SusanR

No need to worry! There is nothing known to indicate that is is contagiousa!! I have studied the family-basis ffor sleep for over 20 years. There appear to be genes that influence the shape of head and size of the throat and genes that influence breathing at night--none of that is contagious. Also, a risk factor for sleep apnea is overweight--which runs in families. Sleep apnea may get worse after drinking alcohol, weight gain, and in some people, after being exposed to substances in the air that can irritate the nose and throat--some family members share these exposures--but this is not catchy.

Great bedtime tips, Jorja! Research also has shown that reading using a "light emitting" reader before bed is associated with more sleep problems compared to reading a printed book. So, its also useful to consider avoiding light from the various devices we are so used to using. Others use downloadable programs to change the light from computer screens (which also can be very helpful to preventing ones circadian system from getting out of balance.) Here is the abstract to that article

AbstractSend to: Proc Natl Acad Sci U S A. 2015 Jan 27;112(4):1232-7. doi: 10.1073/pnas.1418490112. Epub 2014 Dec 22. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Chang AM1, Aeschbach D2, Duffy JF3, Czeisler CA3. Author information Abstract In the past 50 y, there has been a decline in average sleep duration and quality, with adverse consequences on general health. A representative survey of 1,508 American adults recently revealed that 90% of Americans used some type of electronics at least a few nights per week within 1 h before bedtime. Mounting evidence from countries around the world shows the negative impact of such technology use on sleep. This negative impact on sleep may be due to the short-wavelength-enriched light emitted by these electronic devices, given that artificial-light exposure has been shown experimentally to produce alerting effects, suppress melatonin, and phase-shift the biological clock. A few reports have shown that these devices suppress melatonin levels, but little is known about the effects on circadian phase or the following sleep episode, exposing a substantial gap in our knowledge of how this increasingly popular technology affects sleep. Here we compare the biological effects of reading an electronic book on a light-emitting device (LE-eBook) with reading a printed book in the hours before bedtime. Participants reading an LE-eBook took longer to fall asleep and had reduced evening sleepiness, reduced melatonin secretion, later timing of their circadian clock, and reduced next-morning alertness than when reading a printed book. These results demonstrate that evening exposure to an LE-eBook phase-delays the circadian clock, acutely suppresses melatonin, and has important implications for understanding the impact of such technologies on sleep, performance, health, and safety. KEYWORDS: chronobiology; digital media; electronics; phase-shifting; sleep Comment in

Dear PracitcalPrussionBlueGazelle- Lots of research points to the need for most adults to get between 6 and 7 hours of sleep per night. Four hours, especially if broken up as you describe, can adversely influence your alertness as well as your overall healthy and safety. There are many reasons for poor sleep, as you describe, and can include what we call primary sleep problems such as insomnia, sleep apnea or periodic leg movement disorders. Sometimes, people get themselves into sleep routines that further aggravate their ability to fall asleep. Based on what you are saying, I would encourage you to speak with your doctor about your sleep. Also, you may want to read up on sleep problems on our Learn page. You also may want to specifically review some of the advise regarding following good "sleep hygiene" (a funny phrase that refers to the types of sleep habits that can be good or bad for sleep.) Please follow up with your doctor and hope to hear you are sleeping more and better, soon!

Hi FriendlyLilacNewt- The feeling of "ants crawling" over your legs, especially at night, could be a symptom of restless legs syndrome. However, the experience of funny sensations, especially if accompanied by a feeling that your leg is cold, could also indicate a problem with your circulation to your leg, or other problems with the nerves or blood supply to the leg. I suggest you discuss this with your doctor who will want to discuss with you more specifics and do a physical examination. This sounds very uncomfortable--let us know how things work out for you.

HelpfulSapphireDuck--You were right to talk to your doctor- the recommendation is that patients who meet the risk criteria identified by this trial (low cardiac function and central sleep apnea) on ASV discuss their treatment with their doctors, who need to make individualized decisions weighing benefit and risk.

Please take a look at the forum post under NEWS on the Safety Alert regarding use of ASV. Note that this ALERT applies to patients with specifically with heart failure and low cardiac output and predominant central sleep apnea. The results of a large multicenter international trial that was the basis for the Safety Alert were published this month in the New England Journal of Medicine.

There are many questions that this study opens up---such as which specific patients may get benefit or be harmed?--for example, is there a level of heart function below 45% where therapy is safe? What about predominant obstructive apnea in heart failure?

Good luck with your treatment and make sure you continue to talk regularly to your doctors about your treatment.

Please see the new post under Research by Dr. Strohl describing this treatment

Hi TooTall, Its great that you have made the connection between atrial fibrillation and sleep apnea and have made a committment to keep your heart healthy.

If your sleep efficiency remains low, please talk to your doctor. You want to be sure that the pressure prescribed is appropriate -that changes in pressure or airflow over the night are not causing disturbances in your sleep; also that the mask prescribed is as comfortable as possible. Good luck and hope you start sleeping better soon! The Learn page has some information on CPAP that may be useful.

Hello AlwaysTired, There is growing research on upper airway stimulators for sleep apnea (that is what I think you are referring to.) I have asked one of the leaders of the studies on this to prepare a summary for our members--hope we can have that to you soon. At this point, this treatment is mostly used in people who have failed CPAP and have moderate to severe sleep apnea. There are a few other characteristics that also are used to determine the likely benefit (such as the shape of the throat). I agree with Dan that this is something you should talk to your doctor about who can help make an initial assessment of whether this may be an appropriate treatment for you. Not all centers offer this treatment-so your doctor may need to refer you to a center that does this. Let us know how things work out for you!

Jorja,

Glad to hear that things are soring themselves out. Please continue to be part of our community- we need to learn about problems getting the right diagnosis. Technology is changing how diagnoses are made, and your story is very important. Also, so many people suffer from more than one sleep problem, that it would be great to learn from a diverse group of people.

If your sleepiness continues, please talk to your doctor. Its not uncommon that medications require adjustments over time.

This discussion is extremely important-- its understandable how frustrating it is when despite following all medical advice, including wearing CPAP nightly, you still feel poorly. I am assuming by "crappy" you mean you are not feeling refreshed after a night's sleep and are feeling tired or sleepy during the day--is that what you mean?

There are a few straight forward responses, but indeed this problem sometimes does not have an evident quick fix.

As mentioned, when feeling sleepy or tired despite using CPAP the entire or most of your sleep period, you should speak with your sleep specialist to ensure you are indeed getting the optimal pressure and not losing pressure due to mask leak. Sometimes the machine's output is not precise enough to determine whether you really are getting the pressure you need and a follow up formal sleep study is needed.

A second sleep problem--such as periodic limb movements-which can disrupt sleep-might be considered. A repeat sleep study might be needed to assess this.

You and your doctor should ensure that you are getting the right number of hours of sleep per night (generally 7 to 8 for adults, but this could vary person by person) and following a consistent sleep schedule is important: no amount of CPAP will help if you are only getting a few hours of sleep per night!

Sometimes medications have side effects that include fatigue and sleepiness and you and your doctor may want to review your medications, as well as to make sure there are no other medical issues that may be contributing to fatigure or sleepiness. Undiagnosed depression is sometimes a contributor to continued sleepiness or fatigue. Obesity has been associated with sleepiness and fatigue and weight loss and diet/exercise can be helpful in improving alertness and vigor.

Finally, it is estimated that as many as 10% of patients with sleep apnea have some degree of continued sleepiness/fatigue despite what seems to be optimal treatment of their sleep disorder. It has been speculated that these patients may have had untreated sleep apnea for a long time and some of the brain areas controlling alertness may have been affected. In this small group of patients, there may be benefit to careful use of prescription medications that have alerting actions while continuing CPAP--taking such medication needs to be a very carefully considered decision by the patient and his and her doctor, and will require close monitoring by the patient's doctor.

An excellent review of the problem of continued sleepiness despite CPAP therapy can be found at: http://www.medscape.com/viewarticle/812910. This might be something you want to print out and discuss with your doctor.

But dont give up--as noted above, there are many things that need to be explored to find which of the factors, when addessed, will help you the most.

I would like MyApnea.Org to consider future research on this problem. If this problem affects 10% of patients, then with our current membership of almost 5000 people, there are at least 500 sufferers in our community. Let me know your thoughts.

Thanks for the opportunity to contribute to the discussion-Susan Redline