Tag Sleep disorder

11 Tips to Prevent a Drowsy Driving Death this Weekend


In 2010, 397 people died in crashes over the Memorial Day weekend.

Memorial Day Weekend is traditionally one of the heaviest travel weekend of the year. If you are one of the millions of Americans traveling this holiday, please follow these tips and save a life.

Please remember that turning on the radio, stretching your neck, putting your face out of the window, slapping your face, chewing a gum, or pushing a sharp pin in your thigh does not work!

 

1. Get a good night’s sleep every night, certainly prior to the long trip.

2. Avoid driving between mid-night and 7 am as our brain is sleepiest during these hours.

3. Be extra careful driving around mid-afternoon.

4. Share driving responsibility.

5. Take a break every 2 hours.

6. Take a 10-15 minute nap before you become sleepy.

7. Enjoy a strong cup of coffee in anticipation of drowsiness.

8. If you have untreated sleep apnea, shift work sleep disorder, or any other sleep disorder, let someone else drive.

9. Resist distractions. Don’t play with your Smartphone or MP3 player.

10. If your thoughts become dreamy or lose touch with reality, pull over right away, or you shall die.

11. Do not drive drunk. According to National Highway Traffic Safety Administration, 40 percent of the 397 deaths from car accidents nationally were alcohol-related.

Please share freely and save a life.

Obstructive Sleep Apnea leads to Cardiac Dysunction even in Patients without Congestive Heart Failure; a Study


A study published in this month’s Journal of Clinical Sleep Medicine indicates that Obstructive Sleep Apnea is associated with cardiac dysfunction even in the absence of Congestive Heart Failure.

A total of 79 patients with sleep disordered breathing, but preserved systolic function, and normal pro-brain natriuretic peptide level were enrolled. Sixty-five patients were classified to have moderate to severe OSAS (apnea-hypopnea index [AHI] ≥ 15/h), while the other 14 patients with mild or no OSAS (AHI < 15/h) served as control subjects.

The left atrial size, mitral A-wave velocity, and left ventricular end-diastolic volume were significantly larger, while E/A ratio was lower in patients with moderate to severe OSA than those without (p < 0.05). Notably, Apnea Hypopnea Index (number of times a patient stops breathing per hour) in Rapid Eye Movement sleep was significantly correlated with the aortic root size, E/A ratio, left ventricular volume, and stroke volume. In addition, the area under the receiver operator characteristic curve for AHI in REM sleep ≥ 32.3/h was 0.647 (95% CI [0.525, 0.769]) in predicting the development of left ventricular diastolic dysfunction. 

Patients with moderate to severe OSAS tend to have cardiac dysfunction revealed by echocardiography. High AHI in REM sleep is significantly associated with cardiovascular remodeling and ventricular diastolic dysfunction, and may be a potential variable to predict cardiac dysfunction.

JCSM – Influence and Predicting Variables of Obstructive Sleep Apnea on Cardiac Function and Remodeling in Patients without Congestive Heart Failure.

If you snore, please talk to your physician or us about a convenient and cost-effective home sleep test to diagnose sleep apnea.

Sleepy During the Night Shift? Try These Tips.


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“How can I stay alert at 3 am?” asks Twilight, an ICU nurse who has been working nights for years. She knows that our internal pacemaker (SupraChiasmatic Nucleus) makes us sleepy at night and alert during the day. How can you go against the might of Mother Nature? Well, it is tough, but you can summon the help of these seven friends.

  1. Stay Active
  2. Take a PREM nap
  3. Massage Your Tender Points
  4. Look at the Light Often
  5. Enjoy a Cup of Coffee
  6. Snack Smartly
  7. Seek Spiritual Help (My All-time Favorite)

And beware of a formidable foe in alcohol when faced with insufficient sleep and long days. Let us discuss them one by one.

Stay Active

The Alertness starts declining the longer you stay still. One way to prevent this is to “deskercise” every hour. Deskercising will also help you to reduce muscle tension and stress while helping you preserve the flexibility, strength, and muscle tone you already have. The following are some simple deskercising techniques to try:

The Wrist Muscle Stretch

When working at the computer, stop occasionally and deskercize using the wrist muscle stretch. Slowly stretch your wrist muscles by using a full range of motion. Joints that have become sore and stiff because of repetitive motion activity will respond to slow stretches. Do not risk pulling a muscle by attempting the stretch rapidly. Get the full benefit of the stretch by doing it slowly.

The Pectoral Stretch

The following is an easy stretch you can do at your desk. Simply clasp your hands behind you head and slowly move your shoulders and elbows back. Repeat this a few times. It is a great way to stretch your pectoral and chest muscles.

Wrist Flexion

Using your left palm, gently apply force to the right hand, causing the right wrist to stretch toward the underside of the right arm. Hold it there for five seconds and then release and repeat on the left hand. Repeat the exercise five times.

Wrist Hyperextension

Using the left palm, slowly apply force to bend the right hand backward. Hold it there for five seconds and then release and repeat to the left hand. Repeat the exercise five times.

Sitting Bend

In a sitting position, with your feet flat on the floor, your knees about ten inches apart and hands at your sides, bend over as far comfortable with your hands reaching toward the floor. Hold the position for five seconds and then slowly pull back into a sitting position while tightening your abdominal muscles. Repeat four times. This exercise stretches your lower back muscles and hamstrings.

Vertical Stretches

Vertical stretches provide an excellent way to reduce tension and activate all of your major muscle groups. With your feet shoulder-width apart, lift yourself upward on your toes and extend your arms over your head. Reach each hand as high as possible for about seven seconds and then relax. Repeat four times.

Get Up and Walk Around

Sitting too long can have several negative effects. It’s important to get up and walk around at least once each hour. A ten-minute walk around the office would be excellent. But, when that’s not possible, shorter walks to the water cooler, filing cabinet, or restroom are better than nothing.

When you are working at desk, get up at least once every twenty minutes and move around. 

  • Take a PREM (Patel’s Relaxed Eye Muscles) Nap. Studies have shown that a fifteen-minute nap can improve alertness and last for almost three hours.  This can be life saving when taken before driving back home after bight shift.
  • Massage Your Tender Spots. Gently massaging your calf muscles, your neck, and your temple area can improve alertness by relieving muscle aches, back pain, headaches, burning in the eyes, and other distracting physical symptoms precipitated by sleep deprivation. Untreated, these symptoms can drag your energy level and your alertness down.
  • Look at the Bright Light Often. It has a tremendous alerting influence. Use this to your advantage. Sit facing bright light. Put a bright light lamp behind your desktop while working on it.
  • Enjoy a Cup of Coffee. Caffeine has alerting property, but it has the duration of action of twenty-four hours, so a cup of coffee consumed at 2 AM is still in your bloodstream at 8 AM when your brain is trying to fall asleep. Because of this reason, caffeine should not be used indiscriminately. It should be used as medicine, at the right dosage, at the right time, and for the right reason.
  • Snack Smartly. Eat a Protein Snack Every 2-3 Hour. I will maintain your energy and alertness while eating a large starchy meal will degrade your alertness. Avoid rice, pasta, and dessert.
  • Seek Spiritual Support. Spiritual support has helped me the most during my drives to ER at 2 AM. I would ask for divine help. “Give me energy, my Lord, to serve my patients well.”

Do you have a particular trick that works best for you? Which of the above intervention has helped you most?

This blog post is dedicated to my good friend Mahesh Patel MD who has devoted his life to saving premature babies in Bismarck, ND, and millions like him who have spent nights after nights serving others. God Bless You All.

Adopted from the book “Sleep Well, Lead Well” now available on Amazon

What does a Sleep Doc do When He Can’t Fall Asleep


Photo Credit: YogaSportDallas.com

Photo Credit: YogaSportDallas.com

Well, there are times even a sleep doc can’t fall asleep! This happens most commonly prior to a big trip or sometimes after a page from the hospital or a phone call from the sleep lab. I used to get frustrated and worried about the busy day next day, which in turn would make matters worse.

Now, I have learned to relax. I do progressive muscle relaxation starting from my scalp muscles all the way down to my toe muscles; I contract them one by one, and feel them relaxing while I breathe slow and deep. This whole process if done leisurely would take 10-15 minutes. After I am done with this, I just lay there limp, completely atonic.

Then I work on my racing mind. I practice complete detachment (Vairagya). I observe these thoughts as a third person. They arise and they subside. I do nothing with them. I give up all the worries, desires, expectations, and anger to Almighty, to the Higher Power, and I just lay there completely relaxed.

This is called Savasana, which literally means “corpse posture.” When I do this, I get the physical, mental, and spiritual rejuvenation despite being awake.

I may fall asleep; I may not fall asleep. I do not worry. I do not care. Sleep is a natural phenomenon. If it comes, it comes. If it doesn’t, it doesn’t. I don’t care. I trust the Lord. I have been through tougher times with little sleep in the past. I can do that again with the help the Lord.

Well, I hope you don’t have difficulty falling asleep, but if you do, I urge you to try this. If you find it beneficial, share this post and spread the wealth!

Sleep Well, Live Well.

7 Tips for an Alert, Energetic, & Enjoyable Monday


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Have you noticed how sleepy, tired, lethargic, and complacent you feel on Mondays? Medical studies indeed have shown reduced productivity and increased errors on Mondays secondary to disrupted sleep schedule on weekends.

Here is how you can enjoy and excel at work even on Mondays.

  1. Keep moving. Staying physically active all day will energize your Mondays. Exercise in the morning. Take stairs at work. Go for an evening walk. Do deskercize.
  2. Face the light. Look at the bright light in the morning both at home and at work as light has alerting influence.
  3. Take a PREM nap. A 15 min power nap will provide you alertness, energy, vitality, and vigor lasting for 155 minutes. Leave some room on your schedule for it preferably in the afternoon.
  4. Get a relaxing massage. Insufficient sleep results in aches and pains which can be easily treated with a relaxing massage, which can be combined with a nap if the situation permits.
  5. Snack smartly. Eat high protein snacks. Avoid heavy meals on Mondays especially at lunch. Grilled or baked fish or chicken is great. Avoid rice, pasta, and dessert as it can make afternoon sleepiness worse.
  6. Consume caffeine judiciously. Caffeine has alerting properties, but it should be consumed sparingly as it can rob you of your deep sleep. Avoid caffeine after 1 PM.
  7. Seek spiritual support. You are going against the might of Mother Nature trying to excel and enjoy Mondays with disrupted sleep schedule and sleep debt. Tap into your enormous spiritual reservoir. At every unguarded moment, look up and say, “Help me God serve my customers with joy.”
Have a wonderful week. Sleep Well, Lead Well.
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