Sleep Dynamic Therapy

Archive for December, 2007

Day in and day out, it is remarkable how many sleep apnea patients never achieve an optimal clinical response due to mouth breathing. The problem starts with the fact that so many people believe that mouth breathing is somehow normal and the problem ends with the fact that so many people are reluctant to use chinstraps. I went almost two years on an APAP device, imagining I was getting a fairly good response until I tried a chinstrap. Then, “all of a sudden,” I began waking up in the morning without a dry mouth and realized what I had been missing.

I too was one of those individuals that just couldn’t imagine putting yet another contraption around my face or head, yet once I effectively placed the chinstrap and obtained a much better clinical response, I was very grateful that so many different styles of chinstraps were on the market.

The biggest barrier to the use of the chinstrap, I believe, is psychological comfort, because when you first use one, it really feels confining. But, I think this physical sensation actually translates into a psychological feeling of discomfort, which is the more difficult sensation to overcome.

Currently, I use the Respironics Premium Chinstrap, which I personally believe is the best on the market for two reasons. First, it uses a behind the head strap to leverage the chinstrap in a snug but not too tight manner. Second, because of this design, the chinstrap component that goes under the chin and up over the head actually exerts force in a vertical fashion to pull the chin up. Whereas, you can find many chinstraps that are designed in a more compact way, these straps exert force on the chin in two directions, up and backward. This backward force occurs because the chinstrap imaterial runs in a diagonal from the chin towards the top portion of the back of the head. You can actually feel that it’s tugging your jaw backwards, which theoretically could worsen your breathing.

In sum, never sell short the potential value of a chinstrap in your efforts to achieve a great response to PAP therapy. If you awaken in the morning with a dry mouth, chances are high you need one.

Here’s a very interesting story on the political website Powerlineblog.com. There’s no mention of a sleep angle, but I’ve always wondered whether sleep problems would affect someone’s political philosophy. I could see it evolving in several ways, primarily related to how sleep affects keys personality traits such as attitude, ambition, and achievements.

I’ve noticed in my work that a lot of high achievers often show great disdain for people with sleep problems and assume rather quickly that the person is really lazy or otherwise lacking in ambition. I think this high achiever’s perspective would move someone towards a conservative slant, because the individual would imagine “if I can do it with hard work, why can’t the next guy?” Which raises the question: is the high achiever a normal sleeper and thus blessed with a terrific amount of energy to use throughout the day? And if so, does this high energy level lead the high achiever to believe that others should possess the same high energy?

Among a large proportion of patients I meet with severe sleep problems, there are some who appear to look inwardly at their problem and recognize very clearly that they are “weaker” in the energy realm and see how much it hurts their productivity, ambitions, and achievements, yet those who face this dilemma honestly have shown a greater tendency towards a healthy acceptance of the sleep problem itself. That is, they demonstrate more of a roll-up the sleeves mentality and demonstrate clear cut enthusiasm for trying to solve it as rapidly as possible. Again, my sense is these individuals are more conservative.

There is another group that complains mightily about their sleep problems, not necessarily in a “oh, woe is me,” spirit, but more in the framework of being unable or unwilling to face yet another burden in life. These patients may prove more difficult to treat in that there is an “entitlement” mentality that surrounds a part of the treatment process. For example, when they must treat their sleep apnea, they are bitter or easily frustrated about how much time, energy or effort it takes to adapt to the positive airway pressure breathing mask treatment. Instead of diving in to treatment with the hope and belief that their mental or physical health will attain rapid gains from sleeping better, these individuals appear to walk around the swimming pool, dipping a toe in here and there testing the waters. My sense is that these individuals would more readily embrace a liberal perspective.

Then again, I’ve also noted that some sleep patients, who expressed liberal political views, have shown more empathy for others with sleep problems. When some of these sleep patients have undergone successful sleep treatments, they are among the first to recognize how sleep disorders can hold a person back from accomplishing their aims, and they are among the first to want to see that others receive the treatments they need.

To be fair, I’ve seen sleep patients of all political stripes who do not fit any of these models, and I don’t profess to know that one model is particularly accurate. But I do suspect that if research would examine the same data and asked questions about sleep, they would have found that the Republicans reported sleeping better than the Democrats, for no other reason than people who report better mental health usually report better sleep.

Even so, I don’t think you can improve (or worsen) your sleep by changing political parties. But, we might be surprised one day to find out how much our sleep affects the way we think about such things. As I’ve written in the Epilogue to my book Sound Sleep, Sound Mind (available at www.sleeptreatment.com), once a person solves their sleep problems, they often undergo a personal revolution due to the sudden increase in energy and productivity they develop, both mentally and physically. As I conclude in the book, though, better sleep does not determine how you will use that energy. Either a conservative or a liberal could accomplish great achievements in this world if in fact they use that new energy wisely.