by BENEDICT CAREY from the New York Times

Brief respiratory problems during sleep may play a larger role in causing insomnia than the usual suspects, a small study suggests. 

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Dr. Barry Krakow on PTSD, Insomnia, and Sleep Apnea

Market success depends on getting sleep-disorder breathing patients to use therapy devices

Compliance is the Holy Grail of sleep-disorder breathing therapy. Technologies such as continuous positive airway pressure (CPAP) devices only work if patients use them, and yet industry statistics suggest compliance rates hovering around 50 percent, to the detriment of both patient well-being and DME/HME providers’ bottom line.

Compliance is critical to successful treatment of sleep-disorder breathing and also to the success of DME/HME providers. It’s clearly in everyone’s interests to boost compliance, but how?

Devoting time and resources to ensure compliance is particularly challenging for DME providers in the age of competitive bidding, says Mitchell Yoel, executive vice president of business development and government affairs at Drive Medical Design and Manufacturing. “Current pressures on providers are coming from multiple fronts,” he says. “Providers must both facilitate and confirm compliance with PAP therapy to ensure clinical outcomes and reimbursement, and must also manage the operational costs associated with the amount of time clinical staff spends on PAP patients to get the appropriate fit and comfort.”

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A friend recently told me that her husband has nightmares several times a week, during which he tosses and turns with a look of concern on his face.

Her dilemma: Should she wake him from these disturbing dreams or let them run their course? And does he need to see a sleep specialist and/or a mental health professional? To get some guidance for my friend, I called Dr. Barry Krakow, founder and medical director of Maimonides International Nightmare Treatment Center in Albuquerque, New Mexico.

ARE NIGHTMARES HEALTHY?

About half of all adults have occasional nightmares—unpleasant dreams that cause strong negative responses, such as fear, horror, anxiety or sadness, said Dr. Krakow. Why? Nightmares often help dreamers understand upsetting events of the day and their emotional responses to them. Therefore, occasional nightmares are usually healthy, according to Dr. Krakow. But sometimes nightmares can be unhealthy. And when they become unhealthy, you may need to wake the sleeper and/or refer him or her to a sleep specialist and/or a mental health professional. To learn how to tell the difference, here’s the first question to ask yourself…

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