I can’t sleep at night

“I can’t sleep at night.”

A poor night’s sleep may be due to an actual blockage in your breathing tubes, or airway.

It can also be due to a lack of a brain hormone called melatonin. While this phenomenon is becoming increasingly recognised, it has always been with us.

How many people suffer from this condition known as sleep apnoea? The experts, such as Kirsty Wade from our CPAP Sleep Apnoea department, tell us that – while as many as 240,000 Australians have been diagnosed with the disease annually but the total number of people who suffer from this malady and remain as yet undiagnosed is closer to one in five Australians, according to a Parliamentary House report. See link: https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/SleepHealthAwareness/Report/section?id=committees%2Freportrep%2F024220%2F26954

Now that’s huge, considering that all of these people report varying levels of anxiety, interrupted sleep, daytime drowsiness and often chronic sinus conditions accompanied by morning “dry throat” and dry cough.

The help that we offer comes at several levels.

The first stop is to drop in and arrange an overnight screening test, if you are in doubt. If warranted, then you need to visit your GP who can consider prescribing melatonin capsules. These will need to be manufactured by our compounding pharmacist. Simply fax in your prescription at 9418 6846 and arrange to have it picked up or delivered. Either way, please bring the original prescription with you or post it in.

If this does not do the trick, then the next step is to get a feferral to a sleep specialist, who will organise an overnight sleep study. If urgent, this may take the form of hiring our “Auto” machine that will not only adjust its pressure output to match your airway resistance or blockage, but also give you a “read-out” on a memory stick that you can take to the specialist if necessary. All of this equipment, including masks and machines from all manufacturers, is available at our CPAP Sleep Apnoe shop.

Why have so many choices? Simply because sometines a certain mask will fit a facial shape that others won’t. And machines differ in their “comfort” features, not to mention the look and silence, that may better suit your situation.

So, that’s why we stock Fisher and Paykel, Philips, Resmed and even Transcend – the traveller’s machine!

I urge you to make a free appointment to see Kirsty regarding the process that may get you into a good night’s sleep.

Thirdly, we have Somnogard AP mouth guards (called mandibular advancement splints). These are often recommended by sleep specialists at our local Royal North Shore Hospital Sleep Study Unit as a first line treatment. For this and other jaw-adjustment devices (or mandibilar advancement splints) – one model combined with a very convenitne mask, call us or pop in for a quick overview. Call 61 (0)2 9420 4959 or 0414 805 154 or contact us.

Finally, our clinic can also evaluate you for the underlying causes that may lead to this condition, be it obesity or another reason why your airway may become obstructed such as chronic sinusitis. Our programme of targeted nutrition and abdominal fat loss has led to many success stories of permanent fat loss.

see also Home Testing for Sleep Apnoea

Whatever the issue, you will receive our full attention when you use us as your sleep apnoea CPAP treatment provider.

That means that one in every five Australian adults is nodding off during the day, perhaps experiencing microsleeps behind the wheel, or maybe not performing at their best at work and will possibly be unaccountably irritable.

Yet, why do not these people simply die in their sleep? The answer lies in your wonderful brain. There is a centre in the brain that detects blood levels of the gas carbon dioxide (CO2). This is produced in the lungs from “used” blood. If the blood level of CO2 becomes too high, you may suffer from brain and organ damage. So, the brain has this arousal centre that detects your blood levels of CO2 and wakes you up if it gets too high. Usually.

However, repetitive bouts of this problem over time could desensitise the arousal centre and it may become inefficient. Alcohol and perhaps other sedative drugs also may inhibit the activity of the arousal centre.That means that many people are sleeping through the periods of high CO2 levels – and also low oxygen levels – and may gradually accumulate heart, brain and other organ damage, including the brain. One day, this might reach a critical point and you may suffer from a heart attack or brain slow-down or gradual organ failure.

This condition could possibly even be one of the causes of dementia by Alzheimers.

The bottom line is that many ill health states may exhibit sleep apnoea as part of their symptoms.

So what causes sleep apnoea and what can we do to treat it or help prevent it or at least relieve the symptoms?

Treatments

Looking at this issue first, conventional treatments for sleep apnoea involve the use of specialised masks and machines that pump out continuous pressurised air that keeps the airway open. The phrase used to describe this system is Continuous Positive Airway Pressure or CPAP for short.

This system was invented by Professor Colin Sullivan in Sydney, Australia and developed by Dr Peter Farrell, the managing director of ResMed Australia. His first machine, built around 1994, was said to have been a converted pool pump and the air hose was passed into his patient’s bedroom via a hole drilled into his double brick wall.

CPAP machines and masks have since become far more sophisticated and are made in the USA and France as well as Australia, and there is now a large variety of both to choose from.

The machines are real space age devices these days – with smart chips controlling the pressure and giving very detailed reports of your sleep patterns. They have also become progressively smaller and more quiet, and are well received by people from all walks of life.

Certain categories of vehicle drivers must have a report certified by their breathing doctor (respiratory specialist) or else they may lose their license. Our sophisticated and highly specialised computer software will interpret this information in the form of an easily-read bar-graph that we can issue to you, saving you and your doctor’s valuable time.

Obesity

While it is not the only cause, obesity is a major cause of sleep apnoea. Visceral fat is the major offender, causing a pressure build-up in your abdomen, torso and neck areas. This causes the swallowing muscles to collapse, blocking off your airway. Also the muscle layers in necks can themselves become fatty over time, enhancing this potential.

To make matters worse, recent studies have revealed that fat depots can cause inflammation. – particularly in visceral fat. They generate inflammatory chemicals called cytokines that dilate blood vessels locally and can also cause blood to thicken. Blood thickening can lead to stroke and heart attacks – a common occurrence in people suffering from untreated sleep apnoea.

That is why – although CPAP is a major advance in stabilising people in this state of health – your doctor will also emphasise the importance in overweight people of losing unwanted fat at the same time. If you can succeed in achieving this goal, you will usually be able to see a droop in CPAP pressure basically every time you do a sleep study.

Carefully tailored fat loss can be permanent. See our article on fat loss.

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