So I went to this lecture the other night . . .

Respironics was one of the sponsors of the meeting, so they sent along some copies of a brochure that I thought was nicely done, entitled I Have Sleep Apnea. Now What?

Here is a pdf of it: http://www.athenssleepcenter.com/PDF/Wh ... ooklet.pdf

Nice brochure, thanks jnk.

jnk wrote:
He stressed that patients with both OSA and insomnia often present with depression/anxiety/pain. He talked about the three P's of dealing with insomnia: Predisposition (such as classic type-A personality), Precipitating factors (such as onset of stressful situation), and Perpetuation (naps/alcohol/time awake in bed, which extend the problem and make it worse). SLEEPING PILLS ARE NOT THE ANSWER! You tell 'em, Doc!

He mentioned that a lot of CBT practitioners who specialize in treating insomnia do very good work and help a lot of people.

These three P's are all nicely addressed in Barry Krakow's book.
He offers CBT solutions to all of them.

I enjoyed reading through the brochure.
It helps me realize how much I know about cpap therapy
and how successful I am at providing cpap therapy, to me....

jnk wrote: I wish all you guys could be there for the meetings. There's plenty of room. One day we'll all have to meet up there

It would be so much fun to have a cpaptalk ride downtown gathering.

Thanks for the report.

carbonman wrote: . . . These three P's are all nicely addressed in Barry Krakow's book.
He offers CBT solutions to all of them. . . .

I am glad you mention Dr. K. and his book on this forum every once in a while.

When friends mention insomnia, I always mention that book, based on nothing more than your recommendations, since I've never had insomnia and haven't read the book, myself.

One time a good friend of mine in NC mentioned a problem with her sleep. I told her, "You should get the book Carbonman says changed his life." She looked at me blankly and said, "WHO?" I just laughed. My wife finally spoke up and said to her, with a roll of her eyes: "One of his forum friends."

The friend got the book, by the way, and has found it very helpful. Her comment was that she is learning as much about herself as she is learning about sleep.

So, thanks.

http://books.google.com/books?id=F1h1iy ... &q&f=false

jnk wrote:My wife finally spoke up and said to her, with a roll of her eyes: "One of his forum friends."

I can just feel the love.

jnk wrote:Her comment was that she is learning as much about herself as she is learning about sleep.

.....which tells me she has read and is making a real effort w/the material presented.
It is not an easy read and is even more difficult to put into practice.
Self-introspection can be very difficult.
I credit my years in CB therapy w/a talented therapist
to be able to see, accept and put into practice
the techniques in the book.

jnk wrote:......OSA is worsened when "unperceived" pain is still perceived by the brain during sleep, which causes alpha-intrusion. The chronic pain causes increased tiredness in that way, which, in turn, makes the airway more likely to close. This creates a vicious circle, since fragmented sleep then heightens pain perception...

Oh boy can I attest to that! Since I fell on my shoulder end of July I'm having to sleep on a wedge on my back to avoid more pain. Since I haven't slept on my back since I was diagnosed Apr '07, this is miserably uncomfortable. I hadda buy a cervical collar to prevent my jaw & mask from dropping loosening my pillows causing high leak, my median & 95%centile pressure are up. My AHI has tripled, I now have apneas & a lot more hypops, and I have pain that's always worse when my AHI is up. I have EDS and get cranky in the afternoon. It is slowly improving but so slowly I can see improvements only on a month-to-month comparison of range of movement .

I gotta ck out hte presentation. Sure wish we had someone like him here locally.

KatieW wrote:Nice brochure, thanks jnk.

It sure is. I hadn't seen it before. Adding my thanks, too, Jeff.

rested gal wrote:

KatieW wrote:Nice brochure, thanks jnk.

It sure is. I hadn't seen it before. Adding my thanks, too, Jeff.

That makes me feel better; I assumed most everyone had seen it before but me!

I like it that they weren't too heavy-handed in promoting their own products, even using generic terms in copy instead of proprietary ones--"Bi-level" instead of "Bi-PAP," for example.

Nicely done, Respironics! We appreciate your thinking of us, whether we are your customers or not.

Thanks, jnk.

By the way, after that summary, I don't believe your brain is damaged.

Great brochure too.

I have no praise for the brochure because it is incomplete - no mention at all of the very important efficacy data-capable machines and software.

They also lie in the brochure:

Your homecare provider will train and educate you and your family on the use, care, operation, and maintenance of the equipment.

(See viewtopic/t52312/Ridiculous-quotes-and- ... -DMEs.html)

There happened to be enough very good information in the brochure that I'd sure praise it.

Personally, I'd like to have seen the cpaptalk.com URL included in the information resources at the end, but oh well. Determinedly inquisitive people will use Google and find their way here.

Anyway, for newly diagnosed people who will never be interested in educating themselves about OSA and the treatment they're about to embark upon (probably the vast majority) I thought the brochure was excellent. Covered the basics very, very well, imho.

He also said straight out that "Apnea CAUSES weight gain, not just the other way around." For him, the proof of that is how many patients have sudden acceleration of weight gain in the six months preceding seeing a doctor. Obviously, to him, the sleep problem causes that phenomenon.

Let's emphasize the word "just" in the quote above. I missed it the first time I read that, and it appears to be the most important word in that sentence.

I don't understand how an acceleration of weight gain in the 6 months prior to seeing a doctor is any more proof that OSA causes weight gain than it is proof that weight gain causes OSA.

Obviously the causes of OSA are complicated and multi-factorial, with obesity having an important role for many people, either by causing it OSA directly or in interaction with other risk factors. That having OSA also packs on the pounds creates a vicious cycle. Nevertheless, just as we want to say that it is a myth that OSA is ALWAYS due to weight gain, it is a myth to say that OSA is rarely caused by weight gain. Considering it is one of the few variables that people have some amount of control over, it is harmful to suggest that it doesn't play a key role in the etiology of OSA for many people. I believe that is why he lists attaining an ideal body weight first under behavioral interventions on his slide show.

He balked at the statement that "weight loss treats OSA." He emphatically stressed that it does not. "But," he said, "it often DOES 'improve' a person's condition." He repeated again that it is not a "treatment."

How is it not a "treatment" if it "improves" a person's condition? Or do you mean that he said it does not "cure" OSA?

His view of the fibromyalgia connection with OSA was fascinating. His way of looking at it is that OSA is worsened when "unperceived" pain is still perceived by the brain during sleep, which causes alpha-intrusion. The chronic pain causes increased tiredness in that way, which, in turn, makes the airway more likely to close. This creates a vicious circle, since fragmented sleep then heightens pain perception.

Having shown recent signs of chronic pain, I'm interested in this part. Why would pain be "unperceived" during wake but be perceived during sleep? Or am I not understanding what he said?

Thanks for passing along all this information.

SleepingUgly wrote:

He also said straight out that "Apnea CAUSES weight gain, not just the other way around." For him, the proof of that is how many patients have sudden acceleration of weight gain in the six months preceding seeing a doctor. Obviously, to him, the sleep problem causes that phenomenon.

Let's emphasize the word "just" in the quote above. I missed it the first time I read that, and it appears to be the most important word in that sentence.

I don't understand how an acceleration of weight gain in the 6 months prior to seeing a doctor is any more proof that OSA causes weight gain than it is proof that weight gain causes OSA.

For me I was under 125 until I was 57 when I started get very tired and I gain more then 30 lbs in 6 months. My blood pressure had been acting up for about 7 years at the time.

SleepingUgly wrote:

His view of the fibromyalgia connection with OSA was fascinating. His way of looking at it is that OSA is worsened when "unperceived" pain is still perceived by the brain during sleep, which causes alpha-intrusion. The chronic pain causes increased tiredness in that way, which, in turn, makes the airway more likely to close. This creates a vicious circle, since fragmented sleep then heightens pain perception.

Having shown recent signs of chronic pain, I'm interested in this part. Why would pain be "unperceived" during wake but be perceived during sleep? Or am I not understanding what he said?

If you get busy with interesting stuff you will often not perceive pain, especially the nagging low grade kind.

ozij wrote: . . . after that summary, I don't believe your brain is damaged. . . .

Oh no! That means I'm gonna need a different excuse for my odd behavior!