Nicholas Bashline, RPSGT, CCSH

02/13/2023

Mis-PAP-ception Mondays!

CPAP is meant to be comfortable and not difficult to use.

The mask or interface fitting is paramount to ensure the device, especially Auto adjusting, can perform at its maximum benefit for a patient.

A CPAP user shouldn’t be loud and shouldn’t still be snoring. Masks shouldn’t leave marks, over-tightening can actually cause the very leaks you’re trying to prevent.

If you know someone suffering through their therapy have them search for a Sleep Educator.
We can absolutely make a difference.

10/02/2022

Let me preface this with a spoiler alert; positional apnea is very real.
That is one of the (very) few things this author managed to get correct.
His complaints and attitude of sleep medicine being a money maker are off-base.
A HST to in lab titration (to a tech giving results and essentially a diagnosis) that didn’t solve anything to the possibility of ASV?! There’s a few speculative issues that may have occured.
Reading this article actually made me quite disappointed in the amount of misgivings it is promoting.
A proper doctor or sleep clinic does not want to ”treat everyone”. If you’re not suffering from daytime drowsiness then treatment is not appropriate.
As a matter of fact, the author mistakenly proves this himself. An AHI of 10/hr without symptoms is considered normal.
Lastly, the concluding statement “turns out people don’t like machines in their bed” because so many quit, is inaccurate for one reason. Not everyone is given proper education and coaching prior to and during CPAP usage.
It always comes back to education.

An industry has grown up around the condition, stirring concerns about overdiagnosis and overtreatment.

09/26/2022

It becomes a bit lost at the end, but yes, speak to a doctor or sleep specialist

Almost 7 out 10 Americans don't get restorative sleep. How does your sleep stack up?

09/23/2022

Excited to share some specific numbers with you all. I often talk about how important proper sleep education is.

From May 2020 to May 2022 I had 850 appointments in office as a Sleep Educator.
710 were unique patients.
Taking into account the various subsets where the outcome can not be quantified (lost to follow up, provider left, stopping for the recall or insurance issues only, no longer qualify, have an upcoming appointment, or deceased)
We have 500 known outcomes, with 414 of those patients compliant.
That is good for 83%. The national average for continued compliance is approximately 70-72%. A full 33% quit in the first year alone!

An added bonus is the patients that have been lost to follow up are able to be tracked and the offices will be getting a nice list of patients we can follow up with.
The numbers continue to grow, with around 150-200 patients since May

83%

Sleep Education is vital.

09/21/2022

People with more severe sleep apnea are at greater risk of developing venous thromboembolisms—a potentially life-threatening condition.

09/19/2022

Misconception Correction Monday:

“I don’t need a sleep study, I sleep just fine. My snoring doesn’t bother me”

Sleep studies don’t measure how “well” you sleep. They look at how the body functions during sleep. Primarily the study focuses on the presence of Apnea, or periods of not breathing. It also looks at brain wave activity to see what stages of sleep a patient achieves, or in some cases does not achieve.
Muscle movements, respiratory effort, heart rate and rhythm, oxygen saturation and snoring round out the study.

And snoring often does bother the individual, especially if it is disruptive and causes them to awake or go into a lighter stage of sleep.

Sleep well

09/17/2022

Good afternoon,

It’s been a while since I’ve posted something more than an article, because life can get fast paced and there’s never even time for everything, right? We just have to squeeze a little more into the 24hrs we have.

Traditionally the first thing that gets sacrificed is our sleep.
Whether this is intentional because you have to get that next episode in, or that deadline is fast approaching so there’s work to do, or there’s no way this game is going to OT or you won’t to be able to fall asleep so why bother Maybe you can’t just drift off in a reasonable amount of time or you’re restless for hours. You may be someone that just wakes up too early and you think that’s just you, best just get up.
Maybe you’re scoffing, thinking I have no problem sleeping, I’m out the second my head hits the pillow and I can function fine on 5 hours.
Poor sleep will impair cognition, fine motor skills, memory, mood and so much more.
Increased risk for stroke, heart attack, motor vehicle accidents? Check.

According to reports being awake just 17 hours is the equivalent of a blood alcohol level 0.05%, which U.S. laws say is legally impaired.
After 24hrs without sleep the equivalency goes up to a BAC of 0.1%, above the legal definition of drunk!
Now compound that 17hrs, or more, a day awake over the course of a weekend, a week or longer and that’s some major damage in the long run.

There’s hope though!
Don’t cut yourself short for the sake of anything short of emergencies.
Still can’t sleep?
Talk to an expert. There’s a multitude of sleep disorders you may be dealing with, and you may not even know.

And if it’s apnea, with the right coaching, settings and interface the PAP machines can be a wonderfully helpful therapy.

Starting this upcoming Monday, I am going to be dispelling some fairly common myths about sleep studies and PAP machines.
So if you have specific questions about any of this, feel free to share them with me.

Sleep well, folks

09/17/2022

Aside from a pretty glaring omission of sleep disorders effecting poor sleep, interesting data here also

Insomnia is linked to a variety of problems, including obesity and heart disease.

09/17/2022

A new study found Pycnogenol French maritime pine bark extract to significantly relieve and prevent symptoms associated with restless legs syndrome.

09/05/2022

“Sleep age” could predict health and lifespan • Earth.com

09/05/2022

Further theory that sleep is the root of a lot of our body’s functions and systems and can impact a wide range

New research published in PLOS One suggests that depressive symptoms are longitudinally associated with increased inflammation. Furthermore, the new study provides evidence that sleep quality plays a significant role in the link between depressive symptoms and later inflammation. ...

08/31/2022

Interesting stuff here

Eye movements during REM correspond to things we’re gazing at things in the dream world our brains have created, according to a new study.