Obstructive Sleep Apnea versus Central Sleep Apnea
Obstructive sleep apnea is when the airwaybecomes narrowed or obstructed and you're making the effort to breathe but we do notsee any flow in air movement coming from your nose or mouth. Where central sleep apnea occurswhere your brain forgets to tell your body to breathe. If we're looking at it from avery simplistic term and so we do not see the drive to breathe. So the first step isto come into the and be seen by one of our physicians in the sleep medicine .We'll go through a questionnaire and try to determine what risk factors we think you havefor sleep apnea such as obesity, snoring, daytime sleepiness and then if we think thatyou have a high risk for meeting those criteria
then we would set you up for a sleep studyeither in your home to do an overnight sleep study or in our laboratory, depending on yoursituation. The CPAP can be used to treat both conditions and, in some patients, that isenough. However, there are some patients that have more complex types of central sleep apneathat require more complicated types of machines to treat that condition. Obstructive sleepapnea actually has been linked to a lot of other problems such as high blood pressureand then, you know, difficulty functioning during the day. If it goes untreated for along period of time there's an increased risk of early heart problems and those types ofthings.
How Anxiety Messes With Your Sleep
Do you ever wake up in the middle of the nightand wonder if you don't have a similarly sleepless friend that might be up for a gameof Boggleé I know I do. Hey guys, a sort of tired Amy here with youon DNews today. If you've ever woken up in the middle ofthe night and been unable to fall back asleep because your mind is racing with all the thingsyou've got on your to do list you're certainly not alone. The middle of the night sleeplesspanic cycle is one some of us know all too well, but why do we wake up in the first placeand suddenly go into panic modeé Panic attacks aren't simply moments of anxiety,thinking about that deadline that's coming
up a little faster than you'd like. Feelingshaky, short of breath, or dizzy can be a sign that you're having a panic attack.But there are also physiological effects to panic attacks, including an increased heartrate and vascular reactions that can lead to a tingly sensation. Panic attacks can come on completely withoutwarning. You can be watching TV and be hit with an array of symptoms including increasedheart rate, shortness of breath, and an acute fear of dying completely without warning. Our subconscious mind is a big part of theproblem. After experiencing something traumatic
that led you to panic, your subconscious mindcan mimic that pattern and send you into panic mode once you're removed from the situation.And because panic attacks can be brought on at the subconscious level, you don't haveto be awake to experience one. Panic attacks can hit when you're asleep,sometimes sparked by dreams or nightmares that call back to the same subconscious patternsthat bring panic attacks on for no reason while you're watching TV. The psychologicaland physiological reactions rapid heart rate, shortness of breath, dizziness, andsweating can combine to wake you up and persist for minutes. This can start a cycleof insomnia: you worry about what will happen
if you lose sleep, but can't sleep, so youworry more. Being isolated in a dark, quiet room (i.e. your bedroom at night) doesn'thelp alleviate the sudden stress of waking up in a panic. Dealing with panic attacks isn't easy, butthere are some tips and tricks to breaking the midnight insomnia cycle. Experts say thatgetting out of bed, out of your bedroom, and doing something to dispel negative thoughtsuntil you're really tired enough to fall asleep is best. Do you guys have any tricks for dealing withthose late night bouts of sleeplessnessé
Let us know in the comments below or you cancatch me on Twitter as @astVintageSpace. And don't forget to subscribe for more DNewsevery day of the week.
Anxiety Disorders OCD PTSD Panic Attack Agoraphobia Phobias GAD Generalized
Distinguished future physicians welcome toStomp on Step 1 the only free tutorials series that helps you study more efficiently by focusingon the highest yield material. I'm Brian McDaniel and I will be your guide on thisjourney through Anxiety Disorders. This is the 3rd tutorial in my playlist covering Psychiatryand we are going to review things like Generalized Anxiety Disorder, PTSD, Phobias Panic attacks. Anxiety is uncontrolled fear, nervousnessandor worry about trivial or nonexistent things. It is an unpleasant fear of futureevents that are unlikely to occur. Some patients have insight and realize that their uneasinessis illogical, but that does not alleviate
symptoms. A certain level of anxiety is considerednormal in many situations, but frequent anxiety or anxiety that inhibits function is pathologic. During anxiety sympathetic nervous systemactivation can result in physical symptoms such as Palpitations, Tachycardia, Shortnessof breath, Muscle tension, Restlessness, Lack of focus, Sweating or chills and Changes insleeping pattern. In order to make a diagnosis of anxiety, onemust rule out other potential causes of these symptoms. The differential diagnosis for anxietyincludes other psychiatric disorders, cardiac abnormalities (such as myocardial infarctionor valvular disease), endocrine disorders
(like hyperthyroidism) and respiratory disease(such as asthma or Pulmonary Embolism). Substances such as street drugs and prescribed medicationsmust also be ruled out as a potential cause of the symptoms. We are going to hold off on discussing mostof the different treatment options for anxiety until a later tutorial that will cover all ofpharmacology for the psychiatry section. That tutorial will cover things like SSRIs, anxiolyticsand cognitive behavioral therapy which can be used to treat anxiety disorders. However,during this tutorial I will mention a couple treatment options that are used for specificanxiety disorders.
We will start our discussion with GeneralizedAnxiety Disorder or GAD. You can see here in the top right corner I give GAD a highyield rating of 2. For those of you who aren't familiar with the High Yield Rating it isa scale from 0 to 10 that gives you an estimate for how important each topic is for the USMLEStep 1 Medical Board Exam. GAD is a prolonged period of near constant anxiety. Their anxietyis not linked to a specific item, person, or situation (AKA it isn't a phobia). They usually worry about a wide variety ofthings including schoolwork performance, finances, health, friends andor family members.Their anxiety is â€œgeneralizedâ€� across
many situations. Their anxiety frequentlypresents with â€œphysicalâ€� symptoms and may be severe enough to impair function. A Panic Attack is sudden onset period of extremelyintense anxiety accompanied by numerous signs and symptoms of anxiety. The attack is oftenassociated with a sense of impending doom. These â€œepisodesâ€� usually last 10 to 30minutes and are disabling. The patient returns to their normal level of function soon afterthe panic attack. They may be brought on by an inciting event or be completely unprovoked.I'd like to stop here for a moment to clarify the difference between generalized anxietydisorder and a panic attack. GAD can be thought
of as a constant moderate level of anxietywhile panic attacks are short periods of severe anxiety. Panic Disorder is recurrent panic attacksthat are unprovoked and have no identifiable trigger. The onset of these anxiety episodesis unpredictable. Patients may be relatively asymptomatic between attacks, but often haveanxiety about having more attacks. Their fear is related to the panic attacks themselvesrather than a particular external stimuli. This differentiates Panic Disorder from PanicAttacks that are caused by things like phobias. Agoraphobia is anxiety related to open spacesandor crowded places. These people are afraid