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My Sleep Apnea: The Beginning

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It's time for a new occasional feature! Rejoice! In this column, I'll talk about my personal experience being diagnosed with sleep apnea, what treatments are available, the science behind the condition, and (hopefully) my miraculous improvement after being treated. For this first entry, I'll talk about the experience leading up to my sleep study. In future columns I'll reveal the diagnosis and treatment, and you can follow along as I try to catch some sleep. Before we begin the narrative, let's get a quick definition of "sleep apnea" from Wikipedia (slightly edited for clarity by me):

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal, a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "Sleep Study" which is often conducted by a pulmonologist.

...the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

My sleep problems started probably ten years ago, during college, when I became aware that my snoring was really loud. And let me dwell on this a moment -- we're talking sawing logs with industrial machinery loud. The term "epic" was used to characterize my snoring, and neighbors in my college apartment building actually complained. I tried using several nose-opening devices, nasal sprays (disgusting!), sleeping with my mouth closed, and different sleeping positions, but nothing seemed to help. Eventually I ended up in a corner apartment where my neighbors couldn't hear me: problem solved?

Rewinding a few years...at some point during my teenage years, my father had been diagnosed with obstructive sleep apnea. He and I have very similar body types, including a predisposition for charming plumpness as well as a relatively narrow airway in the throat. I have a small mouth (at least relative to my neck), and I still have my tonsils. So it stood to reason that I might develop obstructive sleep apnea as well.

In the time since my snoring became an issue and my recent diagnosis, I really didn't do anything about my sleep problems. I've always been a very sleep-positive person, often sleeping in until noon (and beyond) on weekends. Over the last year or two, I found myself even sleepier: spending entire weekend days asleep, and ultimately not feeling refreshed. Something was wrong. I went to my doctor, who did a bunch of blood tests and ultimately referred me to the Sleep Disorders Program at a local medical institution.

The sleep specialist had me fill out extensive questionnaires about my sleep history and habits, and did some physical tests and a complete interview before prescribing a sleep study. Now, let me back up a little bit here: I actually had a sleep study before. Three years ago, in a similar bout of sleeplessness, I had been sent off to a somewhat lower-rent sleep clinic for a study (which was not preceded by a consultation with a sleep specialist). That experience was a disaster: I spent the night covered in wires and surgical tape, vaguely panicked, and ultimately unable to sleep. After ten hours, they finally discharged me without having slept at all. The study was inconclusive, and my insurance paid handsomely for the ordeal. So when I was prescribed another sleep study, I was wary. Well, let's just say it: I hated the idea. The previous study was awful, lying in the dark for ten hours struggling to sleep while connected to various machines, occasionally being interrupted by lab techs over a speaker asking me why I wasn't sleeping. I didn't want to go through that again to end up with nothing.

This time, things would be different, the sleep specialist said. For one thing, the new sleep study would be carried out in a modified hotel suite, rather than a hospital room. In the new study, I was encouraged to bring my own pillows from home (this actually was a real problem at the old study -- their pillows were awful). For another thing, my doctor prescribed Ambien as a sleep aid during the study, and suggested I get used to taking it prior to that night. Finally, being aware of my previous experience, the staff was extra-nice and accommodated my one odd request: I wanted the room to be as cold as possible, to get as close to my home situation as possible. (I sleep in a fortress of solitude in the frozen North.) With the air conditioning set at 64, I was all set.

Next entry: I'll talk about the sleep study -- what was involved, what they were looking for, and how it went. Do you have sleep apnea? Share your experiences in the comments!

(Image courtesy of American Academy of Family Physicians.)

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Big Questions
What Is the Difference Between Generic and Name Brand Ibuprofen?
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What is the difference between generic ibuprofen vs. name brands?

Yali Friedman:

I just published a paper that answers this question: Are Generic Drugs Less Safe than their Branded Equivalents?

Here’s the tl;dr version:

Generic drugs are versions of drugs made by companies other than the company which originally developed the drug.

To gain FDA approval, a generic drug must:

  • Contain the same active ingredients as the innovator drug (inactive ingredients may vary)
  • Be identical in strength, dosage form, and route of administration
  • Have the same use indications
  • Be bioequivalent
  • Meet the same batch requirements for identity, strength, purity, and quality
  • Be manufactured under the same strict standards of FDA's good manufacturing practice regulations required for innovator products

I hope you found this answer useful. Feel free to reach out at www.thinkbiotech.com. For more on generic drugs, you can see our resources and whitepapers at Pharmaceutical strategic guidance and whitepapers

This post originally appeared on Quora. Click here to view.

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Health
8 Potential Signs of a Panic Attack
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It's not just fear or worry. In fact, many panic attacks don’t look like panic at all. Panic attacks come on rapidly, and often at times that don't seem to make sense. The symptoms of panic disorder vary from person to person and even from attack to attack for the same person. The problems listed below are not unique to panic attacks, but if you're experiencing more than one, it's a good idea to talk to your doctor either way.

1. YOU'RE DIZZY.

Doctors sometimes call the autonomic nervous system (ANS) the "automatic nervous system" because it regulates many vital bodily functions like pumping blood all on its own, without our having to think about it. Panic attacks often manifest through the ANS, leading to increased heart rate or decreased blood pressure, which can in turn lead to feeling lightheaded or faint.

2. YOU'RE LOSING YOURSELF.

Feeling detached from yourself is called depersonalization. Feeling detached from the world, or like it's fake or somehow unreal, is called derealization. Both forms of dissociation are unsettling but common signs that a panic attack has begun.

3. YOU'RE QUEASY.

Our digestive system is often the first body part to realize that something is wrong. Panic sends stress hormones and tension to the gut and disrupts digestion, causing nausea, upset stomach, or heartburn.

4. YOU FEEL NUMB OR TINGLY.

Panic attacks can manifest in truly surprising ways, including pins and needles or numbness in a person's hands or face.

5. YOU'RE SWEATY OR SHIVERING.

The symptoms of a panic attack can look a lot like the flu. But if you don't have a fever and no one else has chattering teeth, it might be your ANS in distress.

6. YOU KNOW THE WORST IS COMING.

While it may sound prophetic or at least bizarre, a sense of impending doom is a very common symptom of panic attacks (and several other conditions). 

7. BREATHING IS DIFFICULT.

The ANS strikes again. In addition to the well-known problems of hyperventilation or shortness of breath, panic attacks can also cause dyspnea, in which a person feels like they can't fill their lungs, and feelings of choking or being smothered.

8. YOU'RE AFRAID OF HAVING A PANIC ATTACK. 

Oddly enough, anxiety about anxiety is itself a symptom of anxiety and panic attacks. Fear of losing control or getting upset can cause people to avoid situations that could be triggering, which can in turn limit their lives. 

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