How do you Manage Chronic Pain?

Pain is our bodies warning system, alerting us to a problem. But pain can outlive its purpose and become chronic pain. When that happens, it causes even more harm. Let’s see what can be done about that.

Good Pain bad Pain

Short-term, or acute pain, is good pain.  This pain not only draws our Chronic Painattention to a problem, it also protects a damaged area from further harm (more on this later). There’s also long-term or chronic pain. This type of pain has outlived its purpose and is no longer useful. In fact, it now begins to cause its own injuries. But why does pain sometimes persist long after it’s needed?

Let’s explore these things, shall we?

Acute Pain is Your Friend

Imagine life without pain. What would it be like? If you’re suffering from chronic pain, living life pain-free probably sounds pretty good about now. Imagine how it would be to not feel pain…ever. But pain is our bodies warning system, alerting us to a potential problem.

But think about it.

You’re walking along barefoot somewhere, step on something, and slice your foot open. But, you don’t have any pain, so you pay no attention. Then there’s that sunburn, which makes your skin hypersensitive to light and touch. This keeps you from touching that area or exposing it to further light so that it can heal faster.

Or if you dislocate your hip, the pain will (hopefully) keep you from putting weight on it; thus causing more damage. And what about that chest pain that sent you to the hospital. That pain possibly saved your life. Think of the damage caused by not feeling any pain. So then, pain serves an initial purpose.

However, the very pain that saved your life can become your enemy.

Chronic Pain is Your Enemy

So that injury you had a while back is healed, but you’re still in pain. Or maybe some pain just started.  There seems to be no reason for it, but it won’t go away. What causes this?

First of all, chronic pain complaints increase with age.  And there are many causes. For example, just the changes that accompany normal aging can result in joint pain. Yet, on the other hand, older people tend to cope with pain better than younger people. This is due in part to peoples life experiences, and also health expectations in general.

But what damage does chronic pain cause? To begin with, it takes more effort to do daily tasks. Over time, this saps your strength. And that can make social interaction more difficult; as a result, you began to isolate more and more. Now it’s quite natural to become anxious about this. Eventually, depression can set in. However, anxiety and depression increase the sensation of pain; so it takes on a bit of a snowball effect.

But that’s not your only problem

Studies show that chronic pain actually changes your brain chemistry. This leads to memory and concentration problems. But perhaps the damage caused by stress is the most serious. And pain causes stress. And when stress becomes chronic, it causes chronic inflammation. Now you’re vulnerable to a whole bunch of other diseases.

And of course, pain also affects your sleep.

Chronic Pain and Sleep

If you have chronic pain, you’ll also suffer from fatigue and sleepiness. Your memory and quality of life will be reduced as well. The reason it has this effect is at least two-fold. First, chronic pain can cause you to wake up many times at night. But it also changes the amount of time spent in each sleep stage.

This is important because we need to spend a certain amount of time in each sleep stage. For instance, specific hormones are released in stage 3 sleep that help with the growth and restoration of your body. And Rapid Eye Movement (REM) sleep is important for memory consolidation. Additionally, some sleep stages affect your perception of pain.

And while pain causes sleep fragmentation, poor sleep can cause an increase in perceived pain. This starts a vicious cycle. Because the anxiety and depression from pain and lack of sleep increase the feeling of chronic pain.

When Mice Don’t Sleep

When lab animals were deprived of sleep, their body temperature dropped, internal organs shut down, and they died fairly quickly. How does this happen?  One study indicated these mice used up their energy almost twice as fast as other mice that were left to sleep. And because they couldn’t keep up with the energy loss, they died within 32 days!

With humans, hallucinations and paranoia set in long before more serious physical symptoms do. And although no human has been reported to die from sleep deprivation, it still has done some serious harm. Thus the once beneficial pain that alerted you to trouble, has now turned against you and is actually causing damage itself.

So if poor quality sleep leads to increased pain, it follows that getting a good nights rest can reduce pain. But how are you supposed to get some good quality sleep when you can’t even get comfortable?

Let’s look at some treatment options that can help us achieve this.

Treatment Options 

Conventional

A group of medications known as Nonsteroidal Antiinflammatory Drugs are commonly used to treat pain. Some of these are Motrin and Aleve. However, studies now show there are dangers in taking these medications. These risks include:

1-Increased risk of Heart failure.

2-Ulcers and internal bleeding.

3-Kidney failure

4-Serious allergic reactions

5-Dangers to children and teenagers.

Then there’re the narcotics, such as Tylenol with codeine, and Vicodin. However, these not only slow down your breathing but cause you to breathe more shallow as well. And if you already struggle with breathing in your sleep, these medications will only make things worse. Additionally, narcotics also reduce Stage 3 sleep, which is essential for the growth and restoration of your body.

So, whenever possible, treat the cause of the pain, don’t just numb it.

Alternative 

Exercise and other stressors release a chemical in our brains called Endorphins. The word Endorphin comes from 2 Greek words: Endo (from within), and Morpheús (The god of dreams), where we get the word MorphineThis is why physical exercise can make you feel good. Think runners high here.

But physical activity does more than just release endorphins. Additionally, physical activity (exercise) can prevent, or at least delay, pain;  because pain can increase with immobility. So although being too physical can increase pain, lack of physical exercise has the same effect. Therefore balance is the key.

Cognitive Behavior Therapy (CBT) is another interesting thing you might want to check out.

So again, doing things to reduce pain can help you sleep better. And when you sleep better, pain is further reduced. In all this, the real challenge is to allow the good acute pain in, but keep the bad chronic pain out.

Conclusion

Acute pain protects us from further injury. But chronic pain just causes more damage. We need to be able to reduce chronic pain as best we can, while not affecting the benefits of acute pain. If you’ve found something that has helped your chronic pain, please leave a comment. You can help others suffering from this as well.

Till next time…Blessings.

 

Do you Have What it Takes to be a Sleep Technologist?

The life of a sleep technologist is far from boring. Are you one of the many that think we just sit there all night watching you sleep? Think againIn this article, I define what a Sleep Technologist is and does.

What is a Sleep Technologist?Sleep Technologist

I can’t speak for all Sleep Technologists, but when I first heard of this field of study, I was immediately interested. What’s so fascinating about staying up all night watching people sleep, you ask? I have no idea, I don’t do that. Although, it’s amazing how many people think I do.

Let’s clear this misconception up a bit shall we? But before I go into what a Sleep Technologist does, let’s define what one is.

First of all, not just anyone can be a Sleep Technologist. And I don’t think everyone would want to be one! For one thing, we’re up at night and sleep during the day. Also, many of us work alone and spend hours at a computer. Actually, we’re usually working 2 computers at the same time because we routinely test 2 patients each night.

But really, I enjoy working by myself; especially at night when it’s nice and quiet. And by quiet I don’t mean sitting there twiddling my thumbs…that would drive me crazy!

No, a quiet night just means a nice pace where I’m able to keep up with everything. And because not everyone’s the same, what works for one person might not work for someone else. So it’s good to keep ahead of things in case something unexpected happens. Thus, good time management, with an eye for detail, is a must.

And while you’d think it would get boring doing the same thing every night, it’s not at all. That’s because, even though I have the same routine every night, I deal with different people. And it’s the people that make my career most interesting.

Not that everything else isn’t interesting. As one of my patients put it “You have a really cool job!” And while that may be true, they were wrong about one thing. It’s not just a job. I’m helping people live a longer, more enriching life. It’s what I’ve become.

But just what does a Sleep Technologist do?

What Does a Sleep Technologist do?

One of the more frequent comments I get is ‘It must be boring watching people sleep.’ Another question people ask is ‘Did you have to go to school for this?’ It’s tempting to answer that question with, ‘No, I’m smart enough to have figured this out all by myself’. But I don’t. ’cause I’m not.

Of course, people who say such things just don’t understand the complexities of this position. And for the record, we don’t watch you sleep. That would be a silly, boring and quite useless job, no?  However, after I explain what I do, the question usually becomes “How much schooling did it take you to learn all this?”

With that, let’s take a look at some of the things that take place during your sleep study.

Let’s begin with the hookup. There’re a lot of wires attached to you. These sensors measure leg movement, breathing, oxygen levels, heart rate, and brainwaves; as well as muscle tension, eye movement, and snoring. And while I’m hooking you up to all these sensors, I like to explain what I’m doing as I go. I also explain what Obstructive Sleep Apnea, or OSA, is. And this naturally leads to a brief discussion of CPAP.

After you’re hooked up, I have you try on different CPAP masks, just in case I decide to start you on treatment. This not only gets you accustomed to the mask but also helps you relax, as you now know what to expect. Then, during your sleep study, I need to determine if you need CPAP or not. And if I start you on treatment, when to adjust pressure to get you breathing well.

Once I have your study up and running, you’re reduced to a bunch of crisp clear squiggly lines on my computer monitor. All these lines show me what your version of sleep looks like. At that point, I settle into my chair and began the process of helping you live a longer more enriching life…Literally.

But in order to do this, I need to be knowledgeable about a few things.

A Sleep Technologist Does Know Some Stuff

A Sleep Technologist wears many hats. And once we pass a board exam, our ‘official’ title is Registered Polysomnographic Technologist or RPSGT.

Among the many skills we possess are:

♦ Basic EKG interpretation One of the things I record is your heart rate and rhythm. It’s not a full EKG but still gives me a heads up if something isn’t right, that is as long as I know what I’m looking at. Additionally, when I’m at a lab in a hospital, I can always call the charge nurse and get a second opinion on anything questionable.

♦Charting. Accurate assessment of your condition. Knowing what’s significant and what’s not. And with proper spelling and medical terminology (so I don’t look dumb to the Doctor)

♦ Computer skills.

♦ Medical knowledge. Diseases, medicines, medical terminology. I need to know how different diseases affect sleep. Also, medications that are prescribed for these diseases have their own effects on the sleep-wake cycle. All these variables not only affect your sleep but also influence how you respond to CPAP.

♦ Pattern Recognition-When I look at the computer monitor, all I see are a bunch of squiggly lines. But each squiggle means something. And I need to be able to determine whether a squiggle is significant or not. By morning, I’ll have around 900 pages of data recorded on you, so I really need to know what I’m looking at. Therefore, I’m the eyes and ears of the Doctor.

♦ People skills-The hook up process is 1 on 1 time. Not only is that the time to gather information on your medical history. It’s also the time to help you relax and prepare for the night. Interpersonal skills are very important. Especially at this time.

♦ Troubleshooting both equipment and computer. Although I do have access to an on-call person, I need to be able to handle problems as best I can. Of course, experience alone helps there.

We also attend monthly classes that keep us up to speed on the ever-evolving fields of sleep.

Conclusion

I hope this rather brief description of what a Sleep Technologist is and does helps you better understand this complex and highly technical field.

I’m a Sleep Technologist and I love what I do. Helping people live a longer more enriching life is awesome!!

Till next time…Blessings.

There are different ways to qualify for a Sleep Technologist. Our exact titles are Registered Polysomnographic Technologist or RPSGT. And depending on your medical background, there are the various ways you can become one of us.

The Challenge of Life With Obstructive Sleep Apnea

Have you heard of Obstructive Sleep Apnea, but aren’t really sure what it’s all about? This article will help you understand it better. And although the following story is fictional, the events are taken from real life experiences. It’s about a fellow I’ll call Ron, who has Obstructive Sleep Apnea, or OSA.

This is his story.

Ron’s Story

“Honey, you’re gonna be late for work!! Hurry up!”  Once again, Ron drags himself out of bed, his head throbbing. ‘Why do I always wake up with these @#$% headaches?’ he wonders as he staggers to the bathroom in a daze.

Ron, a fairly overweight 54 year old, works down at the local factory. He’s on several medications for both high blood pressure and diabetes. And just like this morning, he usually wakes with a headache.

Sue, his wife, has been concerned about Ron for some time. His loud snoring eventually led them to sleep in separate bedrooms so that she can get some sleep. But it’s those anxious moments when he stops breathing that are especially alarming to Sue. She’s told Ron about these things, but he doesn’t believe her and says he’s just fine.

But Sue also notices that he’s just not himself lately. He easily becomes irritable, and she suspects he might be depressed.

Looking at himself in the mirror he groans ‘you can do this’. Although that little pep talk really doesn’t do much, it’s still better than nothing. Splashing some water on his face, he mentally prepares for the day. As he lumbers down the steps, he smells his favorite coffee waiting for him.

Coffee. “That’s what I need”. Just the thought lifts his mood a bit.

Slamming down his breakfast, he fills his mug with more Java and heads off to work. His headache is gone by the time he pulls into the parking lot, and the coffee is kicking in. But, he knows this level of wakefulness won’t last long. For some reason, this reminds him of a conversation he had with a co-worker. They had mentioned something about obstructive sleep apnea. But Ron just shrugged it off.

He drinks some more coffee at his morning break and has an energy drink with his noon meal. But by the afternoon, he’s struggling to stay awake. He got some more coffee, but it’s not doing much good at this point. Finally, after fighting sleep all afternoon, it’s time to clock out for the day.  He feels like he weighs a ton as he walks out to his truck. ‘I just wanna lay down’, he thinks to himself, blinking the sleep from his eyes.

But he has to drive home yet. Good thing he doesn’t have far to go. He climbs into his pickup and pulls out of the parking lot…The loud screech of car tires startles him, as he realizes he had just pulled out in front of someone. Ron’s not very alert at this point.

In fact, most of his drives home are performed with numerous battles to stay awake. There are even times he doesn’t remember parts of the drive home. ‘Funny I haven’t killed someone yet’, Ron thinks as he fights the strong urge to just close his eyes and drift off to sleep.

Does Ron Have Obstructive Sleep Apnea?

He hasn’t told his wife about those near accidents, and how he struggles to stay awake. He just doesn’t want her to worry. ‘Besides’, Ron says to himself, ‘I’ve done o.k. all this time.’ And actually, when he thinks about it, there are some days where he doesn’t feel bad at all. But Sue is all too aware. And she’s quite concerned. In fact, she finally convinces Ron to at least talk with his Dr. “You snore and sometimes you actually stop breathing. That scares me.” She says.

“O.K.”, Ron replied, “I’ll talk to him at my next check up”.

Ron visits his Doctor

Sue accompanies Ron to his next annual physical. And there she tells his Doctor all about Ron’s sleep habits. The Doctor asks Ron some pointed questions, which includes a sleep questionnaire. This assesses’s his level of sleepiness throughout the day. Ron’s answers are alarming. They show he’s bordering on dangerously sleepy.

Additionally, when his Doctor points out that obstructive sleep apnea can cause high blood pressure and lead to sudden death, Ron takes notice. He remembers how loud his dad would snore. And he passed away from a massive heart attack when he was only 50. Ron figures he’s already beating the odds.

His Doctor also explained how obstructive sleep apnea can cause numerous trips to the bathroom.

“What happens is this” Ron’s Dr. began. “Obstructive sleep apnea causes stress . And this stress makes your body think there’s extra fluid around your heart. So it flushes out what fluid is there. Hence the extra trips to the bathroom”.

Between his Dr. and his wife, Ron is beginning to see the seriousness of what he’s facing. So when his Dr. orders a sleep study, he actually feels some relief.

Ron has a Sleep Study

Ron’s sleep study shows that he stops breathing around 30 times an hour. He’s placed on a CPAP machine at a pressure of 9 CmH20.  It takes Ron a couple weeks to really start getting used to the machine, but he’s glad he didn’t give up. Now, he can’t believe how much better he actually feels. And no more waking up with a headache.Obstructive Sleep Apnea

Also, his blood pressure is coming down, so Ron’s Dr. decreased his blood pressure meds. His blood sugar number look better too! Not only that, but his wife notices that he’s in a much better mood lately. And they’re back sleeping in the same bed.

Conclusion

Is Obstructive Sleep Apnea something that you struggle with? Is there anything about Ron’s story that sounds familiar? If so, I’d recommend you talk with your Doctor. Or maybe you know someone that’s suffering from this disorder. If so, you could possibly save a life. Seriously.

Till next time…Blessings.

Will you be the Next Victim of Denial?

Denial is the refusal to believe that something exists or is real. And in this article, I share the tragic story of how denial killed my friend. 

Denial Killed my Friend

Some time ago, Sam (not his real name) came up to me and said: “I had a sleep study and they put me on that CPAP machine, but I don’t really like it”. A fairly overweight gentleman in his late 50’s, Sam was a casual friend of mine.

“What do you mean?”, I asked.

“Air keeps blowing out the side of my mask. And a lot of times when I wake up my mask is lying next to me, just blowing away”. It sounded to me like a poorly adjusted mask. Or maybe it was the wrong type of mask. Possibly even the wrong pressure.

I talked with him about all these things, offering some suggestions I felt could be helpful. I also encouraged him to go back to his CPAP provider and have them check his mask.  He always seemed interested in what I was saying. However, when I ran into him a few weeks later, he hadn’t made any calls. And yes, he was still having problems.

We had several meetings like that. I’d always remind him of the dangers of improperly treated sleep apnea. And  I’d encourage him to get things checked out. But the next time I saw him, it was the same thing all over again. Now, Sam was no dummy, and he wasn’t lazy. He was also married; happily, I believe. Yet, knowing the dangers of sleep apnea, he never followed through with my advice.

Tragically, not long after our last conversation, I heard that he had passed away in his sleep. The Coroner said he had had a massive heart attack. This news, of course, devastated his wife. I immediately suspected improperly treated sleep apnea was the culprit. And if so, his death might’ve been prevented.

In any case, what stopped him from following my advice?

Are you in Denial, or What?Denial

My friend knew about the dangers he faced but must’ve been in denial. Like so many of us, Sam apparently just couldn’t accept that he could die if his sleep apnea wasn’t treated properly. Maybe someone else would, but not him. Naturally, I was shocked by his death. But that only made it more puzzling to me. I mean, we had several talks about this issue, and yet, he never did anything about it.

Some people just can’t accept certain possibilities. You know how it is. It (whatever ‘it’ is) always happens to the other guy, right?

Well, then there are those people who just don’t know about the consequences of untreated sleep apnea. To them, CPAP is just about getting a better nights sleep. I’ve even heard some people tell me they don’t need a sleep study because “I sleep just fine”. And while getting some good quality sleep is nice, that’s really just a side effect of CPAP.

And yes, people do die in their sleep because of sleep apnea. However, not because their breathing stopped, but because their heart stopped. Your heart can only take so much stress before calling it quits.

Am I Preaching to the Choir?

It’s easy to put things off, especially if it’s ‘not that bad’. After all, you’ve been like that for so long now. I mean, that’s just the way you are, right?

So, have you settled into a kind of complacency? Is this really ‘just the way you are? Do you understand the dangers of untreated, or even under treated sleep apnea, but don’t think you’re in any danger? Maybe you just don’t understand the real threat that exists.

Or are your finances hindering you? Can you really afford to go through more tests? Let’s face it, even with insurance, there can be some hefty fee’s involved. And I can understand how you might feel that way.

Remember, knowledge can be powerful, but denial can be deadly. So please, carefully consider what’s important in your life, and act accordingly. Who knows, the life you save might be your own.

Till next time…Blessings.