Sleep Well Canada

CSS on CityTV Breakfast Televison

cpapmeister — Thu, 10 Mar 2011 06:58:26 +0000

Thank you to the crew of CityTV for a wonderful segment on Sleep and Sleep Apnea. A most special thanks to Dr. Alan Hoffman for taking the time away from his busy schedule to help us continue our efforts to educate our community about the different sleep disorders that people may suffer from. I hope everyone enjoys the link of the video segment below!

http://video.citytv.com/video/detail/817354476001.000000/greg-harper-gets-some-sleep-tips/

Fisher & Paykel: Icon Auto CPAP Review

cpapmeister — Fri, 04 Mar 2011 01:10:39 +0000

Fisher & Paykel Icon Auto

PROs: Packed with all the technologies; compact size and space saving features; excellent heated humidifier; quiet operation.

CONs: Stays warm even when not operational; needs chamber that is easier to clean; operation to change certain settings may be difficult for some.

OVERALL: Excellent Auto-CPAP for the frequent traveler and the “home-body”

The Icon Auto is the most advanced unit of the Fisher & Paykel Icon line of CPAP machines. It is the replacement for the HC254 which was the first Auto-CPAP unit that Fisher & Paykel developed. As with the Icon Premo, this was a total redesign of the HC254. It essentially combines all the technologies that Fisher & Paykel has been renowned for, particularly their industry leading heated humidifier, all into one small and unique package.

(full review available at: http://www.clinicalsleep.com/product-reviews.cfm )

Simple Activities Count! (weight loss for OSA continued)

cpapmeister — Thu, 03 Mar 2011 17:11:54 +0000

Did you know one of the biggest differences I have made that contributed to my weight loss has been based on simple activities that I do from day-to day. Sure the trips to the gym are important but activities such as using the stairs, walking to places that are only a short distance away, and just trying to do things more quickly has made a huge impact to my activity level. You might be asking yourself “how much of a difference it could it possibly make”. Well lets just say that on my iPhone, I placed a pedometer app to track my movements daily; the difference in the number of steps I took per day just by making sure I walked to the nearest stairwell to take the stairs to my destination increased by 10%. I did it when seeing patients at their home, in the mall, etc. After seeing that, I took it upon myself to “walk” more and now when I try to get to a place that is only a few blocks away, I make it a point to walk when i the past I would normally drive. This has resulted in a 20-25% increase in my daily number of steps.

So why do I think this is important? Well, first of all, it is something EVERYONE can do… you don’t need a gym or a personal trainer! This alone should start to improve your cardiovascular health as well as strengthen you muscles especially if you climb stairs regularly or if you need to go up hills or inclined roadways. Try it a see how much it will make a difference.

UPDATE: A quick update on my progress; well I’ve lost a total of 32 pounds now and tracking my Auto CPAP pressure from the end of January to the end of February, the trends have decreased from 10 – 10.5 cmH2O to 8.5 – 9.5 cmH2O. To put it into perspective, I used to be on a constant CPAP pressure of 14 cmH2O for the past 9 years! It’s been a huge improvement in not just the way I feel but also in the irritation of my sinuses; with the lower pressures, I do not get as congested even with a lack of humidification at times and the overall therapy feels more comfortable in general. I’ve posted my stats below for everyone to see. Thanks!

The Lung Health Chinese Community Forum

cpapmeister — Fri, 18 Feb 2011 08:13:03 +0000

Chronic Lung Disease: Prevention and Self Management

Guest Speakers: Dr. J.M. FitzGerald, Dr. S. Lam, Dr. S. Kwan, Dr. S. MacDonald, Ms. Maria Li, RRT

Sunday, Feb. 27, 2011

12 pm – 4 pm

Chinese Cultural Centre

50 E. Pender St., Vancouver BC

125 Reasons to Lose Weight

cpapmeister — Tue, 01 Feb 2011 06:05:09 +0000

Well I’m sure that I can list 125 reasons why losing weight would be beneficial to all of us but I was inspired once again by another patient “BB” who lost 125 pounds and improved her Obstructive Sleep Apnea significantly. Her OSA has improved so much that there are no more traces of drop in her blood oxygen levels that would be of any cardiovascular risk. So is she “cured” of OSA, well I’m not one to make that conclusion and she would need further testing however I can say that I am so proud of her because using CPAP to improve her sleep quality and the way she feels upon waking is now a choice and not a necessity.

I’m sure there are many more people like her… imagine 2 people who I have known for years and who have struggled with moderate to severe OSA have all but received a clean bill of health with regards to their OSA. If that doesn’t inspire you, then nothing will. Losing 125 pounds is not easy for anybody and I personally would need to lose less than that to achieve an ideal weight and body mass index (BMI); that’s even more a reason why I know I can do this over a realistic time frame of a year.

Since starting this program I switched to using an Auto CPAP to track my trends for titrated* CPAP pressures and Apnea/ Hypopnea Indexes. I started with a 90th percentile pressure** of around 14 cmH2O and an AHI of around 2.5 events per hour. A recent download of my data has shown that my pressures have now been reduced to around 10.1 cmH2O and an AHI slightly elevated to 3.2 events per hour. More importantly , I feel just as good upon waking and I exhibit no sign of a degrading sleep quality.

If there was one change in my exercise routine that I had last week was that I had a personal training session. Let me tell you that was 1 hour of pure effort and exhaustion. If I was not motivated, I probably would’ve quit 20 minutes into it! Guess what I made it through. Even after days of aches and pains, I proved to myself that I’m getting there. Its the little achievements that’ll keep us going. Whether it be a lower CPAP pressure or survival of an extreme workout, at the end of the tunnel will always be “NO MORE OSA”

Definitions:

* Titrate: The adjusted pressure that is ideal for managing one’s OSA to keep the Apnea/ Hypopnea index below 5 events per hour.

** 90th Percentile Pressure: The CPAP pressure determined by an Auto-CPAP that will eliminate at least 90% of Apneas and/or Hypopneas over a period of time.

Technology to the Rescue… But it’s not a CPAP machine!

cpapmeister — Wed, 19 Jan 2011 07:21:11 +0000

One the most interesting revelations throughout these past few weeks is how much the simple things around me has helped me cope with the challenges of this endeavor. For anyone who has tried to lose weight, you know it isn’t easy. Most of all it isn’t easy to stay motivated. Just as in my previous post regarding the holidays, there are obstacles everyday that impede my progress to achieve the ultimate goal. This past week, i was thrown another curve ball that I’m sure everyone faces at this time of year… I developed a cough and cold! Now that made it tough to just do my everyday tasks and made it even tougher to convince myself to go to the gym. The first thought I had was that it would be another reason to miss days and further push me behind in my program after the “holiday hiatus”. Guess what came to the rescue… the Nintendo Wii!

My kids had received the Wii and a game called the Wii Fit Plus from their grandmother as a Christmas gift. So here I sat sniffling and coughing away thinking, “I guess I gotta skip today” when out of boredom I thought of making a Mii character (this is what they call the character that you make to play the different games on the Wii). But the interesting thing was that the Wii Fit Plus game actually tries to make an accurate model of myself and asks to take measurements such as BMI and Weight that it will track daily and place on a graph. More importantly, it asks me to create a goal to achieve over a catered time frame. Sure enough the measurements indicated that I was “obese” and need to lose weight. Next it had some exercises to perform and estimates calorie consumption after the exercise is done; I did some of exercises or games and lets just say it got me going.

Since that day, I use the Wii to measure my progress instead of a scale just because it’s more visual and interactive. I don’t exercise on it much except to play with the kids but I gotta say the whole thing prevented me from slacking off that one day and the next day I was back on schedule. I’m not suggesting that everyone should get a Nintendo Wii, rather I think there are simple motivations around us, you just got to find one for yourself.

UPDATE: So how is my obstructive sleep apnea today? Well I’ve lost about 8% of my bodyweight in 1.5 months but more importantly I lost about 0.25 inches in my neck-size. This I feel is a great simple tool to gauge if there is any improvements to the severity of one obstructive sleep apnea; even more than BMI and Weight alone. As a resource for everyone, here is the formula for the adjusted neck circumference that can be used as a predictor for having OSA.

ANC = (Neck Size in centimeters) + (4 cm) if one has hypertension + (3 cm) if a habitual snorer + (3 cm) if you choke or gasp in the middle of the night

If your size is less than 43 cm you have a LOW probability, 43 to 48 cm you have an INTERMEDIATE probability, and if your ANC is greater than 48 cm you have a HIGH probability.

Holiday Pounds!

cpapmeister — Wed, 05 Jan 2011 06:46:09 +0000

I was almost certain that starting this program before the holidays would give me ample time to set up a regimen that I could continue even with all the temptations that accompany the festivities of season. Let’s just say I didn’t do too well. Before our offices closed for the holidays on December 23rd, I lost a total of 14 pounds since I started the program. After coming back from a well deserved R&R, I gained 2.5 pounds back. YIKES! Maybe I was disappointed or frustrated but to be honest, I had no one to blame but myself. For the past 11 days, I went to the gym once! True I did some walking and if you consider chasing my kids around a workout than I was not a sedentary as I thought I was but the reality is that it just was not enough.

One thing I realized most through this experience is that it is times like this that can easily throw someone off track. I can even imagine some feeling frustrated enough to the point of giving up. Then I started thinking, there’s nothing wrong with enjoying the holiday season…temptations to rich foods, sweets, and other indulgence is part of life How boring life would be if we did not take these moments to have a little fun and break away from the norm (in my case the “new norm” being the program). So here’s my take on it, If I didn’t lose the weight to begin with, it would simply mean that I would’ve gained 2.5 pounds for the year. This way I still had a net loss of 11.5 pounds so I should be pleased with that… and I AM!

I finally went to the gym this evening and it was tough to even get there. But just like before, once I got started and got into rhythm, I actually felt great. I was pleasantly surprised that my endurance was not really compromised too much but I did notice that I could not get my heart rate as high during my elliptical step workout for 30 minutes. I just hope I don’t wake up sore in the morning because that’s always tough to get over for a few days.

Someone asked me to blog about my experiences more often so I certainly will try to do that. Especially when I have a significant experience both positive or negative that I can share with everyone. My new years resolution started last year and I’m glad to say that I think I am still on track. To the hundreds of followers, thanks for your support! You are all my greatest motivation. Happy New Year and until next time… have a good night’s sleep.

Weight Loss… 2 Weeks Later

cpapmeister — Tue, 14 Dec 2010 06:00:18 +0000

I typically wake up at around 6 am go about a very busy works schedule that is most often comprised of a 12 to 14 hour day before I get some time to unwind with my family later into the evening. I guess I always used this as my primary excuse for not living a healthy lifestyle. After all, it’s always easy to use the “i’m too busy” line to avoid going to the gym to exercise. Quite surprisingly however, I actually feel like I have more energy and am invigorated after working out. I worked a routine into my schedule to go to the gym 5 times a week. No rigorous program, boot camp, or palates… rather I just had the goal of increasing my activity level. For example, I do my stretches for 10 minutes before 10 minutes to 30 minutes of cardio exercises then followed by some weight training. I spend no more than 1 hour in the gym then head home to be with the family. After 2 weeks, I’m already seeing the benefits by losing 9 pounds and more importantly, I feel better than I have in years!

If there one thing I learned, however, is that the commitment to exercise is just as important to exercising itself. It is easy to skip a day and regress which I did on one occasion because we had some guest over from out of town, but you have to make it up. When I taught people how to commit to using CPAP therapy using cognitive behavioural learning techniques, I felt that it was the key to 90% of their success… these same principles I’ve applied to this form of treatment for OSA and I hope it works the same way.

So far so good but now it’s off to the most wonderful time of the year… and probably the most difficult time of the year for attempting this project… the holiday season! Wish me luck in the meantime, Happy Holidays and Happy New Year to all!

Improve your Obstructive Sleep Apnea through…. Weight Loss!

cpapmeister — Wed, 01 Dec 2010 06:12:13 +0000

“I had an epiphany”… these were the inspiring words that brought me to start this blog. I woke up one day and said to myself that I’m tired of doing this; “this” being the fact that for the past 9 years I’ve been managing my severe obstructive sleep apnea with CPAP (Continuous Positive Airway Pressure) Therapy and have done nothing else. Don’t get me wrong, this technology is a life-saver for anyone who has sleep apnea; I should know since I am the President and Clinical Director for Clinical Sleep Solutions Inc and I have helped so many people by educating and constantly assisting them in managing their sleep apnea using CPAP therapy. This is and will alway be my life’s passion but the epiphany I was talking about, however, is that I can probably do more. Just as one of my patients has inspired me, I think I have an opportunity to inspire someone else. Even it it is just one person, that is still worth it. So this one year experiment begins to try to improve my sleep apnea (and most likely my overall health and quality of life) through weight loss!

I have to admit that I thought long and hard before putting a personal part of my life online because I used to think to myself that I would never do it… but I know someone will read this and will say “that’s me” and “I can do that too”. So for the someone out there, this is for you.

I’ve tried weight loss before and my weight has “yo-yoed” 15 to 20 pounds over a few months but at the end of it all I’m back to almost where I started. I thought to myself why is it that I find all the excuses to give up my routines and succumb to having a BMI of 38.7 (which by the way is in the obese category) and a neck size of 18 inches. Well it’s because I was trying to lose weight simply to please my own desire to see the scale go down enough and have the excuse to have an extra snack because I deserved it. This time around, it’s going to be different. Why you ask? Well let’s just say that it is not just for me. It’s for my wife and 2 kids. It’s for everyone who has ever asked me “can weight loss really improve my sleep apnea”. Finally it’s for everyone who want to improve their lives and use me as an inspiration. Just like I’ve done for so many to get them to successfully use their CPAP, I hope to help just as many to get off CPAP through this “experiment”.

Every 2 weeks I will be tracking my progress and will be reporting it but I will also be sharing a lot of why despite being privileged to be a practicing therapist in the “sleep industry”, I’m just like many of you with the same day-to-day challenges to improve my sleep, improve my health, and improve my quality of life. I hope all of you can follow me through it all and wish me luck!

Snoring pilot crashes plane!

cpapmeister — Thu, 18 Nov 2010 06:52:35 +0000

Sleepy drivers have always been a road hazard and often times it can only be speculated that someone was sleepy behind the wheel when causing a crash. This recent plane crash had all the evidence pointing toward sleepiness possibly from obstructive sleep apnea as one of the primary reasons for the crash; the black box voice recorder caught it all on tape:

Air India Crash kills 158 people because of a sleepy pilot!

The pilot of an Air India plane that crash-landed in May, killing 158 people, could be heard snoring heavily on the cockpit voice recorder shortly before the incident, an investigators’ report has found.

The official inquiry into the incident on 22 May, when the Boeing 737-800 overshot a hilltop runway at Mangalore in western India and plunged down a ravine, concluded that the Serbian captain was asleep for more than half of the three-hour flight from Dubai and was “disorientated” when he attempted to land the plane.

Listening to the cockpit voice recorder, investigators heard “heavy nasal snoring and breathing” from Zlatko Glusica, said the Hindustan Times, which obtained a copy of the report from the government-appointed court of inquiry. While Glusica had awoken before the landing, he was believed to have had “sleep inertia”, the newspaper said.

The crash was India’s worst air disaster for more than a decade, with only eight people surviving after leaping from the wreckage before it burst into flames. Most of those on board flight IX-812 were Indian workers returning from Dubai.

The court of inquiry found that Glusica, who had more than 10,000 hours of flying experience, landed the plane 1,500 metres down the 2,400-metre runway at Mangalore’s Bajpe airport in heavy rain. He and the co-pilot, HS Ahluwalia, an Indian national, attempted to take off again but failed to gain height and the plane plunged off the edge of the “tabletop” runway into jungle below. Investigators concluded that had Glusica applied emergency braking he could have stopped the plane in time.

The cockpit recorder picked up Ahluwalia repeatedly warning the captain to “abort landing” and “go around”, saying there was not sufficient runway to land. Just before the crash both men are heard saying: “Oh my God.”

The report has been submitted to India’s civil aviation minister, Praful Patel, and will be presented to parliament, the Hindustan Times added.

The crash was the worst air accident in India since 349 people died when a Saudi airliner and a Kazakh cargo plane collided in mid-air in 1996.

In June 2008 an Air India plane travelled 200 miles beyond its destination of Mumbai after both pilots fell asleep. They were finally woken by a special buzzer sounded by air traffic controllers.