Obstructive Sleep Apnea Practice Guidelines

How to Treat Sleep Apnea Naturally

Hi, my name is Troy Giles. I am a of Chiropractic and a Natural Internist. Today I wanted to talk to you a little about apnea,and sleep apnea. This is a major issue in the world. People are having trouble sleepingand there are many reasons for apnea. One is neurologic, where the nerves, the brain,the connection to the lung is not working correctly. Also, thyroid we find, thyroiddysfunction, where low thyroid. Thyroid is what helps you control your breathing patternswhile you are asleep. If you have low thyroid, the thyroid affects the heart and the rhythmof breathing. So low thyroid can affect it as well. But, apnea is when you can't breathwell. Your sleeping and you just stop breathing.

There can be constrictive apnea as well, whereyou have enlarged tonsils, or your throat is closed down. I had a patient that had,this has been probably ten years ago, had a roto rooter, if you will, where they went in down on thetrachea, the throat, removed the tonsils and literally removed and widened the trachea,all the way down through his neck, through his throat. Extremely painful, literally hewished he could have died. That ultimately, still didn't help any. He can get better air,bit still he is on a CPAP machine. The treatment for it, medically, is to use a CPAP or a ByPAPmachine, which helps to force air into you and helps you to breathe during the evening.Another issue is that many times its body

habitus, enlarged gut. If you are laying onyour side and you have a larger tummy, you have to push your tummy up while you are breathing,sleeping at nighttime. Literally, you are having to lift up your tummy all night long.After a couple of hours or so, you become fatigued. The diaphragm becomes fatigued oflifting, pushing. So you just stop breathing for a minute. You can go 30 seconds, a minute,2 minutes. Finally, you gasp for air. This happens over and over and over. The CPAP helpsto force the air in you are just basically breathing easier. The sense of breathing isthere, but you are now lifting with forced air, in the abdomen, and in to your lungs.So to treat this, naturally, we want to look

at supporting the lung tissue. We want tosupport anything that is going to help you to get rid of inflammation through the throat.We want to treat the thyroid and the adrenal glands to have them up and running the waythey should so they are giving good information to the heart and to your breathing pattern.We would do this through supplementation. The supplementation we would want to looktowards would be the adrenal glands first, Adrenex. We would support the adrenals withAdrenex. Thyroiden to support the thyroid tissue. Thyroid again, we want to get itsmetabolism and its function the way that it should. Permalung helps to bring clarity,helps to remove sluggishness of the lungs,

bronchial congestion, mucus. A lot of timesthere is a mucus build up throughout the lung. Even with that we would want to look towardsleaky gut syndrome because when you have leaky gut, you are actually leaking toxins throughthe gut and they overwhelm the liver and its ability to detoxify. So a lot of the overalltoxins will come up and out through the lung. So you will have a lot of increased amountof toxin and production of mucus, so you will tighten up as well. So, asthma and apnea alsowork together. So, you want to see if you can't get rid of some of that tightness andcongestion that you feel. I would work with the diet, just helping, just eating more greenleafy vegetables. It is so vital to eat green

leafy vegetables every meal. So how do eatgreen leafy vegetables for breakfasté I would encourage you to get a significant blender,Vitamix is a good one, Blendtec is another one, Montel Williams I think has one thatis a good like two horsepower motor, that you can put in all the kinds of fruits thatyou want, green leafy vegetables, like kale, baby spinach, literally any vegetable thatyou want can go in there as well. If you make it correctly, it tastes very good. You haveall your fruits. You can get some of the big box stores have frozen fruit. You can putthat with a banana, maybe a protein powder of some type. The one we carry here is calledLepterra. That helps make it smoother and

OSA Screening Guidance for AMEs

*Music* *Airplane Sound Effect* Hello. Welcometo this update on Obstructive Sleep Apneascreening guidance for Aviation Medical Examiners. According to the Federal AirSurgeon, the new guidance willsignificantly improve the safety of the NationalAirspace System while

simultaneously improving pilothealth and career longevity. Today, I'll walk youthrough a triage function resulting in six possibledeterminations. But first, a littlehistory on this topic: In 2008 the NTSB providedrecommendations to the FAA to mitigate the safety riskof Obstructive Sleep Apnea. In response to theserecommendations, the FAA developed lectures onsleeprelated disorders

and in particularObstructive Sleep Apnea, to be delivered at alltraining events. Unfortunately, after fiveyears of awareness training, the number of pilotsidentified with OSA was virtually unchanged. It's important to note thatthe NTSB has recently placed OSA on their quot;Most Wantedquot;list for transportation safety improvements for 2015.

As a result, the FAA hasdeveloped new guidance to address thisgrowing concern. This tutorial outlines the processthat AMEs are expected to perform at eachpilot examination. The process is aresult of input given by industrystakeholders and medical practice guidelinesestablished by the American Academy ofSleep Medicine, or AASM.

AMEs will perform what isessentially a triage function screening and assigningpilots into one of six OSA groups while enteringexam results into AMCS. We do not expect theAME to perform a sleep medicine evaluation,nor do we encourage it. When performing the triage, itis important to keep in mind two principles. Number one: Apilot should not be denied or deferred unless the AMEbelieves he or she represents

an immediate safety hazard. This should be rare regardingOSA. And number two: No pilot willbe deferred based on Body Mass Index alone. Let's go over how anAME will assign pilots to the OSA groups. When examining pilots for OSA,AMEs should apply al judgment using criteriadeveloped by the AASM.

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