The Agony and Ecstasy of Room Sharing for Siblings

Room sharing for siblings presents special challenges for parents and families when it comes to getting a good night of sleep. I wrote an article in the New York Times on this topic which is coming out soon. To help me with this, I asked subscribers to my mailing list to tell me about their experiences.

I’m fortunate to have some of the smartest readers on the internet. I asked my readers about how room sharing affects their family’s routines at night— the good, the bad, and the ugly. This information informed the article I wrote.

Benefits and joys of room sharing

Several moms mother notes that room sharing helped quite a bit with her younger child’s sleep issues. Natasha says:

My daughter age 2.5 and son age 5 share a room. This began about 8 months ago after a sleep trainer recommended it might help with my daughter’s sleep challenges. She would scream at bedtime and wake up in the middle of the night for up to 3 hours. The room sharing worked like a charm!

Dr. Kara Garcia, a pediatrician in Pennsylvania, takes about how helpful this has been with her children, now ages 5 and 7.5 years old:

I put my kids in the same room once my younger one was in a bed, so at about 2 yo. They were in separate rooms before that.

My eldest has always been a “nervous” sleeper, had a

How to Handle Wakeful Windows During Nap Transitions

wakeful windows during nap transitions

Hi. I’m Kim West, The Sleep Lady, and today I’m going to answer Miriam’s question about wakeful windows during nap transitions:

“My eight-month-old son is breastfed, rocked to sleep, and sleeps in our bed. He’s also taking solids and is close to walking. We love him so much! But I just need some sleep and my husband back in my bed.

“He’s dropped his third nap. Even going for walks won’t knock him out which means he can go from 1 p.m. to 6 p.m. wide awake. That is five hours which is a long time for his age group. I’ve had to bring bedtime forward to 6:30 p.m. He gets up around 5:30 a.m. His first nap is around 8 a.m. and it is 40 minutes to an hour long. His total nap times are between 2 and 2-1/2 hours, usually. I’ve tried to do more, but he never wants it.

“Yesterday, after reading advice from various sleep experts, I tried the method of getting him to take naps in the cot. It did involve me getting into the cot with him. I’m light and it’s a travel cot. I breastfed him to sleep and it worked. I tried the same routine for bedtime. He resisted at first but then he did fall asleep. He woke after an hour and a half, though, so I repeated the process. But, he woke three times in an hour. At that

Sleep Apnea During Pregnancy May Increase Risk of Childhood Obesity

The severity of sleep apnea in pregnant women is related to changes in glucose levels during pregnancy and is connected to infant growth patterns related to increased risk of obesity, according to new research.

Published in the Journal of Clinical Endocrinology and Metabolism, the study included 18 women who did not have gestational diabetes and a body mass index of 30-40 kg/m2 during their third trimester – making them at higher risk for sleep apnea. Twelve of the 18 participants were diagnosed with sleep apnea.

“They were very surprised by the diagnosis. Often unrecognized, obstructive sleep apnea worsens over the course of a pregnancy and is associated with poorer perinatal outcomes like gestational diabetes and bigger babies,” said the study’s author Sarah Farabi, PhD, RN.

According to Farabi, “In this study, the more severe the mother’s sleep apnea, the more likely she was to have higher blood sugar throughout the day and night. The data indicate that improving sleep habits, as well as screening for and potentially treating sleep apnea may help improve maternal infant outcomes in this high-risk population.” Unlike other studies, the sleep patterns and glucose were directly measured using personal monitoring devices instead of relying on self-report, making the data much stronger in the story they tell.

Study participants were monitored at home with a WatchPAT wrist device and finger probe for three consecutive nights. The WatchPAT detects oxygen saturation levels and external movement. During the

VirtuOx Launches Mobile Cardiac Telemetry Program

Home respiratory diagnostic provider VirtuOx has launched a new service: CardioCHECK, a way to diagnose cardiac arrhythmias in the patient’s home.

The VirtuOx CardioCHECK program allow prescribers to order mobile cardiac telemetry (MCT) at the same time as other VirtuOx services like overnight pulse oximetry for nocturnal hypoxemia or home sleep testing for obstructive sleep apnea.

Kyle Miko, founder and CMO for VirtuOx, says in a release, “Research has shown arrhythmias are common with patients who have comorbid conditions like sleep apnea and hypoxemia so now offering mobile cardiac telemetry was a natural progression for VirtuOx.”

Bill Bowden, DO, FACC, a VirtuOx medical directors says, “with access to this large amount of data, we have uncovered huge patient populations who have cardiac arrhythmias at night with severe bradycardia/tachycardia events who may benefit from an MCT.”

from Sleep Review http://www.sleepreviewmag.com/2019/03/virtuox-launches-mobile-cardiac-telemetry-program/…

Itamar Launches Next Generation WatchPAT Home Sleep Test

Itamar Medical Ltd has launched the WatchPAT 300, the next generation of its WatchPAT system for home sleep apnea testing.

“[Sleep apnea] has significant health and economic implications, as half of all patients with cardiovascular disease are believed to suffer from sleep apnea and the total cost of unmanaged obstructive sleep apnea is $150 billion each year in the United States alone,” says Gilad Glick, president and CEO of Itamar Medical, in a release. “Addressing the challenge of efficiently and cost-effectively diagnosing the millions of patients with undiagnosed sleep apnea requires a simple, accurate, and scalable modality. We believe that WatchPAT 300—which demonstrates Itamar Medical’s continued commitment to innovation focused on meeting the needs of patients, health systems, payers, and physicians—can play a critical role in solving this challenge.”

WatchPAT 300 utilizes peripheral arterial tone and other signals to calculate various sleep metrics and to diagnose both obstructive and central sleep apnea.

WatchPAT 300 has three points of contact does not use a nasal canula or chest belts. It is based on the peripheral arterial tone signal (PAT) and uses its actigraphy to differentiate between wake and sleep periods, which Itamar says means that it calculates true sleep time (not only total recording time). WatchPAT 300 uses the PAT amplitude and pulse rate to differentiate between non-rapid eye movement (REM) and REM sleep. It also provides sleep architecture, based on sleep stages, including sleep efficiency, sleep latency, and REM latency.

FDA Approves Solriamfetol for Excessive Daytime Sleepiness Associated with Narcolepsy or OSA

The US Food and Drug Administration (FDA) approved solriamfetol, which will be known be marketed by Jazz Pharmaceuticals as the brand name “Sunosi,”  to improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea (OSA).

Sunosi is the first dual-acting dopamine and norepinephrine reuptake inhibitor (DNRI) approved to treat excessive daytime sleepiness in adults living with narcolepsy or OSA. Once-daily Sunosi is approved with doses of 75 mg and 150 mg for patients with narcolepsy and doses of 37.5 mg, 75 mg, and 150 mg for patients with OSA.

Sunosi is expected to be commercially available in the United States following the final scheduling decision by the US Drug Enforcement Administration (DEA), which is typically within 90 days of FDA approval.

“Excessive daytime sleepiness can negatively impact the daily lives of people living with narcolepsy or obstructive sleep apnea at work, at home, or in daily activities. With this approval, a new, daytime medicine that can provide sustained wakefulness throughout the day will be available for patients,” says Bruce Cozadd, chairman and CEO of Jazz Pharmaceuticals, in a release. “The FDA approval of Sunosi also represents an important milestone for Jazz as we continue to offer new treatment options that address unmet needs for people living with chronic, and often debilitating, sleep disorders.”

At Week 12, 150 mg of Sunosi for narcolepsy patients and all doses for OSA patients demonstrated improvements in wakefulness compared

Jazz Pharmaceuticals: FDA Approves Sunosi for Excessive Daytime Sleepiness in Narcolepsy or OSA

Jazz Pharmaceuticals announced that the U.S. Food and Drug Administration approved Sunosi (solriamfetol) to improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea (OSA).

Once-daily Sunosi is approved with doses of 75 mg and 150 mg for patients with narcolepsy and doses of 37.5 mg, 75 mg, and 150 mg for patients with OSA. This medication is not indicated to treat the underlying airway obstruction in OSA.

Sunosi is expected to be commercially available in the U.S. following the final scheduling decision by the U.S. Drug Enforcement Administration (DEA), which is typically within 90 days of FDA approval.

“Excessive daytime sleepiness can negatively impact the daily lives of people living with narcolepsy or obstructive sleep apnea at work, at home or in daily activities. With this approval, a new, daytime medicine that can provide sustained wakefulness throughout the day will be available for patients,” said Bruce Cozadd, chairman and chief executive officer of Jazz Pharmaceuticals. “The FDA approval of Sunosi also represents an important milestone for Jazz as we continue to offer new treatment options that address unmet needs for people living with chronic, and often debilitating, sleep disorders.”

The FDA’s approval of Sunosi is based on data from the Treatment of Obstructive sleep apnea and Narcolepsy Excessive Sleepiness (TONES) Phase 3 clinical program, which included four randomized placebo-controlled studies that demonstrated the superiority of Sunosi relative to placebo. The most common adverse

Is Your Sleep Apnea Machine Snitching to Your Insurer?

Device manufacturers aren’t covered by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, reports Bloomberg Law.

“So, in most cases, when an individual hands over their health data to a device company, that company is not prohibited from disclosing that data to other entities. This gives device companies a lot of leeway in terms of what they can do with health information they obtain.”

from Sleep Review http://www.sleepreviewmag.com/2019/03/is-your-sleep-apnea-machine-snitching-to-your-insurer/…

Study Finds Significant Differences in How Various ASV Devices Treat Complex Sleep Apnea

Adaptive servo ventilation (ASV) is an effective treatment option for patients with complex sleep apnea, according to a Philips-sponsored study published in the American Journal of Respiratory and Critical Care Medicine. The study, Comparison of Physiological Performance of Four Adaptive Servo Ventilation Devices in Patients with Complex Sleep Apnea, compared the performance of 4 different ASV devices with different algorithms, including Philips DreamStation BiPAP autoSV (pictured), and the ASV device that was originally associated with greater mortality during a prior SERVE-HF trial published in 2015. The recent study revealed that certain physiological performances were quite different across the devices.

In the prior SERVE-HF trial, it was suggested that ASV therapy was harmful to central sleep apnea patients with heart failure, with limited information suggesting that some of the patients in the trial may have received excessive minute ventilation that may have increased patient mortality. This new Philips-funded randomized controlled study suggests the mechanisms underlying the adverse effects of ASV may be secondary to excessive ventilation due to device-based effect rather than a class-effect.

“The pursuit for scientific understanding of various disease and treatment processes is an iterative process where we revisit successes and failures to deepen our understanding of disease processes,” says Sairam Parthasarathy, MD, a lead investigator on the study, professor of medicine and interim chief of Division of Pulmonary, Allergy, Critical Care and Sleep Medicine at University of Arizona College of Medicine, in a release.