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2 Mar 2014

Are You Suffering from Chronic Insomnia?

When you having trouble falling asleep or maintaining sleep which lasts more than a month then you are having Chronic insomnia.

Apart from excessive daytime sleepiness the other symptoms of chronic insomnia include fatigue, irritable mood, difficulties at work and relationship problems. All this can make your life miserable.

Who are at risk of chronic insomnia?

As much as 15 percent of the population maybe suffering from chronic insomnia and its consequences. It is more prevalent among females, the elderly and those with medical and psychological disorders.

Primary vs Secondary insomnia

Those with primary insomnia are in a state of hyper arousal. Some studies have found that people with primary insomnia have a higher basal metabolic rate and their brains consume more glucose when awake and asleep. Some have increased levels of cortisol (a stress hormone) in their blood. Primary insomnia responds well to behavioural therapy and sleeping pills.

Insomnia can sometimes be secondary to another cause. This could be a medical problem like heartburn or asthma, chronic pain or depression. Certain medications and alcohol use can cause insomnia. Although behavioural therapy can help people with secondary insomnia, the main aim is to treat the cause that gave rise to insomnia.

26 Feb 2014

The Ultimate Guide to Remembering Your Dreams

So you want to better recall your dreams?

Dreams are usually difficult to remember. You can try to recall what you dreamed last but often have a vague recollection. There are several theories about dreaming and most of them suggest that dreaming is a by-product of our brain's activity during REM sleep. This means we aren't naturally programmed to remember our dreams.

Luckily we can train our brains to better recall our dreams. Here are few tips to help you beat dream amnesia!

Develop a desire to recall

Some people can remember their dreams better than others. But often it takes time to practice recalling your dreams. You might be interested in what dreams tell you about your unconscious mind or might believe that dreams might predict your future. Whatever the reasons you are more likely to give up unless you have a true desire to recall your dreams.

Practice recalling a daytime incident

Often you won't remember much from your dreams to horn your remembering skills. So an alternative way to practise is to recall a daytime incident. You can think about how you experienced the situation, the dialogues and the surroundings. Our brains filter out familiar details and you will be surprised how little you can recall of the surroundings. Trying this mental exercise will improve your brain's recollection skills that will help you better remember your dreams.

Start remembering your dreams

The next time you wake up, spend a little time remembering your dreams. Don't worry even if you can't remember anything. If you are pressed for time, allocate time during the weekends, when you are more relaxed.

Return to your original sleep posture

Sometimes it helps you revert back to your initial sleeping position to help trigger your memory. If you sleep on your sides, then get into that posture and try to remember what you were dreaming.

Use reminders

Dreams are notorious for quickly fading away within a few minutes of waking up. So it is important to have some triggers to remind you to start recalling your dreams. Ask your partner to remind you or place a post-it on your alarm.

Maintain a sleep journal

Place a notebook and a pen close to your bed to make it easy to write down your dreams. Just write down what comes to your mind without trying to make sense out of it. You can use symbols or sketches. Anything to help you record it quickly. Alternatively you can have an audio journal by recording it in a voice recorder.

If you are keeping a sleep diary, then you can even combine both. This way you can see how the amount and quality of your sleep affects your dreaming.

Wake up peacefully

A smooth awakening gives you the best chance of remembering your dreams. A dramatic wake up will distract your brain and throws in interference (layers of new memories and data) which can let your dreams slip away.

Keep your alarms nearby so you don't need to get out from bed. Or better still, try waking up without your alarm.

Keep practicing

Persistence pays off when it comes to dream recall. The more you practice the better you become at remembering dreams.

Avoid sleep deprivation

Not getting enough sleep is detrimental to your health. And it affects dreaming as well. Since most of the REM sleep occurs at the latter part of your sleep, cutting down the number of hours of sleep will reduce REM sleep and thus time for dreaming. Sleep deprivation also hinders your ability to wake up naturally.

Did I miss anything? What helped you to remember your dreams?

23 Feb 2014

Snorer.com's Guide on How to Choose PAP Therapy

If you are diagnosed with sleep apnea, one of the treatment options is Positive Airway Pressure (PAP) therapy. It is reserved for people with moderate to severe sleep apnea that responds poorly to lifestyle changes and weight reduction.

Finding the right PAP machine can be a daunting task. Unlike any other piece of equipment we use, PAP machines are worn during our sleep. So for satisfactory results it needs to fit into your lifestyle and sleep style!

Finding details about different PAP machines can be confusing. A quick Google search will bring up about a million search results. The snorer.com's guide is a perfect starting point for anyone wanting to learn about starting PAP therapy.

Here are few reasons why you should read this guide before embarking on your PAP therapy.
  • The entire guide is written in a simple, easily understandable language. And immediately explains any 'jargon' or abbreviations.
  • The guide is well illustrated.
  • Addresses issues that are commonly encountered by novice PAP users.
  • The guide can be easily read in an hour.
  • It is independent (snorer.com has no affiliations with PAP machine manufacturers). So it is not biased towards one type of PAP machine.
  • And it's free!

You can download your copy of this guide here

And don't forget to leave your comments about this guide.

29 Oct 2013

Top 10 Factors That Worsen Your Sleepiness

Listening to a boring lecture can make you doze off in broad daylight, but you have no trouble staying up late watching a thriller movie.

Many things can alter your sense of 'sleepiness'. Studies have shown that some people are naturally more sleepy compared to others. They fall asleep easily at night. This is the opposite of people who are naturally more alert during the day and find it difficult to sleep at night. This may have to do with the hard-wiring of the brain with regards to sleep.

Besides your genetic predisposition, here are the top ten factors that can make you more sleepy.

Advancing age

Most people beyond middle age struggle to get a good sleep. This means many aren't getting quality sleep. An elderly person will feel more sleepy than an adolescent in a similar situation.

Physical illnesses

You probably would have noticed that when you are not well you fall asleep much easier (unless you have breathing difficulties or severe pain).

Sleep disorders

Sleep disorders like narcolepsy increases daytime sleepiness. Any sleep disorder that disrupts night-time sleep can make you much sleepier than usual.

Sleep debt

Sleep requirements wary among individuals. Not getting your required amount of sleep creates a 'sleep debt'. A small amount of sleep debt a day can add up in time and your body will try to catch-up on sleep by forcing you to fall asleep.

Duration of wakefulness

The longer you stay up, the more sleepier you will feel. The reason why you are more likely to fall asleep at work in the evening than the morning. Taking a daytime nap can help you overcome sleepiness and remain alert.

Time of the day

Our bodies take cues from outside world (mainly the light and dark) to adjust our biological clock so we are active during the day and slumbering during night. We have the highest alertness around 10am. Our alertness drops slightly in the afternoon, coinciding with siesta time. We are more likely to fall asleep around this time. Our sleepiness diminishes again but as we go into the night, we become more are more sleepy.

Medications

Certain medications can cause sleepiness as a side-effect. Some of these effects can last longer and increase the tendency to fall asleep even while working.

A heavy meal

You are more likely to feel sleepy after devouring a large meal. There are several explanations as to why this happens. After a meal, blood circulation is diverted more towards your guts to collect the absorbed nutrients. This reduces blood flow to the brain, making you sleepy. A carbohydrate rich meal can raise the sugar levels which in turn elevate the insulin hormone level. A hormonal cascade eventually triggers an increase of serotonin which makes you sleepy.

Sleep inducing food

Eating food that promotes sleep like oatmeal, banana, honey, almonds, cherries, dark chocolate and cheese make you more sleepy.

Environmental factors

Your surroundings can increase or decrease your desire for sleep. A boring lecture can put a well rested person to sleep. Lack of stimulation for the brain and low light worsens sleepiness.

28 Oct 2013

What is Your Sleep Personality?


Everyone has their own unique style when it comes to sleeping. Studies has shown that our sleep postures are linked to our personalities.

The following are six common sleep traits. See which one you belong to. It is possible to change traits with time or to share more than one trait at a given time.

Night owl

Some people stay up past midnight as a habit. It is believed that this preference for delayed sleeping is engraved in our genes. Night owls often feel energetic and creative at late hours. It can also be a sign of delayed sleep phase syndrome. Teenagers naturally tends to sleep late because of a change in their biological clocks.

Night owls often have problems getting up early and often lose REM sleep as a consequence of losing their latter part of sleep. If you are a night owl, then try to fall asleep and wake up at regular times. Also plan for the following day and make preparations at night, so you can get more sleep in the morning.

Early to bed

Our ancestors slept early. And some people habitually sleep early. These people often find it difficult to keep their sleep habits with late night parties or dinners. Falling asleep early can be a sign of advanced sleep phase cycle syndrome. If you feel sleepy during the day and fall asleep early, it is a sign of severe sleep deprivation.

Weekend catch-up sleeper

Some people work hard during the week days often sacrificing their sleep and get some additional rest during the weekends. This accumulated sleep debt can be detrimental to your health. While it is better to get adequate sleep during the weekends, oversleeping cannot compensate for the sleep deprivation during the week.

If you belong to this category, then try practicing good sleep hygiene. If you can't improve on quantity, improve the quality of your sleep.

Heavy snorer

Snoring is often a danger sign. If you are a heavy snorer, you need to get screened for sleep apnea. Snoring means an obstruction to your airways. Heavy snorers also feel sleepy during the day despite getting an adequate night time sleep.

Snoring can also be detrimental to your sleep partner.

Frequent napper

Taking a nap during the day helps you to revitalize your body. But too many naps can interfere with your night time sleep. Some people habitually sleep more during the day and sleep less at night.

These polyphasic sleep patterns cannot be sustained for long periods. The Uberman sleep schedule includes only a series of short naps spaced during the 24-hour day.

Worried insomniac

If you find it difficult to fall asleep at bedtime, then you need to make changes to your lifestyle. Avoiding caffeine, exercise and napping in the evening can help you fall asleep. Also learn to relax before bedtime since worry can worsen insomnia.

Does your sleep habits match these six categories?

25 Oct 2013

How to Get the Most Out of Your Daytime Nap

In the right setting, daytime naps be bring many benefits. But done incorrectly, daytime napping can backfire and ruin your night-time sleep.

A short daytime sleep can help you relax, reduce fatigue, improve your mood and performance, improve creativity and help you get rid of daytime sleepiness.

Who benefits more from daytime napping?

  • The sleep-deprived: When you don't get enough sleep the previous night, daytime naps help mask the sleepiness.
  • Narcolepsy: Brief naps before tasks that need more attention, helps people with narcolepsy.

Drawback of daytime napping

When you are struggling to fall asleep at night, even a single daytime can prevent you from feeling sleepy at bedtime. One beheviour modification for insomnia, is to eliminate daytime naps.

Sleeping for too long also makes you feel drowsy and lethargic. This is called sleep inertia. When you wake up suddenly in the middle of deep sleep, your brain needs some time to adjust.

The right time...

Daytime naps are best taken when you're feeling drowsy. But between 1pm to 3pm we naturally feel sleepy, as our biological clocks slow down your bodies. Avoid napping close to your bedtime as this can interfere with night time sleep.

The right environment...

It is important to nap in a quiet environment. Use earplugs and eye patches to create a sleep friendly environment. If you are napping in your bedroom, close the windows and ask others not to disturb you during your short nap.

The right duration...

Daytime naps are best kept under 30 mins. Oversleeping can drift you into deep sleep. Waking up from deep sleep is a nasty experience. Set up an alarm or ask someone to wake you up.

The right posture...

Unless you're working for Google or Nike (or any other company that promotes daytime napping), you are less likely to find a decent place to nap. Sleeping in awkward postures can cause neck strains and back pains.

Daytime naps have many benefits. More and more companies are encouraging their employees to take naps. But feeling too sleepy can also be a sign of a sleep disorder like sleep apnea. So if you are constantly feeling sleepy during the day, discuss it with your doctor and rule out a sleep disorder.

9 Oct 2013

How to Deal with Your Partner's Snoring

This is a guest contribution by Adrian Zacher of snorer.com

Picture of a woman dealing with a snoring partnerWhether you or your partner is snoring – don’t fight about it. It’s all too easy to argue and never really get to a solution... instead try these constructive ideas below to stop that snoring noise!

But before we dive into that; an important question: is the snorer excessively sleepy in the day? If yes then seek help from your doctor by asking about obstructive sleep apnea.

OK, here are few tips to help you with a snoring partner….

Timing - find your moment

Like delivery of the punch line to a good joke – timing is critical. If you want to discuss something that is very personal and may make your partner defensive, be sensitive to when they might take on board what you are saying.

Try to be calm - it’s how you say things

If you have spent night after night awake listening to their snoring or ‘have had a gutful’ of the noise and now sleep in the spare room or on the sofa you may launch into a tirade against the offending snorer. That doesn’t help your cause!

Propose a course of action

Investigate the options first –do your homework. Find out what that the snorer can do about the racket they cause. Your local family Doctor is a good starting point.

The snorer may otherwise throw the “What do you want me to do about it?” line at you. As they may feel helpless, defensive and think there is nothing they can do to stop snoring and think you are just moaning.

Support and encourage

Plant the seed in the mind of the snorer, that there is an issue that they can resolve. Then be patient (but do persist!) and encourage them to act. Offer to go with them to the Doctor – but try not to take over the conversation when you are there.

Follow up

Like a good salesperson – follow up on your activities to encourage the snorer to change their ways. This is absolutely critical!

In a Nutshell...
Snoring is more than just a nuisance and is eminently treatable. Evidence suggests it is a health issue for the snorer regardless of the presence of sleep apnea. Good Luck and I hope you sleep well.

About the Author: Adrian Zacher is the founder of Snorer.com a website devoted to anonymous home sleep studies and Jargon-Busted, evidence-based, How-to-Choose Guides about the various treatment options for snoring and obstructive sleep apnea.

23 Sep 2013

How Do You Determine the Severity of Sleep Apnea

This is Part 4 in series of blog posts on Sleep Apnea. Read Part 1, Part 2 & Part 3

Picture of a man snoring
Knowing the severity of sleep apnea is important when it comes to treating sleep apnea. There are three grades of sleep apnea: mild, moderate and severe.

The degree of severity is judged not only by symptoms, but also considering the obstruction to airflow and resulting reduction in oxygen level in blood (oxygen saturation)

Not all sleep experts agree on a single method to determine the severity. This is partly because there isn't much data on sleep habits and sleep apnea. This is nothing new in medicine. And as knowledge gathers, it becomes clear what is 'normal' and what is 'abnormal'. Also as we learn more about the health risks of sleep apnea, it will become possible to categorize sleep apnea based on its outcome on your health.



What is Apnea-Hypopnea Index (AHI)?

An apnea is the cessation of breathing for 10 seconds or more due to complete blockage of airway. This causes a drop oxygen saturation.

Hypopnea is partial obstruction in the airway with a reduction in airflow (by at least 30%) which results in a drop in oxygen saturation.

The AHI or apnea-hypopnea index is the number of apneas and hypopneas that occur in an hour of sleep.

What is oxygen saturation?

When blood is pumped through the lungs, it becomes saturated with oxygen. Usually this saturation is very close to 100 percent. But in sleep it can drop a little. In sleep apnea, partial or complete blockade of airways prevent gas exchange and saturation of blood oxygen.

Read the other posts in this series
Part 1 - What is sleep apnea?
Part 2 - Obstructive sleep apnea
Part 3 - Treatment options for sleep apnea

18 Sep 2013

Treatment Options for Sleep Apnea

This is Part 3 in a blog post series on sleep apnea. Read Part 1 and Part 2.

If you are diagnosed with sleep apnea, then it helps to know what treatments are available. There is a range of treatment options starting from behaviour modifications to surgery.

Lifestyle changes

Some risk factors can be changed so you no longer belong to that risk group. Cessation of smoking and limiting alcohol consumption at bedtime can improve sleep apnea. Also avoid sleeping pills which reduce the muscle tone of the upper airway.

Sleep apnea is worse when sleeping on your back. At least in milder form of sleep apnea, side sleeping helps reduce snoring and apneas, by helping to keep the airway open.

Weight loss

Two thirds of those who have sleep apnea are obese. Losing weight helps reduce snoring and progression into severe sleep apnea.

Nasal decongestants

This is helpful in mild cases of OSA to relieve an obstruction in the nasal cavity.

Oral appliances

There is a wide range of devices that are marketed as sleep apnea treatment. They move the lower jaw forward. Even a little change can help keep the airway open. These oral appliances are helpful in mild to moderate sleep apnea.

CPAP

Continuous positive airway pressure or CPAP keeps the airway open by continously blowing an air stream into your upper airway. CPAP is given via a mask applied to the nose or cover both nose and mouth. CPAP is recommended for moderate to severe sleep apnea.

Surgery

Surgery is aimed at correcting the airway obstruction. Since airway obstruction can occur at multiple sites, it is not easy to determine which part needs surgical correction. The commonest type of surgery is uvulopalatopharyngoplasty or UPPP. It has a success rate of 50 percent.

Alternative methods

Playing the Aboriginal musical instrument, didgeridoo has been found to improve sleep apnea. Didgeridoo playing may help improve the muscle tone of the upper airway so that it resists collapsing while sleeping.

This is Part 3 in a series of blog posts on sleep apnea.
Read Part 1 - What is sleep apnea?
         Part 2 - Obstructive sleep apnea


17 Sep 2013

Obstructive Sleep Apnea | A Lot More Than Snoring!

Obstructive sleep apnea (OSA) is the most common form of sleep apnea. The other two forms are central sleep apnea and complex sleep apnea.

Awareness on sleep apnea is growing. But still three out of four individuals with sleep apnea remain undiagnosed. Lack of awareness among patients delays seeking treatment. Doctors often look for alternate causes than sleep apnea, when patients present with lack of energy or excessive sleepiness.

One way to overcome these problems is by improving awareness on sleep apnea.

Obstructive sleep apnea results from a narrowing of airways at the level of the throat. For most people, OSA is synonymous with snoring. But every snorer doesn't have OSA.

What are the symptoms of OSA?

  • Loud snoring
  • Sleep disturbances and insomnia
  • Awaking during sleep gasping for breath
  • Brief 'pauses' in breathing observed by a bed partner
  • Waking up with a headache
  • Excessive daytime sleepiness
  • Difficulty in paying attention
  • Forgetfulness
  • Falling asleep while driving or at work
  • Irritability
  • Reduced sex drive

Roughly 3 to 7 percent of adult males and 2 to 5 percent of adult females are affected by sleep apnea. This isn't a big number. But sleep apnea is more prevalent in certain risk groups.

Risk factors for obstructive sleep apnea

  • Obesity - An increased body mass index (BMI) puts you at risk of obstructive sleep apnea. Obesity is on the rise in all parts of the world. This in turn is increasing OSA. Excessive weight gain is associated with rapid progression of sleep apnea from mild to severe. Weight loss can reverse the progression of OSA or even make you symptom free.
  • Age - Obstructive sleep apnea is more prevalent among the elderly. Some studies show that 20 - 50 percent of people over 65 years have OSA symptoms. Changes in the body structure, lengthening of soft palate and increased fat deposition around the pharynx occurs with aging is believed to increase the risk of OSA in elderly.
  • Sex - Men have a higher incidence of OSA compared to women. The risk among women rises after menopause, suggesting a protective effect by female hormones.
  • Race - Asians have the same risk of developing OSA as Europeans and Americans. But since Europeans and Americans are more obese, body weight plays a bigger role among Asians when it comes to OSA.
  • Facial anatomy - Certain facial features naturally make the airway narrower than usual. Backwardly placed tongue, enlarged tongue, tonsils and soft palate and backwardly placed maxilla and mandible (lower jaw bone) reduces the diameter of the airway.
  • Family history - Having first degree relatives with OSA puts you at risk of developing sleep apnea. It could be due to inheritance of structural changes and obesity.
  • Smoking and Alcohol - Cigarette smoking (including second hand smoking) can damage the upper airway and throat increasing the risk of airway collapse. Alcohol can reduce muscle tone and cause airway collapse.
  • PCOS - Polycystic ovary syndrome (PCOS) increases the androgen (male hormone) level in the body and increases fat deposition, which in turn increases the risk of OSA.
  • Hypothyroidsm - Lack of thyroxin hormones in the body can cause obesity and enlargement of tongue and pharyngeal soft tissues. Some studies have hinted that hypothyroidism also reduces the respiratory drive.
  • Pregnancy - Changes in the body structure may partly explain the rise in OSA and snoring among pregnant mothers. Severe OSA can cause fetal growth retardation.

How do you diagnose obstructive sleep apnea?

Obstructive sleep apnea is diagnosed based on symptoms and sleep study. The sleep study (whether in a special sleep clinic or home based) will monitor your sleep and record any apneas or hypopneas. This also helps to assess the severity of sleep apnea which is helpful when it comes to deciding what treatment to use.

This is Part 2 in a series of blog posts on sleep apnea.
Part 3 Treatment options for sleep apnea (will be posted tomorrow)