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Petition Tag - sleep
Radiofrequency Tongue Base Volume Reduction (RTBVR), CPT 41530, is a safe, timely, efficient, effective, equitable and patient-centered in-office procedure designed to improve, and at times eliminate, the adverse health consequences of Obstructive Sleep Apnea (OSA).
RTBVR is the only FDA Approved Minimally-Invasive Therapy proven effective in managing OSA in the office setting. RTBVR may be performed under local or intravenous anesthesia, eliminating the requirement for general anesthesia in the hospital setting. RTBVR has been covered by CMS since 2009 but recently has been considered a mis-valued (over-valued) service.
CMS has drastically reduced 2016 RTBVR Reimbursement by 69 percent. Physicians are no longer able to offer the procedure as a cost effective alternative to CPAP or more expensive and invasive hospital-based procedures.
In addition, CMS MAC Part A/B Carriers are inconsistent in their coverage of CPT 41530. Although CMS has NO National Coverage Determination (NCD), two MAC Carriers, Wisconsin Physician Services (WPS) and First Coast Service Options (FCSO) have a Local Coverage Determination (LCD) listing CPT 41530 as a "Non-Covered Service." These LCD's restrict ALL Medicare Beneficiaries in (1)Iowa, (2)Kansas,(3)Missouri,(4)Nebraska, (5)Indiana,(6)Michigan and (7)Florida access to RTBVR. The other 43 States have MAC Carriers that list CPT 41530 as a "Covered-Service." In addition, WPS is a MAC Part A Carrier for 40 States. WPS invokes their restrictive LCD on RTBVR performed in the hospital setting. In 33 of these States, the MAC Part B Carrier allows RTVBR to be provided in the office but WPS restricts the same Medicare Beneficiary from having it performed in the Hospital setting.
Patients overwhelming prefer the in-office setting for RTBVR and find it highly cost effective at the 2015 Office-based CMS Fee Schedule. Based on a study by Harvard Medical School Division of Sleep Medicine. The price of fatigue: the surprising costs of unmanaged obstructive sleep apnea. Boston, MA: Harvard Medical School; 2010, RTBVR saves the US Economy over $186,000 per each successfully treated patient. With a success rate over 45 percent, this translates to an effective net savings over $90,000 per treated patient.
As a Federal Health Program, Medicare Beneficiaries should have access to CPT 41530 in all 50 States and in all treatment settings, Hospital, Ambulatory Surgery Center or Office setting.
Just when we start enjoying the early-morning light in the morning, the government makes us spring ahead to groggy dark commutes and endless yawning.
There is no logical reason to force the change to millions of alarm clocks, excessive electricity usage and extra double-doubles.
Medical health professionals agree that as humans, the need to take what’s commonly referred to as a “power nap” in the western world is not only beneficial, but programmed into our natural Circadian rhythm.
From an evolutionary point of view, this alludes to the notion that over the course of our development (via natural selection), those humans that took a nap right after mid day break had a higher survivability rate than those who did not. A 2000 study done in Greece found that those who regularly took a midday siesta were more than 30 percent less likely to die of heart disease, Canada's 2nd leading killer after Cancer.
Studies have shown productivity may be increased by as much as 20 percent. NIMH grantee Alan Hobson, M.D., Robert Stickgold, Ph.D., and colleagues at Harvard University show that a midday snooze reverses information overload, allowing for more information to be retained, thereby maximizing overall efficiency.
While teens have known this for a long time, recent studies have begun to show that teens have irregular sleep patterns which are caused by biological factors and need to be accommodated by their schedules. These sleep patterns are regularly disturbed by the time that they are required to wake up. Teenagers need from 8 and one-half to 9 and one-half hours of sleep per night.
The vast majority do not receive this amount. It is biologically normal for teenagers to have trouble falling asleep before 11:00. On a schedule where they got to bed at 10:00, a teenager would have to wake up at 7:00 to get the recommended 9 hours of sleep. One might argue that a student could wake up at 7:00, since school starts at 7:30, however there are many things that a student has to do in the morning. These include eating breakfast, picking out clothes for the day, packing a lunch, packing athletic gear, filling up a water bottle, checking that all school supplies are packed, and brushing teeth. Students who take showers in the morning, ride their bikes, or walk to school need to wake up even earlier. Some wake up at 6:00 or before. Even with a bed time of 10:00, that is only 8 hours of sleep. So on a good day, teenagers still do not get enough rest time. The following is a quote from the National Sleep Foundation website discussing the results of their study concerning teenage sleep patterns.
"The National Sleep Foundation's 2006 Sleep in America poll found that America's adolescents (6th-12th grade) are not getting the sleep they need, and this lack of sleep gets worse as they progress through their teen years. According to our study -
* Just one in five adolescents get an optimal nine hours of sleep on school nights; nearly one-half (45%) sleep less than eight hours on school nights.
* More than half of adolescents report feeling too tired or sleepy during the day.
* More than half of adolescents say they know they get less sleep than they need to feel their best.
* Nine out of 10 parents believe their adolescent is getting enough sleep at least a few nights during the school week, leaving an "awareness gap" between parents and teens."
This article describes the effects of pushing back school start times in Minnesota from 7:15 to 8:40. A study of the results of this action shows that students experienced:
"* less likelihood of experiencing depressed moods;
* reduced likelihood for tardiness;
* reduced absenteeism;
* better grades;
* reduced risk of fall asleep car crashes; and
* reduced risk of metabolic and nutritional deficits associated with insufficient sleep, including obesity."
Arbolitos Sports Field was created in 1996 when it became necessary to create a detention basin to prevent flooding south of the current location of Abraxas High School. The Sports Field was created in the process of grading the detention basin in what was originally an open space nature preserve. To secure the cooperation of the local residents, The City of Poway promised that the the Fields would be for DAYTIME USE ONLY and that FLOODLIGHTS would never be installed there for nighttime lighting.
Sports boosters attempted change this agreement in 1998, at which time a REAL LIFE lighting test showed the ADVERSE IMPACT on residents around Arbolitos Park that would result from lighting the Arbolitos Sports Fields, (you could easily read by the light) leading to the proposal to light Arbolitos Park being dropped.
With recent changes to the Poway City Council membership, sports boosters are again trying to go back on previous understandings regarding Arbolitos Park. In response to the renewed request, the Poway City Council directed Study Reports for Noise, Lights and Traffic if FLOODLIGHTS were added to Arbolitos Park for nighttime use. The results of the studies were presented at a Neighborhood Meeting on July 7th. City Staff is updating their analyses and will present their recommendations at the Poway City Council Meeting on September 7th. Significant SHORTCOMINGS were identified for the TRAFFIC, NOISE, and LIGHT Studies during the presentation at the July 7th Neighborhood Meeting.
A MAJOR SHORTCOMING of the studies was that they relied heavily on computer modeling with results that do not match the real world experience of neighborhood residents. Other issues with the current direction being taken for Arbolitos Park include the incorrect assumption that IMPACT OF THE FLOODLIGHTS would be restricted to only a few residents on Crestwood Avenue, the potential loss in property values has not addressed or considered, and the promises made by Poway Youth Soccer to cover the cost of the lighting Arbolitos Field are not enforceable, leaving the expense to be paid for by the City of Poway. City Staff have stated that the City would DIVERT THE NECESSARY FUNDS from other operations budgets to cover any funding shortfall.
Further review of the study results have shown there are other shortcomings with the proposal to add floodlights to Arbolitos Sports Fields, including determination if installing floodlights would violate agreements with FEMA regarding the detention basin, whether the Arbolitos fields could stand up to the proposed additional use, and the effect that lights would have on local wildlife. The renewal of the proposal to light Arbolitos Park is a BREACH OF TRUST with Arbolitos residents by the City of Poway and highlights a CONCERN FOR ALL RESIDENTS near any of Poway’s neighborhood Parks. Lighting neighborhood parks will SERIOUSLY DAMAGE Poway resident’s QUALITY OF LIFE and threatens to turn Poway, “The City in the Country” into just .....a City.
We who have Bipolar Disorder suffer sleep deprivation almost nightly. And it often triggers or exacerbates the more obviously dangerous symptoms of the disorder.
For example, anger, impulsiveness, mixed manic episodes, depression, and manic risk-taking; all of which can result in destructive, painful, and even suicidal behavior. Yet, in our treatment, sleep deprivation is poorly addressed and frequently dismissed.
Getting a good night's sleep vastly improves our experience of bipolar and transforms our quality of life. But it rarely happens.
Therefore, we request that NIMH increase its research in this area.
Over 4500 infants die suddenly and unexpectedly in the U.S. each year. Many of these deaths are accidental sleep deaths related to an unsafe sleep environment and are potentially preventable.
The National Institutes of Health, the American Academy of Pediatrics, and SIDS prevention organizations around the world all agree that babies should always be placed on the back to sleep. Sleeping on the stomach doubles the risk of a baby dying of SIDS.
Babies should sleep on a firm surface, such as a safety-approved crib mattress covered by a fitted sheet. Soft objects, such as pillows, quilts, sheepskins, and bumpers should never be placed in the baby’s sleep area. Sleeping on soft bedding increases the risk of SIDS 5 times. When soft bedding is combined with sleep in the prone (stomach) position, the risk of SIDS increases 21 fold!
Babies should sleep close to, but separate from the parent or caregiver. Numerous studies have demonstrated the danger of infant suffocation death when an adult sleep surface is shared with the baby. Babies dying of SIDS are more than 5 times as likely to have had a sibling in the bed. A study by Kemp, et al. demonstrated a 40-fold increase risk of dying of SIDS if the baby was sleeping together with the parents.
Advertising is a very powerful tool and has the ability to effect behaviors relating to healthcare. A recent study by Joyner and Moon (Peds 124(3):e425-e431) reported that in magazines widely read by women of childbearing age, more than one-third of the pictures showed infants in an inappropriate sleep position and two-thirds demonstrated an unsafe sleep environment. Showing infants in potentially life-threatening situations sends a very dangerous message to the public. It undermines the efforts of SIDS prevention organizations by providing a false sense of security to families and reinforcing the misconception that these dangerous sleep environments are safe.
Advocacy efforts can result in positive change as evidenced by the results of campaigns to eliminate cigarette advertising targeting minors. Efforts have also been successful with the entertainment industry to promote health by not glamorizing cigarette use and promoting seatbelt use. Help us promote a consistent safe sleep message to the public by supporting this petition to ask the advertising industry to support infant sleep safety in their advertising images.
For more information please refer to the American Academy of Pediatrics website at: www.aap.org, Safe Kids Worldwide: http://www.safekids.org/suffocation-prevention-and-sleep-safety
or Cribs for Kids at: www.cribsforkids.org. A sample of infant safe sleep guidelines can be viewed on the First Candle website at: http://www.firstcandle.org/about/for-the-media/safe-sleep-image-guidelines/
Narcolepsy and Cataplexy are incurable conditions which are inter-linked. They cause problems for the sufferers due to the spontaneity of the condition and the severity of it, causing any situation to become dangerous.
Cataplexy is, in brief, a condition in which heightened emotions cause muscles to weaken, making the sufferer collapse, which can potentially and almost always be life-threatening.
Narcolepsy, in brief, is a condition in which the sufferer sleeps excessively and experiences hallucinations and sleep paralysis on a daily basis.
This can be distressing and painful for everyone involved and so medication to control the conditions is essential in most cases. This medication can drastically change a life and allow sufferers like me to work and live almost as normal.
Pinelawn police depart has a history of being filthy. Rodents and bugs share the cells with the visitors. Toilets are never cleaned and there is no hand soap to prevent diseases.
There are not enough cell bunk beds there for the number of visitors, so you are made to sleep on the floor with filth that has been building up over the years.
Males and females have to share restrooms and females have special needs monthly.
Most importantly, if an officer id not in a good mood you may not be able to take your medicine or get the proper medical attention needed.
The children of the UK are being deprived of so many important thing in life:
. Lesuire Time- As so as they arrrive home from school many have some homework they have little time for themselves, to socialise, hobbies or just play out with friends and those who do don't get the vital work done.
. Sleep- This may sound silly but with the most kids stilling up till at least midnight and having to wake up at 7 a.m they are not getting the sleep required to be alert and focused in school. this results in them not getting the education they deserved.
So what i'm proposing is that the Government cuts school hours down so all secondary schools would start at 9 a.m and finish at 3.15 p.m with a 20 minute break and 50 minute lunch.
My Petition is Threefold - I am petitioning for the Govenor of California to appeal Proposition 184- the 3 strike law took effect first in Washington Dec, 1993 then in 1994 in California a mandatory 25- life sentence, which in My opinion is utterly ridiculous for it is exactly the old term a stiff sentence which does not prevent crime nor liberate anyone it just causes the institutions to be over populated, only way these men and women can be free from commiting crime is to have their heart and mind renewed in God, they need to be healed from the root cause of why they chose to commit such crime.
My second petition is that the Men and Womens' institution facilities would serve and prepare better food for the inmates, I've heard for over 2 decades now about the poor quality of meals served in these facilities and most of the time the inmates do not even know what you all some of the food now that's bad, they may have errored or accused of one against the law but their nature do not change, for they are still human beings who need proper nutritional meals for the body, My last petition is that something be done about the inmates having to sleep on the floors of the facilities and I came up with in Idea to implement against this problem which is addressed in another letter to our Governor of California and at this time this concludes My Petion.
Studies have proven that most teenagers do not get the proper amount of sleep needed. Part of this problem is the demanding early hours of school.
My family and I have resided in Parker Island aka "Palm Haven Estates" located off County Rd 29, Lake Placid, FL, for 11 years. The best thing about the purchasing our home and land was for the "QUALITY OF THE GREATEST WATER AROUND". We have had the best drinking and cooking water here, until the beginning of 2003. Our water has been tainted due to the fact of excessive pumping from "Heartland Waters". This water is being pumped from my families backyard, the traffic of all hours is unbearable. Especially to those of us whom are waken from sleep due to the noise.
I have children that go to school everyday tired from a lack of sleep, I myself am a mason by trade and need sleep too. I noticed sand in the bottom of our glasses, and my fish tanks as well as my pool, which also brings on an uncontrolable amount of algea build up. I also notice in the bottom of a cup this am, of 03/11/2003 some type of grit and greenish colored substance. Which took bleach to remove the stain. I have never in the 11 years I have lived here needed bleach for my clothes (which are starting to yellow). Much less needed bleach for my dishes. Please don't forget about our personal cleansing I myself have finicky skin and even the softest soap such as Dove, Lever 2000 is rough on my skin. I feel that yes my neighbors are suffering from the same problems. This pumping is causing a road attached to my propety aka "Coots Road" to cave in. (Which the residents have chosen to claim as theirs and fenced it off). They are also dumping some type of fluid into the canal (county maintained) which is also attached TO MY LAND, which is discoloring the water. Keep in mind my children love to fish and do so in this now putrid canal. Which is being ruined by "Heartland Water" excessive pumping. I personally am going to be at a loss of a safe environment if this pumping continues. PLEASE SIGN OUR PETITION AND SAVE "PARKER ISLAND"
Thank You Shara Michaelsen
This petition is banning the public showing of the end of Escape from Alcatrez on national television. Many times around the country of United States children are reported of having little or no sleep due to the ending of this movie once viewed. Children are scared by the face of on the mask. They describe it to their parents during family time as in the Summer's home. "Mangled hair, scary lipstick, and a gooey face dad. Let me sleep in your room tonite." This is not uncommon to be heard around on Central Avenue where the show is mostly watched. In one case *Timmy Winters was wathcing this movie with his family one night by the fire when it ended. Sally and Jimmy were sent to the psychiatric office for 1 month to be only cured slightly of the horrifying experience of Morris's freaky mask.
Recent studies suggest that supplementing melatonin may bolster our immune systems, keep our cells from disintegrating, slow the growth of tumors and cataracts, and ward off heart disease, all the while helping us sleep better. (Newsweek, August 1995)
"Studies suggest that low-dose supplements of melatonin can hasten sleep and ease jet lag, without the hazards or side effects of prescription sleeping pills." Melatonin may have many other uses and has been reported to make people feel better, strengthen the immune system, and reduce free radicals in the body. Current research is underway to determine melatonin's effect as an anti-oxidant, immno-modulator in cancer, delayed sleep-phase disorders, and jet lag. Tests are still under way so there is much to still be learned about melatonin and its effects on the human body." (Newsweek, November 6, 1995, p. 60-63).
Melatonin secretion is involved in physiologic sleep onset, and melatonin may be useful in treating insomnia. (Clinical Pharmacology and Therapeutics, May 1995, Harvard, Cambridge, & MIT) Low melatonin levels correlate with low sleep quality. Seven days treatment with melatonin at a level of 2 mg. daily can improve sleep patterns in elderly patients with insomnia. (Dr. Haimov, British Medical Journal, 1994) Young adult subjects assess their sleep as "deeper" after melatonin treatment. (Dr. Nave, European Journal of Pharmacology, 1995)
We produce melatonin abundantly until puberty, and then it declines steadily into old age. (Dr. Russell Reiter, University of Texas) Melatonin is produced in the pineal gland, which is a small gland in the center of the brain. As darkness fall, the pineal gland produces a surge of melatonin that goes to all parts of the body. When light hits the retina of the eye, neural impulses signal the pineal gland to slow melatonin production.
Melatonin has been found to inhibit LDL [low density lipids or "bad cholesterol"] and the synthesis of cholesterol. (Dr. Muller, Biochemical and Biophysical Research, 1994)
Melatonin selectively and efficiently detoxifies highly reactive oxidants [free radicals] by donating an electron to electrophilic compounds. (Dr. Poeggeler, Annals of New York Academy of Sciences, 1995) This may explain why breast cancer and prostate cancer patients taking melatonin had greater survival rates. (Dr. Massion, University of Massachusetts, Medical Hypotheses, 1995) Mice treated with melatonin showed a 50 percent reduction in tumor weight when compared to control mice. (Dr. Berkowitz, Journal of Urology, 1988)
Melatonin helps alleviate the symptoms associated with "Winter Depression". (Dr. Tukholmankatu, Medical Hypothesis, 1994)
Blood pressure normalization is enhanced with melatonin, and it also modulates the release of heart killing stress hormones.
According to many, one of the more effective means of taking a supplement such as melatonin is the sublingual (under the tongue) method. A high quality sublingual melatonin supplement will usually contain 2.5 mg. of melatonin (often in a base of sorbitol and a natural flavor such as peppermint). One tablet can be dissolved under the tongue before retiring. Since this tablet can be dissolved under the tongue, it is excellent for children with sleep disorders and hyperactivity.