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Do You Have a Midnight Train to Nowhere?

social_snoring

So, your significant other begs to be allowed to fall asleep first. You avoid camping or sharing a room with anyone because when you fall asleep, you’ve been told that you saw logs. You could have sleep apnea. Sleep apnea is when you stop breathing repeatedly during sleep, and is considered a serious disorder.

If left untreated, sleep apnea can result in a number of health problems, including:

  • High blood pressure
  • Stroke
  • Heart failure, irregular heart beats, and heart attacks
  • Diabetes
  • Depression
  • Worsening of ADHD

Untreated sleep apnea may also be responsible for poor performance in everyday activities, such as at work and school, car accidents, underachievement at school in children and adolescents, and having to sleep on the couch…or elsewhere.

snore

A sleep study, or polysomnogram, is needed to diagnose sleep apnea. This is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. Most of the time, this study is done at a sleep disorder clinic or sleep lab.

If your sleep apnea is mild, you may be asked to:

  • Lose weight
  • Avoid alcohol and sleeping pills
  • Change sleep positions to improve breathing
  • Stop smoking.  Smoking can increase the swelling in the upper airway, which may worsen both snoring and apnea.
  • Avoid sleeping on your back

Sometimes sleep apnea is severe enough that other measures are needed. Continuous Positive Airway Pressure, or CPAP, may be prescribed. This involves a mask that you wear over your mouth or nose. It’s hooked to a machine that blows air into your airway. This way your airway stays open, preventing you from snoring or holding your breath. Depending on the person, a dental device may be a better option, or even surgery, if an anatomical problem is causing the airway to be blocked.

Consider these questions:

  • Are you a loud, habitual snorer?
  • Do you feel tired and groggy on awakening?
  • Are you often sleepy during waking hours and/or can you fall asleep quickly?
  • Are you overweight (BMI > or = 35)  and/or do you have a large neck (> or = to 16in)?
  • Have you been observed to choke, gasp, or hold your breath during sleep?

If you or someone close to you answers “yes” (or plays you a recording of your snoring!) to any of the above questions, you should talk to your healthcare provider about getting tested for sleep apnea. ¡Salud!

Sources: http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea,          http://www.sleepfoundation.org/sites/default/files/2005_summary_of_findings.pdf

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CAGE yourself

CAGE

Have you ever wondered if you drink too much? The CAGE questionnaire is a screening tool that can be used by yourself or your healthcare provider to see if you have a problem that needs evaluation. It’s not used to diagnose alcoholism, only as a way to see if a person possibly needs help or support.

The questions are:

  1. Have you ever felt you should cut down on your drinking?
  2.  Have people annoyed you by criticizing your drinking?
  3. Have you felt bad or guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves
    or get rid of a hangover (eye-opener)?

If you answer “yes” to 2 or more questions, that’s an indication of an alcohol problem.

There are the different levels of misuse:

  • Risky or hazardous use–having more than 4 drinks in one day for men or more than 3 drinks in one day for women
  • Harmful use–drinking that causes physical or mental harm (i.e. falls, high blood pressure, unclear thinking)
  • Alcohol abuse–drinking that causes a person to lose his job or have decreased work or school performance, neglect home responsibilities, driving while drunk, and/or have legal or social problems
  • Alcohol dependence (alcoholism)–a craving for alcohol, physical dependence (get the shakes without a drink), loss of control over drinking, and a need to drink an increased amount to feel the effect.

For those with a positive screen that fall under the “Risky or hazardous use”or “Harmful use” categories, brief counseling with more than one session has been found to be effective. For those who fall in the “Alcohol abuse” or “Alcohol dependence” categories, brief counseling hasn’t been shown to work well; a treatment program with ongoing support would be more effective.

I’ve noticed that a lot of my patients are really not aware of what is considered “drinking in moderation.” For men, this would be no more than 2 drinks a day or no more than 14 drinks per week. For women, moderate drinking is no more than one drink a day or no more than 7 drinks per week. A drink is considered to be 12 oz of beer, 5 oz of wine, or 1.5 oz of liquor.

drink

Please see your healthcare provider if you have questions or concerns about your alcohol use.

Source: http://www.uspreventiveservicestaskforce.org/uspstf12/alcmisuse/alcomisart.htm

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