Sleep Apnea Disorder

Your Free Sleep Apnea Information Digest

Galloway Township:Sleep Apnea Support Group Offers Free Service

The Bacharach Sleep and Neurodiagnostics Center will hold a meeting of its sleep apnea support group, Alert, Well and Keeping Energetic, 5:30 p.m. Thursday, July 23 in the Pomona Room at the main campus in Galloway Township. The meeting will feature talks by psychologist Dr. Kenneth Leight and respiratory therapist Karen Schoenfellinger.

There will be complimentary pressure checks and light refreshments. Call (609) 748-5405.

High Incidence of Obstructive Sleep Apnea in Suburban Dental Practices

(Press Release)- In a recent study published in the journal Sleep and Breathing*, Dr Todd Morgan and others showed that the prevalence of obstructive sleep apnea (OSA) may be higher than expected in suburban dental practices.

 

In this multi-site study, a questionnaire designed to predict OSA was used to survey dental patients presenting for routine appointments. The validated questionnaire asks questions such as: “Do you snore?” and “Have you been told that you hold your breath while sleeping?” The survey takes only a minute or two to complete and correctly predicts the likelihood of OSA and its severity.

The questionnaire is a valuable tool for any healthcare practitioner who screens patients early in the disease process. Most OSA is undetected until significant negative health effects, like cardiac problems, hypertension and excessive daytime drowsiness precipitate a physician or dentist visit. This study proved that up to 67% of men and nearly a third of women were in need of a sleep study. Follow-up sleep recordings, made on a subset of those polled, showed that the questionnaire had a 95% sensitivity for predicting OSA.

Dr Morgan worked with Advanced Brain Monitoring, a company that supplied the home monitor used to test the subjects. The study was part of a larger project looking at novel ways of diagnosing and treating sleep apnea, and funded by the NIH.

“Undetected sleep apnea is believed now to be a cause of cardiovascular disease, type II diabetes and stroke. These diseases are more often, now, associated with sleep apnea and doctors are ordering more sleep studies. Early detection may prevent disease and potentially save many lives,” said Morgan.

Dr. Morgan maintains a private practice in Encinitas, CA and is a member of Snoring Isn’t Sexy, LLC.

The Rough Road to a Better Night’s Sleep:Sufferer’s Account

Bruce Corcoran is the managing editor of The Chatham Daily News. Here is an interesting account of his suffering with the deadly disease called sleep apnea disorder.

Tonight my summer movie will likely be “Sleepless in Leamington.” This despite going to a sleep clinic.

I’m back to the Leamington Sleep Lab to get fitted for a mask and test drive a CPAP (continuous positive airway pressure) machine.

Basically, a CPAP is a unit with a fan that blows air down a hose into the mask around your nose, which in turn sends that air into your nostrils.

Sounds like a great way to sleep, NOT!

But I’m told once I get used to it this contraption will help me get a better night’s sleep and will help lower my blood pressure.

I’ve got sleep apnea, I’m told, where I stop breathing an average of about 20 times an hour (if I read the index correctly), and upwards of 46 times an hour while on my back.

That can’t be good. Then again, if it were a contest, I’d be well back of some friends who also have sleep apnea. Some of these boys have it upwards of 60 or more times an hour.

Talk about a poor spectator sport, one that our spouses have no doubt been unhappily watching for years.

With sleep apnea disorder , as you fall into a deeper sleep, your throat muscles relax, which cuts off the flow in your airway. As a result, your body is working to inhale, but isn’t getting any air. You startle yourself awake in the process and gasp in a breath.

Well, you don’t fully wake, but your sleep cycle is messed up regardless. Not only are you almost awake many times an hour, you don’t get enough deep sleep to feel rested.

There are certainly days when I’m dragging my butt around the office. Hmm.

I knew I snore, but never thought I had sleep apnea. Now I know.

And now I will get fitted with a device that will make sleeping a challenge, but only for the short term.

My wife will exchange her nightly a spot beside Snorville Redenbacher for a chance to cuddle up with Darth Vader.

The CPAP machines are supposed to be extremely quiet, but it’s the air that goes into the mask, and my imagination, plus my warped sense of humour, that will have me doing bad Vader impressions, much to my wife’s chagrin.

Then again, some of it won’t be my fault. I’m told by the crew of friends who have CPAPs that I won’t be sleeping with my mouth open -the air will blast through my nostrils and right out my uncovered mouth. That sounds like a childish joke waiting to scare the heck out of my wife at about 3 a. m.

Also, there’s supposed to be an exhaust tube on the mask, I’m told, where the exhaled air, and excess pressurized air is expelled. If I don’t place that tube over the headboard, I might wind up inadvertently blowing air in my wife’s face in the middle of the night.

I’ll aim for the ear. Yeah, that will go over well.

When I first heard the internist tell me I had sleep apnea, I briefly debated continuing on without the machine. But considering how many nights my snoring sends my wife into the spare bedroom and how burned out I feel at times, this will ultimately be good for everyone involved.

I’m sure my daughter will be very curious and will want to try the thing on too. May as well let her get very familiar with it, as it could scare the heck out of her when she comes into the room after a bad dream and thinks Mommy is sleeping with Jason from the Friday the 13th movies.

Bird update: Those pesky feathered fiends have pretty much moved out of the backyard and into the country, but the haunting continues. I plan on replacing my porch light this weekend, as the motion sensor is toast. For whatever reason (the commando robin) the light is on the blink.

On top of this, each night my truck spends parked on the road under the neighbour’s maple tree is one where the birds gleefully drop some carefully placed poop.

They’ve now got an uncanny knack of hitting the driver’s side window, and it seems to be done minutes before I get in the vehicle to drive to work. No matter how well I wipe it off, there always seems to be a little leftover on the rubber part of the door that fits right up against the window.

I always roll down my windows, eschewing the air conditioning in favour of natural ventilation.

And I always end up with bird poop on my forearm as I unwittingly put my left arm on the door.

Oh, well, maybe the CPAP machine will leave me a little brighter in the morning and this repetition will cease.

Biomarker of Breathing Control Abnormality is Associated with Hypertension and Increased Risk of Stroke

(AASM) (Press Release) - A study in the July 1 issue of the journal SLEEP identified a distinct ECG-derived spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFCNB), that is associated with prevalent hypertension, stroke, greater severity of sleep disordered breathing and sleep fragmentation in patients suffering from obstructive sleep apnea (OSA). 

Results indicate that the odds ratio for prevalent stroke was 1.65 [CI: 1.19–2.29] in those with versus without the presence of e-LFCNB. The biomarker was detected in 1,233 participants (23.5 percent), with statistically significant differences between those with and without it. Patients with the biomarker tended to be older (average 64.7 years versus 61.4 years), male (63.3 percent versus 45.1 percent), slightly heavier (average body mass index 29.3 versus 28.6) and sleepier (according to the Epworth Sleepiness Score test results). Sleep apnea disorder severity and use of diuretics, calcium blockers, and B-blockers were associated with increased e-LFCNB. After adjustment for age, sex, body mass index, hypertension, and diabetes, only prevalent stroke remained associated with both categorical and continuous measures of e-LFCNB, while treated and total hypertension were associated only with the ECG biomarker as continuous measure. 

According to lead author Robert J. Thomas, MD, assistant professor of medicine at the Beth Israel Deaconess Medical Center & Harvard Medical School in Boston, Mass., the electrocardiogram (ECG)-based technique allows the tracking of interactions (“coupling”) of breathing amplitude and heart-beat rate changes, which are both influenced by sleep, thus providing a ‘map’ of sleep behaviors. Use of this technique allows physicians to assign patients with sleep apnea into groups who have or do not have breathing control abnormalities. 

“Central sleep apnea is precisely timed, meaning that breathing stops and starts with near identical timing from event-to-event,” said Thomas. This type of timing abnormality results in the narrow-band pattern, even if by usual scoring methods the respiratory abnormality looks obstructive.” We found that having the pattern suggesting a central or breathing control abnormality was associated with worse sleep, more severe sleep apnea, high blood pressure and an increased risk of prevalent strokes. Therefore, OSA patients who are at increased risk for high blood pressure may be at even greater risk if they also have a control abnormality.” 

The cross-sectional retrospective study obtained polysomnographic and clinical data from 5,247 patients (of the original 6,441) who were included in the baseline examination of the Sleep Heart Health Study (SHHS), a multi-center longitudinal study of participants over the age of 40, designed to determine the cardiovascular consequences of sleep apnea disorder at a population level. Associations were estimated with use of various drugs and pathologies including prevalent hypertension and cardiovascular and cerebrovascular disease. 

According to the study, the ECG-derived spectrogram’s detection of periodic breathing-type respiratory oscillations exceeds that identified by visual detection of periodic breathing. Conventional scoring may be biased toward the scoring of obstructive hypopneas during periods of periodic breathing, and measurement of the biomarker could bring attention to parts of the polysomnogram where the probability of periodic breathing or central apneas is high. The spectrogram is automated, objective, and capable of mapping the spectral dispersion of low-frequency, coupled cardiopulmonary oscillations; therefore, it could be a more accurate marker of periodic breathing and could provide insights into sleep physiology and pathology. 

The authors claim that there is an increased prevalence of periodic breathing following ischemic cerebrovascular disease, which is one way by which strokes may cause an increase in the biomarker. Hypertension may be the cause of undiagnosed cardiac dysfunction, which may also lead to an increase in the presence of e-LFCNB

According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation. Brief arousals from sleep restore normal breathing but can cause a fragmented quality of sleep. Most people with sleep apnea snore loudly and frequently, and they often experience excessive daytime sleepiness. 

More information about OSA is available from the AASM at http://www.sleepeducation.com/Disorder.aspx?id=7

For a copy of the study, “Prevalent Hypertension and Stroke in the Sleep Heart Health Study: Association with an ECG-derived Spectrographic Marker of Cardiopulmonary Coupling,”  please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

Poor Sleep is Independently Associated with Depression in Postpartum Women

(AASM) (Press Release)— A study in the July 1 issue of the journal SLEEP suggests that postpartum depression may aggravate an already impaired sleep quality, as experiencing difficulties with sleep is a symptom of depression. Twenty-one percent of depressed postpartum women included in the study reported having also been depressed during pregnancy, and 46 percent reported at least one previous depressive episode prior to conception, suggesting that new mothers diagnosed with postpartum depression are not merely reporting symptoms of chronic sleep deprivation.

 Results indicate that two months after delivery, poor sleep was associated with depression when adjusted for other significant risk factors, such as poor partner relationship, previous depression, depression during pregnancy and stressful life events. Sleep disturbances and subjective sleep quality were the aspects of sleep most strongly associated with depression. Overall, nearly 60 percent of the postpartum women experienced poor global sleep quality, and 16.5 percent had depressive symptoms. 

According to lead author Karen Dørheim, MD, PhD, psychiatrist at Stavanger University Hospital in Norway, depression after delivery is often not identified by new mothers, whereas tiredness and lack of sleep are common complaints. These symptoms may be attributed to poor sleep, but the tiredness could also be caused by depression.   

“It is important to ask a new mother suffering from tiredness about how poor sleep affects her daytime functioning and whether there are other factors in her life that may contribute to her lack of energy,” said Dørhei. “There are also helpful depression screening questionnaires that can be completed during a consultation. Doctors and other health workers should provide an opportunity for postpartum women to discuss difficult feelings.”

Data were collected between October 2005 and September 2006 from 2,830 women who gave birth to a live child at Stavanger University Hospital in Norway. Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS).

The mean self-reported nightly sleep duration was 6.5 hours, and sleep efficiency was 73 percent. The mean age of the mothers at the time of reply was 30 years, and the mean age of the infants was 8.4 weeks.

Depression, previous sleep problems, being a first time mother, not exclusively breastfeeding or having a younger or male infant were factors associated with poor postpartum sleep quality. Better maternal sleep was associated with the baby sleeping in a different room. 

According to authors, the first three months after delivery are characterized by continually changing sleep parameters. Women who are tired during this period may attribute this to poor sleep, but the tiredness could alternatively be caused by depression; thus talking about sleep problems may provide an entry point for also discussing the woman’s overall well-being. Individual women may react differently to shorter sleep duration and lower sleep efficiency during the postpartum period, and that the sleep of women with a history of depression may be more sensitive to the psychobiological (hormonal, immunological, psychological and social) changes associated with childbirth. 

For a copy of the study, “Sleep and Depression in Postpartum Women: A Population-Based Study,”  please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

 
 

Sleep Duration is Associated with Variations In Levels of Inflammatory Markers in Women

(American Association of Sleep Medicine)—A study in the July 1 issue of the journal SLEEP demonstrates that levels of inflammatory markers varied significantly with self-reported sleep duration in women but not men. 

 The study found that both interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels varied with sleep duration in women following multiple adjustments for a number of confounding factors. Compared with women who reported sleeping seven hours on an average weekday, IL-6 levels were significantly lower in women who reported sleeping eight hours. Levels of hs-CRP were significantly higher in women who reported sleeping 5 hours or less. In contrast, adjusted results show no significant variations in inflammatory markers with sleep duration in men. 

The study reports that hs-CRP, a nonspecific marker of acute-phase inflammatory response, is predictive of future cardiovascular morbidity, and the relationship of IL-6 to coronary heart disease is similar to that of CRP.  

According to lead author Michelle A Miller, PhD, associate professor (reader) of biochemical medicine at the University of Warwick Medical School in the U.K., short-term sleep deprivation studies have shown that inflammatory markers are elevated in sleep-deprived individuals, suggesting that inflammatory mechanisms may play a role in the cardiovascular risk associated with sleep deprivation. 

“Our study may provide some insight into a potential mechanism for the observation in previous studies which indicates an increased risk of death from cardiovascular disease in individuals who have less than five hours sleep per night and increased risk of non-cardiovascular death in long sleepers,” said Miller.

Results indicate that participants of both sexes sleeping five hours or less had a poorer health status and lifestyle profile. This was particularly evident in males. Men sleeping five hours or less were more likely to be in the lowest employment grade, to be unmarried, to have a higher body mass index and waist circumference, to have lower mental and physical health scores, to smoke and have a higher diastolic blood pressure. Women were more likely to be unmarried, have lower physical health scores, to smoke and have higher systolic blood pressure. Men and women sleeping nine hours or more were also more likely to have decreased physical health scores.

The study involved more than 4,600 White participants from the University College London based Whitehall II cohort study; 73 percent were men. Participants between the ages of 35 and 55 years were recruited between 1985 and 1988 from 20 London-based civil service departments. Data for this study is from the phase 3 follow-up (1991-1993). Sleep duration was determined by subjective questionnaires, and general health was assessed during a screening examination.

According to the authors, these findings add to the growing body of evidence which suggests that there is a non-linear relationship between cardiovascular risk factors and duration of sleep. Furthermore, they support the idea that short sleep is associated with an increase in cardiovascular risk and that the association between sleep duration and cardiovascular risk is markedly different in men and women. Further prospective studies are required to ascertain causality but the results also are consistent with the idea that sleeping seven or eight hours per night appears to be optimal for health. 

For a copy of the study, “Gender Differences in the Cross-Sectional Relationships Between Sleep Duration and Markers of Inflammation: Whitehall II Study,” please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

New Oral Device for Treating Snoring and Sleep Apnea

(Press Release)-Breathe right to sleep right… Are you tired of buying endless “stop snoring devices” that have been proven to be ineffective, leaving you unsatisfied? Don’t worry; Dr. Farhad Hakimi has an innovative solution called VIAdmd. VIAdmd is an oral device designed to cure sleep-breathing disorders such as Snoring and Sleep Apnea. The device is medically approved and reliable. Dr. Hakimi’s treatment is effective, scientific and designed to improve your overall health. 

 Dr. Farhad Hakimi is a well renowned Doctor of Medical Dentistry. He has experience in teaching and is affiliated with the most prestigious societies. His clinical experience and knowledge of sleep-breathing disorders give him credibility in curing Snoring and Sleep Apnea disorder. Dr. Hakimi will never treat your Snoring or Sleep Apnea problems with temporary or superficial techniques. He is committed to solving sleep-breathing disorders by eliminating their root causes. Dr. Hakimi’s highly recommended solution to treat Snoring and Sleep Apnea can be found at www.VIAdmd.com.

Snoring and Sleep Apnea can create airway blockage, causing a shortage of oxygen in your body while asleep at night. Very few people know that Obstructive Sleep Apnea (O.S.A.S.) is life threatening. To achieve overall wellness of the body it is necessary to eliminate Snoring and Obstructive Sleep Apnea. Sleep Apnea and Snoring may cause and are contributory factors to obesity, diabetes, cardiovascular diseases, depression and high blood pressure. Most people are under the assumption that injection, surgery or CPAP machines are the only treatment options for Snoring and Sleep Apnea. Surgery and injections are quite painful and have been proven to be unsuccessful. CPAP machines are intolerable, cumbersome and very uncomfortable to sleep with, forcing the user to remove it at night.

Dr. Hakimi’s method is painless and quite simple. He believes that oral harmony leads to overall well being of the body. VIAdmd-oral device is proven effective in treating patients who suffer from Snoring and Obstructive Sleep Apnea. It can work wonders for people who are deprived of oxygen when asleep. VIAdmd opens the airway during sleep to increase the intake of oxygen into the body by repositioning and stabilizing the tongue. Mouth breathing is ceased when using VIAdmd-oral device. It soothes the nerves and muscles eliminating headaches, stress, body pain and neck pain. It may not be necessary to use VIAdmd-oral device for the rest of your life like other Snoring and Sleep Apnea treatments. VIAdmd-oral device is placed on the upper teeth and very comfortable to fall asleep with. It is custom made for each individual, non-allergenic, non-surgical, non-invasive and highly effective.

Dr. Farhad Hakimi is patient in understanding your problems and will treat them accordingly. You are sure to notice the difference in just a few days after you have started wearing the VIAdmd-oral device. You will feel refreshed, recharged, energetic and productive during the day.

Recent studies show that around 95% of Dr. Hakimi’s patients have benefited from his method. In most cases the use of VIAdmd-oral device is no longer necessary once snoring has stopped. For more information visit www.VIAdmd.com

Contact:Farhad Hakimi, 120 Central Park South, Suite 1C-1D, New York, USA - 10019 , Phone: 0123456789

Young Men with Sleep Apnea Have Higher Risk of Death

Most patients referred for evaluation of sleep apnea, a condition in which airways become blocked during sleep and breathing stops for brief periods, are in their 50s, but men in their 20s with this condition appear to have the highest risk of death, an research team reports.

“The implication is that we must diagnose patients while they’re young, in their 20s and 30s, if we are to prevent mortality,” Dr. Peretz Lavie told.

Lavie and colleagues at Technion-Israel Institut of Technology in Haifa examined the survival rates of nearly 14,000 men between 20 and 93 years old evaluated over a 10-year period at their clinic for possible sleep apnea disorder. During an average follow-up of 4.6 years, there were 372 deaths.

Among those with a respiratory disturbance index (RDI) score greater than 30, only men between 20 and 29 years old had a significantly higher mortality than their counterparts in the general population, the investigators report in the European Respiratory Journal.

The researchers performed another analysis that was restricted to the 1,909 patients with severe sleep apnea (RDI scores greater than 50 and an average of 73 respiratory events per hour of sleep), among whom 95 died during follow-up.

In this group, the mortality rate for men in their 20s was nearly 10 times greater than that seen in the general population. For men 30-to-39 years old and those 40-to-49 years old, mortality rates were more than three times and almost two times higher, respectively. Men who were 50 year of age or older did not have a higher mortality risk.

Given these surprising results, Lavie said, “We believe…some individuals are able to develop a coping mechanism that allows to them to live with this nightly insult of and brief awakenings.” He noted that there are three high-risk groups that should probably undergo screening.

Young obese patients with a body mass index of 31 or higher is the first target population, “because the combination of severe apnea and obesity at this age is a killer.” Other targets are patients who have a parent with sleep apnea, and those who develop high blood pressure at a young age.

To bring down the cost of screening, Lavie and his associates have developed a device, called the WatchPAT, comprised of sensors that are placed on the fingers at night. A positive result, means that a complete workup for obstructive sleep apnea is needed.

Source: Onlinenews.Com.pk

Dr. DePaola in North New Jersey Helps Sleep Apnea Patients Not Tolerating CPAP

(Press Release)-Untreated Sleep Apnea Increases Risk for Stroke, Heart Attack and Brain Damage

Do you use your CPAP as prescribed? Are you frequently tired during the day? Call Dr. DePaola for an evaluation at 888-396-5556 or visit http://www.northnj.IHateCPAP.com.

Sleep apnea disorder is a serious illness most often characterized by snoring, gasping for breath and excessive daytime sleepiness. It is implicated in many disorders including high blood pressure, changes in insulin resistance and a six fold increase in heart attacks and strokes. CPAP is the Gold Standard of treatment for sleep apnea and is very effective. Patients with moderate apnea disorder who have untreated sleep apnea have a 36% decrease in 8 year survival compared to treated patients according to studies in the journal SLEEP.

Dr. DePaola in Hoboken, New Jersey is concerned that patients not using their cpap may be at risk of brain damage, stroke, and heart attack. He urges all patients who are not using their CPAP on a regular basis to pull their machines out of their closet and clean them thoroughly then begin using them immediately. “The problem is that only “23-45% of patients prescribed CPAP actually use it regularly while the majority of obstructive sleep apnea patients do not” and this places these patients at greater risk for heart attacks and strokes, and even brain damage.

Medical studies have shown that even patients who use their CPAP average only 4-5 hours a night not the recommended 7 1/2 - 8 hours. Recent studies have shown that patients who tolerate CPAP well from the beginning of treatment tend to continue treatment and patients who HATE CPAP or do not tolerate it at the start of treatment rarely embrace CPAP use.

Dr. DePaola has completed a variety of courses in sleep medicine from the esteemed Las Vegas Institute for Advanced Dental Studies (LVI), including Treating Sleep Breathing Disorders. He is improving lives in Hoboken, Livingston, Westfield, Ridgewood, Teaneck, and all across North New Jersey with custom night-use oral appliances that keep the airway open, ensuring a restful night sleep and lowering his patients’ risk of stroke, heart disease, and sleep-related car accidents.

Residents of North New Jersey who even suspect that they or a family member might have sleep apnea should schedule an appointment with Dr. DePaola for an evaluation at 888-396-5556 or visit http://www.northnj.IHateCPAP.com.

CPAP May Stop Snoring And Save Lives

By Dan Wilson (Best Syndication News)

 There is one sure-fire way to stop snoring. Typically the sound caused during sleep is due to a relaxation in the nose or throat. The problem could be a sign of a more serious problem like obstructive sleep apnea. It has been estimated that between 30 and 50 percent of people snore, depending on the country.

A sleep study can diagnose the problem and determine whether a Continuous Positive Air Pressure (CPAP) machine is needed. This will open the airways and stop the snoring in nearly all instances.

There are other benefits to the CPAP as well. If you are diagnosed with obstructive sleep apnea (OSA), your risk of stoke and heart attack increases. Your airways are restricted and you actually momentarily wake up before you begin to breathe again. The Mayo Clinic says that your spouse may also momentarily wake up. Neither of you may be aware of these interruptions because you are asleep and sleepy.

There are several reasons for the snore. The throat may be week and unable to allow air to flow when relaxed. Fat could be pushing in on a relaxed throat causing it to constrict and reduce air flow. There may be a problem with the nasal passageway. The effect of all of these problems is a snore.

The CPAP device will provide a constant pressure to either a nasal or full face mask that covers the nose and mouth. Various companies make the masks and CPAP machines and they may be covered under Veterans Administration (VA) and insurance benefits / plans.

Losing weight and smoking cessation will reduce the risk of snoring. But if you have tried to do those things and failed, you may want to see a doctor and get a sleep study done.

Sleep studies take only one night (unless you are unable to sleep) and can tell the specialist why you snore. A technician will monitor your breathing, heart rate and other vitals while you sleep. In the morning you wake-up and go home. It is as simple as that.

Only a doctor can write a prescription for a CPAP machine. If your insurance does not cover the device, you can shop around online and save hundreds of dollars.