceeds from the event will benefit the Foundation’s Mission of providing diagnosis and treatment to sleep disorders sufferers whose socio-economic situation makes it impossible for them to access care otherwise.

For more information and registration, visit the event section of the Foundation’s website.

Did Billy Mays have Sleep Apnea?

Out of all the news about famed TV pitchman Billy Mays’ death, one point hasn’t been revealed.  While we know that he died in his sleep, we don’t know when.  If he died somewhere between 3:00 and 4:00 in the morning, one has to wonder if he didn’t die in much the way that former football legend Reggie White did … complications of sleep apnea.  If he did, then it would be entirely consistent with what we’ve heard so far about heart problems.

So many people who die in their sleep of heart problems also have sleep apnea.  That is one reason why it is so important that people who snore at night and are exhausted during the day have a full evaluation by a sleep specialist.  38,000 Americans die every year from complications of sleep apnea.  It doesn’t need to be that way.

Steve Gardner

The Sleep Wellness Institute

Online Sleep Apnea Screen Available

The Sleep Wellness Institute, Wisconsin’s largest independent sleep disorders laboratory, now offers a free, online service that allows web users to determine if they are at risk for obstructive sleep apnea.

The screening service is a combination of the Epworth Sleepiness Scale, Berlin sleep apnea questionnaire, and a body mass (BMI) calculator.  The Epworth helps determine a person’s daytime sleepiness level, while the Berlin is focused on behaviors that are typical of sleep apnea.  The BMI calculator is based on height and weight … a BMI of 30 or greater is considered one of the risk factors for sleep apnea.

The interactive screening tool can be found on the Sleep Wellness Institute’s website on the home page.

Sleep apnea is a common, yet serious sleep disorder that can lead to or exacerbate other health problems such as cardiovascular disease, stroke, diabetes and more.  It affects approximately 18 million Americans and is typified by snoring, pauses in breathing during sleep, and daytime exhaustion.

Steve Gardner

Preliminary Results Show Treatment of Sleep Apnea Can Lower Healthcare Costs

Over the last two years, the Sleep Wellness Institute has partnered with Kleen Test Products (KTP) to study the effect of screening, testing and treatment of Obstructive Sleep Apnea (OSA) on a volunteer segment of their employee population. Through numerous benefits programs, Kleen Test rewards employees for healthy lifestyles and offers many programs to improve the well-being of all who work for them. This study offered a unique opportunity to learn about OSA, provide treatment to those employees affected and determine if OSA increased employee/employer healthcare costs.

KTP has a workforce of 585 employees. Our original recruitment target was to get sixty volunteer employees to come forward – with 20 in each group. After recruitment we were able to start with 65 employees (representing 11% of the company’s workforce.)
To cost-effectively determine which employees had OSA, we initially used an at-home portable ApneaLink screening device for one night. Those employees who showed potential OSA from the results of the ApneaLink screening were given an overnight sleep study. The results of each sleep study were interpreted by a board certified sleep physician to confirm if the employee had OSA. The results of the sleep studies demonstrated that 33 of the KTP employees showed no evidence of OSA, 27 showed evidence of OSA, and 5 subjects withdrew from the project.

We are still in the process of collecting data regarding healthcare usage during the 12 months each employee was in the study. Our targeted completion date is October 8, 2009. Once all data have been collected we will be able to make assertions and findings that are statistically significant. However, of the 65 employee volunteers there are 11 employees diagnosed with OSA using their CPAP devices for 4 or more hours per night, preliminary data shows a trend of reduction in healthcare spending. (To date, the reduction in spending in this group of employees is down from an average of approximately $3,900 per employee to $205 per employee.) The premise of the trial does appear to be valid – patients suffering from Obstructive Sleep Apnea use more healthcare than non-OSA sufferers. During the next year, we will continue to collect compliance and healthcare spending data to determine what effects CPAP set-up and screening have on healthcare costs of OSA patients.

Luke Goodpaster
Director of Research

Tips to Help You Fall Asleep … and Stay Asleep

People often ask us what we  recommend to help them fall asleep.  Here are some tips that will help you develop habits that can help you to fall asleep and stay asleep.

• Ensure adequate exposure to natural light during the day.
• Exercise in the morning or late afternoon can promote good sleep.
• Stay away from large meals close to bedtime.
• Avoid stimulants such as caffeine, nicotine, and alcohol 4 hours before bedtime.
• Avoid using electronic devices (computers, cell phone texting, video games) 1 hour before bed.
• Keep a notepad and pencil by your bed to write down any thoughts that may wake you up at night.
• Turn your alarm clock around so it’s not facing you; do not look at the clock during the night as this can cause more stress and anxiety about your sleep.
• If you wake up during the night and can’t fall back asleep, get out of bed (do NOT use the computer).  Go back to bed only when you feel sleepy again.
• Associate your bed with sleep.  It’s not a good idea to use your bed to watch TV, listen to the radio or read.
• Make sure your sleep environment is pleasant and relaxing.  The bed should be comfortable and the room should not be too hot or cold, or too bright.
• Establish set times for waking and sleeping.

Mark Stoiber, President

The Sleep Wellness Institute

Does Snoring Mean I have Sleep Apnea?

A question we are often asked is “I snore, so do I have sleep apnea?”

Loud snoring is certainly one of the signs of sleep apnea.  But an important point is that while all people who have sleep apnea snore, not all people who snore have sleep apnea.

Other symptoms of sleep apnea, in addition to snoring, include pauses in breathing during sleep, gasping and choking, and can include frequent overnight urination, morning sore throat, and morning headaches.  Equally important is how you feel during the day.  If you snore at night and feel exhausted during the day, then you might have sleep apnea.

The Epworth Sleepiness Scale is very helpful in determining if you need to see your doctor or a sleep specialist.  Basically, you should read the following questions and answer 0, 1, 2, or 3.  0 means that there is NEVER a chance in dozing during this situation.  1 = a SLIGHT chance of dozing; 2=a MODERATE chance of dozing; and 3=a HIGH chance of dozing.

The questions are:

• Do you doze off while sitting and reading?

• While watching television?

• Sitting in a public place, i.e., a theater or meeting?

• As a passenger in a car for an hour without a break?

• Lying down to rest in the afternoon?

• Sitting and talking to someone?

• Sitting quietly after lunch (without alcohol)?

• In a car while stopped in traffic?

Total your scores for each question.  If your total score is:

0-7: you have a normal amount of sleepiness

8-9: you have an average amount of sleepiness

10-15:  you may be excessively sleepy depending on the situation and you may want to seek medical attention

16-up:  you are excessively sleepy and should seek medical attention

This simple test can be helpful in determining if you need to seek help.  If you score in the upper ranges, print a copy of the test and take it with you to your doctor.

Steve Gardner

The Sleep Wellness Institute