Sleep Apnea

7 Simple Questions to See If You Have Sleep Apnea

A lot of people wonder if they have Sleep Apnea and never take the next step. It could be a lack of time, fear of getting bad news or just plain procrastination. I'd like for you to answer the following questions. They are simple, short and to the point.

  • Do you snore loudly?
  • Do you often feel tired, fatigued, or sleepy during the daytime?
  • Has anyone observed you top breathing during sleep?
  • Do you have (or are you being treated for) high blood pressure?
  • Are you over 50 years of age?
  • Is your neck circumference over 16 inches?
  • Are you male?

If you answered "Yes" to four or more of these questions, you are at risk for obstructive sleep apnea?

You can review our site for additional information concerning this condition. Please consider a no-obligation telemedicine consultation with me, Dr. Howard Hoffman, to discuss your specific situation and see how we can help.

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Sleep Apnea

Basic Routines Can Get You Better Sleep

A lot of people struggle getting to sleep and the main cause is poor habits. Here are some basic facts and things to consider to improve the sleep you get.

  1. Go to sleep at about the same time each night and wake up at the same time
  2. Adults need 7-8 hours sleep each night
  3. Relax before going to sleep- soft lights, meditate? slow things down
  4. Sleep in a darkened room - use a sleep mask
  5. Sleep in a quiet room - No TV , No Computer (avoid that blue light coming from the TV and computer)
  6. No alcohol or sedatives at  bedtime
  7. No late night heavy meals
  8. Avoid too many liquids late at night which may create the need for bathroom trips during the night
  9. Exercise every day
  10. Avoid naps if it makes falling asleep difficult (especially late afternoon naps)
  11. Avoid caffeine and nicotine in the evening
  12. Sleep in a cool room- temperature 60- 70 degrees
  13. Keep a Sleep Diary
  14. Use your bed and bedroom for sleep and sex, only
  15. Get into the habit of falling asleep within 5-10 minutes; if having difficulty, get up and do something soothing and relaxing (like reading,listening to soft music, or meditating) before trying to fall asleep again
  16. Make sure that your mattress and pillows are comfortable- if not, maybe it?s time to replaxe them
  17. Use earplugs if the bedroom is too noisy
  18. Position your alarm clock so that you are not watching the clock
  19. Take a warm bath or shower before bedtime
  20. If exercising late in the evening, keep it to something relaxing, like yoga
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Sleep Apnea

Patients with Type 2 Diabetes or Hypertension Must Be Evaluated for Sleep Apnea

The American Academy of Sleep Medicine (AASM) is advising anyone with Type 2 diabetes or hypertension to be evaluated for sleep apnea by a board-certified sleep medicine physician. The recommendation comes as the group of international clinicians and researchers meets in Baltimore for SLEEP 2013, the foremost gathering of sleep experts annually.

Overwhelming clinical evidence has shown that patients suffering from two very common illnesses ? Type 2 diabetes and hypertension ? are at much higher risk for obstructive sleep apnea (OSA), a dangerous condition characterized by episodes of complete or partial airway obstruction during sleep. Research also has shown that treating sleep apnea can help in the management of these two disorders.

?Type 2 diabetics and people with hypertension are much more likely to have obstructive sleep apnea than other people, and as a result should immediately discuss their risk for sleep apnea with a sleep specialist,? said M. Safwan Badr, MD, president of AASM. ?Diagnosis and treatment of sleep apnea from a board-certified sleep medicine physician will promote improvement in these conditions ? including improved insulin sensitivity, blood pressure and cholesterol.?

Type 2 Diabetes and Obstructive Sleep Apnea
According to the Centers for Disease Control and Prevention, 25.6 million Americans aged 20 years or older suffer from diabetes, and Type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases. Seven in 10 people with Type 2 diabetes also have obstructive sleep apnea, and the severity of the sleep disorder directly impacts diabetes symptoms; the more severe a diabetic?s untreated sleep apnea, the poorer their glucose control.

?Treating sleep apnea in diabetics improves nighttime glucose levels and insulin sensitivity,? said Badr. ?Treatment also will provide benefits of improved sleep unrelated to diabetes ? including increased alertness during the day and improved memory and cognitive function.?

A recent study from the University of Chicago shows that continuous positive airway pressure (CPAP) treatment of sleep apnea may have as much of an effect as prescribed oral diabetes medications.

?In our study, one week of optimal CPAP use lowered average 24-hour glucose levels and improved post-breakfast glucose response in Type 2 diabetics with obstructive sleep apnea,? said Esra Tasali, MD, lead author of the study and assistant professor of medicine, pulmonary and critical care medicine at the University of Chicago Department of Medicine. ?The dawn phenomenon, an early-morning increase in blood sugar in people who have Type 2 diabetes, also was reduced by 45 percent as a result of CPAP therapy.?

Hypertension and Obstructive Sleep Apnea
High blood pressure, known as hypertension, is the most important risk factor for cardiovascular disease and is not limited to diabetes sufferers. A staggering 67 million Americans have high blood pressure, which is about one in every three adults. Between 30 and 40 percent of adults with high blood pressure also have sleep apnea, which is even more prevalent in those with resistant hypertension. Approximately 80 percent of patients that do not respond to hypertensive medications have sleep apnea. Seeking and adhering to sleep apnea treatment is a proven means of decreasing blood pressure.

?Evidence shows that sleep apnea treatment lowers nighttime and daytime blood pressure, with the greatest improvement in patients seeking treatment for moderate to severe sleep apnea,? said Badr. ?The higher your blood pressure, the greater your risk of suffering a heart attack or stroke. Reducing your blood pressure lowers your risk of cardiovascular disease and improves your overall health.? 

Patients suffering from Type 2 diabetes or hypertension should discuss their risk for obstructive sleep apnea with a board-certified sleep medicine physician, who can oversee their diagnosis and prescribe the most appropriate treatment. The team of health care professionals at an AASM-accredited sleep center works individually with patients to ensure long-term treatment effectiveness. To find a local sleep specialist or accredited sleep center, patients can visit

About The American Academy of Sleep Medicine 
Established in 1975, the American Academy of Sleep Medicine (AASM) is the leader in setting standards and promoting excellence in sleep medicine. With nearly 10,000 members, the AASM is the largest professional membership society for physicians, scientists and other health care providers dedicated to sleep medicine. For more information, visit

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Sleep Apnea

Tragedy on the Highway (AGAIN)- Sleep Apnea?

Palm Springs Oct 23, 2016

Bus rams into the back of a truck.  13 Dead, 31 Injured in HORRIFIC, DEADLY ACCIDENT.

Absolute anger,dismay, angst(it's hard to describe the feeling) that I felt when hearing of this senseless accident on I-10 near Palm Springs. Coincidentally, I was just there about a week ago, attending the Desert Trip concert in nearby Indio, CA.

We have become callous, accidents occur all of the time and we think nothing of it. Life goes on.

How and why did this accident happen? What can be done to prevent similar disasters and tragedies in the future?

Let's look at some of the known facts. (NTSB has not completed their investigation)

  • The bus involved left Los Angeles about 8:00 PM  Sunday evening, taking a group of people to a casino near Palm Springs for an evening of gambling.
  • The bus arrives at the Casino sometime between 11:00 and 11:30. Patrons gamble til 4:00 AM. Drivers usually sleep. (No report yet, as to whether or not this particular driver had slept).
  • 4:00 A.M. Bus leaves the casino.
  • 5:15 A.M. Bus rams into the back of a stopped tractor trailer truck at full speed. (65 MPH speed limit). There was work going on, on the highway. Traffic was stop and go, not exceeding 15 mph.
  • When the bus rammed into the truck, its force drove it 15 feet into the back of the truck. The front of the bus was totally "scrunched".
  • Bus Driver killed instantly plus 12 more. 31 Injured.
  • THERE WERE NO SKID MARKS - This is a very crucial piece of information. If a driver knows that he is about to hit something, the natural reaction is to slam on the brakes, leaving skid marks, or swerving to try to avoid an accident. This did NOT occur here.

So, what happened? Unless the driver just passed out or had a massive heart attack, it is highly likely that he was drowsy and either "zoned out" or dozed off at the wheel.

The bus driver never saw the accident coming.

If the bus was traveling at 60 mph and the driver dozed off for only ONE SECOND, the bus would travel 88 feet or almost 6 car lengths in that time frame. How easy is it to nod off for 5 or 10 seconds, or more? In 15 seconds the vehicle would cover about 1/4 of a mile, whilst the driver nods off, oblivious to everything.

The force of a bus ramming into something at traveling 60 mph is devastating.

Drowsy Driving or Sleeping at the Wheel can be deadly in a heartbeat.

Studies have shown that Drowsy drivers are as dangerous as those Driving Under the Influence (DUI). Even worse, the drowsy driver is still accelerating when he hits someone or something. He never brakes.

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