Tag tired

Sleep Doc’s 5 Tips if You Feel Sleepy Despite Using CPAP


Majority of my patients feel more alert and energetic when they start using CPAP, but a substantial number of patients do continue to feel “no different than before.” If you happen to fall in the later group, follow these tips and talk to us or your doctor.

1. Ask your spouse if you snore or stop breathing with the CPAP on especially in the early morning hours. This would mean that the CPAP setting need to be adjusted.

2. Make sure you are using CPAP at least 7 hours every night. Studies by Antic et all published in Sleep journal (Volume 34, Issue 01) have shown that CPAP use of more than 7 hours provides the greatest chance of curing excessive daytime sleepiness.

3. Check with your pharmacist and your doctor to see any of the medications you take for your medical conditions can contribute to your fatigue, tiredness, or excessive daytime sleepiness. Further, ask them if these medications can be taken in the evening or at bedtime.

4. Make you sure you are not depressed. When I ask my patients if they are depressed, I often get, “I already am taking anti-depressant medication.” I tell them it is still possible to have residual depression symptoms including fatigue, tiredness, and sleepiness.

5. If you continue to feel sleepy even after going through above checklist, talk to your doctor about Nuvigil, a stimulant medication.

I do stress to my patients that the CPAP use reduces the risks of stroke, heart attack, uncontrolled blood pressure, uncontrolled diabetes, and of drowsy driving death whether they feel better or not. CPAP in this regard is similar to cholesterol medication, which reduces the risk of stroke and heart attack, but does not make you feel better. You still keep on taking cholesterol pill to maintain your health. Same way, you should keep on using CPAP every night for seven or more hours.

Best Wishes. Sleep Well, Live Well.

3 Tips to Help You Meditate When Sick

Maintaining an uninterrupted and a pleasant, relaxed focus during meditation can be a challenge when you are achy, tired, or sick. Ironically, these are the times you need the rejuvenating effect of meditation the most. Here, are the tips to help you meditate under those trying circumstances.

1. Modify your posture (asana) to minimize pain and discomfort. I have found the Savasana (corpse) posture helpful. If the situation does not allow that, then sitting upright in a chair is another option.

Photo Credit: yogasportsdallas.com

Photo Credit: yogasportsdallas.com


2. Practice Pranayama. Close your eyes and be pleasantly aware of your inhalation. Feel your body relaxing as you exhale out. Do this 10-15 times.

3. Focus on a pleasant area of the body. First, scan your body from head to toe looking for uncomfortable areas. Accept the pain without any negative emotions and move on. After that, find and focus on a pleasant spot in your body. Maintain an uninterrupted focus on that pleasant spot in the body. If your mind wanders of, use breath awareness as an anchor and bring the focus back to that pleasant spot. If you do this for a total of 15 minutes, you will find the pain abating and energy level increasing.

In summary, aches and pains are an obstacle to a successful practice of meditation. The above mentioned tips will help you get started in the right direction such that you can benefit from the rejuvenating effects of meditation even when sick.



Insomnia may cause pain in people over 50: Research | NEWS.am

Insomnia may cause pain in people over 50: Research | NEWS.am

In a study published in the journal Arthritis & Rheumatology, researchers collected data from 4,326 people over age 50 in order to analyze their psychological and physical health, lifestyle and levels of pain. Though all patients were free of widespread pain at the start of the study, 2,764 reported some pain, Fox News reports.

Researchers found that people who experienced non-restorative sleep, anxiety, poor physical health or cognitive complaints were more likely to have developed widespread pain.

To read  more, please click on the link above.


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.

7 Strong Reasons to Take a Power Nap Today

Winston Churchill in Downing Street giving his...

“A nap in the afternoon gives you two days in one.”

While talking to Dan Rather of CBS News in 1993, Bill Clinton said, “If I can take a nap—even fifteen or twenty minutes—in the middle of the day, it is really invigorating to me. On the days when I’m a little short of sleep, I try to work it out so that I can sneak off and just lie down for fifteen minutes, a half hour, and it really makes all the difference in the world.”

Because of our internal circadian rhythm, our alertness and, hence, our performance dips in the afternoon. This nadir is deeper when we are sleep deprived and when we are traveling across multiple time zones. If we can fight this drowsiness with a strategically placed power nap, then we can maximize our  efficiency and avoid fatal mistakes. (Most fatal vehicular accidents occur in the midafternoon and after midnight.)

Studies prove that a fifteen-minute power nap provides benefits lasting up to 150 minutes, including:

  1. Improved alertness, both subjectively and objectively
  2. Reduced fatigue and improved vigor
  3. Enhanced creativity and problem solving
  4. Improved perception
  5. Facilitated learning
  6. Improved declarative and procedural memory
  7. Positive mood and emotions, clearer communication, humor and optimism, and situational awareness

If a fifteen-minute nap gives you 150 minutes of improved executive function, how can you resist such an investment? Click here to learn the technique of PREM power nap.

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