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.

Summers Time for fun, Even if it Kills you

When you’re having fun, it’s easy to overlook the importance of safety. In this article, I’ll go over some things to keep in mind while on vacation. I’ll address some safety issues, as well as help you make sure you’re taking care of the important stuff.

But what does this all have to do with sleep? Read on…

Have fun but be SafeFun

It’s finally here! The day you’ve been waiting for. All the planning paid off, and now it’s time to enjoy that time away. But did you forget something? Hopefully, you have everything ready; but you already feel a sense of urgency because you need to get on the road by a certain time. So your stress level is up a notch. But remember, keep it fun.

Then there are all those extra cars on the road. That’s another thing. And that thought raises your stress level another notch. But you’re not the only one whose stress level goes up thinking about theses things. So, we’ve got several things going on here:

1-There are more cars on the road, with people driving more miles.

2-People’s stress levels might a bit higher than usual.

3-Drivers face more distractions.

With all that planning, don’t forget the most important thing…

SAFETY FIRST

First, let’s take a look at some of the things that cause distracted driving. They are:

  • Talking-either with other in the car. Or other people talking. Like kids, for instance.
  • Talking on a cell phone or texting-Pull over if you need to make that call, or send that text.
  • Eating-Stop somewhere, and take time out to eat.
  • Changing radio station/changing temp controls.
  • Reaching to pick up something you dropped.
  • ‘Zoning out’.

And as you can see, they all have one thing in common…paying attention to something other than driving. However, ‘zoning out’ is the biggest cause of distracted driving.

Let’s take a look at some of these things.

Dying to Have fun

Did you know that the highest number of traffic fatalities occur on Memorial Day weekend, with Labor Day and July 4th close behind? In addition to this, the time between Memorial Day and Labor Day are known as the 100 deadliest days for teenage drivers.

With that, consider the following.

An average car weighs around 4,000 pounds; while an average SUV is somewhere around 6,000 pounds.

At 60 MPH, you travel 88 feet every second. That’s the length of a football field in 3.4 seconds! And drivers who text, take their eyes off the road for an average of 5 seconds. At 88 feet per second, that’s 440 feet or almost one and a half football fields!

And most vehicles are going faster than 88 feet per second on the highway.

Imagine a 4,000-pound chunk of steel barreling down the road at 88 feet per second all by itself. That’s essentially what happens when you take your eyes off the road.

Now, let’s add you into this mix.

You’re on the road, most likely on unfamiliar roads, so at least that helps you stay more alert. However, other factors come into play to add to your distraction/tiredness. Things like kids in the car, a different sleep schedule, sleeping in different places, and driving more than usual. And you can still ‘zone out’ if you drive for too long a time.

Let’s face it, vacations can be tiring.  And drowsy driving is just as dangerous as drunk driving and can be just as deadly. See  http://sleepguyblog.com/drowsy-drivers-kill-people/ Yup, here I go again, spoiling all the fun.

But really, you can still have fun if you just keep some things in mind.

Don’t Forget What’s Important

So then, here are some helpful tips on preparing for your awesome vacation:

Maintaining the same sleep schedule is important, but probably not practical or realistic while on vacation.

Get a good nights sleep, not only before the trip but all throughout your vacation as well. Keep in mind that getting a good night’s rest the night before can be more difficult if you’re excited about the trip.

When driving long distance, switch drivers every 2 hrs. Or switch sooner if you feel tired, or find it hard to ‘stay in the moment’. Like, maybe you’re getting anxious, and feel the need to rush things a bit. Stay patient!

Make sure your car is in good shape–Get a tune up before taking off.

Plan your route. Use GPS, and have it ‘dialed in’ before you start out.

Still not sure where to go? Follow this link to some affordable vacation ideas. https://www.tripadvisor.com/VacationRentalsBlog/2015/06/19/summer-savings-29-affordable-vacation-rental-destinations

O.K, so you’ve got your trip all planned out, and your car is tuned up and ready to go; but what about you? Are you both physically and mentally ready for this? Because, really, there will already be enough drowsy/distracted drivers out there. You really don’t need to add another one.

Let’s check one more thing.

Have fun, but get it Done

With all that danger out there, it’s even more important that you’re extra alert. With that in mind, let’s talk sleep apnea for a moment.

Do any of the following describe you?

  • Loud chronic snoring.
  • Gasping or choking sounds.
  • Frequent trips to the bathroom.
  • Waking with dry mouth and/or a sore throat.
  • Waking with a morning headache.
  • Are you tired all the time?
  • Being moody and irritable.

If so, have you used any of these excuses for how you are?

  • This is how I always sleep.
  • It’s not that bad.
  • I could just lose some weight.
  • Snoring doesn’t hurt me.
  • I don’t want to wear a mask.

Do you need a sleep study, but are too busy right now? Maybe you’ll wait till fall when the kids are back in school. Perhaps now is a bad time. After all, you’re getting ready for that fun vacation you’ve been planning for some time. You can always go in later, right?

I mean really, who wants to spend a night in some hospital when it’s so nice out? Besides, this is vacation time! And these days are numbered.

Well, if you haven’t already, you might want to see my article on the dangers of untreated sleep apnea http://sleepguyblog.com/alarming-truth-sleep-apnea/

It’s worth not being another statistic.

And yes, you can travel with a CPAP machine. One of my patients is a Doctor who takes his CPAP with when he goes mountain climbing. It’s a special one that adjusts to different elevations.

Conclusion

While it’s nice to get away, it’s even more important to be fully awake and alert while on the road. With increased traffic, comes increased distracted drivers, and increased traffic fatalities. Plan ahead, stay alert, and don’t get in a hurry. And remember, even if you’re ok and alert, there are others who aren’t.

I hope you have lots of fun on your vacation. Be carefree, but not careless.

Till next time…Blessings

 

Is CPAP Treatment Really Just A Scam?

There are people who think that CPAP is just another way for ‘them’ to get your money. Is it? Join me as I examine this quite reasonable viewpoint.

“This is a Racket!”Is CPAP a scam?

The patient sitting before me was a rather tough looking gentleman who voiced his opinions quite bluntly. I kept trying to discuss the sleep study, but he just wanted to talk about guns and knives, and how he ‘takes care’ of situations.

He even took out one of his knives and showed it to me.

“Oh, it’s still got blood on it,” he said, wiping the blade on his pants leg. Putting the knife down, he scrutinized me suspiciously, and said: “I think this is a racket!” And he was serious. This guy doesn’t say anything unless he is serious.

Then he went on to ask me some pointed questions. One of which was “How many people that you test end up on CPAP?’ It was a good question, and I answered him as accurately as I could.  “About 50-75% + are started on CPAP”, I replied.

With that, he said, “Yeah, see. Now if you’d told me only a few people are put on CPAP, I’d be o.k. with that. But with that many, it sounds like a racket to me.”

I sure was glad he was no longer holding that bloody knife.

We continued this conversation as I proceeded to hook him up. As it turned out, He thought CPAP was a racket for several reasons. One of them was that he really didn’t understand the consequences of untreated sleep apnea.

However, he did listen as I talked. Maybe that was because I was up front with him. Or that I really tried to speak at his level. Actually, he didn’t have much choice; I kinda had him strapped in the chair. (LOL!!)

Standards of Care

We needed to find a way to treat people more effectively. Therefore, some kind of standard had to be developed. Something we could use as a reference to determine the severity of sleep apnea. Thus, the creation of the Apnea Hypopnea Index (or AHI).

This index categorizes the severity of sleep apnea and is based on the number of times you stop breathing in an hour. For instance, if you stop breathing 5 times in an hour, your AHI would be 5.

AHI categories are:

  • Not significant: AHI less than 5.
  • Mild sleep apnea: AHI 5-15.
  • Moderate sleep apnea: AHI 15-30.
  • Severe sleep apnea: AHI greater than 30.

Using this standard as a reference, it’s estimated that as many as 20% of Americans have some degree of sleep apnea; although that figure could actually be low. Also, many factors can impact the severity of OSA to a greater or lesser degree. These include age, disease, and sex.

Uncovering the Great CPAP Scam!!

But are these standards manipulated in a way that’s more focused on sales, as opposed to appropriate treatment? In other words, are these standards set intentionally low so that people who really don’t need treatment are started on CPAP anyway? Much research has gone into establishing accurate guidelines.

One such study is reported in an article in the American Academy of Sleep Medicine. It details an 18-year follow-up of 1,522 people. These people had anywhere from ‘no’ sleep apnea (AHI less than 5), up to severe sleep apnea (AHI greater than 30). The study shows that people with sleep apnea are 3 times more likely to die than those who don’t.

Also, we use at least 2 different standards to determine whether someone actually qualifies for CPAP. As a result, those who are more at risk of sudden death, such as people who already have heart disease, for example, can qualify for treatment with a lower AHI than those who have no known heart disease.

So no, we can’t just decide, ‘hey, let’s put this guy on CPAP because we’re a little short on money’. (And actually putting someone on CPAP when they don’t need it can be harmful in itself). That whole thing could be a lawsuit in the making.

Although it does seem like money, more than compassion is the driving force behind much of health care. Maybe it is. But the unfortunate by-product of that is many of us well-meaning healthcare folks get a bad rap.

To die or not to die, That is the Question
I’ve said this before, but it’s worth repeating. So many people don’t realize how threatening  poor quality sleep is to your health. There’s also a direct link between sleep apnea, Heart disease and Diabetes.
What Would you do?

So, if you had a friend with sleep apnea, and you knew about the diseases it caused, would you talk to them about it? Yeah, I know, we can’t force anyone to do anything. It’s ultimately up to the person. But the more you care about someone, the more strongly you’ll try to help, right?

And while I really don’t know my patients very well. I do have a concern for mankind in general. And that is what drives me to help. And there’s a bunch of us out there.

Final Thoughts

I guess there will always be those who think we’re just out to scam people. It’s funny, though. The only people I’ve heard accuse us of that are the ones who aren’t using CPAP, and/or don’t really know anyone who is. And really, I don’t hear the scam word all that often.

But I think about the lives I’ve really helped. And the people who have actually experienced CPAP, and what they say about it.

Sure, there are people who want to ‘help’ you just because they’ll make money doing so. And yeah, I also make money helping you. But, honestly,  even if I had all the money I needed so that I didn’t have to work, I’d still enjoy doing what I do.(But then again, maybe I’m a bit crazy!)

However, there are a lot of scams and insurance fraud out there. And I think it’s harder than ever to trust people. But Sleep Apnea really is a serious life-threatening disorder, and CPAP is still the gold standard of care.

I’d like to hear your thoughts. Have you ever experienced any medical or insurance fraud? Please leave out any names, but otherwise, be as specific as you can. Let’s talk.

Till next time…Blessings.

 

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