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For milder cases of sleep apnea, your doctor may recommend lifestyle changes, such as losing weight or quitting smoking.


If these measures don' t improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available. Certain devices can help open up a blocked airway. In other cases, surgery may be necessary.


Treatments for obstructive sleep apnea Therapies Continuous positive airway pressure ( CPAP) . If you have moderate to severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep.


With CPAP ( SEE- pap) , the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring. Although CPAP is a preferred method of treating sleep apnea, some people find it cumbersome or uncomfortable.


With some practice, most people learn to adjust the tension of the straps to obtain a comfortable and secure fit. You may need to try more than one type of mask to find one that' s comfortable. Some people benefit from also using a humidifier along with their CPAP system. Don' t just stop using the CPAP machine if you experience problems.


Check with your doctor to see what modifications can be made to make you more comfortable. Additionally, contact your doctor if you are still snoring despite treatment or begin snoring again. If your weight changes, the pressure settings may need to be adjusted.


Adjustable airway pressure devices. If CPAP continues to be a problem for you, you may be able to use a different type of airway pressure device that automatically adjusts the pressure while you' re sleeping.


For example, units that supply bilevel positive airway pressure ( BPAP) are available. These provide more pressure when you inhale and less when you exhale. Oral appliances.


Another option is wearing an oral appliance designed to keep your throat open. CPAP is more effective than oral appliances, but oral appliances may be easier for you to use.


Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea. A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you' ll still need to follow up with your denti at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.


The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea.


Surgical options may include: Uvulopalatopharyngoplasty ( UPPP) .


During this procedure, your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring.


However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic. Maxillomandibular advancement. In this procedure, your jaw is moved forward from the remainder of your face bones.


This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure may require the cooperation of an oral surgeon and an orthodontist, and at times may be combined with another procedure to improve the likelihood of success. Tracheostomy.


You may need this form of surgery if other treatments have failed and you have severe, life- threatening sleep apnea.


In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe. You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.


Removing tissues in the back of your throat with a laser ( laser- assisted uvulopalatoplasty) or with radiofrequency energy ( radiofrequency ablation) are procedures that doctors sometimes use to treat snoring. Although sometimes these procedures are combined with others, they aren' t usually recommended as sole treatments for obstructive sleep apnea. Treatments for central and complex sleep apnea Therapies Treatment for associated medical problems.


Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help. For example, optimizing therapy for heart failure may eliminate central sleep apnea.


Supplemental oxygen.


Using supplemental oxygen while you sleep may help if you have central sleep apnea.


Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs. Continuous positive airway pressure ( CPAP) . This method, also used in obstructive sleep apnea, involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway to keep it from collapsing.


CPAP may eliminate snoring and prevent sleep apnea.


As with obstructive sleep apnea, it' s important that you use the device as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made. Bilevel positive airway pressure ( BPAP) . Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, BPAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale.


The goal of this treatment is to assist the weak breathing pattern of central sleep apnea. Some BPAP devices can be set to automatically deliver a breath if the device detects you haven' t taken one after so many seconds. Adaptive servo- ventilation ( ASV) . This more recently approved airflow device learns your normal breathing pattern and stores the information in a built- in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing.


ASV appears to be more successful than CPAP at treating central sleep apnea in some people. Along with these treatments, you may read or hear about different treatments for sleep apnea, such as implants. Although a number of medical devices and procedures have received Food and Drug Administration clearance, there' s limited published research regarding how useful they are, and they aren' t generally recommended as sole therapies. & copy; 1998- 2011 Mayo Foundation for Medical Education and Research ( MFMER) .


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Tim Welch was never the kind of guy who worried about his weight. In fact, the 37- year- old accounts manager from Seattle, Washington, ate a fairly balanced diet and loved participating in sports while growing up. & quot; I was thin and fit my whole life, & quot; Welch remembers. & quot; I was always active in sports such as running cross- country in high school and swimming on the swim team in college. & quot; Things started to change in 1995 after he graduated from college.


Welch got a job, moved out of his parents' house and began indulging in late- night meals with his friends. & quot; I remember specifically in 1995, my waist size went from a 34 [ inches] to a 38 in a matter of months, & quot; Welch said. & quot; I got a size 36 pants to accommodate my waist size and I had to ask for a bigger size for Christmas because they were too tight. & quot; Welch was in total disbelief when he stepped on the scale and realized he was carrying 200 pounds on his 5- foot- 10- inch frame.


Despite the initial shock, he continued to gain weight.


Even though he fit the medical definition of obese, Welch stayed physically active. He joined a master' s swim team, hiked and walked regularly. Because he was physically active, Welch thought he could keep whatever he wanted. As his weight crept up, his desire to waned.


By the winter of 2005, the extra calories and his now- sedentary lifestyle caught up with him. During a doctor' s visit, Welch discovered that his weight had skyrocketed. & quot; That was pretty depressing to see that 262 [ pounds] on the physical. Just knowing that I had become that heavy, & quot; said Welch.


About the same time, Welch started walking with a cousin who had lost 70 to 80 pounds on Weight Watchers.


During their walks, she would gently encourage him to give the program a try, he says. She also tried to calm his fears that he' d have to stop eating all of the foods he loved in order to lose . & quot; I kept expressing a really persistent fear I had of restricting my comfort foods. I felt to truly lose weight, I couldn' t ever eat the things I loved - - hamburgers, ice cream, chocolate, bacon, cheese [ and] cookies, & quot; said Welch. & quot; I felt like in order to lose weight I would have to give up those things. & quot; Welch started to become depressed and ashamed of his increasing waist size. Embarrassing moments such as asking for a bigger pants size and having a homeless man yell, & quot; Hey, big guy! & quot; on the street - - began to take a toll on him. As a new year approached, Welch reached his breaking point.


In January 2006, as part of his New Year' s resolution, Welch reluctantly attended his first Weight Watchers meeting, but not before making one last stop for what Welch called his & quot; last meal. & quot; & quot; I had a double- cheeseburger, onion rings and milkshake at Johnny Rockets right before the meeting, & quot; said Welch. & quot; I weighed 252. 6 at my first meeting. & quot; During the first week on Weight Watchers, he dropped 7 pounds. Welch also learned how to enjoy his favorite foods through portion control, eating in moderation and choosing healthier foods first. Welch, who was already walking 3. 5 miles a day roundtrip to work, started taking water aerobics three times a week and swimming again competitively.


The weight continued to come off, about 2- 3 pounds a week. & quot; When I got to 200 pounds, I decided, well, ' Why don' t I go for a weight that' s a healthy weight range for my height, ' & quot; said Welch. & quot; So I did, and by that point the weight had slowed down.


It doesn' t come off as quickly as you get closer to your goal weight. But it was still coming off. & quot; Eight months later, Welch had lost 87 pounds and reached his goal weight of 174 pounds, which is the maximum weight for someone who is 5 feet 10 inches tall, according to the national guidelines. People were stunned by his dramatic weight loss. & quot; I literally had people that knew me that didn' t recognize me, & quot; said Welch. So, what' s the best advice Welch has for others who want to lose weight? & quot; Be the best friend you can to yourself while you' re going through this weight loss journey.


I' ve always been someone who was very hard on themselves and suffered from low self- esteem. & quot; Welch said he tried to be very forgiving of himself during the whole process and he still is. He said you should congratulate yourself and focus on any accomplishment you make each day or each week, rather than focus on areas were you have failed. For example, Welch says if you have an extra helping of mashed potatoes, don' t beat yourself up.


Stop yourself and focus on the fact that you chose salmon and peas for dinner and ate two helpings of mashed potatoes - - compared with the cheeseburger and French fries you would have eaten two years ago. Welch also says people shouldn' t deny themselves completely. Allow yourself to indulge in some chocolate when you want it. But instead of eating the entire candy bar, break off a few squares, count the calories, and enjoy it. Also, learn to recognize the fats that are better for you.


Don' t cut out all of the fat. Instead, choose a healthier fat. For example, Welch often allows himself to eat peanut butter or guacamole, which are higher in fat but are a healthier fat than eating something fried. How has the weight loss changed Welch' s life?


Welch can bend over and tie his shoes without discomfort. He feels much lighter going up a flight of stairs and he can hike much faster. More importantly, he' s become more optimistic. & quot; It made me realize I can, in fact, do anything I set my mind to, & quot; said Welch. & quot; It gave me a confidence I desperately needed that I try to apply to other areas of my life. & quot; i. Report. com: Have you lost weight?


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If you think you may have an abdominal aortic aneurysm, or are worried about your aneurysm risk because of a strong family history, make an appointment with your family doctor. If an aneurysm is found early, your treatment may be easier and more effective. Since many abdominal aortic aneurysms are found during a routine physical exam, or while your doctor is looking for another condition, there are no special preparations necessary. If you' re being screened for an aortic aneurysm, your doctor will likely ask if anyone in your family has ever had an aortic aneurysm, so have that information ready. Because appointments can be brief and there' s often a lot of ground to cover, it' s a good idea to be prepared for your appointment.


Here' s some information to help you get ready for your appointment, and what to expect from your doctor. What you can do Be aware of any pre- appointment restrictions. At the time you make the appointment, be sure to ask if there' s anything you need to do in advance, such as restrict your diet. For an ultrasound or echocardiogram, for example, you may need to fast for a period of time beforehand.


Write down any symptoms you' re experiencing, including any that may seem unrelated to an abdominal aortic aneurysm. Write down key personal information, including a family history of heart disease or aneurysms.


Make a list of all medications, as well as any vitamins or supplements, that you' re taking. Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.


Be prepared to discuss your diet, exercise habits and tobacco use. If you don' t already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started. Be sure to tell your doctor if you' re a current or former smoker. Write down questions to ask your doctor. Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together.


List your questions from most important to least important in case time runs out.


For an abdominal aortic aneurysm, some basic questions to ask your doctor include: What is likely causing my symptoms or condition? What are other possible causes for my symptoms or condition? What kinds of tests will I need? What' s the best treatment? What' s an appropriate level of physical activity?


How often should I be screened for an aneurysm? Should I tell other family members to be screened for an aneurysm? What are the alternatives to the primary approach that you' re suggesting?


I have other health conditions. How can I best manage them together? Are there any restrictions that I need to follow? Is there a generic alternative to the medicine you' re prescribing me?


Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting? In addition to the questions that you' ve prepared to ask your doctor, don' t hesitate to ask questions during your appointment at any time that you don' t understand something. What to expect from your doctor Your doctor is likely to ask you a number of questions.


Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask: When did you first begin experiencing symptoms? Have your symptoms been continuous or occasional? How severe are your symptoms?


Do you have a family history of aneurysms? Have you ever smoked? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms?


What you can do in the meantime It' s never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. These are primary lines of defense to keep your blood vessels healthy and prevent an abdominal aortic aneurysm from developing or worsening. If you' re diagnosed with an abdominal aortic aneurysm, you should ask about the size of your aneurysm, whether your doctor has noticed any changes, and how frequently you should visit your doctor for follow- up appointments. & copy; 1998- 2011 Mayo Foundation for Medical Education and Research ( MFMER) .


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Washington ( CNN) - - It' s a daunting assignment for an Army combat brigade at Fort Bliss, Oklahoma - - get all the military' s high- tech software, uplinks, phones, drones and computers to talk to each other. The goal of the Army is to fine- tune a global network to provide everyone, from commanders to frontline soldiers, the same information, quickly and seamlessly. & quot; The network will literally redefine how we fight in the same way that social media has changed the way we interact and communicate in our personal lives, & quot; Army Vice Chief of Staff Gen. Peter Chiarelli said Monday. & quot; The network will change how we operate on the battlefield. & quot; Chiarelli said that over 10 years of war in Iraq and Afghanistan, new equipment had been raced to the battlefield, some of it off the shelf.


Now the task is to synchronize new and old equipment in a battlefield setting in the vast and rough terrain of Fort Bliss.


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Already the Army is experimenting with smartphones, finding uses as diverse as monitoring the eye- in- the- sky, real- time video of drones, or transmitting pictures of the wounded to doctors miles away, or calling up biometric details of suspected insurgents stopped at checkpoints. Traditionally formal Army procurement programs could stretch eight years or longer, finally delivering a product to specifications that might already be years behind current technology.


Now if the Army is able to integrate existing software into its network, then industry can regularly and quickly update the technology. & quot; Together we must we ensure have the most current technology available so that ultimately we may get it into the hands of our soldiers as quickly as possible, & quot; Chiarelli said. Over time the Army will be able to plan and buy equipment more efficiently. & quot; The Army will buy what it needs, when it needs it, for those that need it, & quot; Chiarelli said. & quot; This allows us to buy less, more often and incrementally improve the network capability over time. & quot;


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Regina Regazzi, a 38- year- old New Yorker, is one of the lucky ones. Found to have type 1 diabetes as a child, she has remained relatively free of complications and continues to lead a healthy, active lifestyle.


In fact, this executive recruiter has even run several marathons. She tests her blood sugar six times a day ( sometimes more) and uses an insulin pump to administer the hormone all day long, which keeps her blood sugar as close to normal as possible. Now, research shows that this fairly new approach to controlling type 1 - - as opposed to the one or two daily insulin injections that had been advised for decades - - pays off. People who aim for - - and achieve - - such intensive glucose control are much less likely to lose their vision, have kidney failure, develop heart disease, or need an amputation than those who don' t, according to a study published Monday in Archives of Internal Medicine. What' s more, the research shows that people with type 1 diabetes, including Regazzi, fare much better nowadays than they did 25 years ago.


Type 1 diabetes is an autoimmune disease that occurs when the body attacks the insulin- producing cells of the pancreas, leaving people with no way to control their blood sugar, or blood glucose. About 10 percent of people with diabetes have type 1, which often occurs in children or young adults. ( Most people with diabetes have type 2, which tends to develop later in life. ) People with type 1 diabetes need insulin injections to survive, and like all people with diabetes, are at risk for complications such as heart disease, blindness, nerve damage, and kidney damage caused by high levels of blood sugar. For diabetics, a normal blood sugar is between 90 and 130 mg/ dl before meals, and less than 180 mg/ dl after meals. In the new study, a research team led by David M.


Nathan, M. D. , of Massachusetts General Hospital, in Boston, looked at results from three large, long- term studies: the Diabetes Control and Complications Trial ( DCCT) ; its follow- up study, the Epidemiology of Diabetes Interventions and Complications ( EDIC) ; and the Pittsburgh Epidemiology of Diabetes Complications ( EDC) study.


People in the DCCT who kept their glucose levels as close to normal as possible were 50 percent less likely to develop retinopathy, an eye disease that can cause blindness, than their counterparts who did not. Those in the intensive glucose control group were also less likely to develop kidney problems and heart disease, when compared with those with conventional glucose control. Fewer than 1 percent of people in the intensive group went blind, had a limb amputated, or needed a kidney transplant as a result of their diabetes during the study.


In people who had diabetes for about 30 years, the rates of diabetes- related eye damage and kidney problems were much lower in those who practiced tight control, compared with their counterparts who had the disease before intensive therapy was common. In those who did not practice intensive control, the rates of eye, kidney, and were 50 percent, 25 percent, and 14 percent, respectively, compared with 21 percent, 9 percent, and 9 percent in those who practiced tight control. & quot; This is great news, & quot; says Nathan. & quot; Intensive therapy improves the long- term outlook for people with type 1 diabetes, and if they are able to achieve and maintain glucose levels that are as close to a normal person as possible, they have a much lower chance of suffering from the devastating complications that have historically affected people with diabetes. & quot; What was considered intensive therapy when the study began is now standard diabetes therapy, & quot; he explains. Overall, the outlook for people with type 1 diabetes is much better than it has ever been, according to Nathan. & quot; Physicians and patients can now have a clear idea of what their prospects are over a long period of diabetes, & quot; he says. & quot; They had a bad outlook - - a chance of developing amputation, , and blindness.


But with modern- day therapy, their outlook is much brighter than it has ever been. & quot; Modern therapy includes insulin pumps, such as the one Regazzi uses; a greater variety of insulin products, including man- made versions of the hormone; and better treatments for high blood pressure, high cholesterol, and other illness that tend to occur in people with diabetes. The advancements are a boon for patients, according to Randall J.


Urban, M. D. , a professor and the chair of the department of internal medicine at the University of Texas Medial Branch, in Galveston. & quot; It really shows that for type 1 diabetes, very intense glucose therapy reduces the risk of complications. & quot; However, for some patients, intensive therapy may be easier said than done. & quot; I see a lot of teenagers in my practice, and during the time when they transition into adulthood, there is not good control, & quot; he says. & quot; But as you move into adulthood, a lot of type 1 diabetics do maintain excellent control. . . .


Tight control is the best chance to limit the incidence of complications. & quot; Regazzi, for one, intends to stay the course. & quot; Seeing people with some of the side effects, such as someone who develops a foot ulcer and then it turns into gangrene and leads to amputation, makes me stop and evaluate what I am doing, & quot; she says. & quot; I would never want to become a burden on family or society because I couldn' t control my diabetes. & quot; Regazzi sees a diabetes specialist as well as an eye doctor who' s an expert in retinopathy. & quot; My [ diabetes] doctor and I analyze blood sugars over periods of time and make proper adjustments, & quot; she says. It isn' t always an exact science and there are bumps in the road, she admits. & quot; [ But] I want to live as long and healthy a life as possible. & quot; All study participants who received conventional treatment as part of the DCCT study were offered intensive therapy after this trial ended in 1993, and researchers followed up with them in the EDIC study. When the DCCT study began, conventional treatment for type 1 diabetes involved one or two insulin injections a day with daily urine or blood glucose testing. Intensive therapy includes keeping glucose levels as close to normal as possible by targeting hemoglobin A1C readings of 6 percent or less with at least three insulin injections a day ( or an insulin pump) .


A1C readings provide a snapshot of average blood glucose levels over the past two to three months to give an idea of how well diabetes therapy is working. to win a monthly Room Makeover Giveaway from My.


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