“I will change how I treat my patients because of your talk.”

Last month, I gave one of my favorite presentations at the 10th Biennial Pediatric Sleep Medicine Conference hosted by my alma mater, Brown University.

My “TED-style talk” had two key messages:

  1. Prescribing social support to people with narcolepsy,
  2. Partnering with patients, patient leaders and organizations to develop patient-centered research toward recognizing and addressing stigma.

I’d spent months preparing for this speech. Having only 18 minutes, every second mattered. I practiced and revised and revised more. Arriving at the conference, the room was much bigger than I’d expected, between 200-300 pediatric sleep researchers, doctors and technicians in the audience. 

Once on stage, I didn’t get through my material perfectly, but I hit the emotional arch I wanted and I articulated my first key messages in new ways that I believe resonated strongly.

The response was tremendous, people stopped me all weekend to thank me, even as I loaded my suitcases into my lyft the next day, a doctor approached me to say that she is going to change how she treats her patients because of my talk. Wow!

Also kinda funny, I overheard two doctors talking about me in the hallway (really nice things), and I had to awkwardly be like “Oh, um hi! I’m right behind you.”

To me, speaking is an art form and I’ve fallen in love with it, and I can’t wait to continue developing this talk and sharing these messages in more places.

From there, I traveled to Washington, D.C. for Project Sleep’s Congressional Briefing and Hill Day co-hosted with the Sleep Research Society (SRS). I felt ready for this advocacy day and the activities went super well.  I believe we are doing unique and important work advocating specifically for sleep health and sleep disorders research and awareness. Read the full re-cap on Project Sleep’s blog.

While in DC, I got to meet some very special people, including Project Sleep’s newest Board Member, Anne Taylor and Project Sleep’s 2017 Jack & Julie Narcolepsy Scholarship recipient, Cassandra Stewart. I also had some important meetings that will likely mean exciting things for Project Sleep in the years to come. I can’t …

26th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring

This course has been coordinated through the University of California, San Francisco Department of Otolaryngology-Head and Neck Surgery and the Penn Center for Sleep Disorders at the University of Pennsylvania. The program is designed to provide a comprehensive review and update on recent advances in sleep apnea and snoring. New approaches and controversies in the management of patients with sleep disordered breathing will be highlighted. Leaders in the field from Pulmonary and Critical Care Medicine, Otolaryngology – Head and Neck Surgery, Dentistry, Oral and Maxillofacial Surgery, Pediatrics, Bariatric Surgery, Neurology and Obesity Research will share their medical and surgical expertise in didactic sessions, case presentations and workshops with the intent to close practice gaps in physician knowledge and competence for diagnosing and managing sleep disordered breathing and complications resulting thereof. Patients with sleep disordered breathing are highly prevalent in every physician’s practice, and complications related to the disease can manifest in a number of ways to the detriment of patient health and well-being. There will be ample opportunity for interaction with participating faculty. An electronic course syllabus, complete with program outline and up-to-date references, will be provided to each participant. Please bring your laptop or tablet if you would like to view the syllabus during the didactic sessions.

TARGET AUDIENCE
This continuing medical education activity is intended for the physician in Sleep Medicine, Otolaryngology-Head and Neck Surgery, Pulmonary Medicine, Oral and Maxillofacial Surgery, Family Practice, Internal Medicine, Pediatrics, Cardiology, Neurology, Psychiatry, Anesthesia, and Geriatrics. Dentists, sleep respiratory therapy technologists, nurses, and other healthcare professionals are also invited to attend this program.

from Sleep Review http://www.sleepreviewmag.com/events/26th-annual-advances-diagnosis-treatment-sleep-apnea-snoring/…

How I Transitioned My Dental Practice to a Dental Sleep Medicine Practice

Four dentists discuss their motivations, challenges, and rewards of treating patients who have obstructive sleep apnea.

Dental sleep medicine is now a viable career path for dentists looking to expand their professional horizons and help a growing number of patients who are experiencing sleep-related health problems.

But the bigger question is how? How can a dentist make the transition? What are some of the pitfalls to avoid? What are the unexpected rewards?

As the following four dental sleep medicine practitioners explain, there’s no single way to make the transition, just the one that works best for you, your practice, and your patients.

Don Johnson, DDS, Idaho

Don Johnson

Don Johnson, DDS, has been practicing dental sleep medicine for the past decade. Photo courtesy of Don Johnson, DDS

Don Johnson, DDS, has been providing dental sleep medicine services for about 10 years at his practice in Coeur d’Alene, Idaho, which includes the Northwest Snoring Center.

“The main reason I started doing sleep dentistry is because sleep apnea kills people,” Johnson says. “All you have to do is open the obituaries and you’ll see a young person who died of ‘natural causes.’ You don’t die of natural causes if you’re 39. More likely it was sleep apnea.”

And to that point, Johnson’s mission is clear: to save lives.

It’s a mission Johnson, who’s practiced general dentistry for 40 years, is quite passionate about. But his passion didn’t supersede preparation.

“You can’t do a weekend course and you’re qualified to practice sleep dentistry. It’s a huge investment in time and equipment,” says Johnson, who emphasizes that learning “everything that you can” about the temporomandibular joint (TMJ) and its disorders is essential.

Johnson not only continued his education formally, but he also found a mentor with whom he spends time with regularly to better comprehend facets such as billing and building a referrer network. “You really have to learn how to work with physicians,” he says. “And you have to get paid, including learning how to bill medically—and hire specialists to help you. If you don’t accept insurance, you’re losing a lot.”

Among

Treating Mild Sleep Apnea Results in Higher Vitality Scores

CPAP can improve energy levels and vitality in people who experience mild sleep apnea—that is, those with an apnea-hypopnea index between 5 and 15 events per hour—according to a new study.

This is the finding from a new study of over 200 patients, published in the journal The Lancet Respiratory Medicine, led by Imperial College London.

The research was conducted at 11 National Health Service (NHS) sleep centers across the United Kingdom, including the Royal Brompton & Harefield NHS Foundation Trust. Although previous trials have found a CPAP machine to improve symptoms of moderate to severe cases, the researchers say the significance of this study is it is the first large trial to find that mild cases of OSA can also be treated with this technology.

Lead author Mary Morrell, PhD, professor of Sleep and Respiratory Physiology at the National Heart and Lung Institute at Imperial, says in a release, “We are seeing increasing cases of sleep apnea, and in a wide range of patients. Although the condition was previously thought to mainly affect overweight men, we now know it also strikes post-menopausal women, the elderly, and even children.”

Morrell, who is also honorary researcher at the Royal Brompton Hospital, says, “Around 60% of all cases of sleep apnea are classed as mild, but until now we didn’t know whether a CPAP would be helpful to these patients.”

In the study, 115 patients were asked to use the CPAP for three months, while 118 received were given advice on improving sleep and avoiding anything that can exacerbate the condition, such as drinking alcohol before bed.

The research revealed those who used the CPAP machine had an improvement of 10 points on a vitality scale, compared to those who received standard care. The vitality scale assesses a range of factors such as sleep quality, energy levels, and daytime sleepiness. The researchers also saw improvements in a number of additional factors among the patients who used the CPAP, including fatigue, depression, and social and emotional functioning.

The researchers have not yet conducted an economic analysis of the cost to the NHS

How Does Sleep Deprivation Affect The Body?

Is something, or are some things keeping you up? Maybe you’ve had a lot of coffee than you normally do, or maybe you are having insomnia for some reason. If you are not getting the recommended hours of sleep a day, you won’t just feel tired, cranky, and moody the next day. Sleep deprivation has other effects too.

 

Sleep is an important part of everyday life. It is just as important as eating. The body won’t last for too long if left without sleep. In other words, it is crucial. But it isn’t just the hours of sleep that you get that should be paid attention to. It’s also the quality of it. Other than making the brain hazy, sleep deprivation can adversely affect other parts of the body as well.

 

The brain is a part of a bigger system called the Central Nervous System. Brain cells travel and function within it. A deprivation in sleep can cause fatigue in the brain.

During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well.

You may also find it more difficult to concentrate or learn new things. The signals your body send may also be delayed, decreasing your coordination and increasing your risk for accidents.

Sleep deprivation also negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity.

(Via:https://www.healthline.com/health/sleep-deprivation/effects-on-body#4)

 

Your immune system functions to protect the body from foreign invaders, especially pathogenic ones. It also works to fight such intruders.

While you sleep, your immune system produces protective, infection-fighting substances like cytokines. It uses these substances to combat foreign invaders such as bacteria and viruses.

Cytokines also help you sleep, giving your immune system more energy to defend your body against illness.

Sleep deprivation prevents your immune system from building up its forces. If you don’t get enough sleep, your body may not be able to fend off

How Important Is Sleep To Children?

Kids do get sleep. In fact, babies sleep almost all the time. While adults need the recommended 7-9 hours of sleep a day, babies need 2/3 of the day sleeping.

As children grow older, the amount of sleep they need varies:

  • toddlers: 11 to 14 hours
  • preschoolers: 10 to 13 hours
  • school-aged children: 9 to 12 hours
  • teens: 8 to 10 hours

(Via:https://www.healthline.com/health/how-much-deep-sleep-do-you-need#deep-sleep)

Children need to have good quality and quantity of sleep simply because they are growing. And sleep helps support their growth stage. A lot of things can happen during the growth stage. They will need all the help they can get for optimum growth. And sleep is one of them.

 

Deep sleep stimulates growth, especially in babies.

“Growth hormone is primarily secreted during deep sleep,” says Judith Owens, M.D., director of sleep medicine at Children’s National Medical Center, in Washington, D.C., and a Parents advisor. Mother Nature seems to have protected babies by making sure they spend about 50 percent of their time in this deep sleep, considered to be essential for adequate growth. Italian researchers, studying children with deficient levels of growth hormone, have found that they sleep less deeply than average children do.

(Via:https://www.parents.com/health/healthy-happy-kids/the-7-reasons-your-kid-needs-sleep/)

 

Even at a young stage, sleep protects children from cardiovascular harm due to cholesterol and stress hormones.

“Children with sleep disorders have excessive brain arousal during sleep, which can trigger the fight-or-flight response hundreds of times each night,” says Jeffrey Durmer, M.D., Ph.D., a sleep specialist and researcher in Atlanta. “Their blood glucose and cortisol remain elevated at night. Both are linked to higher levels of diabetes, obesity, and even heart disease.”

(Via:https://www.parents.com/health/healthy-happy-kids/the-7-reasons-your-kid-needs-sleep/)

 

Children, including babies, can actually go overboard with food as well, especially if parents mistook their babies’ cry as hunger. But getting enough sleep can counter this.

That’s key, because the sleep-weight connection seems to snowball. When we’ve eaten enough to be satisfied, our fat cells create the hormone leptin, which signals us to stop eating. Sleep deprivation may impact this hormone, so kids keep right on eating. “Over

Sleep: What You Need To Know

Mankind has never been busier before than they are now. Today is all about hustling. And it is becoming a norm. At work, there are a lot of things that need to be done in a short period of time. The same goes at home. Getting sleep is almost a luxury. Time ticks so fast that often times we have a hard time getting a hold of it. But if you don’t know it yet, sleep is a vital part of life.

 

Sleep, more specifically enough sleep and good quality sleep, is crucial so you could work efficiently and safely. Not getting enough of it can lead to many problems.

According to the NSF, these are some of the ramifications of sleep problems:

  • Decreased alertness and attentiveness
  • Increased irritability and relationship difficulties
  • Decreased concentration and judgment
  • Decreased performance and productivity
  • Increased risk of accidents

(Via:https://www.parents.com/parenting/moms/healthy-mom/adult-sleep/)

 

Sleep deprivation can cause lessen work efficiency and competence. It can also affect relationships. And most of all, it can get you in an unwanted accident. So if you want to be at the top of your game, all you might be missing is a good night’s sleep. Safety is crucial as well. Getting enough sleep will prevent road accidents from taking place.

 

The recommended hours of sleep is at 7-9 hours a day. But for some people who aren’t getting enough sleep lately, the numbers may change. To determine it yourself, you can do a simple test.

The amount of sleep needed varies with each individual. The NSF suggests a simple experiment to determine your optimum amount of sleep. You need a week or so to determine it, so you should be able to go to sleep when you’re tired and wake up naturally with no alarm clock. Taking a vacation or planning to have someone to help with your children is necessary to do this test.

Simply go to bed when you feel tired, and get up when you feel ready — don’t set an alarm clock. For a few days, you might be sleeping more if you’ve

AASM Issues Position Statement on Chronic Opioid Therapy and Sleep

Patients and medical providers should be aware that chronic opioid use can interfere with sleep by reducing sleep efficiency and increasing the risk of sleep-disordered breathing, according to a position statement from the American Academy of Sleep Medicine (AASM).

In addition to understanding the risks of opioid addiction and abuse, it is important for health care providers to be aware that chronic opioid use is associated with changes in sleep architecture and an increased risk of respiratory depression during sleep.

“This statement increases awareness among health care providers of the important adverse events that can occur in patients on chronic opioid therapy,” says co-author R. Nisha Aurora, MD, associate professor of medicine at Rutgers Robert Wood Johnson Medical School in New Jersey, in a release. “The paper also highlights the need for providers to recognize and diagnose sleep-related breathing disorders that are frequently seen with chronic opioid use.”

The position statement was developed by the AASM board of directors and is published in the Nov 15 issue of the Journal of Clinical Sleep Medicine.

Patients who have chronic pain often experience fatigue and disturbed sleep. Studies have shown that chronic opioid therapy has the potential to further disrupt sleep by reducing sleep efficiency, slow wave sleep, and rapid eye movement sleep. Another adverse effect of opioid use is respiratory depression, which can increase the risk of sleep-related breathing disorders such as sleep-related hypoventilation, central sleep apnea and obstructive sleep apnea.

Medical providers who care for patients on chronic opioid therapy need to be aware of the signs of disrupted sleep, such as snoring and excessive daytime sleepiness, in order to provide their patients with high quality care.

“Because of the complex relationship between pain, sleep, daytime functioning, and opioid therapy, a strong collaboration between pain specialists, sleep physicians, and primary care providers is needed to optimize patient benefit and minimize complications when opioids are part of chronic therapy,” says Aurora.

While opioid therapy can contribute to sleep disruption and sleep disorders, it can be an effective treatment for patients with restless legs syndrome (RLS), a sleep disorder associated

Light and Deep Sleep: How Much Do You Need For Each Of Them?

It is recommended for adults to have 7-9 hours of sleep every day. If you think that’s a lot of time and that you could have done something productive at that time, then it depends on what you mean by productive because resting the body for 7-9 hours is fruitful itself.

 

The body goes through a lot while you sleep so you can be more productive when you wake up. It goes through stages of sleep. Along with knowing that you need 7-9 hours of sleep a day, it is also important to know how much you need per stage of it.

There are five stages of sleep that rotate between non-rapid eye movement (NREM) and rapid eye movement (REM) and include drowsiness, light sleep, moderate to deep sleep, deepest sleep, and dreaming.

Experts have recommended that adults gets about 7 to 9 hours of sleep per night. New research aims to identify not just how much total sleep you need — but also how much of each stage of sleep you need.

Sleep stages 1, 2, and REM consist of light sleep, while 3 and 4 comprise deep sleep.

(Via:https://www.healthline.com/health/how-much-deep-sleep-do-you-need)

 

Healthy individuals need about a quarter of the total number of sleeping hours to be in deep sleep.

In healthy adults, about 13 to 23 percent of your sleep is deep sleep. So if you sleep for 8 hours a night, that’s roughly 62 to 110 minutes.

However, as you get older you require less deep sleep.

During deep sleep, a variety of functions take place in the mind and body:

  • memories are consolidated
  • learning and emotions process
  • physical recovery occurs
  • blood sugar levels and metabolism balance out
  • the immune system is energized
  • the brain detoxifies

(Via:https://www.healthline.com/health/how-much-deep-sleep-do-you-need)

 

The same goes for REM sleep. The REM cycle starts at 1 ½ hours after you’ve fallen asleep and repeats at the same time interval.

For most adults, REM takes up about 20 to 25 percent of sleep, and this seems to be healthy during average sleep cycles. However, sleep research is raising some interesting

What’s Causing You To Snore?

You won’t always know that you snore. In fact, you don’t actually realize that you are snoring. It’s your partner that knows and complains especially if it gets loud. It can be really loud.

 

Snoring affects millions of people. But why do people snore? What is it really? Well, have you noticed an animation about someone singing loudly that their tiny tissue hanging on their throat is showing? Yes, that one. Sound is produced when air vibrates within the soft palates and that tissue. This happens when your airways get narrow.

When you hear someone snoring, it means air is not flowing freely through the back of the throat. The sound occurs when air causes vibration of the soft palate and the uvula, the tiny pink flap of tissue that hangs down at the rear of your throat.

(Via:http://www.columbianeurology.org/neurology/staywell/document.php?id=136)

 

Besides being an inconvenience to other people, snoring can mean something else to you. Snoring is not a disease or an illness. But it can be a symptom or a cause of a medical condition.

Asides from being a nuisance to your friends or your partner, snoring also affects how you sleep. It reduces the quality of your sleep, could result in sleep apnea or lead to chronic sleep deprivation. Ever woken up in the morning tired, cranky and not quite feeling like you got a good night time’s rest? Snoring might be the cause.

(Via:https://www.sleepcycle.com/snoring/10-natural-snoring-remedies/)

 

We need to know the factors other than medical ones that could affect snoring so we can properly address it on our own. The first and common one is weight. If you weigh more than you should at your age, height, or physical activities, then chances are that you’ll snore. If biology were to be a basis, then men are less fortunate than women.

A couple of factors come into play here. One popular one is weight. Carrying excess weight around your neck and throat can cause snoring. Then there is good old biology. In general, men have narrower air passages than women and are most likely to