New Treatment Helps Ease Sleep Apnea, Snoring

Click here to watch video

Importance of Cleaning CPAP Filters

Cleaning of your CPAP filter is an important part of taking care of your CPAP equipment. It is imperative to keep your filters on your CPAP machine clean and free of debris.

There are different types and sizes of filters depending on the type of CPAP unit you have and which manufacturer produced your machine. Basically there are disposable filters and non-disposable filters, sometimes referred to as pollen filters.

Disposable filters are to be replaced on a regular basis. This means, when your filter appears dirty, discolored, or has collected lint, it is time to replace. You should remove the old filter, throw it in the garbage, and put a new, clean filter in your CPAP machine. How often you need to replace your disposable CPAP filter will many times depend on your home environment. If you have pets that shed or smokers in the home, you may find that you need to replace your filter as often as every two (2) weeks. If you do not have pets and/or smokers in your home environment, you may only need to replace your CPAP filter every month or even every other month. The outside environment may also play a role in the frequency of CPAP filter replacement.

Non-disposable filters, also known as pollen filters for your CPAP machine can be washed. Once a week, it is important to remove your pollen filter from your CPAP machine and wash it in warm soapy water. Make sure to rinse your filter out good to remove any soap residue. Once your CPAP filter is washed and rinsed well, you should set it to the side to air dry completely before putting it back into your CPAP machine. It is always a good idea to have an extra pollen filter on hand to use while your other one is drying out.

You should refer to your user guide or booklet that came with your CPAP machine to guide you through the process of changing your CPAP filter.

National Sleep Apnea Awareness Day

The American Sleep Apnea Association calls upon all who are concerned about sleep apnea-health professionals, patients, and their advocates-to make special efforts on April 18 to alert the public to this serious, chronic, life-shortening disease. An estimated 18 million Americans or more are believed to have this disease, and three-quarters of them don’t know it.

Untreated sleep apnea in adults can lead to hypertension, chronic heart failure, stroke, sudden death, diabetes, depression, fibromyalgia, excessive daytime sleepiness, and could cause automobile accidents, and other serious and often fatal consequences.

Untreated sleep apnea in children can lead to hyperactivity, compromised immune systems (allergies), delayed cognitive development, and an inability to meet standard growth goals.

"Every day is sleep apnea awareness day at the ASAA (American Sleep Apnea Association)," said executive director Edward Grandi, "but we designated April 18th as Sleep Apnea Awareness Day because we believe that educating people about sleep apnea’s dangers is critical."

April 18, 1981 is the day The Lancet, the respected British medical journal, published a ground-breaking article describing the invention of the Continuous Positive Airway Pressure (CPAP) machine by Dr. Colin Sullivan, an Australian respiratory physician and a professor of medicine at the University of Sydney.

"CPAP therapy revolutionized the treatment of sleep apnea," Ed Grandi said.

Prior to Sullivan’s discovery, the only effective treatments for severe sleep apnea were, in some cases, radical weight loss or major surgery. The sleep world has come a long way with the modern transition from frightening procedures such as a tracheotomy to the current use of CPAP to help control breathing.

Sleep apnea’s most frequent form is obstructive sleep apnea when the sleeper’s tongue and soft palate fall back against the back of the throat closing off the airway so firmly that the sleeper doesn’t fully inhale in repeated episodes that last 10 seconds or longer. In severe sleep apnea patients, the episodes can recur hundreds of time during the night, giving rise to serious impairment due to repeated oxygen deficiency.

Since those early days of positive airway pressure therapy three decades ago, many refinements to the device have been introduced and there exist a variety of new therapies, with others in development.

None of the therapies, however, can help the 13 million-plus people who have sleep apnea and are unaware of their medical condition or don’t seek help early for themselves or their children. Symptoms may include regularly awakening exhausted after a full night’s sleep, snoring frequently or loudly, or being seriously overweight; however, some sufferers of sleep apnea have none of these characteristics. A sleep study conducted by qualified health care providers in a sleep laboratory or in the home bedroom is the only conclusive way to determine if a person has sleep apnea.

Edward Grandi
American Sleep Apnea Assn.

How to Stop Mouth Leaks During CPAP

If you use a CPAP (Continuous Positive Airway Pressure) machine to reduce the unwanted effects of sleep apnea, but wake in the morning still feeling tired, with a dry mouth or swollen nasal passages, you may be experiencing air leakage from your mouth during sleep. If the mouth leak is significant, it can reduce the effectiveness of your treatment and result in unpleasant side effects. Mouth leakage can be reduced, and even avoided, by making adjustments in your treatment regime that will improve CPAP effectiveness and leave you feeling refreshed and relaxed.

Instructions

1. • 1

     Try sleeping in a different position to the norm. If you sleep on your back, try sleeping on your side. Air leaks from the mouth when it is open during sleep. A different position may help to keep your mouth closed and avoid any leakage.

   • 2

     Train your tongue to help seal your mouth during sleep. Place your tongue tip behind your upper teeth and allow the body of it to spread out and seal the mouth. Even if your mouth opens during sleep, the position of the tongue will help reduce air leakage.

3 Use a chin-strap to keep your mouth closed. These can be obtained from your sleep specialist. Straps are made from comfortable materials and help improve CPAP effectiveness.

4 Add a humidifier and air-warmer to your CPAP setup. Many models of CPAP machines are able to support the addition of these units. The warm, moistened air helps to soothe nasal membranes and, as the air passage is smoother and easier, there is less chance that air will pass through the mouth.

5 Switch to a full-face mask. This effectively seals both the nose and mouth so, if your nasal passages become blocked during the night, or if you persistently breath through your mouth, the positive air pressure will not be compromised. Speak to your health care professional about the best mask design for your needs.

http://www.ehow.com/how_8669853_stop-mouth-leaks-during-cpap.html

What is the purpose of Occupational Therapy?

What is the purpose of Occupational Therapy?

The purpose of Occupational Therapy (OT) is to help people increase their functional independence in daily life while preventing or minimizing disability. Often OT is combined with other treatments including Physical Therapy.

These programs are very structured, goal-oriented, and customized to meet the patient's needs. OT strives to promote emotional well-being, independence, and an enhanced quality of life. It could be said OT teaches life skills.

OT can help a person with activities of daily living (ADLs), which include dressing, bathing, food preparation, and return to work or school following injury or illness.

What is an Occupational Therapist?

Prior to becoming an occupational therapist, students must obtain a Bachelor's, Master's, or Doctoral degree in Occupational Therapy and pass a national licensing examination.

Their education includes (but is not limited to) anatomy, human growth and development, the physiological and emotional effects of illness or injury, and supervised clinical internships in different health care settings (e.g. hospital, rehab center).

Occupational Therapy Assistants (OTAs) are required to complete a two-year Associates Degree in OT. Both Occupational Therapists and PTAs work in hospitals, outpatient clinics, rehabilitation centers, home health agencies (homebound patients), and private practice.

What does an OT do?

Usually the attending physician prescribes a course of OT. The occupational therapist assesses the patient's general health, past medical history, and functional abilities to determine areas of weakness or lost function. The therapist may visit the patient's home or place of work to evaluate the environment.

The therapist can then address those weaknesses to help the patient be more productive in all areas of their life. OT may include therapeutic activities, exercise, simulated work tasks, and special devices designed to help the patient such as a walking aid (e.g. walker, cane).

Adaptations to the home or work environment may include handrails, ergonomically designed furniture, foot rest, stairlift, or items that make opening jars easier. The list of creative solutions is practically endless!

Who benefits from Occupational Therapy?

Patients of any age with low back problems, rheumatoid arthritis, spinal cord injury, fractures, learning difficulties, stroke, an injury sustained during a fall, and many other problems.

Source

Safe Patient Transfers

Keeping patients safe during transfers requires proper staff education and equipment.

By Terri Lynn Kazanjian, MS, PT, And Audrey Link Archer, DPT

Whether you're a 6-foot body-building enthusiast or a petite 5-foot-2-inch couch potato, it all comes down to technique, rather than muscles, when transferring patients in the rehabilitation setting.

Having the right equipment to facilitate those techniques is important, as are teamwork and education, particularly on keeping patients safe from injury during transfer.

Because manual lifting and transfers are high-risk patient handling tasks that could lead to injury, it's vital that all staff use safe, appropriate transfers during the patient's rehab process.

Before performing any transfer, be aware of the patient's cognitive status, ability to communicate and/or understand verbal cues, physical limitations in all extremities and orthopedic weight-bearing precautions.

To avoid injury, assess whether you need a second person to assist before attempting to transfer the patient.

Four types of transfers exist: mechanical lifts, sliding board, stand pivot and squat pivot transfers, which are addressed below:

• Mechanical lift. Use a mechanical lift to complete a transfer if a patient is dependent or needs maximal assistance for sitting balance. Mechanical lifts are also necessary when patients have weight-bearing restrictions on bilateral lower extremities or are restricted to perform active transfers by the physician. A mechanical lift and a body sling are required for the lift transfer.

Two primary types of slings exist, which may, or may not, include support for the head. A full body sling covers the posterior surface of the patient from the shoulders to the back of the thighs/knees. A second type of sling also supports the patient's body, but has divided legs that cross between the patient's legs and support him on the posterior surface of the thighs.

To complete the mechanical lift transfer from the bed to the wheelchair, place the sling under the patient by rolling him from side to side. For safety reasons, make sure the sling is in the correct position. Next, place the wheelchair at a 90-degree angle from the bed, with the back of the wheelchair placed against the foot of the bed. Make sure the brakes are locked. If the wheelchair is a recliner or a tilt-in-space, it should be reclined/tilted for easier positioning into the chair. Place the widened base of the lift under the bed and lower the arm to attach the sling.

The chains or hooks of the lift are attached to the net with the shorter length of chain/loops at the head/shoulders of the sling. The longer length of chain/loops are attached at the lower end of the sling. This will encourage a seated position. Certain types of slings have loops made out of the material as part of the sling, instead of chains and metal stays.

The lift is raised and moved 90 degrees to straddle the wheelchair. The legs of the base of the hoyer should be positioned behind the back wheels of the wheelchair and the front casters. The patient is lowered into the wheelchair with the assisting person pressing on the person's knees to encourage the pelvis and hips to land correctly in the wheelchair. The pelvis should be placed toward the back of the seat.

• Sliding board. The sliding board transfer is used when a patient has the upper extremity and trunk strength to maintain a sitting posture and can assist in lifting weight off the buttocks to scoot. Clinicians need a gait belt and sliding board.

To perform a transfer from the bed to the wheelchair, place the wheelchair at a 30-degree angle to the bed, with the brakes locked. Have the patient sit on the edge of the bed with assistance, if needed. Place the gait belt on the patient, and remove the armrest of the wheelchair closest to the bed.

Then have the patient lean away from the wheelchair and place the board under the buttocks and upper thigh area, taking care not to pinch the patient's skin. Have the person return to the upright seated position and place his feet on the floor slightly behind the knees.

The transfer requires a series of push-ups by leaning forward and away from the wheelchair to unweight the body, straightening the upper extremities, and depressing the shoulders to lift the buttocks and scoot toward the wheelchair. Multiple scoots should be used to complete the transfer. The patient shouldn't slide or be pulled across the board, since sliding places shearing friction on the patient's skin. This increases the patient's risk of skin breakdown.

The assisting person can help the patient by lifting his buttocks and assisting with the lateral movement to scoot.

The patient needs to reposition the hands and feet to gain a firm surface to push before each scoot during the transfer. To avoid pinching, make sure the fingers or hands aren't under the board.

Once in the wheelchair, the patient should lean away from the bed so the board can be removed to complete the transfer. The armrest should be returned to the chair.

• Stand pivot. Commonly practiced on a rehab unit, the stand pivot transfer is used with patients who can stand for a short time, have adequate hip, knee and ankle range of motion and strength, and good sitting balance. Clinicians need a gait belt.

To complete a stand pivot transfer, put the gait belt on the patient. Place the wheelchair next to the bed at a 30-degree angle, with the brakes locked. Help the patient scoot forward to the edge of the bed. The patient's feet should be placed flat on the floor just behind the knees, and the person assisting the transfer should cue the patient so the two move together as a team. The patient should come to a standing position.

Then have the patient pivot the feet, moving the buttocks toward the wheelchair. The patient's feet must pivot with the body to eliminate twisting at the knee and ankle. The patient slowly lowers to sit in the wheelchair. If he has a weak leg, the staff person assisting should guard the leg to make sure it doesn't collapse during the transfer.

• Squat pivot. A modification of the stand pivot transfer is the squat pivot transfer, for which a patient must have good sitting balance and upper extremity strength. During this transfer, therapists employ the same steps as in the stand pivot transfer, except that the patient doesn't come to a full standing position. Instead, he maintains a squat position while lifting the hips, using the upper extremities to move from one surface to another.

Use the squat pivot transfer with patients who have limited trunk control, and limited knee or hip extension strength. The squat pivot transfer also can be used with patients who have limited knee or hip extension range of motion that inhibits them from being able to maintain a standing position.

Transfers are a key skill needed for a patient to regain independence. On a rehab unit, therapists and nurses work as a team to determine the appropriate transfer to facilitate the progression toward independence.

Proper staff education and equipment will ensure safe and successful transfer outcomes. n

Terri Lynn Kazanjian, MS, PT, is therapy supervisor and Audrey Link Archer, DPT, is a senior physical therapist at the Shepherd Center in Atlanta.

Sharing PT Competencies

Body mechanics, transfers and lifting are common elements of nursing and rehab education. In addition to this training, the following recommendations should help the nursing staff, who are at high risk for injury:

· Share orientation cross-training competencies with nurses to review transfer skills.

· Provide online intranet transfer education material for easy reference accessibility.

· Conduct an annual competency to review transfers, lifts and equipment.

· Provide appropriate transfer and lift equipment on the floor, including mobile or ceiling lifts, drop arm/bedside commodes and sliding boards.

· Have a communication system in place between nursing and physical therapy to share types of transfers recommended for the nursing staff.

· Achieve management buy-in if a second person is occasionally needed for safe transfers.

–Terri Lynn Kazanjian, MS, PT, and Audrey Link Archer, DPT

Canes: which one should I choose?

1

You deserve a beautiful cane that supports your needs. Here's how you'll find the right one for you at Alpine Home Medical:

1. Assess how much help you need. Canes are the lightest walking aid, and transfer weight to your wrist or forearm. They are generally used to aid light injuries or to improve balance. A cane cannot and should not sustain a large portion of your body weight.

2

2. Choose your style. Canes come in a variety of forms in order to meet the needs of different users. Variables to assess include

Grip. Some canes are meant to be held with your palm and fingers, while others can also provide support for your forearm. Whatever you select, make sure the grip feels solid and manageable, not slippery or too big.

Shaft. The shaft is the long part of the cane, and can be composed of wood, metal, carbon fiber polymer and other materials. Some shafts are collapsible for easy portability.

• Ferrule. The tip or bottom of the cane is usually covered in rubber to provide better stability. Some canes have three or four ferrules at the bottom instead of just one; this enables them to carry more weight.
• 
  

3. Check the length. To select the proper length for a cane, stand up straight with your shoes on and arms at your sides. The top of the cane should reach the crease on the under side of your wrist.If the cane is a proper fit, your elbow will be flexed 15-20 degrees when you hold the cane while standing. Cane length is usually about one half the cane user's height, in inches, wearing shoes.

4. Choose a side. If you're using a cane because you're injured, you'll want the cane to be in the hand that is opposite the side of the injury - for example, if your left leg is hurt, put the cane in your right hand. If you're using a cane for better balance, consider putting it in your non-dominant hand so that you can continue to use your dominant hand for everyday tasks.

5. Start walking. When you step forward on your bad leg, move the cane forward at the same time and put your weight on them together, allowing the cane to absorb more strain than the leg. Don't use the cane to step with your good leg. As you become accustomed to the cane, it will ideally feel like a natural extension of yourself.

• To walk up stairs with a cane, put your hand on the bannister (if available) and place your cane in the other hand. Take the first step with your strong leg, then bring the injured leg up to the same step. Repeat.
• To walk downstairs with a cane, put your hand on the bannister (if available) and place your cane in the other hand. Take the first step with the injured leg and the cane at the same time, then bring down your strong leg. Repeat.