What is Sleep Apnea?

An Electronic Mental Health Newsletter from Joel I. Kimmel, Ph.D., P.A. & Associates

Volume 9, Number 4

April is Autism Awareness Month in the United States and has been recognized since the 1970s. It is celebrated as a special opportunity to educate about this disorder and related issues within the Autism community. Autism is a developmental disability that affects a person’s ability to communicate and socially interact with others. It is a spectrum disorder that differs to varying degrees within individuals. Its prevalence is now estimated at 1 in every 68 births and almost 1 in 54 boys. We hope you will learn more about Autism and the importance of education, support, and research to help those families with members who have disorders across the Autism Spectrum.

This month’s E-letter focuses on sleep apnea. Our Ask the Doc question is about maintaining weight loss and our email of the month is about the Universal Laws of Life. We hope you find the enclosed information helpful. As always, we appreciate your questions and comments.

Practice News

Depression group. For the past few weeks, we have been conducting a weekly support group for people who suffer from depression. This group is run by Dr. Jim Kaikobad and meets once a week for one and one-half hours. The group is educational, supportive, and confidential and is limited to 8 people. We are expecting to form another group in the near future and if you are interested, please contact Jillian at 954 755-2885.

Welcome to Dr. Terry Newell. We are pleased to announce that Dr. Terry Newell has joined our staff. Terry is a licensed clinical psychologist who graduated from Nova Southeastern University (NSU) with her Doctorate in Psychology (Psy.D). While studying at NSU, she spent 5 years working as a member of a trauma research team. Terry also has over 4 years of experience working as a manager of a battered women’s shelter and spent 6 years working at an adult day care center in a variety of positions. Her experience includes working as a therapist in both inpatient and outpatient facilities.

Terry has significant experience working with trauma, eating disorders, substance abuse, anxiety/stress, mood disorders, crisis management and severe and persistent mental illnesses. Her clinical leanings tend towards humanistic, existential and self psychology. In addition, Terry has a wealth of life experiences that include: living in England and 5 different states ranging from the very rural (Vermont) to the urban (NYC and NJ). She has traveled to 18 countries and 37 states. Terry has also worked as an American Culinary Federation certified cook, a camp counselor and with pre-school children diagnosed with Down’s Syndrome.

Research Study. We continue to participate in a research study with Life Extension Institute assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Informal results from this educational group continue to show success for those subjects who are in the study. For more information about the study, contact Jillian, at 954 755-2885.

Testings. Our practice conducts psychological and psycho-educational evaluations to help answer questions about academic performance and placement. Information about these evaluations can be found on our website. If you have more specific questions, please contact Dr. Kimmel who would be happy to answer them.

Parent Education and Family Stabilization Course. Our practice is one of the few offices certified to provide the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages.  The course is offered live on a flexible schedule, based on the availability of those attending the course.  Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.

Handouts from previous E-Letters can be found on our website, www.KimmelPsychology.com.  We invite you to read and download them if desired.

UNDERSTANDING SLEEP APNEA!

Our E-Letter this month focuses on an often undiagnosed problem that not only affects our cognitive functioning but can also be fatal…sleep apnea. It is a serious sleep disorder that happens when a sleeping person’s breathing is interrupted during sleep. It can happen hundreds of times a night and means that the brain and the body does not get enough oxygen. People will snore loudly and often awaken with a loud snort and fall back asleep. There are two types of sleep apnea: Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). OSA is more common and is caused by a blockage of the airway usually by fatty tissue. CSA occurs when the brain does not signal the muscles to breathe because of problems in the respiratory control center and not because of blockage in the airway. At times, both can occur together.

During a Sleep Apnea episode, airflow stops and the oxygen level in the blood drops. The brain responds by disturbing sleep enough to restart breathing which often is accompanied by a choking or gasping sound. The person may stir enough to open their windpipe and they may or may not be conscious of awakening.

Risk factors for sleep apnea include being overweight, being over age 40, having a large neck, being male, having large tonsils, having a large tongue, having Gastro-Esophageal Reflux Disease (GERD), and having an allergy or sinus problem. Symptoms include: loud snoring, frequent waking up with a dry throat or choking, abrupt awakenings accompanied by shortness of breath, lack of energy or sleepiness during the day, falling asleep while driving, headaches, memory problems, moodiness, and restless sleep.

Sleep Apnea is diagnosed through a sleep study where a person’s sleep patterns are monitored. If not treated, sleep apnea can result in high blood pressure, depression, stroke, heart arrhythmias, heart attacks, diabetes, memory and concentration problems, and death. It can affect performance in school and on the job and lead to overuse and dependence on prescribed or over-the-counter sleep aids.

Lifestyle changes that can be made to treat sleep apnea include losing weight, avoiding drinking, avoiding sleeping pills, stopping smoking, changing sleep positions to sleeping on one’s side, and sleeping with a dental appliance to keep one’s airway open. Other treatments include surgery to correct nasal problems, to remove soft tissue on the back of the throat and palate, or to remove facial problems or throat obstructions.

The most effective treatment for Sleep Apnea is using a Continuous Positive Airway Pressure (CPAP) machine. CPAP involves wearing a mask over the nose and mouth while sleeping. A continuous flow of air is delivered and it keeps the airways open so that breathing is more regular.

If you suffer from Sleep Apnea view it as a serious disorder and ask your doctor for a sleep study. Also change your lifestyle to include not smoking, not drinking, and not taking tranquilizers or sleeping pills. Make the aforementioned lifestyle changes.

We offer the following information on Sleep Apnea:

“From reading too much, and sleeping too little,
his brain dried up on him and he lost his judgment”— Miguel De Cervantes

WHAT TO KNOW!

• Sleep apnea is a common sleeping disorder where there are one or more pauses in breathing or there are shallow breaths while sleeping
• Breathing pauses can last from a few seconds to minutes and can occur 30 times or more an hour after which normal breathing begins often with a snorting sound
• It is a chronic condition and since the quality of sleep is very poor, you can feel tired all day long the next day
• Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea where the airway becomes blocked or collapses during sleep
• OSA is common in overweight people and snoring occurs when air is squeezed past the blockage
• Central Sleep Apnea (CSA) is much less common and occurs when the brain does not send signals to your muscles to breathe
• CSA can occur with OSA and is most common in people with certain medical conditions or who take certain medications; snoring usually doesn’t happen
• Airways can become blocked by throat and tongue muscles relaxing more than normal, tongue and tonsils tissue being large, fat tissue from being overweight thickens the windpipe wall, or aging impairs the brain’s ability to keep the airway from collapsing
• Stress hormones can be released by low blood oxygen levels and can lead to high blood pressure, heart attack and failure, stroke and arrhythmias
• In addition to snoring, other signs of Sleep Apnea include memory, learning, and concentration problems, morning headaches, feeling irritable or depressed, frequent waking up to urinate, and dry mouth or throat upon awakening
• Sleep apnea and its severity is diagnosed through a sleep study which measures how well you sleep and how you respond to sleep problems
• After diagnosis, sleep apnea is treated by using breathing devices, surgery, mouthpieces, and making changes to your lifestyle
• Treatment is to restore regular breathing during sleep, decrease snoring and daytime sleepiness, and improve high blood pressure, heart disease, and memory
• The CPAP (Continuous Positive Airway Pressure) machine is the most common treatment; it uses a mask over your nose that blows air into your throat

WHAT TO DO!

• Lose excess weight and exercise to reduce constriction of your throat
• Avoid alcohol and certain medications such as muscle relaxants and sleeping pills
• Sleep on your side or abdomen and not on your back
• Use a saline nasal spray to keep your nostrils open at night
• Stop smoking as it worsens OSA
• Try an oral appliance usually obtained from a dentist to keep the airway open
• Consult with your physician and obtain a sleep study and CPAP machine
• Seek professional help to develop coping strategies to deal with the emotional consequences of having sleep apnea

We Can Help!

Call us at (954) 755-2885 or email us at [email protected]

Joel I. Kimmel, Ph.D., P.A. and Associates
5571 N. University Drive, Suite 101
Coral Springs, Florida 33067

As always, we would like to welcome new readers to our e-Letter. We hope that you find it informational and enjoyable. We invite you to share this e-Letter with others. If you have received this from a fellow reader, please send us your email address to include you on our list.

Ask the Doc

BL writes: I have been struggling with my weight. Over the past 2 years, I have lost 50 pounds and felt good. My friends tell me I look terrific and I can buy clothes that are much smaller sizes. My doctor tells me that I am healthier than ever. However, recently I have put back on a few pounds and I am so depressed. I can’t seem to keep to my eating program and I am worried. Why can’t I keep to my program? What should I do?

Dr. Joel Kimmel replies: It’s good to hear that you were able to keep to your weight loss program and had great success. However, what you report is far too common. Many people who have lost weight struggle to keep it off. It sounds like you changed your eating patterns and the types of food you eat and it shows in the comments of your friends and your doctor. However, there is a large possibility that the reason you are slipping back is due to emotional reasons.  In my opinion most weight gain is due to not only poor choices but to emotional reasons. People often seek out comfort food when they are depressed or anxious. So I would suggest that you take an emotions inventory and determine whether something is bothering you. Are you angry about something? Are you anxious about something? What might you be worried about?

Of course, gaining weight can cause you emotional upheaval but try to look beyond that. What other feelings might you be having that could be upsetting you? Keep a feelings diary and try to identify how you are feeling and what may be driving you to eat when you do eat. Once recognized, deal with your feelings by resolving issues or by asserting yourself.

In addition, recommit yourself to the original goals you had when you first began losing weight. Reward yourself once you achieve them. Slipping back is not failure but an indication that you need to stay with your program.

Email of the Month

We would like to thank John G. for the following email:

UNIVERSAL LAWS OF LIFE!

Law of Gravity – Any tool, nut, bolt, screw, when dropped, will roll to the least accessible corner.

Law of Probability – The probability of being watched is directly proportional to the stupidity of your act.

Law of Random Numbers – If you dial a wrong number, you never get a busy signal and someone always answers.

Law of the Alibi – If you tell the boss you were late for work because you had a flat tire, the very next morning you will have a flat tire.

Variation Law – If you change lines (or traffic lanes), the one you were in will always move faster than the one you are in now (works every time).

Law of the Bath – When the body is fully immersed in water, the telephone rings.

Law of Close Encounters – The probability of meeting someone you know increases dramatically when you are with someone you don’t want to be seen with.

Law of the Result – When you try to prove that a machine won’t work, it will.

Law of Biomechanics – The severity of the itch is inversely proportional to the reach.

Law of the Theater – At any event, the people whose seats are furthest from the aisle arrive last.

The Starbucks Law – As soon as you sit down to a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.

Murphy’s Law of Lockers – If there are only two people in a locker room, they will have adjacent lockers.

Law of Physical Surfaces – The chances of an open-faced jelly sandwich landing face down on a floor covering are directly correlated to the newness and cost of the carpet/rug.

Law of Logical Argument – Anything is possible if you don’t know what you are talking about.

Brown’s Law of Physical Appearance – If the clothes fit, they’re ugly.

Oliver’s Law of Public Speaking – A closed mouth gathers no feet.

Wilson’s Law of Commercial Marketing Strategy – As soon as you find a product that you really like, they will stop making it.

Doctors’ Law – If you don’t feel well, make an appointment to go to the doctor, by the time you get there you’ll feel better. Don’t make an appointment and you’ll stay sick.

Please continue to send us your comments, questions, and favorite emails for our e-Letter.

Till May…

The information provided in this electronic newsletter is not a substitute for professional treatment. It is the opinions of the writers and is provided solely for educational purposes. For mental health care, seek a qualified professional.

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If you find this information interesting or helpful, please forward this e-Letter to your contacts and friends.

Copyright © 2014 by Joel I. Kimmel, Ph.D., P.A. and Associates.