Better Sleep Coach; Your Help to Better Health through Better Sleep

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If you have sleep apnea and are using a CPAP machine than you know that there can be issues that make this therapy difficult to use.  Sometimes you can find support to resolve these issues and sometimes there are solutions that your doctor, sleep tech or respiratory therapist may not be aware of.  Researching this on the internet can be equally as baffling because of all the contradictory information.  There are however some solutions that might solve some common problems when using CPAP.   

 One of the biggest issues people have is with their mask.  During the first thirty days after receiving your machine you can change your mask at no cost just by calling the company that set up your machine.  After that if you want to change your mask you need to get a prescription from your doctor.  In many cases your sleep lab or your sleep doctor can bring you in to try out different masks and than write a prescription and send it to the DME company. 

If the mask leaks or if you are developing a sore on the bridge of your nose a device called a Gecko nasal pad will help to reduce leaks around the nose and will take the pressure off your skin.  Remzzz makes a full face mask liner that will also assist with this problem. 

If you are developing dry mouth or a dry nose and you have increased your humidifier as high as it can go than you may want to ask about a heated tube.  In certain machines they can be added to help increase humidity without water raining out into the tubing. 

If you are finding that your face is breaking out where the mask sits than there can be a couple of solutions to this problem.  You are not washing your mask cushion every day or you may be using a soap that is too harsh.  Make sure you wash the mask with something you can also wash your face with.  Make sure it is rinsed well and air dried.  You also need to make sure you are changing your mask and mask cushion frequently enough.  If you go too long the cushion begins to get brittle and will develop leaks, you will than tighten it too tight which will than cause problems with your face.

If you are a side sleeper, than you might like the new sleep pillows that several companies have created.  They have great support while having cut outs that allow you to roll on your side without the mask becoming dislodged and leak. 

If you are unable to tolerate the pressure, than you might be a candidate for an oral appliance.  Sometimes they will replace the CPAP and sometimes you can use them in conjunction with the machine to reduce the pressure.  There are many different types of oral appliances and they should be created by a dentist trained in sleep specific oral appliances. 

The most important thing you can do is talk to those who are there to help you.  Discussing your problems with the sleep doctor, sleep lab or DME company is the best way to solve your problems.  CPAP therapy is long term therapy and we understand that it sometimes takes a little time to get used to it.  It is the job of the professionals to help you adapt to the therapy and if you can not than to help you find an option that will work best for you. 

I I was chatting with some technicians the other night who were concerned about remembering everything they needed for taking their test.  As I was talking with them I realized no one had ever taught them how to study or how to take a standardized test effectively.  This surprised me since we have to take so many tests in this day and age.  So where did the lessons in how to manage our time effectively go.  I am not sure, but I thought I would share some of the best tips and tricks I was taught to help me study.

 

• The more senses we use the better we will retain something.  For the information that is black and white such as formulas and definitions if you copy and say them out loud 10 times you are about 80% likely to retain that information.  I use note cards for the information so I am killing three birds with one stone.  So I am reading, writing and saying out loud ( not whispered in my head) the definition I need to retain.
• When you are planning for a test you should always look to see if they have a layout of the test or a blueprint.  This will allow you to spend your time effectively.  If 50% of the test is on 1 or 2 topics than 50% of your study time should go into that topic however if 10% of the test is on a subject you should only spend 10% of that time studying that topic. 
• Always start studying by taking a sample test.  This lets you know what your strengths and weaknesses are.  You will be amazed what you actually know.
• Always read the answers before you read the question.  This allows your brain to know what answers are available and will search for the correct answer to the question.
• Make sure if there is a specific book they suggest you use that you have access to a copy of it.  If it is a sleep test you should have an AASM scoring manual and the Articles written by the AASM on titrations.  If it respiratory therapy you should use the texts that your school uses and check the NBRC and AAST websites for articles on new therapies and standard procedures for delivery.
• Give yourself enough time to study.  You should start studying for a test 6 months prior to the test.  If it is a test you can take upon graduation than you should take it as soon as possible.  The longer you wait the more information you will loose.  However if you are preparing for a test where you are not taking a course than you should spend at least 6 months preparing and studying a little each day.  Cramming will do nothing but make you nervous and you will not retain the material you need. 
• Always sleep well while you are studying.  You all know that if you do not sleep well the information will not move from short term memory to long term memory.

Standardized testing is a way of life if you want to work in the healthcare field.  Using some simple study skills makes your time more effective and you have a better chance of passing the first time.  Remember that the person who passes with a perfect score and the person who passes by 1 point will still have the same credentials.  This is about testing your knowledge about your chosen field and not a way of torturing you.

_ As we go through out review of the past year and look forward to our next year it is important that the time we take to review and pledge to move forward we considers all aspects of our lives. If we do not create a life that is balanced we cannot be optimally healthy. There are several steps you can take to make goals more successful when you are planning how to balance them.

Your health should always be your priority. You cannot be successful in other areas of your life if you do not care for yourself. If you find that you have more chores than hours of the day you need to prioritize. You should always write them down whether it is on your smartphone, on paper or on your computer. You will have emergencies arise but if you plan for things like exercise, meal preparation and your yearly physical than you are more likely to to accomplish them. The same is true of your sleep time. If you plan for bedtime than you are more likely to go to bed in a timely manner.

With bedtime in mind you might want to consider adding 10 minutes of stretching or yoga to help you to relax. Giving yourself time to unwind that is not electrical in nature will help you to go to sleep easier. The light from television, your cell phone or your computer can be too stimulating to your brain and keep you from going to sleep. The proper amount if sleep will help you be healthier, think clearer and lose weight of that is one of your goals.

Take time to pack your meals. Eating healthy is difficult but if you take a little time to pack your breakfast and lunch you will find you will eat healthier and feel better. In the morning if you do not have the time to eat a full meal consider a meal replacement shake. Having your breakfast will help you to not be so hungry at night. This is especially important for those with acid reflux, hiatal hernias or GERD because you really should not eat right before bed.

Plan your exercise time in advance. If you are not a morning person do not plan to get up early to exercise because you are setting yourself up for failure. If however you know you work late every night than plan to get up a little earlier and go for a walk or do a video. The nice think about videos is that no one else will see how uncoordinated you are.

Take time to connect to your friends and family. People who are connected are less stressed. When you have less stress you are less likely to suffer from insomnia. If you do have insomnia issues behavioral changes have been found to be more successful than medications for long term treatment.

Looking forward to the new year we need to find the balance between work, family and taking care of ourselves. It is not an easy goal but with a little planning you can put your health at the top of your list. As it is said when you feel good those around you feel good.

_ Research about sleep and its association with health problems have abound over the past year. Yet even with all this research many people do not know when to approach their doctor if they have questions. Even if they do have questions they wonder when medication will help and when to ask if they need a sleep test. The more informed you are the more likely you will get the care you need.




If you are snoring during the night and it is loud enough to keep someone else awake you should talk to your doctor about having a sleep test. Snoring can be a sign of sleep apnea which is a blockage of the upper airway when you fall asleep. This causes disrupted sleep, increased work of breathing, decreased oxygen levels and increase pressure on the heart. Not everyone who snores has sleep apnea but it is something that should be discussed.




Not everyone who has sleep apnea snores. There are other issues that can be indications of sleep apnea. If you wake up to go to the bathroom more than 2 times a night that is something that you should discuss because it might be sign that you have sleep apnea during REM sleep, or when you dream. If you find yourself tossing and turning all night long than you should tell your doctor when you go in for your yearly physical.




If you are taking medication and you are experiencing insomnia than you should take the time to talk to your doctor. Many medications including over the counter medications have insomnia as a side effect. It can also be the effect of mixing medication or supplements. Whenever you see your physician you should not just tell them what medications you are taking but also any vitamins, supplements or over the counter medications you take. If you have not changed medication than you should keep a sleep diary for 2 weeks before you see your doctor. If there is anything affecting your sleep he or she will be able to have a good idea or you may see something in your routine you can change that will help you to sleep better.




If you are having insomnia issues and they have lasted longer than a few weeks. You might want to talk to a sleep coach or look into cognitive behavioral therapy to help evaluate sleep and to help you to change some of the behaviors that are causing the insomnia. New research has found that CBT is more effective than medication.




Many people who think they are depressed or are very fatigue may have a sleep disorder that they are missing. We many not notice out own snoring or disrupted sleep but we do notice the effects of sleep deprivation. Taking a simple Epworth Questionnaire will let you know if you should have your sleep evaluated due to fatigue. Since this questionnaire is subjective it is very important that you are honest not just with the doctor but with yourself. If you come home from work every night and sit in your recliner and go to sleep even if you slept 7-8 hours that is not normal. If however you get sleepy around 3pm, but you have no real difficulty staying awake, that is a normal part of our body's internal clock and does not need to be evaluated.




The best thing about evaluating your sleep is that if you do have a sleep issue and it is treated you will feel better and have more energy. You may not have known that your sleep was being effected but a little self evaluation is always helpful before visiting your physician. It will help you to keep yourself healthy and have a much more productive time when you do have to see your doctor.

_ We all want to change. Whether it is changing your sleep habits, getting used to your CPAP or losing weight or adding a healthy sleep routine to your life. The problem many face is that if you are trying to change those who are closest to you may not be as supportive as you hope or need.

When you change the changes can be threatening to those who you life with. This is especially if you are changing something that they do not want to change themselves. People like what they know and what they are used to but when you change it makes it necessary for them to either change themselves or to keep you from changing.

If this is your issue than sitting down with the person and discussing this issue may help. If it does not than it might be best to look for support outside your immediate family. You should take advantage of the many resources at your disposal.

• Internet- There are some great resources on the internet for support no matter what your goal is. You should not have to pay for it. For information and support on CPAP you can go to cpaptalk.com or sleepguide.com. For weight loss sparkpeople.com is a great resource for support with other people going through the same thing as you.
  
  
• Local Support Groups- A.W.A.K.E. Groups are throughout the country and can be a great place to meet other people who are trying to get used to CPAP therapy and may give you some ideas you never thought of.
  
  
• Your Sleep Lab or Sleep Physician-These are the people who work with CPAPs every day and are there to help you be successful over the long term. Call them and ask your questions. If they do not have the answers they will know who does.
  
  
• Your Medical Equipment Company-Again they work with the equipment every day and they understand when you are having problems and can give you advice on what to do next if you are having problems.
  
  

Support is essential to success in any goal you set. Look for and ask for help. You never know where you will get it if you do not ask. The final goal is for you to make a change with as little stress to you and your loved ones as possible.

The commercials show a family all smiles enjoying a meal laughing and enjoying great conversation. They all look relaxed happy and well rested. The truth is that the holidays can be a stressful, depressing and hectic time of year. However, with a little planning and setting a few priorities you can enjoy your holidays and not look like you just trained for a marathon.




Make bedtime a priority. You will feel better if you go to bed at the same time every night. This does not mean you should never go out and enjoy a night out with friends, but this should not be an every night. Sleep deprivation will make you fuzzy, grouchy and tired the next day. You can sleep in the next day and you will make up for some of the lost sleep.




Take time to unwind. With all the excitement going on during the holidays we take very little time to relax and unwind. This is the time of year when a sleep routine is most helpful. Take twenty minutes to relax, read a little, journal, an do a little stretching to help you unwind. It will be one of the best ways for you to fall asleep faster.




Get some exercise in the morning. A little physical activity in the morning will help you start off the day with a little more energy. It will be even more helpful if you can spend that time outside. The light and the increase in oxygen and blood flow will help you to be more focused during the day.




Drink your water. Dehydration can keep your mind fuzzy and increase you stress. If you are dehydrated you can also have muscle cramps that can keep you up at night. It is one of the easier things to keep you healthy.




Don't sweat the small stuff. A little planning and the acceptance that some things will go wrong during the holidays will allow you to enjoy the holidays with less stress. The holidays are not about perfect place setting but about laughing and hugging. These will help you to relax and when it is time to go to bed you will find you will be able to fall asleep faster.




The goal of the holidays is to all your to enjoy food, fun and family. Whether it is Thanksgiving, Hanukkah or Christmas take some time out to enjoy it and make sure that you plan your sleep time into your day.

There are so many myths about sleep and so many people who believe that the rules apply to everyone but them.  The truth of the matter is that our bodies need so much sleep and they are designed to work with our environment.  This includes the fact that it is light out during the day and dark at night.   So here are five myths about sleep that everyone thinks do not apply to them and why you should not ignore them.

1.       I do not need 7-8 hours of sleep.  There are a small group of people who are short sleepers and trust me you probably are not one of them.  Life everything 7-8 hours is an average.  But our bodies need this much sleep so we can go through the different stages of sleep.  If you do not get enough sleep you will not wake refreshed.   During the first third of the night you will be in slow wave sleep which is where your body heals and grows.  The last part of sleep is when you have your extended REM cycle, when you dream, this allows your brain to reboot.  If you wake too early you miss out on the last REM or worse you will wake during it.

2.       I need the television on to sleep.  This one is so untrue it hurts.  Television is actually designed to wake you up by using the flashing of light and dark.  If you have a sleep disorder that causes you to wake during the night or that keeps you from maintaining sleep having the television on will keep you from returning to sleep.  Again the light will stimulate you and keep you from going back to sleep.  You do not need the television to go to sleep.  You need a stronger sleep routine prior to going to bed so you can go to sleep faster.  If you are waking during the night you should talk to your doctor because it may be a symptom of another issue that is not being treated.

3.       If I stay up all night and cram for work, a test or anything I will do better.  The truth is our minds move things from short term to long term memory when we sleep.  So if you give up sleep you will not recall information as easily or as quickly.  Also sleep deprivation causes issues such as poor memory recall and the inability to concentrate.

4.       I can make up my missed sleep by sleeping in on the weekends or on weekdays.  There is an element of truth to this but our body is not designed to constantly miss sleep and then make it up a week or two weeks later.  Our body craves routine.  This is why you should have the same bedtime every night.  That does not mean you cannot go out once in a while but a routine of regular sleep is what will help you achieve optimal health.

5.       Alcohol helps you to sleep better.  Although a drink can help you to go to sleep faster over the night it will actually cause disruption of your sleep.  Your body goes through a certain cycle of sleep and alcohol keeps the second half of the night from going the way it should.  Instead you will have multiple awakenings and will not be able to go into dream stages properly.  If you do drink you should stop three hours before going to bed so it will not affect your sleep.

Sleep is probably one of the easiest ways to help you be healthy.  However if you do not take it seriously you can develop problems from sleep deprivation.  Create your routine, go to bed at the same time each night and make sure you get enough sunlight in the morning and you will soon see that you will have more energy and a sharper mind.

I was approached by Select Comfort, the people who created the sleep number bed, and was asked if I would evaluate their new sheets and in exchange they would give one of my readers a free set of sheets.  How can I say no to that?  So this is my first giveaway.  It is also a product review of something other than a CPAP mask.

I had to admit that I am all about comfort, especially when it comes to my bed.  I want soft sheets and a cool bed.  I want colors that help me to relax.  I also have to make sure that the bed is allergy free due to the men in my life have severe skin and nasal allergies. 

The sheets I received were ice blue in color and when I reviewed the information they said they were woven with silver which helps to control allergens.  I also went to my local store to find out more about the sheets.  This is part of a whole line designed to help people to sleep comfortably based on their needs.  They have a very inventive line of products.  My favorite product I saw there was the blanket that kept cool.  This is ideal for those of us who get hot at night.

I washed them several times and they stood up to the laundry very well.  They remained soft and kept their shape well. 

So now for your chance to have a new pair of these allergen resistant sheet,  in the comment section of this blog ask your sleep question or tell us one thing you do as part of your sleep routine.

The AAST sponsored the State Leadership Conference in Chicago.  This was designed to help the organization to learn from each other and understand the important organizational information such as financial planning and publicity.

 

The AAST was very well represented as well as the AASM.  What was really amazing was the people from the 26 states that were represented.  I was there as the president of the new Florida Association of Sleep Technicians.  The others people who were there were from all over the country brought a wealth of experience from well established groups to new start ups like me.

The information during the first half of the day dealt with daily operations of an society.  This is invaluable information for the newer organizations.  It was like being mentored by someone who already knew what pitfalls you would hit.  The second half of the first day really had little to do with an association and more to do with promoting the AASM, ADSM and Sleep Behavioral Therapists.  Although it had some good general information it really did not enhance running a state sleep society.

The second day was all about legislation and licensure.  This is a part of the future of sleep that is not going away and should not be ignored.  It also talked about how difficult and expensive this process will be when it comes to our home state.  I believe the most important thing I took away from this is that we need to plan and we need to have an open relationship with the state medical society and the state respiratory society. 

I also had the chance to meet Melinda Trimble the new president of the AAST.  She really brings a new voice and vision to the AAST.  Her communication style will probably help to avoid any future misunderstandings.  She was fantastic at explaining why the AAST did not take a stand about the new test.  She was able to elaborate on how the AAST is working to help sleep techs in the areas of CECs and support.  Her background in education really is helping to shape a strong road for the AAST.

The representatives the AASM offered really have strong backgrounds in legislation and offered to help the states go through the process.  The avoided discussing the new test and the reasoning behind it.  I believe that was due to the audience that was there. 

The networking was invaluable.  I had the opportunity to talk to the people from Texas who really has a strong association of doctors and technicians working together.  The association in Wisconsin was friendly and I am sure I will be working with them in the future. 

Everyone who was there really was dedicated to the growth and professionalism of the field of sleep.  I could not have asked for a better experience.

I believe that all great leaders are constantly learning and growing. I also believe that there are two great ways to do this. Read and Listen. I read every night as part of my night time ritual. I also attempt to listen to books on tape whenever I can. This is what shapes me as a leader and as a therapist. The following are a list of books that I have read that help me with my management and leadership skills. I also believe that some of these authors have more than one book that should be read and I am including one book that I have not read but was recommended to me by mentor as an essential learning opportunity.

• The Seven Habits of Highly Effective People by Steven Covey. This book is great for teaching essential time management and project management skills. The first time I read it (back when my kids were in elementary school) it changed my life and I read it every 1-2 years just to brush up on my time management skills and to remind me what is productive and what is just busy work.
• The 360 Degree Leader by John C. Maxwell. Anything written by John Maxwell is educational but I find this particular book gives a very good view of leading from any level and can be applied to everyone. 
• Fish! A remarkable way to boost morale and improve results by Steven Lundin.  This book is easy to understand and has great ways to create a team within a business.
• The Big Moo! By Seth Godin.  We are all marketers of our lab, whether we are actuallyout marketing or simply part of the leadership of the facility. This book gives some great ideas about marketing and customer service as well as getting the customer to be your best marketer. Again anything you read by Seth is exceptional.
• The 9 Things a Leader Must Do by Dr Henry Cloud. This is the book I have not read yet but it was recommended to me by my mentor. The reason I add this is because I trust my mentor's suggestions and because I wanted to remind new leaders that seeking out a mentor to help you during your growth is essential. 

Make sure as a new leader that you take the time for your own improvement so you can continue to grow in your new position. This little bit of time every day will help. 

If anyone has other books to recommend please let me know. I love to read and am always looking for a great book.