ENT and Sleep Disorders

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DR FORD SPEAKS ON ENT ISSUES AND SLEEP DISORDERS

Lloyd Clarke Ford MD

Dr. Ford, is board certified in Otolaryngology and has his practice with the Contra Costa Ear,Nose and Throat. He spoke at the Winter Support Group meeting on “Ear, Nose and Throat (ENT) issues and Sleep Disorders.”

There are many ENT problems that can effect sleep but Dr. Ford concentrated on those problems causing Obstructive Sleep Apneas. These range from enlarged tonsils to throat muscles that relax during sleep and cause the throat to narrow. This can cause snoring, sometimes with reduced or completely blocked airflow. A completely blocked airway without airflow is called an obstructive sleep apnea (OSA).

Many patients have OSA because of a small upper airway. As the bones of the face and skull develop, some people develop a small lower face, a small mouth, and/or a tongue too large for the mouth. These features are genetically determined, which explains why OSA tends to cluster in families. Obesity is another major factor.

Dr. Ford stressed that if you have been diagnosed with Obstructive Sleep Apnea and have been prescribed a Continuous Positive Airway Pressure (CPAP) machine stick with it. Find the right mask or nasal pillow and make it a nightly habit to use it. To have Sleep Apneas and ignore the benefits of treatment is inviting future medical problems.

 

NEW IMPLANTABLE UPPER AIRWAY STIMULATION THERAPY

Many people suffering from obstructive sleep apnea (OSA) are unable or unwilling to make CPAP therapy work. For these patients who are intolerant of CPAP, Inspire Medical Systems (info@inspiresleep.com) has developed an implantable Upper Airway Stimulation (UAS) Therapy. Inspire therapy is designed to deliver physiologically-timed, mild stimulation to the hypoglossal nerve on each breathing cycle to prevent airway obstruction during sleep. Early clinical experience suggests that significant decreases in apnea-hypopnea index (AHI) can be achieved in properly selected patients.

In contrast to other surgical procedures to treat obstructive sleep apnea, Inspire therapy does not require removing or altering a patient’s facial or airway anatomy. It is implanted in the chest wall. A clinical study closely evaluated 126 patients implanted with Inspire therapy. Complete trial results have been published in the January 9, 2014 edition of the New England Journal of Medicine (http://www.nejm.org/doi/full/10.1056/NEJMoa13 08659#t=articleTop). Over the initial 12 month follow-up period in the study, the majority of patients implanted with Inspire therapy experienced experienced significant reductions (approximately 70 percent reduction in sleep apnea severity) in sleep apnea events and improvements in quality of life measures.

Inspire Therapy is currently approved by the FDA for sale in the United States.

SLEEPING WHEN ITS BLISTERING HOT!

(courtesy of the ccsleepfoundation.org)

In just a few months it will be summer. One of our favorite times of the year. BUT sometimes it’s too hot to sleep. If you don’t have air conditioning, or a power outage knocks yours out, the heat can seem unbearable. Here are some tips to help you cool down on nights without the AC or if fans aren’t enough.

What you can do about where you sleep.

Do whatever you can to prevent excessive heat buildup in your home. During the daytime ise blinds or curtains to block sunlight and keep windows closed. At night when it is cooler outside than in, open your windows.

Remember that heat rises. The lower you are the cooler it will be.

Camp out in the backyard for a few nights. DO NOT sleep in a motor vehicle and leave the AC running. This can be dangerous because there may be s buildup of carbon monoxide in a non moving vehicle.

What you can do before going to bed

Drink lots of cool fluids and eat smaller, more frequent meals during the day.

Water is a great cooling agent. Try taking a cool shower or bath before bed and leaving your hair damp.

Spray yourself with a water mister.

Freeze a damp washcloth, or try using an icepack or a bag of frozen veggies as a compress.

What you can do to improve your sleep environment

Sleep with light bedclothes, thin pajamas or no pajamas. Consider sleeping on linins with wicking features.

If you wake up sweaty and your sheets and pillow cases are wet, consider taking a brief shower and changing the bed clothes.

Protect your health

Remember that when you sweat a great deal, you lose both water and electrolytes. This can be dangerous. Make sure that you replenish both and do not become dehydrated. Avoid excessive and unprotected sun exposure. Sunburn will add to your misery in trying to sleep when it is too hot!

SEVEN STEPS TO BETTER SLEEP

By Mayo Clinic Staff

You’re not doomed to toss and turn every night. Consider simple tips for better sleep, from setting a sleep schedule to including physical activity in your daily routine. Feeling crabby lately? Or simply worn out? Perhaps the solution is better sleep.

Think about all the factors that can interfere with a good night’s sleep — from pressure at work and family responsibilities to unexpected challenges, such as layoffs, relationship issues or illnesses. It’s no wonder that quality sleep is sometimes elusive. Although you might not be able to control all of the factors that interfere with your sleep, you can adopt habits that encourage better sleep. Start with these simple sleep tips.

No. 1: Stick to a sleep schedule

Go to bed and get up at the same time every day, even on weekends, holidays and days off. Being consistent reinforces your body’s sleep-wake cycle and helps promote better sleep at night. There’s a caveat, though. If you don’t fall asleep within about 15 minutes, get up and do something relaxing. Go back to bed when you’re tired. If you agonize over falling asleep, you might find it even tougher to nod off.

No. 2: Watch what you eat & drink

Don’t go to bed either hungry or stuffed. Your discomfort might keep you up. Also limit how much you drink before bed, to prevent disruptive middle-of-the-night trips to the toilet.

Nicotine, caffeine and alcohol deserve caution, too. The stimulating effects of nicotine and caffeine — which take hours to wear off — can wreak havoc with quality sleep. And even though alcohol might make you feel sleepy at first, it can disrupt sleep later in the night.

No. 3: Create a bedtime ritual

Do the same things each night to tell your body it’s time to wind down. This might include taking a warm bath or shower, reading a book, or listening to soothing music — preferably with the lights dimmed. Relaxing activities can promote better sleep by easing the transition between wakefulness and drowsiness. Be wary of using the TV or other electronic devices as part of your bedtime ritual. Some research suggests that screen time or other media use before bedtime interferes with sleep.

No. 4: Get comfortable

Create a room that’s ideal for sleeping. Often, this means cool, dark and quiet. Consider using room darkening shades, earplugs, a fan or other devices to create an environment that suits your needs. Your mattress and pillow can contribute to better sleep, too. Since the features of good bedding are subjective, choose what feels most comfortable to you. If you share your bed, make sure there’s enough room for two. If you have children or pets, set limits on how often they sleep with you.

No. 5:Limit daytime naps

Long daytime naps can interfere with nighttime sleep — especially if you’re struggling with insomnia or poor sleep quality at night. If you choose to nap during the day, limit yourself to about 10 to 30 minutes during the midafternoon. If you work nights, you’ll need to make an exception to the rules about daytime sleeping. In this case, keep your window coverings closed so that sunlight — which adjusts your internal clock — doesn’t interrupt your daytime sleep.

No. 6: Include physical activity in your daily
routine

Regular physical activity can promote better sleep, helping you to fall asleep faster and to enjoy deeper sleep. Timing is important, though. If you exercise too close to bedtime, you might be too energized to fall asleep.

No. 7: Manage stress

When you have too much to do — and too much to think about — your sleep is likely to suffer. To help restore peace to your life, consider healthy ways to manage stress. Start with the basics, such as getting organized, setting priorities and delegating tasks. Give yourself permission to take a break when you need one. Share a good laugh with an old friend. Before bed, jot down what’s on your mind and then set it aside for tomorrow.

Lastly, know when to contact your doctor

Nearly everyone has an occasional sleepless night — but if you often have trouble sleeping, contact your doctor. Identifying and treating any underlying causes can help you get the better sleep you deserve.

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