The Insomnia Blog by Sleep Doctor Michael Breus, Ph.D.

Sleep on the Government’s Agenda

Has someone been falling asleep in Congress?

I was delighted to hear that Florida Congressman Gus Bilirakis has just introduced a sleep apnea awareness resolution to the House of Representatives. The goal is to raise public awareness of this serious condition and encourage all Americans to educate themselves—and others—about the consequences and potential treatments of sleep apnea. Perfect timing given the fact the President is about to focus on health care.

Trouble Keeping Up with Your CPAP?

It’s widely known in sleep medicine circles that the most common—and helpful—treatment we have these days for patients with Obstructive Sleep Apnea (OSA) is the CPAP machine, short for Continuous Positive Airway Pressure. If you’ve been diagnosed with OSA, then you know exactly what I mean.

The problem with CPAP therapy is that not a lot of people are good about using it on a routine basis. Or, like trying to start a ambitious exercise program, they are compliant at the start and then slowly drop off. Within a few months, they are rarely found using their CPAP. And sleeping poorly as a result.

But there’s hope: new research that just surfaced and was presented last week at a conference in San Diego has revealed that when patients are prescribed just a two-week course of a certain sleep aid (the one marketed as Lunesta), they are more apt to be using their CPAPs in six months.

Stormy Weather, Stormy Sleep

Have you ever had trouble sleeping when a storm blows through? (No, I don’t mean being awakened by the sound of thunder or the pelts of rain on your window.) If you suffer with obstructive sleep apnea, listen up: there’s new evidence that the weather can worsen your sleep-disordered breathing. In other words, when the pressure drops, so does your ability to achieve smooth, restful breathing during the night. 

Surprisingly, not much has been studied when it comes to connections between the weather and sleep. Lots of studies have been done to show the effects of high-altitude, which also worsens sleep apnea; but weather-related changes in atmospheric pressure and breathing during sleep has been a neglected area of study. Until now.

Snoring: A Health Hazard or a Harmless Habit?

When I tell people that snoring can be a sign of a serious health problem, they typically act surprised because snoring is so common. In other words, how can it be so serious if it’s so universal?

Approximately 90 million American adults snore, and of those 37 million snore on a regular basis. It’s a problem among all ages and both genders, but it seems to affect men more than women, and it can worsen with age.

Snoring is a turbulence problem. Air rushes down a tube that causes a vibration in the tissue, which causes a cadence and then a snore. This can cause frequent disruptions in a person’s sleep (not to mention the other person trying to sleep in the same bed). Snorers generally don’t wake up feeling as refreshed as they should.

So, what makes this so dangerous?

Sleep Disorder Saves a Life

I love an unusual story about sleep that has as good ending. Check out this headline: Sleep Disorder Helps Woman Escape Fire.

This past week a woman in Texas can thank her CPAP machine for saving her life when a fire gutted her home. For those unfamiliar with the CPAP (Continuous Positive Airway Pressure machine), it’s a device used by people with obstructive sleep apnea who have a problem that causes their airways to collapse during sleep. Their breathing essentially gets cut off multiple times during the night. With a CPAP, the airway stays open so breathing is possible. Sleep becomes much more restful and solid.

For Geraldine McNeil, here CPAP became her lifeline.

The fire broke out in the early morning hours, and, according to the report, her entire face was covered in soot and ash (and probably chemicals from the combustion, too) except for the area where the CPAP had been. Had she not had the machine on her face, she likely would have been overcome by the smoke.

I can’t think of a more terrifying event than waking to a fire in your home in the middle of your sleep. We’ve heard plenty of stories in the news of people who don’t survive such tragedies. I’ve never heard of a CPAP saving a life in an occurrence such as this.

Not that one would wish to have sleep apnea. But if it were me, I think I’d choose the sleep apnea and CPAP over trying to wake up in a burning house smothered by smoke and find a way out. The number one cause of death related to fires is smoke inhalation—not burns.

Hey, I know the CPAP doesn’t win points for being the most attractive device, but now it’s got an added benefit: Might save you during fire. Imagine that.

Click here to see Dr. Breus's list of recommended sleep products. 

The Eyes Have It

The associations made in medicine can be quite amazing. I just read an article online that summarizes the possible links between a common sleep disorder and eye disease. Plenty has been written about the connections between sleep and conditions like heart disease and obesity, but eye disorders? It doesn’t seem like an intuitive relationship. That is, until you dig a little deeper.

The sleep disorder in question is obstructive sleep apnea (OSA), which afflicts more than 12 million Americans and is characterized by repeated stops and starts of breathing during sleep when throat muscles relax and block the airway. When left untreated, OSA can trigger a variety of health problems, some of which can become evident in the eye when they affect the vascular system. When a doctor looks into your eyes during an exam, he or she is checking on how healthy the blood vessels at the back appear. If they don’t look right, then your doctor will want to understand why—and what the root cause of the problem is.

For some doctors, OSA may not seem like an obvious culprit. Another sign of OSA could be floppy eye syndrome. This sounds more painful that it is: the eyelids turn inside-out spontaneously during the night, causing excessive watering and discomfort. While not a serious medical problem, OSA could be the underlying cause here, too, which can lead to more serious health problems that eventually show up in the eye.

The lesson here is simple: eye disorders or disease don’t necessarily have to be isolated problems. They are often signs of other conditions in the body that affect the health of the eye. Having a doctor well-trained in looking beyond the eye itself to uncover remote—albeit fundamental—problems is important. Proof that they eyes really do have it. How well you are sleeping isn’t just written on your face. It’s written in your eyes, too. Windows, indeed.

Attention Jet Setters Who Snore

Air travel just got more dangerous. A new report just came out indicating that flying strains the hearts of people with sleep apnea.

Obstructive sleep apnea is the most common form of the disorder; breathing becomes halted or very shallow for short bursts of time during sleep. Because of this, the levels of oxygen drop in the blood as not enough gets in through the nose or mouth. Imagine what this could mean for someone with heart or other vascular challenges.

Why Flying is More Dangerous for People with Apnea

It makes sense that the environment on a plane could exacerbate someone’s sleep apnea. (It exacerbates a lot of things, like people’s patience and flexibility.) Oxygen and pressure levels can change, and compounding the problem is the fact people who suffer from sleep apnea generally have higher metabolic demands during flights. In other words, their bodies—especially their hearts—have to work harder to stay fully oxygenated. It doesn’t help that many people who suffer from sleep apnea have another problem: obesity. The two often go hand in hand.

Got Sleep Apnea? Go Green, as in Green Tea

If you find yourself having the proverbial brain freeze at work all too often, and you know you suffer from sleep apnea (or think you do because you just can’t feel rested after a long night’s sleep), then listen up: it’s time to reach for the green tea.

More than 18 million Americans suffer from sleep apnea, a sleep disorder that causes your airway to collapse during sleep. If you’re among those millions, then each night your breathing essentially gets cut off multiple times, and so does that restful sleep. Untreated sufferers of sleep apnea never feel fully rested, which can result in chronic sleep deprivation that can be life-threatening.

Symptoms of Sleep Apnea

You could have apnea if:

• You snore
• You wake up with a headache
• You're moody most days
• You are tired to the point of falling asleep
• You have constant congestion
• Someone has seen you stop breathing

But there’s some good news to report: chemicals found in green tea may be able to prevent some of the cognitive problems that can happen with obstructive sleep apnea.

Help Hubby Sleep: Don’t Vacate the Bedroom

Attention wives whose husbands snore at night: you hold the key to shutting him up and aiding in treating his sleep apnea.

Not long ago, you might recall a comment I made about CPAPs ruining relationships in the bedroom due to their “unsexy” factor. The Continuous Positive Airway Pressure machine, or CPAP, is a device used by people with obstructive sleep apnea who have a problem that causes their airways to collapse during sleep. Their breathing essentially gets cut off multiple times during the night. With a CPAP, the airway stays open so breathing is possible. Sleep becomes much more restful and solid. Untreated sufferers of sleep apnea never feel fully rested, which can result in chronic sleep deprivation that can be life-threatening.

The CPAP is the best strategy we have now to treat apnea, and I encourage people to use it, even though it may not be the most attractive thing to put on at night (or sleep next to). But there’s more to the story now.

Researchers at Rush University Medical Center in Chicago just published a study in an industry journal showing that men whose wives sleep with them in the same bed are more likely to keep using the CPAP.

In fact, one of the authors of the study points out that a woman who has vacated the bedroom—to sleep soundly elsewhere—before her husband has been diagnosed and treated can help her husband’s treatment if she returns to sharing the same bed again. The chance of his continuing to use this very successful treatment is 60 percent higher than if she sleeps alone.

Clearly, a man prefers to get his wife to join him again… even if it means donning the CPAP and taking control of his snoring so she can rest peacefully beside him. And I predict that if a sex study were done to compare notes between those who sleep separately versus those who sleep together… the couple who sleep together wins. Er, has the better sex life.

You see, CPAPs can come off in seconds. Motivating a spouse in another room on the other side of the house isn’t so practical. And now we know that it’s also not as easy to motivate oneself to use a CPAP regularly without a spouse close by.

Proof that a couple that sleeps together, CPAPs together, among other things.

CPAP: Cannot Possibly Act Passionate

Is Your Spouse’s CPAP Machine Ruining Your Sex Life?

I can’t pass up the opportunity to blog about this recent MSNBC headline: “Do you think I’m sexy? Apnea aid raises doubts.”

It’s the white elephant in the room. The thing no one wants to notice much less talk about. How does a couple where one person uses a CPAP machine at night get past the “unsexy” factor of the machine to keep the bedroom a romantic spot?

What is CPAP?

The Continuous Positive Airway Pressure machine, or CPAP, is a device used by people with obstructive sleep apnea who have a problem that causes their airways to collapse during sleep. Their breathing essentially gets cut off multiple times during the night.

With a CPAP, the airway stays open, so breathing is possible. Sleep becomes much more restful and solid. Untreated sufferers of sleep apnea never feel fully rested, which can result in chronic sleep deprivation that can be life-threatening. And last time I checked death is not too sexy.

The Downside

Many people who participate in the support group at www.sleepapnea.org share very positive remarks about the experience with a CPAP. I think I would, too, if I suddenly got a good night’s rest. But there are plenty of detractors out there dying to complain about this device.

The CPAP machine is the best we have right now for treating sleep apnea. It also shuts up the snoring that frequently accompanies that apnea (unsnoring partners listen up: data shows that sleeping with a snoring bed partner makes you lose about 1 hour of sleep!).

But it's no surprise to me that for some couples, the CPAP is derailing romance more than snoring or any other disturbance in the bedroom. There’s nothing sexy about being hooked up to a face mask with hoses and whirring sounds that can seem like you’re sleeping next to a little motor, or in the case of your partner’s CPAP, Darth Vader. This is such a triple-edged sword, though.

Too Tired for Sex

According to the National Sleep Foundation, troubles in the bedroom leads three in 10 couples to sleep in separate bedrooms. What’s more, about 25 percent of people with partners and 10 percent of singles admit that sleep problems leave them too tired for sex. But what happens when the solutions to sleep problems become a new problem for getting it on? And how can you otherwise solve the sleep problems that also put a damper on sex?

The Solution: Sex Before CPAP

My answer (and I don’t think this is all that revolutionary): schedule sex before bringing out the CPAP and stop looking for excuses!

Let’s get real, I don’t think it takes a CPAP machine to kill the moment. There are so many other issues we deal with that can make having a vibrant sex life equally as challenging. How about the hours we put in at work? The late-night TV watching and e-mailing? The kids’ distractions?

I believe the number one reason people don’t have sex as frequently as they’d like is because they feel too tired. So if the CPAP provides restful sleep, it can save your sex life—you can’t have it both ways! You need the CPAP to capture the Zs to deal with your day—and have energy left over at night.

Certainly you can think of a million reasons—other than a CPAP machine—for why you’re not feeling randy. You’re simply not trying hard enough (no pun intended). Think of CPAP as standing for “can put away promptly.” It’s not a permanent fixture. It’s like a piece of clothing you can take off… just as you would for sex.