Posts for category: Sleep Apnea
Learn more about this sleep disorder that affects nearly 3 million people worldwide.
Narcolepsy is a sleep disorder that is believed to affect around 1 in every 2,000 people in the US. Unfortunately, it’s believed that only about 25 percent of people with this condition have actually been diagnosed and properly treated. From the office of our Portland and Astoria sleep medicine physicians, Dr. Radhika Breaden, and Dr. Jennifer Kim, here’s what you should know about this sleep disorder.
What are the symptoms of narcolepsy?
The most obvious symptom of narcolepsy is excessive daytime sleepiness. Those with narcolepsy will experience daytime drowsiness even after getting adequate total sleep time on a regular basis.
Unlike stereotypical portrayals of narcolepsy in the movies and on the internet, patients with narcolepsy do not typically fall asleep while talking or suddenly slump in the middle of an activity unless their narcolepsy is severe, which is very rare. Instead, most patients with narcolepsy live with their excessive daytime sleepiness during the day and try to control it with caffeine and brief naps whenever they can. However, despite these measures, the sleepiness affects their daily life and function.
Other symptoms of narcolepsy can include sleep paralysis (waking up during the night with the body feeling paralyzed), hypnagogic or hypnopompic hallucinations (seeing visions or hearing things that are not there as you are falling asleep or waking up) although these symptoms may also be noted with other sleep conditions including sleep deprivation and obstructive sleep apnea.
Some patients may also have cataplexy. The term cataplexy describes the loss of muscle control in the head, neck or shoulders or buckling of the knees during a time of intense emotion, such as laughter or surprise. Not all patients with narcolepsy have cataplexy. However, the presence of cataplexy can suggest that narcolepsy is present.
When should I see a sleep medicine specialist for consultation?
If you are dealing with the above symptoms and suspect that narcolepsy may be present, it’s important that you turn to our sleep specialists in Portland and Astoria, OR, to find out what’s going on.
How is narcolepsy diagnosed?
In order to be diagnosed with narcolepsy, our sleep doctors will need to perform certain tests. After a careful history, we may recommend a combination sleep study called a Polysomnogram with Multiple Sleep Latency Test (PSG with MSLT). During a sleep study, we will apply electrodes to the body to record everything from breathing patterns and movement to brain activity while you sleep. If the overnight polysomnogram does not show a clear explanation for the excessive daytime sleepiness, we proceed with the daytime napping test (MSLT) the next day. During the MSLT, a patient will attempt to nap every 90-120 minutes. By observing how rapidly a patient falls asleep and what stages of sleep are noted, Dr. Kim or Dr. Breaden will then determine whether narcolepsy is likely to be present.
The preparation for a PSG with MSLT follows a standardized protocol which includes adequate total sleep time for the weeks prior to testing, the absence or complete treatment of other sleep disorders such as obstructive sleep apnea, the elimination of medications which may affect testing as well as the elimination of caffeine in the two weeks prior to testing.
How is narcolepsy treated?
Your treatment plan will often include medication and lifestyle modifications to help manage your symptoms and help you get more restorative sleep. Dr. Kim and Dr. Breaden will work with you to find the right medication and treatment options to alleviate your symptoms.
You may be prescribed medication to control sleepiness and REM sleep intrusion (sleep/wake cycle). In addition to many traditional wake promoting agents, there are several newer medications that may be helpful in promoting more restorative sleep.
If you, a friend or a family member is displaying symptoms of narcolepsy or any other sleep disorder, a consultation with our sleep medicine team may help to determine the next steps in evaluation and treatment. Call Pacific Sleep Program in Portland at (503) 228-4414 or in Astoria at (503) 325-3126.
Sleep apnea isn’t something that you can just treat on your own—it requires proper evaluation and treatment from board certified sleep apnea doctors in Portland and Astoria, OR, who can determine not just the severity of your sleep disorder but also help you determine the treatment that is right for you.
That's why our sleep medicine team including Dr. Radhika Breaden and Dr. Jennifer Kim are here to provide you with the care you need to understand and manage your sleep apnea.
Symptoms of sleep apnea include
- Pauses in breathing throughout the night
- Gasping sounds while sleep
- Daytime fatigue
- Trouble concentration
- Mental fog
- Increased irritability
- Depressive or anxiety symptoms
- Insomnia or restless sleeping
- Morning headaches
- Waking up during the night to urinate
- Acid reflux/heartburn during the night
- Tooth grinding
Not all patients with sleep apnea have all or most of these symptoms. The symptoms can also vary in severity based on age. For example, in a child, sleep apnea may manifest as issues of attention or hyperactivity. For women, symptoms may include insomnia alone without any other observed symptoms.
In order to determine whether sleep apnea is present, we may consider either home sleep testing or in-laboratory sleep testing (at our clinic). There are pros and cons to both types of testing, which we will review with you at the time of your initial consultation.
Once you’ve undergone a sleep study, the next step is to create a treatment plan for you. This treatment plan will be based on how severe your sleep apnea is as well as other factors, including changes in severity based on position, stage of sleep and other medical conditions you may have. At your follow up appointment, we will review all treatment options including PAP (positive airway pressure), oral appliance therapy, surgery, Inspire neurostimulator therapy, Provent therapy and positional therapy.
Many patients can also benefit from lifestyle modifications that can help reduce symptoms. Certain lifestyle modifications that our sleep specialists in Portland and Astoria, OR, may recommend include,
- Losing excess weight or maintaining a healthy weight
- Quitting smoking
- Avoiding or limiting alcohol, caffeine, and sedatives
While lifestyle changes can reduce the severity and frequency of your symptoms, you may also require additional treatment, depending on the severity of your sleep apnea.
One common treatment option is CPAP therapy, in which the patient wears a mask interface over their nose and/or mouth. The mask is attached to a machine that generates a gentle air pressure to apply just the amount of pressure needed to keep the airways open and to prevent airflow obstruction.
Many patients may also benefit from getting oral appliance therapy. Using a custom-made device that fits over the upper and lower teeth, oral appliance therapy repositions the jaws to prevent the collapse of tissues in the back of the throat.
Surgical options including the UPPP (uvulopalatalpharyngoplasty) in which the uvula and part of the palate are removed, as well as the MMA (maxillomandibular advancement) in which both the upper and lower jaw are advanced forward to provide more airway space. These surgeries are performed by ENT (Ear, Nose and Throat) surgeons.
A newer option for treatment is the Inspire neurostimulator therapy, in which an implantable device has electrodes which stimulate the airway muscles to provider structure and tone during the night. Inspire surgery is used in patients who have moderate or severe obstructive sleep apnea with a BMI (body mass index) of 32 or less.
Other options including positional belts and collars as well as Provent therapy, which are nasal expiratory pressure stickers for the nasal passages that are used predominantly when camping or travelling internationally.
Pacific Sleep Program has two offices to ensure that patients living in Portland and Astoria, OR, get the comprehensive sleep care that they need. If you suspect that you might be dealing with sleep apnea, we recommend that you schedule a sleep medicine consultation with our clinic.
We know that sleep and weight are closely related. A significant amount of metabolic regulation, including the regulation of insulin (which regulates our blood sugar), leptin (which regulates our body weight and set point) and ghrelin (which regulates our appetite and sense of feeling full) occurs during sleep.
We also know that when our weight goes up, it will increase our risk of certain sleep disorders, such as obstructive sleep apnea. As we gain weight, the fat pads by our neck and along our chest wall and abdomen get bigger, which makes it even harder to open the airway and to breathe.
We know that when sleep is affected, including when we do not get enough sleep or when our sleep is poor quality, our weight goes up. We also know that when our weight goes up, it affects our sleep. It is a vicious cycle.
At Pacific Sleep Program, we understand this
A recent study, which was presented at the Endocrine Society (ENDO) 2019 Annual Scientific Sessions in New Orleans, LA, found that OSA patients undergoing CPAP treatment lost an average of 5.7 pounds more in 16 weeks than OSA patients who did not receive CPAP therapy.
Also per several studies, when people do not get enough sleep, either due to chronic sleep deprivation, insomnia or circadian rhythm disorders, they are more likely to gain weight.
Contact us at Pacific Sleep Program at our Portland or Astoria location to learn more about how we can help you with your sleep and how this may help you in your journey toward a healthy weight.
CPAP—you've heard of it, and now that you have been diagnosed with Obstructive Sleep Apnea (OSA), this bedside machine is going to be your nightly companion. At Pacific Sleep Program in both Portland and Astoria, our team of 4 sleep physicians and their support staff answer many questions regarding the hows and whys of CPAP and how it can reduce the harmful health effects of OSA. Here are some of the most frequently asked questions and their answers regarding this helpful sleep therapy.
FAQs regarding CPAP
1. Just what is CPAP?
CPAP means Continuous Positive Airway Pressure. Prescribed by a board-certified sleep physician Pacific Sleep Program, a CPAP machine counters the harmful health effects of Obstructive Sleep Apnea. A CPAP machine delivers a steady stream of air through a mask into the wearer's airway, keeping it open and the patient both breathing and sleeping well.
2. What does a CPAP machine look like?
There are many CPAP styles, including variations on the machine itself and on the facial mask. Your sleep physician in either Portland or Astoria will help you determine what CPAP machine is right for your sleep disorder.
3. How do I know I need CPAP?
Only a sleep physician can tell you if you have a sleep disorder such as OSA and if CPAP is the right therapy. At Pacific Sleep Program, our professional team has the experience, expertise, and sleep study capabilities to determine why you don't sleep well, snore loudly, wake up multiple times a night, and feel fatigued during the day. Our state-of-the-art facility provides in-house and at-home sleep studies which yield data helpful in pinpointing your particular issue
4. Is CPAP hard to get used to?
Any CPAP machine requires a period of adjustment. Some people feel a bit claustrophobic because of the mask, or others may need time to find their best sleep positions as they use their machine on a nightly basis. Your doctor will work with you to ensure maximum benefit from your CPAP machine.
5. Will CPAP stop my problem snoring?
The American Sleep Apnea Association says that about 90 million American adults snore consistently. Fifty percent of these individuals actually have Obstructive Sleep Apnea. Fortunately, therapy with a CPAP machine reduces snoring considerably because the airway literally is propped open by the steady flow of air. Thus, the vibration of the uvula and other soft tissues at the back of the throat appreciably ceases, and so does noisy snoring.
6. How often should I use my machine?
To maximize its benefits, use your CPAP machine every time you sleep, whether if that is at night or if you take any naps. Consistent use helps sleep therapy patients adjust to their machines more quickly.
Find out more
CPAP machines have revolutionized sleep therapy over the past three decades. To learn more about OSA and other sleep issues, or if you have a question about your current CPAP apparatus, please call the Pacific Sleep Program. We have two offices: one in Portland (503) 228-4414 and one in Astoria (503) 325-3126.
Do you need help from your Portland and Astoria, OR, doctor when it comes to sleep medicine?
Sleep apnea is a sleep-related breathing disorder that affects a person's respiratory airflow. The airflow is interrupted when soft tissue, like the tongue, collapse in the back of your throat while you're asleep, causing a partially closed windpipe. The soft tissue vibrates resulting in snoring.
More About Sleep Apnea
Some interesting facts about sleep apnea are that 12.5 percent of people suffer from a sleep disorder. Sleep apnea may also lead to erectile dysfunction and increase risks of heart attacks, high blood pressure and strokes.
Not getting the sleep you need can be linked to many diseases, which is why it's important to contact your Portland and Astoria sleep medicine physicians.
Obstructive Sleep Apnea occurs when the upper airway is blocked and significant airflow disruption occurs, complete blockage of airflow may result as well.
Someone suffering from sleep apnea may wake up several times a night. These awakenings are called micro-arousals and prevent deep and restful sleep.
Lack of Sleep
There are many diseases that are linked to a lack of sleep, so make sure you ask your Portland and Astoria doctor about how he can help you cope with or treat certain your sleep apnea. The leading sleep apnea treatment is a CPAP (continuous positive airway pressure) machine which blows a gentle stream of air into the airway to keep it open. Your doctor also provides an oral appliance that you wear while you sleep. This helps reposition the jaw and tongue so that there is no obstruction of the airway while you sleep and decreases the effects of sleep apnea.
If you have any questions or concerns regarding your health and would like to know if you are suffering from sleep apnea, then it's a good idea to contact your Portland and Astoria, OR, sleep medicine specialists Dr. Gerald Rich, Dr. Radhika Breaden and Dr. Gregory Clark today!