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Sleep apnea may hold hidden dangers for women

November 5th, 2013 Raquel Rothe

A new study on sleep apnea reveals there could be some hidden dangers – particularly for women who have the condition – where breathing is interrupted during sleep. Women with sleep apnea may appear healthy, but they have subtle symptoms so their sleep problem is often misdiagnosed.

Now, new research, led by the University of California Los Angeles (UCLA) School of Nursing, shows that the body’s autonomic responses, which normally control blood pressure, heart rate, sweating and other basic functions, are not as strong in people with obstructive sleep apnea, and even less so in women.

Obstructive sleep apnea is a serious condition that happens when the person is asleep, sometimes hundreds of times a night. When it occurs, blood oxygen drops and eventually damages many cells of the body.

There are over 20 million adult Americans living with the condition, note the researchers, who explain that it is linked with several serious health problems and also early death.

Women are much less likely to be diagnosed with obstructive sleep apnea than men.

Lead researcher Dr. Paul Macey says:

“We now know that sleep apnea is a precursor to bigger health issues. And for women in particular, the results could be deadly.”

Early detection and intervention needed

Dr. Macey and his colleagues describe their work in a recent online issue of PLOS ONE.

For their study, the team recruited 94 adult men and women, comprising 37 newly diagnosed, untreated obstructive sleep (OSA) patients and 57 healthy volunteers to act as controls.

The three groups had their heart rates measured as they went through three different physical challenges:

  • The Valsalva maneuver – where they had to breathe out hard while keeping the mouth closed
  • A hand-grip challenge – where they had to just squeeze hard with one hand
  • A cold pressor challenge – where the right foot is inserted into near-freezing water for a minute.

The team notes the main results:

“Heart rate responses showed lower amplitude, delayed onset and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in females.”

Dr. Macey adds:

“This may mean that women are more likely to develop symptoms of heart disease, as well as other consequences of poor adaptation to daily physical tasks. Early detection and treatment may be needed to protect against damage to the brain and other organs.”

The team now intends to investigate if the usual treatments for OSA, such as continuous positive airway pressure (CPAP), help to improve the autonomic responses.

CPAP is where a machine helps the OSA patient breathe more easily while asleep.

Funds from the National Institutes of Health and the National Institute of Nursing Research helped finance the study.

In another study published recently, researchers from Brigham and Women’s Hospital in Boston, MA, found that sleep apnea is linked to early sign of heart failure.

Written by Catharine Paddock PhD

Maxillomandibular Advancement Surgery

May 15th, 2013 Raquel Rothe

21 Easy Tweaks for the New Year

January 3rd, 2012 Raquel Rothe

Take Time for Your Fitness and Health

January 14th, 2011 Raquel Rothe



Whether you work in the hospital or home care, you and I know how to scavenge for food. We learned it during our student clinical rotations. By the time we graduated, we were experts in respiratory therapy and feeding ourselves. 

There is the ubiquitous break room birthday cake, vendor-supplied lunches, and even hospital food looks pretty good when you are working long hours and rotating shifts. These calories add up, putting us at high risk for declining fitness. If you do not take time for proper diet and exercise, you could wind up in a hospital bed suffering from similar ailments to those you treat every day. Weight control and exercise are excellent low cost methods of preventative medicine. They can help reduce the risk of heart disease, stroke, diabetes, hypertension, and a variety of sleep disorders. 

A good diet is easier than it seems. Count your caloric intake, and measure it against your daily caloric burn. It only takes a deficit of 3,500 calories per week to lose one pound per week. Once you have cut out chips, candy, ice cream, and fast food, you will find you feel better. Of course, you also will find excuses to skip the run and grab a burger through the drive-thru window. But, remember, everything comes with a price.

A patient recently said to me, “I am here for a good time, not a long time.” He is getting his wish. He is 48-years-old, has had both hips replaced, smokes, drinks excessively, is obese, has obstructive sleep apnea, high blood pressure, and the list goes on. I expect he will get his wish – he will mostly likely be here a short time. He has been a hospital patient more times than I can recall. Where is the fun in that? 

Making time to exercise should be paramount on your list of daily living activities. I travel every week, which means I must plan my triathlete training in advance. There is a YMCA at nearly all my destinations. If not, I pay a daily fee for a health club that has a pool so I can swim. Running is easier; it is always available and cheap. Cycling is more demanding. If I’m traveling by car, I bring a bike. Beforehand, I search Map My Ride for courses other cyclists have downloaded. I call the local bike shop to see if they have a scheduled ride from the shop while I am in town.

Over the years, I have created a network of friends across the globe with whom I train. Seek a physician in your hospital who is extremely fit as a mentor who can help you choose a fitness program that appeals to you. Oftentimes, this physician knows more about sports medicine and fitness than his medical specialty suggests. Of course, do not bypass your own physician who can monitor your exercise regimen and help you set goals.

At your hospital, start your own fitness group. You will have support, and it will promote espirit de corps. In Tennessee, we had pulmonary rehab patients who were very weak, and two of them set a goal of a 5K run. They reached their goal; granted they did not cross the finish line first, but they did cross the finish line.Take time for your fitness and health. You deserve it.

David Lain, PhD, JD, FCCP, RRT, RCP, is chief clinical officer for Oridion Capnography Inc. He is a three-time Ironman finisher and member of the 2007 USA Long Distance Duathlon World Championship Team.



Sleep Well-The Heart of the Matter

November 24th, 2010 Raquel Rothe

WebMD Expert Blogs
Sleep Well
with Michael Breus, PhD, ABSM
Sleep disorders include a range of problems — from insomnia to narcolepsy — and affect millions of Americans. Dr. Michael Breus shares information and advice on sleep disorder and insomnia treatments and causes.
Tuesday, October 12, 2010
The Heart of the Sleep Matter
I know I’m not the first to tell you about the benefits of exercise. I also know I’m not the first to tell you that exercise can do a body good from both an emotional and physical standpoint.
But I might be the first to tell you that exercise, and specifically the aerobic kind that gets your heart rate up for an extended period of time, can improve your sleep. If you’re in insomniac, listen up: a new study from Northwestern Medicine that will be published in the journal Sleep Medicine showed serious promise to the benefits of exercise on people diagnosed with insomnia.
Millions of Americans suffer from symptoms of chronic insomnia, including difficulty falling sleep and/or staying asleep, and impaired daytime functioning. Insomnia also tends to strike more severely during middle age and in older adults. Women have the highest prevalence of insomnia. Many of these people resort to prescription drugs and sleep aids to help achieve a better night’s sleep. But drugs are not always a solution over the long term, and there’s no substitute for exercise, which has benefits that go far beyond restful sleep.
The highlights from the study:
Twenty-three sedentary adults, primarily women, 55 and older with insomnia were divided into two groups: one that would commence an exercise program and another that would engage in less physically demanding activities. Both groups received education about good sleep hygiene, which includes sleeping in a cool, dark and quiet room, going to bed the same time every night, and not staying in bed too long if you can’t fall asleep.
The aerobic physical activity group exercised for two 20-minute sessions four times per week, or one 30-to-40-minute session four times per week, both for a total of 16 weeks. Participants worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill.
Participants in the non-physical activity group participated in recreational or educational activities, such as a cooking class or a museum lecture, which met for about 45 minutes three to five times per week for 16 weeks.
The results: The people in the exercise group fared far better than the non-exercise group when it came to their sleep. Exercise not only improved their sleep quality — elevating them from being a “poor sleeper” to a “good sleeper” but they also reported feeling better. Their moods improved, and had more vitality and less daytime sleepiness.
I’ve long been an advocate for getting plenty of physical activity into your life to promote restful sleep. This study may have been among the first to examine the benefits of maintaining an aerobic regimen among insomniac women, but it certainly wasn’t the first to discover the profound role exercise has on supporting high-quality sleep.
Not everyone experiences the same sleep benefits from exercise, but people who suffer from insomnia aren’t usually the athletes and highly active individuals. (The only instance I’ve seen is where athletes over-train and for some reason have a hard time turning their mind off at night, or they are so used to exercising that on their “off days,” their body craves that exercise to help with sleep.) To the contrary, most people who complain of sleep problems lead sedentary lives and don’t practice a regular exercise routine.
Aerobic exercise has shown to aid sleep primarily by doing two things: 1) helping you fall asleep quicker; and 2) plunging you into deep (or delta) sleep for a longer period of time, which is where you need to be to feel refreshed and restored the next day. Other studies on people who participate in aerobic activities show that they have a tendency to secrete more growth hormone at night, which aids in repairing and rejuvenating the body. And let’s not forget the stress component to exercise: getting active tends to help us lower our stress levels, which allows up to calm down enough to welcome sleep!
One current reasoning behind exercise’s effects on sleep centers of the brain is the thermogenic hypothesis, which states that exercise promotes sleep by heating the body or brain. When you work out (it has to be an aerobic workout for at least 20 to 30 minutes), your body’s core temperature rises a couple of degrees (about two degrees Farenheit) and stays that way for about four to five hours. When it cools back down, your core temperature will decrease to a point lower than had you not worked out at all. And it’s this drop in body temperature that is theorized to promote falling asleep and gaining the deep, sound sleep your body needs.
Exercise your body to rest your body. It’s as simple as that.
Sweet Dreams,
Michael J. Breus, PhD
The Sleep Doctor™

The 10 Things You Should Hate About The Loss of Sleep

September 20th, 2010 admin

Did you know that the lack of sleep can make you grumpy and foggy? You may not realize what it can do to your life, memory, sex, looks and even the ability to loss weight, these are all serious-and surprising effect of sleep loss.
Sleepiness Causes Accidents-Some of the biggest disasters in recent history were caused by sleep deprivation: the 1979 nuclear accident at Three Mile Island, the massive/destructive Exxon Valdez oil spill, the 1986 nuclear meltdown at Chernobyl are just a few. Sleep loss is a big public safety hazard every day on the roads we travel. Drowsiness can slow reaction time as much as driving drunk; many studies have proven this and the National Highway Traffic Safety Administration estimates that fatigue is a cause in 100,000 auto crashes with 1,500 crash-related deaths a year in the U.S.
The loss of sleep dumbs you down-Sleep plays a critical role in thinking and learning. Lack of sleep hurts these cognitive processes in many ways. First, it impairs attention, alertness, concentration, reasoning, and problem solving so this makes it more difficult to learn efficiently. Secondly during the night, various sleep cycles play a role in “consolidating” memories in the mind. If you don’t get enough sleep, you won’t be able to remember what you learned and experienced during the day.
Serious health problems can lead to sleep deprivation-Sleep disorders and chronic sleep loss can put you at risk for:
Heart disease
Heart attack
Heart failure
Irregular heartbeat
High blood pressure
According to some estimates, 90% of people with insomnia — a sleep disorder characterized by trouble falling and staying asleep — also have another health condition.

4. Lack of Sleep Kills Sex Drive-Sleep specialists say that sleep-deprived men and women report lower and libidos less interest in sex. Depleted energy, sleepiness, and increased tension may be largely to blame. For men with sleep apnea, a respiratory problem that interrupts sleep, there may be another factor in the sexual slump. A study published in the Journal of Clinical Endocrinology & Metabolism in 2002 suggests that many men with sleep apnea also have low testosterone levels. In the study, nearly half of the men who suffered from severe sleep apnea also secreted abnormally low levels of testosterone during the night.

5. Sleepiness Is Depressing-In a 1997 study by researchers at the University of Pennsylvania, people who slept less than five hours a night for seven nights felt stressed, angry, sad, and mentally exhausted. Over time, lack of sleep and sleep disorders can contribute to the symptoms of depression. The most common sleep disorder, insomnia, has the strongest link to depression. In a 2007 study of 10,000 people, those with insomnia were five times as likely to develop depression as those without. In fact, insomnia is often one of the first symptoms of depression. Insomnia and depression feed on each other. Sleep loss often aggravates the symptoms of depression, and depression can make it more difficult to fall asleep. On the positive side, treating sleep problems can help depression and its symptoms, and vice versa.

6. Lack of Sleep Ages Your Skin-Most people have experienced sallow skin and puffy eyes after a few nights of missed sleep. But it turns out that chronic sleep loss can lead to lackluster skin, fine lines, and dark circles under the eyes. When you don’t get enough sleep, your body releases more of the stress hormone cortisol. In excess amounts, cortisol can break down skin collagen, the protein that keeps skin smooth and elastic. Sleep loss also causes the body to release too little human growth hormone. When we’re young, human growth hormone promotes growth. As we age, it helps increase muscle mass, thicken skin, and strengthen bones. “It’s during deep sleep — what we call slow-wave sleep — that growth hormone is released,” says Phil Gehrman, PhD, CBSM, assistant professor of psychiatry and clinical director of the Behavioral Sleep Medicine program at the University of Pennsylvania in Philadelphia. “It seems to be part of normal tissue repair — patching the wear and tear of the day.”

7. Forgetful? Sleepiness Makes You this way-If you are trying to keep your memory sharp? Try getting plenty of sleep. In 2009, American and French researchers determined that brain events called “sharp wave ripples” are responsible for consolidating memory. The ripples also transfer learned information from the hippocampus to the neocortex of the brain, where long-term memories are stored. Sharp wave ripples occur mostly during the deepest levels of sleep.

8. Losing Sleep Can Make You Gain Weight-When it comes to body weight, it may be that if you snooze, you lose. Lack of sleep seems to be related to an increase in hunger and appetite, and possibly to obesity. According to a 2004 study, people who sleep less than six hours a day were almost 30 percent more likely to become obese than those who slept seven to nine hours. Recent research has focused on the link between sleep and the peptides that regulate appetite. “Ghrelin stimulates hunger and leptin signals satiety to the brain and suppresses appetite,” says Siebern. “Shortened sleep time is associated with decreases in leptin and elevations in ghrelin.” Not only does sleep loss appear to stimulate appetite. It also stimulates cravings for high-fat, high-carbohydrate foods. Ongoing studies are considering whether adequate sleep should be a standard part of weight loss program. So if we are gaining sleep, we should be losing weight.

9. Lack of Sleep May Increase Risk of Death-In the “Whitehall II Study,” British researchers looked at how sleep patterns affected the mortality of more than 10,000 British civil servants over two decades. The results, published in 2007, showed that those who had cut their sleep from seven to five hours or fewer a night nearly doubled their risk of death from all causes. In particular, lack of sleep doubled the risk of death from cardiovascular disease.

10. Sleep Loss Impairs Judgment, Especially About Sleep! Lack of sleep can affect our interpretation of events. This hurts our ability to make sound judgments because we may not assess situations accurately and act on them wisely. Sleep-deprived people seem to be especially prone to poor judgment when it comes to assessing what lack of sleep is doing to them. In our increasingly fast-paced world, functioning on less sleep has become a kind of badge of honor. But sleep specialists say if you think you’re doing fine on less sleep, you’re probably wrong. And if you work in a profession where it’s important to be able to judge your level of functioning, this can be a big problem. “Studies show that over time, people who are getting six hours of sleep, instead of seven or eight, begin to feel that they’ve adapted to that sleep deprivation — they’ve gotten used to it,” Gehrman says. “But if you look at how they actually do on tests of mental alertness and performance, they continue to go downhill. So there’s a point in sleep deprivation when we lose touch with how impaired we are.”

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What is obstructive sleep apnea?

September 12th, 2010 Raquel Rothe

So you never have energy and you are tired most days…..you may have obstructive sleep apnea (OSA).

OSA is a serious, potentially life-threatening disorder that occurs during sleep, and that may lead to life-threatening conditions. The upper airway repeatedly collapses, causing cessation of breathing (apnea-air flow is blocked) or inadequate breathing (hypopnea) and sleep fragmentation. The sleep fragmentation results in chronic daytime sleepiness.


Are you sleepy during the day?
Do you have disruptive snoring at night?
Do you have pauses in breathing during the night?
Do you have pauses in breathing during the night?
Do you wake yourself up choking or gasping?
Large neck (less than 17″-men, less than 16″-women)
Restless sleep
Diagnosis: If you have these signs and symptoms, they could be indicative of sleep apnea. Report these signs and symptoms to your healthcare professional as you may need to undergo a diagnostic sleep study. This test is painless and provides information about how a patient breathes during sleep. The data that is collected will enable the physician to determine the type and severity of sleep apnea, along with your treatment options.

Potential Consequences if OSA is left untreated: Now you know you have sleep apnea but not sure you want it treated? “I think I will be fine without wearing that mask. I’ve slept this way most of my life”.
Decreased quality of life
OSA patients, prior to diagnosis and treatment, consume 2 1/2 times more health care resources that patients without OSA
Hypertension (high blood pressure)
Cardiac arrhythmias (irregularities in heart rate/rhythm)
Heart Attack
Increased risk of motor vehicle and work-related accidents due to sleepiness
Interventions could include Positive Airway Pressure (PAP) therapy, surgery, body position modification, oral appliances, lifestyle changes such as weight loss (if needed), good sleep hygiene, and avoidance of alcohol, sedatives and hypnotics. Your health depends on your intervention to improve your quality of life. At Sleep EZ, we provide a home-like environment that is relaxing so if you need to undergo diagnostic testing for sleep apnea your experience is more comfortable. Remember, it’s your insurance, it’s your choice where to be tested. Sleep EZ “Diagnostic excellence in a serene setting”

Women and Sleep

June 1st, 2010 admin

Yes ladies we ALL have sleep issues at one time or another, typically this is due to our hormone changes during the span of our lifetime. Wow, what a span we have! What symptoms, sign or diseases should prompt a woman tor her doctor to consider that she might need to have a sleep evaluation? Women may experience daytime fatigue, lack of energy or excessive sleepiness despite getting an adequate amount of sleep (usually 7-8 hours) at night. They may notice headaches when they first awaken. Their bed partner may report that they have heavy snoring, or that they have breathing pauses during their sleep and make choking sounds sometimes with these. Women themselves may notice that they have frequent unexplained awakenings at night, awaken frequently to urinate, or sometimes awaken from sleep at night feeling as if they are gasping or choking. These things should be addressed with a healthcare professional.

We also know that women’s risk for sleep apnea increases as they transition through menopause, so that post menopausal women are up to three times more likely to have OSA (obstructive sleep apnea) compared to premenopausal women. Also women who are overweight or obese are at greater risk for having sleep apnea. Women (or men) who have blood pressure that is difficult to control despite taking medication and have some of these symptoms may also wish to be evaluated for sleep apnea, as diagnosis and treatment of OSA can help with blood pressure for control.

Common complaints by women are difficulty maintaining sleep, un-refreshing sleep, chronic fatigue, lack of energy, snoring, frequent nighttime urination, awakening gasping, daytime sleepiness, awakening with a headache, or edema (swelling) of the feet. The “classic” symptoms are snoring, witnessed apneas (pauses in breathing), and daytime sleepiness, but women may not experience these things. Weight gain, depression, waking up gasping for breath, hypertension, and dry mouth in the morning may be tip-offs for women that may need a sleep evaluation. Finally, women who are obese, pregnant women, and post-menopausal women all have a greater risk of OSA (obstructive sleep apnea). Women with the endocrine disorder, polycystic ovary syndrome, are also more likely to have sleep apnea even after controlling weight and should seek a healthcare professional.

A good laugh and a long sleep are the best cures in the doctor’s book. ~Irish Proverb

Sleep Apnea Solutions – ABC News

May 4th, 2010 admin