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| Cindy: Welcome to the Gaylord Chat. Tonight we have Dr. Debra Pollack from Gaylord Sleep Services ready to chat about sleep disorders and sleep problems. Thanks Dr. Pollack for joining us. Dpollack: It’s great to be here. Let the questions begin! Any questions? Cindy: Can you tell us a little about the prevalence of sleep problems among middle aged men? Dpollack: Far and away, the most common sleep disorder in this age group that requires an evaluation at a sleep center is sleep disordered breathing. This includes sleep apnea, snoring and a few others. Other disorders can afflict men of this age as well. But we have a question… RTC: I had a sleep study done and had a rating of 114. Is that high? Dpollack: RTC, it depends on what the "114" referred to. The severity of sleep disorders is evaluated in a number of ways. One way in which sleep apnea, for example, is evaluated is by the number of breathing pauses ("apneas") that a person has in sleep. RTC: 81 in an hour Dpollack: In general, a person must have at least 5 breathing pauses per hour of sleep to achieve the diagnosis of sleep apnea. Above the index of 20-40 pauses per hour of sleep is generally considered more severe. Other factors are considered as well. Lyn: A question was submitted by e-mail: What should a person do when he sleeps well for a few hours and then tosses and turns for the rest of the night? Dpollack: People should generally not remain in bed for long periods of time if they are awake. While I certainly can’t say why this individual is waking during the night, he/she should try to get out of bed and engage in a relaxing, sedentary activity for a while and then return to bed. Kck: The web TV does not seem to like this chat room so I may have to log off. Q how much sleep does a healthy 50 yr old male need at night? Dpollack: The average, healthy adult needs 8 hours of sleep in a 24-hour period, typically with one major sleep period. Tara: I was diagnosed with sleep apnea in August and have suffered sinus infections since. Is this common using cpap machine? Dpollack: Tara, CPAP doesn’t cause sinus infections in and of itself but may cause nasal and throat irritation (dryness, congestion, increased mucous production, etc.). These can be treated. Cantus: At most, I get 2 hrs/sleep/night with Restoril. Should I get out of bed rather than lying there trying to relax? Dpollack: Keeping a regular sleep schedule, regardless of the exact time of sleeping is also important to feeling refreshed. Dpollack: Cantus, especially if you feel aggravated in bed while not sleeping, you should consider getting out of bed for a while and returning to bed when you feel sleepy again. Cameraman: Are there many types of CPAP masks? I’ve had two studies, each with a different type of mask. One I liked, the other… Dpollack: Cameraman, there are many (and I mean many) types of cpap interfaces. Auntie: I have difficulty sleeping as my thoughts of the day and responsibilities flood my mind. Dpollack: Auntie, it may help if you assign a time early in the day/evening (not near or in bed) as "worry time." Making a list of activities completed or projects for the next day may help. Cantus: Since I have been taking Celexa, I don’t care if I’m just lying there. I understand that it may take another month to begin a natural sleep schedule. Is this true? Dpollack: Cantus, it is difficult to answer questions about the specific medication effects in individuals. Everyone responds differently. Amycrisp: My husband reports that just about every night I ‘m either yelling, talking or walking in my sleep. I often turn on lights or walk around the room in my sleep. I did this often as a child. Somehow I thought I would grow out of it! Dpollack: The parasomnias (sleep walking and others) generally begin in childhood but may continue into adulthood or recur after a hiatus, generally during periods of stress or sleep deprivation. Pandabear: My husband often wakes up in the middle of the night and starts yelling and screaming. Could this just be stress related? Dpollack: Amy and panda, there are other behaviors in sleep that begin in older adulthood. Bozo: I am marginally overweight, yet my sleep study for CPAP suggested the maximum settings. Does this sound normal? Dpollack: Bozo, weight has very little to do with final cpap pressure settings. Dpollack Regarding cpap masks, they are available through the home care companies with a prescription from your physician. The companies can show you what’s available. Auntie: How do you know when to seek medical attention? Dpollack: For sleep symptoms of any sort that persist for more than a few days, you may want to see your primary physician. For longer lasting symptoms (more than a few weeks, months), you may need to see a specialist. Auntie: Are there medications that would not leave one drowsy the next a.m.? Dpollack: There are many medications and other non-medication-oriented treatments for sleep disorders. Treatment for sleep disorders is tailored to each patient. Auntie: How does one locate a sleep specialist? Dpollack: Your primary physician may be familiar with the sleep centers in your area. I wold only suggest that you go to an accredited sleep laboratory to try to assure the best treatment. Auntie: Thank you dr. Washie510: I wanted to know what the "pap" in bi-pap stands for? Dpollack: The "pap" in cpap and bipap stands for "positive airway pressure." Washie510: How many different types of masks are there and which one do you recommend? Dpollack: The actual number is too difficult to say. (MANY.) The best mask is the one that fits you best and does not cause any (or as few as possible) problems such as leaks, skin irritation, etc. Washie510: Right now I am using the monach. Love the mask but the headgear leaves something to be desired. Dpollack: You might want to speak with your home care company or your sleep physician about the specific mask that’s right for you. Cantus: My PCP rx’d the Celexa for depression/anxiety and the Restoril 15 mg for sleep. All I hear is that sleeping pills are addictive, habit forming and generally bad. Without the Restoril, I get 0 hrs sleep, although I like to lie in a warm, cozy bed, so I am not aggravated, just tired of checking the clock. How soon will I be addicted to the Restoril for the 2 hr sleep? Dpollack: I don’t know enough about you to say for sure. You should speak further to the prescribing physician or see a sleep physician. You might try turning the clock so that you can’t see it from your bed. Clock watching is generally counter-productive. Cantus: I check the clock for 5 a.m. so I can get up and run 4 miles. Washie510: Cantus, how can you run 4 miles with no sleep??? Cindy: That’s what I want to know! Washie510: I can even walk 1 mile with sleep J Cantus: I’ve gotta have those endorphins. The fresh, cold air actually energizes me for the day. Washie510: What are endorphins? Cantus: Endorphins are chemicals that act like antidepressants. Like eating turkey…That could be an adrenaline kick starting you in the a.m. Washie510: What is the average time for most your patients to tolerate sleeping with the machine? I was there for the disorder test but was never able to go to sleep! Dpollack: You might try a more in-depth consultation with a sleep physician before trying the test again. I’d be happy to discuss it further if you’d like to call my office. Auntie: Dr. P, is your office local? Dpollack: My offices are in New Haven and Wallingford. Gaylord also maintains sleep labs in Fairfield, New London and West Hartford. Cindy: Dr. Pollack can be reached at (203) 624-3140 or 1-800-64-REHAB, ext. SLEEP. Cantus: What do you do for folks who come to the sleep disorder clinic and don’t sleep? OK, I’ll turn the clock around, but let’s not get chatty about the cats on the bed. They are non-negotiable! Dpollack: Cantus, there are many treatments for insomnia, both with medication and without. Gaylord provides a wide range of services for patients who have insomnia. Cdivers: My question revolves around a spouse who suffers from sleep apnea, restless leg syndrome and horrible snoring. I know that he should visit a clinic but he insists that he do none of this stuff. I have spent 5 years not sleeping and am ready to move out of the room except my kids would think there was something wrong with my marriage. How do you convince a stubborn spouse to seek help in a situation like this? Lyn: Good question. Ron: I’m here for that very same reason. While never actually diagnosed with a sleep disorder, my wife insists I have sleep apnea. Dpollack: While you can’t force your spouse to seek medical attention, I believe that education him/her works best. You can obtain info from your physician, on line or see if your loved one would come in for a sleep consultation for the purpose of education. Or better yet, get that spouse on line with us right now. Cindy: Dr. P, can a child exhibit sleep disorders? I swear it sounds like my 3 yr old snores and gasps for air at times during the night. Dpollack: Children are susceptible to sleep disorders as well. Many are behavioral in origin, though no less difficult to treat. Many are medically serious. Many can interfere with daytime behavior and school performance. Cdivers: Does insurance cover these types of consultations? Dpollack: Gaylord participates with most major insurance carriers. Please call to investigate your specific case. Sbfrd: I’ve heard that people require less sleep as they get older. Is this true? Do men suffer form sleep apnea more than women do? Dpollack: Sleep apnea is somewhat more common in men than women, but both genders are at risk, especially with advancing age. Washie510: I think if I could have gone to sleep in my natural way (with the TV on) then I might have been able to go to sleep when I had the test. Dpollack: I’m not sure that "with the TV on" qualifies as "natural." Learning to sleep without TV or other aides is ideal. Lyn: Sleep problems related to perimenopause: treatable or grin and bear it? Dpollack: Sleep problems related to menopause may be treatable as menopause alone (perhaps with hormones. Speak to your doctor. Lyn: Thank you. Cantus: I also take estrogen for menopausal symptoms. I’m probably addicted to that too. Could the estrogen be contributing to my inability to sleep? Dpollack: When sleep problems are due to menopause, they may improve with hormone treatment and sometimes not. Each patient is different. Auntie: Does having an air ionizer help with sleep? Dpollack: I’m not aware of any effects on sleep. But I doubt it could cause harm either. Auntie: Thank you. Cantus: Thank you, Dr. Pollack. If I don’t start sleeping within the next month, I’ll come see you and stay up all night at Gaylord. Dpollack: Thanks to all who contributed tonight. Lyn: Thank you, Dr. Pollack. This was very informative. Dpollack: I hope that I have helped you all to sleep better, or at least, in terms of where to get additional assistance. Goodnight. Sleep well! |
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