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  • Sleep Disorders

    A sleep disorder is a physical and psychological condition or disturbance of sleep and wakefulness caused by abnormalities that occur during sleep or by abnormalities of specific sleep mechanisms. Although sleep disorders exist during sleep, recognizable symptoms manifest themselves during the day. Accurate diagnosis requires a polysomnogram, widely known as a sleep test.
    Here is a list of some well known sleep disorders:

    Sleep Apnea – one of the most common sleep disorders known. Characterized by loud, constant snoring and repeated arousals caused by an obstruction of the airways and disordered breathing. Sleep apnea is known in 3 forms – obstructive sleep apnea, central-sleep-apnea and mixed apnea. Obstructive sleep apnea is the most common, as well as the most serious one of all.

    Snoring – probably the most common one among all sleep disorders. It is a noise produced by a sleeping individual in which the soft palate and the uvula vibrate during breathing. It is a sign that the breathing airway is not completely open. The unpleasant and often annoying sound associated with snoring comes from efforts to force air through the narrowed passageway.

    Insomnia- a sleep disorder that means inability to fall asleep. Insomnia often disrupts the daily routine and it can result from a diet, intake of caffeine or alcohol, emotional difficulties, stress or an underlying disease. It may cause different problems during the day, such as tiredness, lack of energy, difficulty concentrating, and irritability. Insomnia can be classified to 3 – transient, intermittent and chronic.

    Narcolepsy- a sleep disorder that is characterized by excessive and uncontrollable daytime sleepiness. These sleep attacks can occur at anytime, even while the person is engaged in an activity. During sleep, narcoleptics have an abnormal sleep pattern: They enter REM sleep prematurely without going through the normal sequence of sleep stages. Patients with narcolepsy often feel tiredness most of the time. Other symptoms of narcolepsy include cataplexy, sleep paralysis, and hypnagogic hallucinations.

    RLS and PLMD- these are common sleep disorders among elderly. Restless Legs Syndrome (RLS) is a neurological sleep disorder in which patients experience irrepressible sensations in the legs or arms while sitting or lying still. Terms used to describe restless legs syndrome may include creepy, crawly, pulling, tingling, itching, or gnawing. Unlike other sleep disorders such as narcolepsy, RLS occurs only when lying in bed and not during daily routine activities. Periodic Limb Movement Disorder (PLMD) causes jerking in the legs or arms that occurs frequently during resting or sleeping.

    Hypersomnya- this sleep disorder refers to either excessive sleepiness during the day or extended, overly long periods of nighttime sleep. As with most sleep disorders, hypersomnia is underreported because many people inaccurately believe that always feeling sleepy and taking naps are consider a normal behavior. This phenomenon is mostly common with teenagers and young adults.


    Glossary

    APAP – Automatic Positive Air Pressure
    BiPAP- Bilevel positive airway pressure (see also VPAP)
    CPAP – Continuous Positive Air Pressure
    CHF - Congestive Heart Failure
    CSA – Central-Sleep-Apnea
    EPAP - Expiratory Positive Airway Pressure
    EPR – Expiratory Pressure Relief
    IPAP - Inspiratory Positive Airway Pressure
    NREM – Non Rapid Eye Movement
    OSA – Obstructive-Sleep-Apnea
    PLMD- Periodic Limb Movement Disorder
    REM – Rapid Eye Movement
    RLS- Restless Legs Syndrome
    SAS – Sleep-Apnea-Syndrome
    SDB - Sleep-Disordered-Breathing
    VPAP - Variable Positive Airway Pressure


  • What is Obstructive Sleep Apnea?
  • What is continuous Positive Air Pressure therapy?
  • What are the risks that can be caused from OSA?
  • I have been diagnosed with OSA, what should I do?
  • which products provide a complete treatment for sleep apnea?
  • What is a CPAP Machine?
  • Which ResMed CPAP Masks work with which ResMed CPAP devices?
  • What do I get with the Continuous Positive Air Pressure machine?
  • What is a sleep apnea pillow?
  • What is a nasal mask?
  • What is humidification in sleep apnea treatment?
  • What is the HumidAire 3i?
  • How often should I replace my CPAP accessories?
  • Do all machines use filters?
  • What is a smart data card?
  • What are CPAP tubes / hoses?
  • Is there any special maintenance for the S8 machines?
  • What is narcolepsy?
  • What about Medicare's participation in the fee?


    Answers

    What is Obstructive Sleep Apnea?
    Obstructive Sleep Apnea (OSA) is the most common apnea phenomenon in sleep-disordered breathing. It is a condition in which a patients breathing passage seals during sleep, causing the patient to stop breathing. The body responds to this lack of oxygen by waking from sleep.

    What is Continuous Positive Air Pressure therapy?
    CPAP stands for Continuous Positive Airway Pressure. The therapy provides a constant airflow which holds the airway open so that uninterrupted breathing is maintained during sleep. This eliminates apnea and allows the patient to get a restful and continuous sleep. CPAP therapy is traditionally provided through a CPAP machine to which connects a nasal mask that seals the area around the nose.

    What are the risks that can be caused from OSA?
    Untreated OSA is potentially fatal and frequently results in serious health problems, such as heart attacks, strokes, high blood pressure, diabetes, preeclampsia in pregnant women, attention deficit disorder in children and more.

    I have been diagnosed with OSA, what should I do?
    As OSA must be treated seriously on a nightly basis, you must use high quality CPAP equipment. There is a major difference between basic CPAP device and high end CPAP equipment. High end CPAP equipment, such as the ResMed CPAP S8 series, is generally smaller, lighter, quieter, less prone to leak, easier to breathe against, better humidified and easier to travel with than basic CPAP Equipment. The most important thing in this treatment is comfort and one should not compromise on it.



    which products provide a complete treatment for sleep apnea?
    The full CPAP equipment package is generally composed of these products: a machine (APAP, BiPAP or CPAP), a CPAP mask (nasal mask or full mask), CPAP tubing and CPAP filters. It is recommended to add a humidifier to the machine in order to relieve symptoms of dryness and ease the therapy process.

    What is a CPAP Machine?
    A CPAP device (also called sleep apnea machine) is a respiratory ventilator that blows air at a prescribed pressure. The necessary air pressure is usually determined by a physician after review of a study supervised by a sleep technician during an overnight sleep in a laboratory. A typical CPAP machine can deliver pressures from 4 to 20 cm of water. After setting the necessary pressure, the sleep-apnea machine blows the air in a constant rate.

    Which ResMed CPAP Masks work with which ResMed CPAP devices?
    You can safely mix and match nearly all CPAP devices with the CPAP full or nasal mask selection. Note that there are known issues with APAP Machines and certain styles of CPAP masks as well as with sensor tubes and some CPAP masks.

    What do I get with the Continuous Positive Air Pressure machine?
    All of our CPAP devices come with a six foot hose, user manual, ResScan data card, one filter, carrying bag and a power cord. The sleep-apnea machines don't come with a CPAP Mask. CPAP Masks and other CPAP accessories must be purchased separately.



    What is a sleep apnea pillow?
    A sleep apnea pillow is one of the most common CPAP accessories. The sleep apnea pillow holds the sleeper's head in a concave cradle and tilts it back, extending the neck and increasing the diameter of the upper airway to ease breathing. The sleep-apnea pillow offers a reasonable, non-invasive treatment option for patients with mild forms of obstructive-sleep-apnea.

    What is a nasal mask?
    A nasal mask is a common CPAP equipment. The nasal mask seals the area around the entire nose and is held in place with straps, or headgear. This CPAP headgear, used with the nasal mask is mostly recommended for first-time users.

    What is humidification in CPAP treatment?
    Humidification adds moisture to the CPAP-air inside the CPAP machine, reducing irritation in the nasal passages caused by the increased airflow, as CPAP-air is considers irritant. In some cases the irritation dries out the nasal passages and may cause bleeding. It may also cause swelling, excess mucous, congestion or sneezing. The irritation also creates a very fertile ground for infections to develop. The irritation may be cumulative, building up over time. The only way to reduce the irritation is to add moisture.

    What is the HumidAire 3i?
    ResMed's HumidAire 3i is a compact humidifier that is applicable with all the S8 series of sleep-apnea machines. It is a heated humidifier that uses heat to produce moisture. The heat is adjustable for more or less moisture, and the chamber is much smaller than a standard humidifier. It is our experience from years of specializing in CPAP devices and accessories, that patients who use heated humidifiers have a much higher rate of compliance to CPAP therapy.



    How often should I replace my CPAP accessories?
    As all medical equipment, CPAP accessories need to be replaced periodically. It is recommended to replace the sleep-apnea pillow every three months and the whole CPAP mask system every six months. From our experience, most mask cushions begin to deteriorate after about six months of use. The silicone eventually becomes too soft for sealing and the headgear straps must be tightened more and more to get the same quality of sealing. We strongly suggest replacing the sleep-apnea pillow as soon as it starts to soften. Air leaks may reduce the effectiveness of CPAP therapy and CPAP headgear that is too tight may cause facial sores at pressure points.