Wednesday, January 20, 2010

Study on medical marijuana and sleep apnea

Hey again, so I came across another article with potentially interesting implications for people with central sleep apnea and other types of apneas. The study was conducted by a group of scientists at the University of Illinois Department of Medicine. Rats (of course) were used to study the effects that cannabinoids, the chemicals found in marijuana, had on sleep. Delta-9-THC and oleamide were administered in specific doses. The results suggested that the concoction stabilized breathing, blocked serotonin-induced worsening of sleep-apnea, and generally suppressed episodes of sleep apnea in the study rats. The article goes on to comment about how medical marijuana use by patients helps improve their quality of sleep and decrease their perceived fatigue the following day. It doesn't mention if any of those patients had central sleep apnea, obstructive sleep apnea, or mixed, if they were cancer patients, or really what types of ailments they had, however. Finally, the article concluded by suggesting that further studies are needed to look at whether cannabis use has any affect on some of the issues associated with central sleep apnea and other forms of apnea like hypertension (high blood pressure), irregular heart beats (atrial fibrillation), or other forms of heart disease.

Studies that use medical marijuana often use a kind of marijuana that has a much lower percentage of THC than what can be found being grown in Canada, California, and other "mom and pop" operations. Although marijuana is illegal, I'm curious if any studies are being done with humans with central sleep apnea, obstructive sleep apnea, insomnia, narcolepsy, or other types of sleep disorders, because it's not like it would be dangerous for test subjects if the experiment had proper medical personnel, and it seems as though the benefits of such studies could have profound implications for a lot of people. I'm interested in hearing if anyone with central sleep apnea or other forms of sleep disorders, or anyone who "knows someone" for that matter, has noticed a difference in their sleep the next morning after an evening of marijuana use. I personally have a strong moral backing for medical marijuana use because of all the good things it can do for cancer patients as a substitute for expensive drugs needed post-chemotherapy. A special on the National Geographic channel about marijuana highlighted a lot of what I mentioned, so if it's ever on again and you have some time, give it a view.

Mike M. RN BSN
owner of

Tuesday, January 19, 2010

Blue Light Therapy in Sleep Apneas

Hey, again so I came across an interesting type of therapy for central sleep apnea and other types of apnea called blue light therapy. Now after seeing this type of therapy, I don't believe that blue light therapy alone would be sufficient in treating central sleep apnea and other types of apneas, but it might be a helpful adjunct to cpap, bipap, or autopap. I'd really be interested to see if anyone has tried this type of therapy and what type of results they got. Blue light therapy uses blue light via lamps, lasers or light-emitting diodes to expose individuals to specific wavelengths for a prescribed amount of time. It is thought to be advantageous in the treatment of certain sleep disorders like central sleep apnea, obstructive sleep apnea, and insomnia, and may improve mental alertness during the daytime.

Insomnia often corresponds with altered circadian rhythms of body temperature and melatonin secretion. Light therapy in the morning or evening has shown to be an efficient method to reset the internal clock. With sleep disorders like central sleep apnea, obstrucive sleep apnea, or mixed sleep apnea, disruptions in circadian rhythm prevents people from experiencing a complete or restorative sleep. Most people find that the symptoms associated with sleep disorders diminish when their circadian rhythms work properly. There are a few minor potential side effects from blue light therapy for people with central sleep apnea and other sleep disorders, including jumpiness, headache and nausea. Blue light therapy also considered a mood changing treatment, and therefore has a possibility of causing anxiety. Anyone beginning blue light therapy is recommended to use under doctor supervision. Again, please leave comments, questions, or reviews if you've tried out this type of therapy, as it seems kind of under the radar as a treatment option for central sleep apnea and other types of apneas. Thanks.

Mike M, RN BSN
owner of

Monday, January 18, 2010

Central Sleep Apnea + Heart Failure = more article reviews

Hey again, so I just got done reading through another article. This one deals with the benefits of a diuretic, acetazolamide, for patients with heart failure and central sleep apnea. Essentially, what a diuretic does for people with heart failure is it gets rid of some of the excess fluid that accumulates and causes the heart to work harder to pump out the extra volume of fluid. When dealing with central sleep apnea and heart failure, it is important to remember that the heart is already working harder than usual because of heart failure, and if you add in the fact that central sleep apnea causes a decrease in the amount of blood oxygen available, one can see that the heart is going to work even harder to be sufficient. From what I've gathered about this article, the test subjects were given acetazolamide an hour before bed for 6 nights. Lab values that indicate how well their blood was saturated with oxygen showed improvement, while the number of times in an hour the subject woke up from an apneic episode decreased. A miriad of subjective (or opinion-based) perceptions showed improvement in areas such as overall sleep quality, feeling rested on awakening, daytime fatigue, and falling asleep unintentionally during daytime. The article can be found here.  Has anyone with central sleep apnea and heart failure been on a medication like acetazolamide, or other type of diuretic, and experienced the same results?

Mike M., RN BSN
owner of

Sleep apneas and heart conditions

Hey again, so while browsing the web I came across an article, which can be read here, that discusses a relationship between sleep apnea and certain heart conditions, such as high blood pressure or abnormal heart beats. Although this article does not clearly differentiate between obstructive sleep apnea and central sleep apnea, the overall theme of the article suggests to me that the effects of sleep apnea on the heart is relevant for both conditions. The connection between sleep apnea and most heart conditions is that sleep apnea contributes to a decline in the amount of blood oxygen available to the body, a condition termed hypoxia, because of the interruption of normal breathing patterns. When the heart doesn't recieve enough oxygenated blood, it is termed ischemic. Both obstructive and central sleep apnea reduce the amount of oxygen in the blood, which then reduces the amount of oxygenated blood going to the heart muscle. Therefore, obstructive and central sleep apnea can cause heart ischemia. Overtime, a person with obstructive or central sleep apnea that causes episodes of heart ischemia can develop areas of heart muscle that have been damaged.

What is significant about damage to heart muscle, among other things, is that heart beats depend on an electrical current that follows a specific track. Consider the blue line monorail in Chicago as the heart. The beat starts in O'Hare, and ends in Forrest Park. Normally, the "L" (heart beat) runs smoothly from start to finish because each station is in good working order. Now let's say that the Division street station is down. You'd most likely get off at that station and ride a bus to the next station, then get back on the blue line after a short detour. You'd end up getting to your destination eventually, but that detour made your commute a little longer than normal and stressed you out a little more than usual. The same thing happens to the heart and heart beat when it has areas of damage in the muscle. Think of damage to the heart muscle as that downed Division street station. The beat will get to its destination eventually, but the heart will have to work a little harder and take a little longer to get it there. Both obstructive and central sleep apnea can cause these pockets of heart muscle damage, and contribute to abnormal beats or simply stress the heart out more than usual. Increased stress over time can cause the heart muscle to thicken, stiffen, and pump less effectively, which can lead to high blood pressure. These are further reasons why obstructive and central sleep apnea are causes for concern, and why awareness needs to be raised. Was that analogy of the heart beat and Chicago's monorail too dense or was it helpful? I'd appreciate any feedback.

Mike, M. RN BSN
owner of

More info on bipap and auto-pap

Hey again, so I thought I'd discuss two other positive airway pressure machines used to treat central sleep apnea and other forms of sleep apnea in a little more detail. I'm talking about auto-pap and bipap. Both of these machines have similar, if not identical, components as cpap machines (base unit, hosery, mask, etc.). The difference with these machines is how they deliver the stream of oxygen and air. These differences are quite important when dealing with central sleep apnea, due to some of the issues that cental sleep apnea can cause (see previous posts for more about these issues). With auto-pap, the machine automatically figures the amount of pressure needed to maintain an unobstructed airway on a breath-by-breath basis. It does this by measuring the resistance in the patient's breathing, and adjusting the amount of minimal pressure needed to be delivered to overcome that resistance.

The other positive airway pressure machine used to treat central sleep apnea is bi-level positive airway pressure or bipap. The development of bipap allows air to be delivered through the mask at one pressure for inhaling and another for exhaling. Typically, the pressure set for inhalation is higher than the pressure set for exhalation, to make exhaling easier. This makes bipap easier for users to adapt to, and eliminates some of the issues that persons using cpap encounter, such as the inability to overcome the continuous pressure to exhale or retention of cardbon dioxide. Bipap has been found to be particulalrly useful for patients with congestive heart failure and lung disorders, especially those that result in the retention of abnormally high levels of carbon dioxide. I'd be interested to hear what issues people have with either auto-pap or bipap, or preferences for any positive airway pressure machine used to treat central sleep apnea, so please leave your comments.

Mike M., RN BSN
owner of

More info on CPAP

Hey again, so I thought I'd go over in a little more detail about one of the most widely used options to treat central sleep apnea and other sleep apneas, which is the use of positive airway pressure machines. These machines can either come in the form of autopap, cpap (continuous positive air pressure) or bipap (bilevel positive air pressure). Most units typically consists of a base unit, hosery, and mask (most often nasal or full face) with either some sort of chinstrap or headstrap. For persons with obstructive sleep apnea, the use of auto-pap or cpap would most often be sufficient. To remedy the main issue with obstructive sleep apnea, a partial or complete obstruction of the airway during sleep, cpap offers a constant flow of air pressure from the mask designed to prevent the collapse of the airway during respiration.

The cpap machine sets pressure accordingly to the user needs to prevent the collapse of your airway, which is determined by a physician or other certified healthcare personell after a sleep study. The cpap machine delivers a continual stream of compressed air, splinting the airway (keeping it open) so that unobstructed breathing becomes possible. A potential issue with cpap delivered through a full face mask, however, is that extra pressure is needed to exhale against the continual stream of air. This can make it unsuitable for certain people, including some of those suffering from central sleep apnea or mixed sleep apnea (a combination of obstructive sleep apnea and central sleep apnea). Therefore, the use of a nasal cpap may be more appropriate for some people with central sleep apnea who would have difficulty maintaining proper breathing with the full face mask. Another potential issue with cpap that some people report is the potential for dryness in the throat and mouth from the continual stream of air. Humidifiers are available for most cpap machines, if they are not already installed, to help prevent this comfort issue from happening. I encourage anyone who has or knows anyone else with other issues or problems with cpap machines to leave their comments and concerns. Look to my next post for information about another positive airway pressure machine used to treat central sleep apnea, bipap.

Mike, M. RN, BSN
owner of

Thursday, January 14, 2010

Article that links ecstasy use with sleep apnea

Hey again, so I came across this article I found interesteing, while looking for some information on central sleep apnea products. The takeaway message for me from the article is that scientists say they found that users of ecstasy had upwards of eight times the risk of sleep apnea or shallow breathing episodes while asleep compared with those who did not use the drug, and only users of the drug had moderate or severe sleep apnea, with eight cases of moderate sleep apnea and one case of severe apnea detected.  The full article can be read here. Although the article did not specify central sleep apnea versus obstructive sleep apnea, discussions of neurochemical communication lead me to believe that it is relevant in certain cases.

One aspect that the article brings up is that the brain chemical serotonin, which contributes to neuronal communication, seems to be affected by ecstasy after minimal use. I wonder if the amount of serotonin available for neuronal communication is affected or if the ability of serotonin to communicate those messages is affected. Would the youth who use ecstasy multiple times then be pre-disposed to the development of central sleep apnea following continued use, trauma to the spinal column, or the development of another co-morbid condition such as congestive heart failure or Parkinson's disease?

Mike M., RN BSN
Owner of

Intro to treatment options for central sleep apnea

Hey again, so now that I've covered how central sleep apnea is can be tested for and diagnosed, I thought I'd introduce some of the many available treatment options. Central sleep apnea can be treated by the use of oxygen, cpap (standing for continuous positive air pressure), nasal cpap, hi-flow nasal cannulas, bipap (bilevel positive airway pressure), medications that can help stimulate breathing, and surgery. I'd be interested to see what others who have central sleep apnea, or who have family members with the condition, have to say about any of these treatment options, or add something I missed.

Mike M. RN BSN
Owner of

Testing for Central Sleep Apnea

Hey again, so I thought I'd provide some information and links for you all on how central sleep apnea can be tested for and diagnosed. Being diagnosed with central sleep apnea often does not come unaccompanied without another underlying or "co-morbid" condition (as discussed in previous posts). A physical examination by a primary care provider is typically the first step in any assessment. Then based on the patient's history and the results of the physical examination, an array of tests or further examinations would be done to diagnose any co-morbid conditions.

Once other conditions are ruled out or confirmed, a sleep study (polysomnograph) can be used to identify central sleep apnea. Results of the sleep study that would support the diagnosis of central sleep apnea would indicate poor airflow through the nostrils and mouth accompanied by a decrease in blood oxygen saturation (the amount of oxygen in the blood available for use). Other tests that may be done to help identify accompanying conditions that may contribute to central sleep apnea include MRI and Lung Function studies.

Above is a great read for information that will allow you to be better prepared for your upcoming sleep study. Reviewers of this book were greatly appreciative of the information received prior to their sleep study, and felt they could discuss questions, concerns, results, etc. more efficiently with their physician.

Mike M. RN BSN
Owner of

Why Central Sleep Apnea is such an issue

Hey again, I thought I might discuss a little more about why central sleep apnea can be such an issue. I briefly touched on my last post how the brain malfunctions in central sleep apnea in regards to its communication with the muscles responsible for respiration, and how that essentially causes your body to "forget" to breathe. The brainstem controls breathing, so any condition, disease, or trauma to the brainstem may affect how the brainstem communicates. Certain conditions that affect the brainstem can lead to this communication malfunction, and the development of central sleep apnea.

Some of these conditions include congestive heart failure, trauma to the spine, Parkinson's disease,  encephalitis (as its effects could migrate or manifest in the brainstem), congenital anomolies (conditions people are born with) such as spina bifida, severe arthritis and degenerative changes in the spine or base of the skull, or complications arising from the use of certain medications like painkillers. These conditions can all lead to central sleep apnea, and poor sleep. Anything that disrupts normal sleeping problems is a serious issue, as lack of quality sleep can contribute to slow healing wounds, depression, poor memory formation, poor judgement in decision making, or a vulnerable and stressed immune system which leaves the body susceptible to infection. Therefore, anything that disrupts normal sleeping should be discussed with a healthcare professional so treatment options can be discussed.

Mike M., RN BSN
Owner of

Tuesday, January 12, 2010

Central Sleep Apnea Intro

Hello everyone,

Do you or a loved one suffer from central sleep apnea? Central sleep apnea is a condition in which the brain fails to send signals to the respiratory muscles responsible for breathing. Often as a result of another condition, such as heart failure or stroke, central sleep apnea is a concern that can adversely effect the overall health of an individual or a loved one.

As a Registered Nurse, I've had a multitude of patients that acquired this condition, and have seen the undesirable effects that central sleep apnea can have on a person. Although subtle, most of these effects can be attributed to one of the main overall problems that central sleep apnea causes, the lack of a good night's rest. Central sleep apnea causes multiple interruptions throughout the course of a night's sleep, often preventing the deep sleep desperately needed for optimal health and recovery.

I'm opening this blog for people to share stories of how this condition affected their lives or the lives of their loved ones, to ask questions, to post successful interventions and treatments, to promote what products or medications worked best for people, and to raise awareness about central sleep apnea. I look forward to hearing your responses. Thanks!

Above I provided a good read with 100 questions and answers about sleep apnea, to supplement information found on this blog.

Mike M., RN, BSN
Owner of