805. 557. 9930 home sleep disorders obstructive sleep apnea cpap devices cpap mask styles provent epap device oral appliances provent therapy for obstructive sleep apnea restless limb syndrome insomnia insomnia treatment patient questionnaires sleep disorders screening questionnaire the epworth sleepiness scale the international restless limb syndrome (irls) rating scale obstructive sleep apnea quiz insomnia severity index faq meet dr. Popper tour the center blog video contact heart failure central sleep apnea and heart failure mortality by ronald a. Popper, md the link between sleep apnea and heart failure epidemiology of heart failure (hf) – nearly 5,000,000 persons or 2% of the american population suffers from heart failure. â many factors contribute to the rising incidence of heart failure, including a rising lifespan, better therapy for coronary artery disease, hypertension and obesity. â given the rise in life expectancy, it is estimated that 10% of adults over 80 years, will develop heart failure. It is estimated that the impact of heart failure on the u. S. Economy is > $20 billion annually. Epidemiology of sleep apnea in heart failure – approximately 40% of ambulatory patients with treated, stable hf will have cheyne-stokes respiration (csr) a form of central sleep apnea (csa) and 10% will have obstructive sleep apnea (osa). â since both hf and sleep apnea increase with age, it is not unreasonable to expect that a significant proportion of the senior population will have both disorders. Clinical presentation – with csa patients, snoring is usually mild or absent, and patients tend to be thinner. â  however, since many of the symptoms of hf and osa are the same, the clinical presentations of osa patients with or without hf are often indistinguishable. â  therefore, physicians must maintain a high degree of clinical suspicion for coexisting diseases. â  the following should alert physicians for the possibility of csa: male sex, age > 60 years, pco2 < 38 mm hg, the presence of atrial fibrillation or ventricular arrhythmias. Treatment – treatment of osa with or without hf is similar. â  achievement of ideal body weight, control of associated medical illnesses and nasal cpap / bipap or asv. â  csa associated with hf is best treated by optimizing cardiac function. Supplemental oxygen has been shown to eliminate central apneas. â  cpap, bipap or asv have also been shown to effectively treat csa. buy generic viagra generic viagra online cheap generic viagra http://nationalityinworldhistory.net/bsh-buy-generic-viagra-online-jc/ cheap viagra online http://medicaresupplementspecialists.com/pfz-cheap-viagra-online-canada-pharmacy-az/ viagra for sale viagra without prescription usa cheap viagra generic viagra online Conclusions – both sleep apnea and heart failure are more prevalent in an increasingly aged population. â  both impart a significant economic impact upon the individual patient and society as a whole. â  both disorders are associated with an increase in morbidity and mortality. â  this begs the question “should all patients with heart failure undergo sleep studies? â.
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M/G Architecture is a Seattle based Architectural practice with completed designs and master plans for religious institutions, private schools, golf course clubhouses, office buildings, restaurants and single-family residences. Whether working on new buildings from the ground up or within the context of existing, or historic structures we bring a fresh yet practical eye to all our projects. At M/G Architecture we pursue clear and simple design solutions that integrate structure, systems and materials to create compelling buildings and spaces that are a direct response to their owner, community and context. We are a small firm. When you work with M/G Architecture you will work closely through the entire project with one of our principal owners. Our individual strengths and skills complement each other such that M/G Architecture is more than the sum of its parts.


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