Sleep Apnea And Drive Safely

Appropriate driving can be difficult if you’re too sleepy to stay lookout. Here are some tips for paying notoriety on the road if you have sleep apnea. Most people be informed that driving under the influence of the cup that cheers or buy Ambien Zolpidem online can have dangerous, even inescapable, consequences. But “DWS” driving while sleepy can be fair as deadly.

The Serious Side of Sleep

Profuse drivers know not to get behind the whirl location after drinking alcohol, but sleepiness tends to be another mystery. Some drivers may not even gain how tired they actually are, and characterize as they can drive safely. The statistics say differently:

* Driver fatigue accounts for at least 100,000 accidents per year, according to the National Highway Traffic Safety Administration (NHTSA).

* NHTSA reports exhausted drivers are responsible for 1,550 deaths and 71,000 injuries annually, not to hint at $12.5 billion in monetary losses, as a sequel of auto accidents.

* A fresh sleep poll showed that rest or lack thereof caused or as good as caused car crashes for almost 11 million drivers.

In a up to date survey conducted by the National Sleep Foundation, 20 percent of respondents admitted they had fallen asleep at the to what place at least once during the before year. In fact, when it comes to driving, too baby sleep and too much alcohol take a lot in common both can spoil judgment and vision, slow resistance time, interfere with coordination, storm you feel moody or aggressive, and depreciate alertness.

The foundation has become so disturbed about this issue that it launched a Web locality raise awareness about secured driving in regards to sleep deprivation.

Don’t Hit the Road With Sleep Apnea

With 70 million people in the Unified States dealing with some fount of sleep disorder, drowsy driving is a giant problem. Of those people, at least 12 million be subjected to a condition known as obstructive sleep apnea (OSA). People with obstructive sleep apnea experience brief pauses in breathing while they slumber. These pauses may last for seconds or minutes and can crop up five to 100 times an hour.

The acclimate often causes snoring as the air fights to tour through the nose, mouth, or throat. When the blood oxygen unvarying becomes too low, the brain arouses the sleeper fair-minded enough to take a breath, but not plenty to wake up, which is why people with take apnea often don’t understand why they deem groggy in the morning. In fact, snoring and daytime sleepiness are the two fundamental symptoms of OSA.

There is “a prodigious link between untreated drowse apnea and falling asleep at the disc,” warns Helene Emsellem, MD, top banana of the Center for Sleep and Wake Disorders in Chevy Go out after, Md., and associate clinical professor of neurology at George Washington University in Washington, D.C. The out-and-out culprit seems to be the fluctuations in blood oxygen levels and repeated arousals that happen from the on-and-off breathing that is the verification of this disorder. Dr. Emsellem notes that people with standard lung diseases, such as emphysema, also finish feeling sleepy during the day, because they may act with low blood oxygen, too. Clever oxygenation is essential for staying wide awake and for safe driving, she explains.

Tips for Safe Driving

Emsellem offers these tips for anyone solicitous about safe driving while feeling tired:

* Seek professional advice. If you suspect you be experiencing OSA or any other type of sleep disorder, get a checkup and, if fated, schedule a sleep study. If the condition is treated correctly, people with sleep apnea can be safe drivers.

* Conceive of before you drive. Assess your level of alertness in preference to you get behind the wheel. If you’re feeling tired, consider postponing your misstep until you can get some shut-eye.

* Stop and doze. If you start feeling sleepy while driving, have regard for it an emergency situation. \”Pull over, break your windows, set the alarm on your cell phone, and carry off a 10- to 15-minute nap. If you’re within 30 minutes of your end, a nap will get you there,” Emsellem says.

* Compel ought to some caffeine. Emsellem cites a study, involving traffic drivers in Great Britain, that showed downing a cup of coffee, followed by a 15- to 20-memorandum latest nap, had the most beneficial effects on alertness. “The caffeine takes in the air 15 to 20 minutes to kick in, so by the time you wake up, you’ll be imperturbable more alert,” she explains.

Don’t cut sleepiness behind the wheel — it’s dangerous but very much treatable if you pay attention to the warning signs.

Broad Daylight–Saving Time and Sleep

Sunlight-saving time doesn’t have to disrupt your zizz schedule. A few simple tips help ensure unmarred sleep during daylight-saving time and beyond. For most of us, the springtime birch from standard to daylight-saving time is solely an inconvenience. It might be the cause of skipped appointments if we make out to miss all those reminders telling us to move our clocks into the open one hour on the second Sunday in March.

But for others, the initially few days of daylight saving time can mean sleepiness and reduced concentration. “It exceedingly does damage some people’s sleep,” acknowledges James A. Davis, superintendent of the Anderson Hospital Center for Sleep Medicine in Maryville, Ill. A fourth of the far-out observes daylight-saving time, and researchers participate in documented that some people never surely get into the swing of it.

Daylight Saving Time: Protect Your Sleep

To accept how to avoid sleepiness around the start of proceed from, it helps to understand exactly how daylight-frugal time affects the body, Davis says. Our internal clocks are governed by our circadian thesis, the 24-hour cycle that determines our rest and wake periods, as well as other biological mechanisms. The first day of sun-saving time realigns how we synch our routine clocks with our “internal clock,” in another manner known as the circadian rhythm.

People who sooner a be wearing a problem with daylight-saving space are those who adjust by sacrificing an hour of take a nap. Davis doesn’t recommend following this practice of action and, instead, says you should compliments your sleep time and your band’s need for it. Here’s how:

1. Reset all your clocks on the Saturday ahead of the switch. Divers computers automatically adjust to daylight-saving conditions, but make a note to check.

2. Get a full night’s snooze during the switch.

3. Plan on your conventional time for rising on the first day of daylight-saving time.

4. If you’ve already set your clock onwards by Saturday evening (see step 1), following your received bedtime will ensure you get a full night of slumber. In any event, get a full night’s sleep by adjusting the at all times you hit the hay. “Essentially, you’re going to be getting up an hour earlier, so you take to go to bed an hour earlier,” Davis says.

5. Resist the temptation to catch a nap in the middle of the day on Sunday.

6. Retire on Sunday at your conventional bedtime.

Sheilagh Weymouth, DC, a chiropractor who provides holistic leading care in New York City, is so sensitive to the change-over to and from daylight-saving time that she reorganizes her day when she gains an hour each slump. When she started to align her workday to the handy daylight in winter, she found the switch “much more beneficial to my body.”

When daylight-scraping time rolls around again, her maven schedule, not her body, will adapt. “I’m not flourishing to offer those 8 a.m. appointments then. Our bodies not unexpectedly start to awaken with the light of day, and I’m thriving to use this as a teaching moment with my patients.”

Sleepiness Clinical Trial Suggests Wake-Promoting Properties

Vanda Pharmaceuticals announced top-line results from Proof- of-Concept Phase II clinical trial evaluating VSF-173 in a clinical model of excessive sleepiness.

This Phase II study examined the effects of VSF-173 on a model of excessive sleepiness among 55 healthy volunteers treated with 3 doses of VSF-173 administered at 50 mg, 100 mg and 200 mg and placebo administered at 25 mg, 50 mg and 100 mg at the usual bedtime and at four hours after the first dose. In this model, the effect of the compound was evaluated with a series of six Maintenance of Wakefulness Tests (MWT) given two hours apart starting one hour after the first dose. The effect of the drug was also evaluated on the scheduled daytime recovery sleep following the night time and morning evaluations.

On the primary endpoint which evaluated the effect of the compound on the first four series of MWT tests, VSF-173 demonstrated improvements over placebo. The mean MWT sleep onset scores for the 50 mg, 100 mg and 200 mg, and placebo groups were 10.3, 12.9, 10.6 and 9.2 minutes, respectively. While the pair-wise analysis did not reach statistical significance, this magnitude of effect, ranging from 1.1 to 3.7 minutes, is generally similar to that observed with modafinil in the treatment of patients with narcolepsy.

In a subset of 37 subjects with no observed impairment in pre-dose daytime wakefulness (MWT cutoff equal to 30 minutes), the mean of all six MWT scores for the 50 mg, 100 mg and 200 mg groups showed improvements of 2.1, 3.4 and 2.1 minutes, respectively, compared to placebo. For the dose group of 100 mg, this observation of improvement was statistically significant (p < 0.05).

Further evidence of the wake-promoting properties of VSF-173 was also observed during the scheduled daytime recovery sleep following the night time and morning evaluations. Statistically significant (p<.05; non-parametric) dose-dependent correlations were observed with the following polysomnography (PSG) parameters: increased number of awakenings, decreased sleep efficiency and total sleep time for the first third of the sleep period, and increased wake time after sleep onset for the first 3 hours of the sleep period.

These wake-promoting effects of VSF-173 on MWT and PSG measures suggest that VSF-173 possesses a novel mechanism to address disorders of excessive sleepiness. Vanda plans to conduct additional studies to further understand timing of administration, dose-response and appropriate populations to treat. VSF-173 was also demonstrated to be safe and well-tolerated.

“We are encouraged by the results of this proof-of-concept study on VSF-173,” stated Mihael Polymeropoulos, M.D., President and CEO of Vanda. “We believe that the compound has the potential to address the symptoms of excessive sleepiness in the context of a number of disorders including narcolepsy and shift worker sleep disorder, as well as neurodegenerative disorders.”

Sleep Deprivation Affects Sense Of What We See

Neuroscience researchers at the Duke-NUS Graduate Medical School in Singapore have shown for the first time what happens to the visual perceptions of healthy but sleep-deprived volunteers who fight to stay awake, like people who try to drive through the night.

The scientists found that even after sleep deprivation, people had periods of near-normal brain function in which they could finish tasks quickly. However, this normalcy mixed with periods of slow response and severe drops in visual processing and attention, according to their paper, published in the Journal of Neuroscience on May 21.

“Interestingly, the team found that a sleep-deprived brain can normally process simple visuals, like flashing checkerboards. But the ‘higher visual areas’ — those that are responsible for making sense of what we see — didn’t function well,” said Dr. Michael Chee, lead author and professor at the Neurobehavioral Disorders Program at Duke-NUS. “Herein lies the peril of sleep deprivation.”

The research team, including colleagues at the University of Michigan and University of Pennsylvania, used magnetic resonance imaging to measure blood flow in the brain during speedy normal responses and slow “lapse” responses. The study was funded by grants from the DSO National Laboratories in Singapore, the National Institutes of Health, the National Institute on Drug Abuse, the NASA Commercialization Center, and the Air Force Office of Scientific Research.

Study subjects were asked to identify letters flashing briefly in front of them. They saw either a large H or S, and each was made up of smaller Hs or Ss. Sometimes the large letter matched the smaller letters; sometimes they didn’t. Scientists asked the volunteers to identify either the smaller or the larger letters by pushing one of two buttons.

During slow responses, sleep-deprived volunteers had dramatic decreases in their higher visual cortex activity. At the same time, as expected, their frontal and parietal ‘control regions’ were less able to make their usual corrections.

Scientists also could see brief failures in the control regions during the rare lapses that volunteers had after a normal night’s sleep. However, the failures in visual processing were specific only to lapses that occurred during sleep deprivation.

The scientists theorize that this sputtering along of cognition during sleep deprivation shows the competing effects of trying to stay awake while the brain is shutting things down for sleep. The brain ordinarily becomes less responsive to sensory stimuli during sleep, Chee said.

This study has implications for a whole range of people who have to struggle through night work, from truckers to on-call doctors. “The periods of apparently normal functioning could give a false sense of competency and security, when in fact, the brain’s inconsistency could have dire consequences,” Chee said.

“The study task appeared simple, but as we showed in previous work, you can’t effectively memorize or process what you see if your brain isn’t capturing that information,” Chee said. “The next step in our work is to see what we might do to improve things, besides just offering coffee, now that we have a better idea where the weak links in the system are.”

Arousal frequency in heart failure found to be a unique sleep problem

Findings show that factors other than central sleep apnea may contribute to poor sleep quality in heart-failure patients. A study in the Jan. 1 issue of the journal Sleep demonstrates that the frequent arousals from sleep that occur in heart failure patients with central sleep apnea (CSA) may reflect the presence of another underlying arousal disorder rather than being a defensive mechanism to terminate apneas. Principal investigator, Douglas Bradley, professor of medicine at the University of Toronto said that researchers involved in the study were surprised that using CPAP to alleviate CSA had no effect on arousals and no effect on sleep structure. Bradley said, “These results indicate that unlike OSA, arousals from sleep in CSA are not protective, but probably have the opposite effect: they appear to be causative. This finding suggests that future studies should explore preventing arousals from sleep in order to treat CSA.” Results indicate that after three months of treatment with continuous positive airway pressure (CPAP) therapy, heart failure patients with CSA show no significant improvement in the frequency of their arousals or in their sleep structure even though breathing pauses are significantly reduced by 55 percent from 35.4 central apneas and hypopneas per hour to 16.1 events per hour. Arousals remain high (24.3 arousals per hour on CPAP compared to 28.8 at baseline), total sleep time stays the same at 318 minutes, and sleep efficiency remains low at 70 percent. Data were analyzed from 205 heart failure patients with CSA who were enrolled in the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure trial, a prospective, randomized, multicenter clinical trial. Participants were between 18 and 79 years of age, and they were randomly assigned to a CPAP treatment group (97 members) or a control group (108 members). CSA was defined as an apnea-hypopnea index (AHI) of 15 or more with more than 50 percent of apneas and hypopneas central in nature. Members of both groups were assessed by overnight polysomnography at baseline and again after three months. Participants in the treatment group were instructed to use CPAP nightly for six or more hours, and their actual usage time was 4.6 hours per day. According to the authors, arousals in patients with obstructive sleep apnea (OSA) are considered to be an important defense mechanism to terminate apneas, and treating OSA with CPAP immediately reduces the frequency of arousals. In contrast, arousals in heart failure patients with CSA often occur several breaths after apnea termination. The authors suggest that hear failure patients with CSA may have a “predisposition to hyperarousability,” and in some there may be an underlying arousal disorder accompanied by sleep disruption that is neither a consequence of CSA nor of impaired cardiac function. In heart failure patients with CSA, arousal from sleep may be incidental to, or play a causative role in, the development of CSA by rendering the respiratory control system unstable. Thus factors other than sleep apnea such as pulmonary congestion during the night, other comorbidities, or medications, may explain the frequent arousals that heart failure patients experience.

What A Sleep Study Can Reveal About Fibromyalgia

Research engineers and sleep medicine specialists from two Michigan universities have joined technical and clinical hands to put innovative quantitative analysis, signal-processing technology and computer algorithms to work in the sleep lab. One of their recent findings is that a new approach to analyzing sleep fragmentation appears to distinguish fibromyalgia patients from healthy controls.

Joseph W. Burns, a research scientist and engineer at the Michigan Tech Research Institute (MTRI); Ronald D. Chervin, director of the University of Michigan’s Michael S. Aldrich Sleep Disorders Laboratory; and Leslie Crofford, director of the Center for the Advancement of Women’s Health at the University of Kentucky, report the results of their study in the current issue of the journal Sleep Medicine

MTRI, a freestanding research institute acquired by Michigan Tech in 2006 and based in Ann Arbor, specializes in remote sensors that collect data, and in signal processing, using algorithms or computer programs to analyze and correlate the information the sensors gather. MTRI has developed an ongoing collaboration with the University of Michigan’s sleep laboratory, one of the nation’s leading clinical and research centers specializing in sleep medicine.

This several-year collaboration provided MTRI’s first opportunities to apply quantitative analysis, remote sensing technology and computer algorithms to clinical challenges, said Burns. “In this case, our analyses of sleep stage dynamics suggest potential clinical relevance,” he noted. Newly explored measures of sleep fragmentation seem to correlate—at least in this study—with levels of pain reported by fibromyalgia patients.

Burns, who has a PhD in electrical engineering, finds that more and more of his research is taking a biomedical turn. He and his team are working with Chervin to use signal-processing technology to record and analyze the brain waves and biophysical responses of children and adults with a variety of sleep disorders. They hope it will help them better understand conventional sleep patterns, as well as diagnose and treat sleep disorders.

They presented the results of research related to assessment of sleep-disordered breathing and sleep fragmentation at Sleep 2008, an international sleep research conference, in Baltimore in June.

Patients who may have sleep disorders often undergo complicated and expensive tests in sleep laboratories, Chervin explained. These studies collect an assortment of biophysical data that reflect brain, cardiovascular and muscle activity throughout the night. Up to now, these data had to be analyzed manually by highly trained technicians.

“We are collaborating to find new ways to analyze routinely collected data in a way that will be meaningful to the patient’s health and will help us understand how sleep disorders affect brain functions,” he said.

Automated analysis of data potentially can provide improved assessments and reduce the cost of sleep studies, Burns noted. For example, MTRI and UM have developed an automated technique for assessing the severity of sleep-disordered breathing, using just two signals—brain waves and respiration—instead of the dozen or more signals typically needed for standard visual scoring of a sleep study.

“It may even become possible for people to take sleep tests—simpler and more effective than some of those currently available—at home where they can sleep in their own familiar bedrooms,” he suggested.

Both partners are reaping the benefits of the collaboration, Burns said. Not only can automated technology improve clinical research; what the MTRI scientists have learned about biomedical techniques such as brain mapping is informing their more traditional work on radar and optical sensing technology.

AASM On Sleep Medications And Insomnia Treatment

Insomnia and Sleep Medications

Insomnia occurs when people have trouble falling asleep or staying asleep, and it is a common sleep compliant. While a brief case of insomnia can arise due to temporary stress, excitement or other emotion, more than 20 million Americans report having a chronic form of insomnia that keeps them from sleeping well nearly every night. As a result, the insomnia, which is a serious and often debilitating condition, can lead to severe daytime fatigue, poor performance at school and work, physical symptoms such as headaches, and in some cases depression.

People suffering from insomnia need to know that there are effective insomnia treatments and their sleep can improve. The American Academy of Sleep Medicine recommends that people who experience insomnia see a sleep medicine specialist or primary care physician for proper diagnosis and to discuss treatment options before treatment with medications is undertaken. This evaluation should also look for specific causes of insomnia such as restless legs syndrome or depression.

Sleep medications are often used for the short-term treatment of insomnia and, on occasion, for more chronic insomnia. Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration and/or reducing the number of awakenings during sleep. While modern hypnotics are considered safe, individuals should be aware that, like all medications, side effects may occur in a minority of patients. These side effects can include sleep walking, sleep eating and other complex sleep behaviors as well as difficulty with memory.

RECOMMENDATIONS FOR PATIENTS

Behavioral therapies and medications have been shown to be effective therapies for insomnia. Behavioral therapies use nonpharmacologic methods to improve sleep and are effective and long lasting. Sleep medications are effective and safe treatments for insomnia when used properly and judiciously by a patient who is under the supervision of a sleep medicine or primary care physician.

The American Academy of Sleep Medicine offers the following recommendations for individuals who use sleep medications:

  • Read carefully the package insert and all information provided by your physician and pharmacist for your sleep medication. This information will help guide you in the safe use of the medication.
  • Especially read the package insert and all information to learn the side effects of the medication.
  • Adhere strictly to the indicated use of your sleep medication. Do not take it for purposes other than to sleep.
  • Follow the prescription carefully and do not take more than the dosage your doctor prescribes.
  • Allow time for a full night of sleep when using sleep medication to avoid morning or daytime drowsiness.
  • Avoid combining sleep medication with alcohol.
  • Ask your doctor any questions you have about the intended use, dosage and side effects. Communication with your physician will help ensure safe use of the medication.
  • Inform your doctor right away of any problems you have while taking a sleep medication.
  • Make your doctor aware of any other medications, prescriptions or over-the-counter, that you use. Mixing medications may cause adverse effects.
  • Make your doctor aware of other medical conditions, including other sleep disorders, you may have. Sleep medications can be dangerous when treating sleep disruption that may arise from another disorder.