5/3/1 Rest Pause: A 6-Week Challenge. By Jim Wendler 04/21/13. But didn't stay that way for long thanks to the internet and a growing number of trainees wanting to try the brutally hard but brief DC training system. And a big part of that system includes rest-pause training. Like many people, I was introduced to rest-pause training. Do You Really Need a Recovery Week From Working Out? By Abby Roberts. The average exerciser is fine taking one to three rest days off a week and doesn't require an entire week's recovery. However, athletes doing intense weightlifting or long endurance races should include recovery weeks in their schedule. A couple relaxing at home together.
Sleep Apnea & Snoring
Adult Snoring
Snoring, other than a source of social embarrassment or marital stress, can also be an indication of a serious health condition. Sleep apnea (pauses in breathing with gasping) is an increasing concern in our society and is often undiagnosed. If not treated, sleep apnea has the potential to result in heart disease, lung disease, and elevated blood pressure. An initial screening exam, known as the Epworth sleepiness scale can be a simple test to see if you are at risk for sleep apnea. To complete the test, answer how likely you are to doze off in the following situations:
0 – no chance of sleeping
1 – slight chance of sleeping
2 – moderate chance of sleeping
3 – high chance of sleeping
1 – slight chance of sleeping
2 – moderate chance of sleeping
3 – high chance of sleeping
Situation | Chance of Sleeping |
Sitting and reading | ___________________ |
Watching TV | ___________________ |
Sitting inactive in public place | ___________________ |
Passenger in a car for an hour | ___________________ |
Lying down to rest in the afternoon | ___________________ |
Sitting and talking to someone | ___________________ |
In a car, while stopped in traffic | Cleaner for mac computer. ___________________ |
A score of 9 or higher is an indication you might have sleep apnea.
At DuPage Medical Group, we have a comprehensive approach to sleep apnea that involves Otolaryngology, Pulmonary Sleep Medicine, and Oromaxillofacial departments. Treatments for sleep apnea are provided on an individual basis, and can involve surgery, oral appliances, or CPAP (a breathing assistance machine).
Pediatric Snoring
Pediatric snoring is no laughing matter. If your child displays loud snoring on a nightly basis, or has ever paused their breathing while sleeping, then they may have sleep apnea. It has been shown that children with sleep apnea can often have a more difficult time concentrating at school, or participating in fun daily activities. Often, large tonsils and adenoids are the cause of the snoring. Undergoing tonsillectomy and adenoidectomy can often alleviate the obstruction during sleep. If you are concerned about your child, talk with your physician or schedule an appointment with one of our otolaryngologists for a thorough evaluation.
Sleep Apnea Treatments:
- snoring surgery
- sleep apnea surgery
- tonsillectomy and adenoidectomy
- palatal surgery
- UPPP
- CPAP
- septoplasty
- repair deviated septum
- turbinectomy
- turbinate reduction
- turbinate resection
Snoring
Forty-five percent of normal adults snore at least occasionally, and 25 percent are habitual snorers. Problem snoring is more frequent in males and overweight persons, and it usually grows worse with age. Snoring is an indication of obstructed breathing. Therefore, it should not be taken lightly. An otolaryngologist can help you to determine where the encumbrance may be and offer solutions for this noisy and often embarrassing behavior.
What causes snoring?
The noisy sounds of snoring occur when there is an obstruction to the free flow of air through the passages at the back of the mouth and nose. This area is the collapsible part of the airway (see illustration) where the tongue and upper throat meet the soft palate and uvula. Snoring occurs when these structures strike each other and vibrate during breathing.
In children, snoring may be a sign of problems with the tonsils and adenoids. A chronically snoring child should be examined by an otolaryngologist, as a tonsillectomy and adenoidectomy may be required to return the child to full health.
People who snore may suffer from:
- Poor muscle tone in the tongue and throat. When muscles are too relaxed, either from alcohol or drugs that cause sleepiness, the tongue falls backwards into the airway or the throat muscles draw in from the sides into the airway. This can also happen during deep sleep.
- Excessive bulkiness of throat tissue. Children with large tonsils and adenoids often snore. Overweight people have bulky neck tissue, too. Cysts or tumors can also cause bulk, but they are rare.
- Long soft palate and/or uvula. A long palate narrows the opening from the nose into the throat. As it dangles, it acts as a noisy flutter valve during relaxed breathing. A long uvula makes matters even worse.
- Obstructed nasal airways. A stuffy or blocked nose requires extra effort to pull air through it. This creates an exaggerated vacuum in the throat, and pulls together the floppy tissues of the throat, and snoring results. So, snoring often occurs only during the hay fever season or with a cold or sinus infection.
- Also, deformities of the nose or nasal septum, such as a deviated septum (a deformity of the wall that separates one nostril from the other) can cause such an obstruction.
Why is snoring serious?
Socially – It can make the snorer an object of ridicule and causes others sleepless nights and resentfulness.
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Medically – It disturbs sleeping patterns and deprives the snorer of appropriate rest. When snoring is severe, it can cause serious, long-term health problems, including obstructive sleep apnea.
What is obstructive sleep apnea?
When loud snoring is interrupted by frequent episodes of totally obstructed breathing, it is known as obstructive sleep apnea. Serious episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may experience 30 to 300 such events per night. These episodes can reduce blood oxygen levels, causing the heart to pump harder.
The immediate effect of sleep apnea is that the snorer must sleep lightly and keep his muscles tense in order to keep airflow to the lungs. Because the snorer does not get a good rest, he may be sleepy during the day, which impairs job performance and makes him a hazardous driver or equipment operator. After many years with this disorder, elevated blood pressure and heart enlargement may occur.
Is there a cure for heavy snoring?
Heavy snorers, those who snore in any position or are disruptive to the family, should seek medical advice to ensure that sleep apnea is not a problem. An otolaryngologist will provide a thorough examination of the nose, mouth, throat, palate, and neck. A sleep study in a laboratory environment may be necessary to determine how serious the snoring is and what effects it has on the snorer’s health.
What treatments are available?
Dmg Long Rest 1 Week 4
Treatment depends on the diagnosis. An examination will reveal if the snoring is caused by nasal allergy, infection, deformity, or tonsils and adenoids.
Snoring or obstructive sleep apnea may respond to various treatments now offered by many otolaryngologist—head and neck surgeons:
- Uvulopalatopharyngoplasty (UPPP) is surgery for treating obstructive sleep apnea. It tightens flabby tissues in the throat and palate, and expands air passages.
- Thermal Ablation Palatoplasty (TAP) refers to procedures and techniques that treat snoring and some of them also are used to treat various severities of obstructive sleep apnea. Different types of TAP include bipolar cautery, laser, and radiofrequency. Laser Assisted Uvula Palatoplasty (LAUP) treats snoring and mild obstructive sleep apnea by removing the obstruction in the airway. A laser is used to shrink the uvula and tighten a specified portion of the palate in a series of small procedures in a doctor’s office under local anesthesia. Radiofrequency ablation—some with temperature control approved by the FDA—utilizes a needle electrode to emit energy to shrink excess tissue in the upper airway including the palate and uvula (for snoring), base of the tongue (for obstructive sleep apnea), and nasal turbinates (for chronic nasal obstruction).
- Genioglossus and hyoid advancement is a surgical procedure for the treatment of sleep apnea. It prevents collapse of the lower throat and pulls the tongue muscles forward, thereby opening the obstructed airway.
If surgery is too risky or unwanted, the patient may sleep every night with a nasal mask that delivers air pressure into the throat; this is called continuous positive airway pressure or “CPAP”.
Do you recommend the use of over-the-counter devices?
Dmg Long Rest 1 Week 10
More than 300 devices are registered in the U.S. Patent and Trademark Office as cures for snoring. Some are variations on the old idea of sewing a sock that holds a tennis ball on the pajama back to force the snorer to sleep on his side since snoring is often worse when a person sleeps on his back. Some devices reposition the lower jaw forward; some open nasal air passages; a few others have been designed to condition a person not to snore by producing unpleasant stimuli when snoring occurs. But, if you snore, the truth is that it is not under your control. If anti-snoring devices work, it is probably because they keep you awake.
Self-help for the light snorer
- Adults who suffer from mild or occasional snoring should try the following self-help remedies:
- Adopt a healthy and athletic lifestyle to develop good muscle tone and lose weight.
- Avoid tranquilizers, sleeping pills, and antihistamines before bedtime.
- Avoid alcohol for at least four hours and heavy meals or snacks for three hours before retiring.
- Establish regular sleeping patterns
- Sleep on your side rather than your back.
- Tilt the head of your bed upwards four inches.
Sleep Apnea
Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep 3 or more nights each week. You often move out of deep sleep and into light sleep when your breathing pauses or becomes shallow.
This results in poor sleep quality that makes you tired during the day. Sleep apnea is one of the leading causes of excessive daytime sleepiness.
Overview
Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits. Also, there are no blood tests for the condition.
Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member and/or bed partner may first notice the signs of sleep apnea.
The most common type of sleep apnea is obstructive sleep apnea. This most often means that the airway has collapsed or is blocked during sleep. The blockage may cause shallow breathing or breathing pauses.
When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea happens more often in people who are overweight, but it can affect anyone.
Central sleep apnea is a less common type of sleep apnea. It happens when the area of your brain that controls your breathing doesn't send the correct signals to your breathing muscles. You make no effort to breathe for brief periods.
Central sleep apnea often occurs with obstructive sleep apnea, but it can occur alone. Snoring doesn't typically happen with central sleep apnea.
Outlook
Untreated sleep apnea can:
- Increase the risk for high blood pressure, heart attack, stroke, obesity, and diabetes
- Increase the risk for or worsen heart failure
- Make irregular heartbeats more likely
- Increase the chance of having work-related or driving accidents
Lifestyle changes, mouthpieces, surgery, and/or breathing devices can successfully treat sleep apnea in many people.
Running a by-the-book 5e hex crawl takes practice. There are a lot of fiddly rules on different pages: you have to skip back and forth between the sections on weather, wandering monsters, getting lost, and random hex contents.
I’ve been running hex crawls lately and I’ve boiled down the relevant rules (for me) into a single random encounter chart. Based on the current location/terrain type, the DM fills specific encounters into the chart, Mad Libs-style. The chart does the heavy lifting for determining weather events, chances to get lost, monsters both in their lair and out, surprise, and landscape features.
This chart also reminds me to run a good mix of encounter types: some monsters are friendly! sometimes you run into an inexplicable mystery of the ancient world! Many “encounters” don’t lead to combat! (Of the 12 slots on this table, you only need about 5 potential combats.) With a relatively small and varied number of possible encounters, you can design a bunch that you really want to run, instead of lots of “2d6 goblins” filler. The DM, at least, should be excited to roll on the random encounter table. Here’s my encounter chart template as a PDF.
Checking for encounters: Roll d6 four times a day: morning travel, afternoon travel, first night watch, second night watch. Any roll of 6 means that you roll on the encounter chart. (Or use the official 5e rule: roll 20, encounter on 18-20. Pretty much the same odds, but I like the traditional d6.)
Rolling on the encounter chart: Roll d12 on this chart while traveling, or d6 while stationary (for instance, while resting). The chart is organized so that stationary encounters can’t sneak up on you while you’re not moving.
1: Plot advancing creature: This means different things in different campaigns. If you’re running a campaign about the rise of Tiamat, you might populate this slot with dragons or Tiamat cultists. Plex cleaner and renamer mac. In my open-ended game where the characters are pursuing their own goals, I fill this slot with people or groups related to characters, like the drow assassin that’s chasing the noble. If you’re running a totally plotless hex crawl, fill this slot with a high-level monster (it potentially advances the story by killing the party!)
2: Intelligent creature: Any locale-appropriate group or creature with tool-using intelligence or higher. At night, if the characters hide their camp and don’t light a fire, treat this roll as no encounter (unless your intelligent monsters has darkvision or a sharp sense of smell). That’s the advantage the PCs get for not lighting a fire.
3: Unintelligent creature: Beasts or unintelligent monsters. Most beasts shy away from fire. If the characters are resting and have a campfire lit, treat this roll as no encounter (unless they’re fearless or fire-based beasts). That’s the advantage the PCs get for lighting a fire.
4: Ambush creature: Use stealthy creatures or creatures with special movement modes (flying, burrowing, climbing, swimming, incorporeal). All of these creatures can typically take the party by surprise, so check for surprise against the party’s Perception (rules for perception while traveling: PHB 182). If the PCs are currently using a special movement mode, populate this slot entirely with matching creatures (flying PCs may ignore almost all other encounters, but a 4 is always another flying creature.)
5: Beneficial creature: There are actually a few good monsters in D&D, along with friendly adventurers, kobold bands looking for a new king, and suspicious traders with valuable information to sell. You could roll d4 on this chart to find out what kind of beneficial encounter this is.
6: Weather: If you make the standard 4 random encounter checks per day, you have about an 8% to 12% daily chance to hit bad weather. (The DMG weather chart gives a 15% daily chance of heavy precipitation. Of course, this is probably lower in practice because few DMs roll on the weather chart every day.) Feel free to use any place- and season-appropriate weather that challenges or inconveniences the characters in some way, or use the official weather rules in the DMG p. 109. Possible weather inconveniences: while exposed to the weather, you can’t benefit from a long rest; low visibility forces a Survival check to avoid becoming lost; fords and valleys are flooded.
7. Lair: Locale-appropriate bad guys (or beasts) live here. Usually lairs are where creatures keep their treasure. This could also be a dungeon entrance. No matter the level of the PCs, I make 1 in 6 lairs contain monsters with more than 10 HD/level/CR. Alert PCs shouldn’t run into a cave without scouting first.
8. Survival Check or Hazard: The rules for getting lost (DMG 105) are vague: a Survival check is made “when you decide it’s appropriate.” Consider this encounter slot a reminder. Characters might get lost because of detours, low visibility, or hazards. Hazards include rockslides, quicksand, etc, all detailed in the DMG p. 110.
9. Path Choice: Take a forest shortcut? Ford the river or caulk the wagon? The tradeoff might be apparent (safe path vs. quick path), or a Survival check, or good reasoning, might be needed to reveal which choice is best.
10. Beneficial location: Typically, this means a friendly settlement or homestead (1 in 6 chance of being bigger than a village). Random settlement rules are on DMG 112. In the uncharted wilds, this might instead mean a treasure or natural resource, or a magic resource like a stand of healing herbs or a teleportation circle, or (valuable late in the day) a defensible place to camp.
11. Ruin: One cool thing about the 5e assumptions is that ruins seem to be about as common as civilized spots. A ruin might be a lair or the entrance to a dungeon, but it might just be an abandoned village or castle, an ancient monument (DMG 108), or a weird locale (DMG 109) that hints at lost history beyond the scope of the adventure.
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Macos sierra final dmg. 12. Tracks: It’s cool when the PCs gather information that lets them make informed decisions about their surroundings. Roll d12 on this table; there are tracks, noises, glimpses, or other signs that lead to (or let the PCs avoid) that encounter or location.
OK, so much for the chart explanation. Now here’s an example chart that I’ve made for my campaign, and some blank ones in case you want to print them up and use them.
ENCOUNTER CHART FOR THE WILD HILLS:
1: Plot advancing creature: Depends on the group. Let’s say a monk who’s challenging the monk PC to duel for an available position in the heirarchy: someone murdered the Grand Master of Flowers.
2: Intelligent creature: A paladin from a well-known paladin order. He tells the PCs that he has fought through Hell and returned with a book of devil truenames, and he is fleeing from a pack of vengeful devils. He will accept any help: fight his pursuers (encounter 5); escort him to his destination, which is a holy priory; take his book from him for safekeeping; etc. He is actually a blackguard and he is on his way to sell the book to a devil in a ruined priory.
3: Unintelligent creature: Ghosts of an extinct dwarf clan. They snipe at the party with their ghostly flintlock rifles; from their ancient dwarven curses, it appears that they think the PCs are goblins. They are nearly mindless and cannot be reasoned with. When down to 1/2 HP, each starts retreating to a jumble of bones and treasure in a valley about a mile away. If the bones are blessed, the ghosts will rest.
4: Ambush creature: Hungry wyvern family; will try to fly off with the first PC casualty. Target horses preferentially.
5: Beneficial creature: A troop of paladins searching for the blackguard who stole their book of devil truenames. They will bless and heal friendly PCs and will offer a reward for the book’s return.
6: Weather: Unseasonal snowstorm which follows and surrounds a pack of 7 ravenous winter wolves. Under moonlight, the wolves turn into 7 cursed and miserably cold brothers.
7. Lair: A small tribe of sheep-raising ogres, unusually well-supplied with wool kilts, led by Queen Morag, a relatively industrious and intelligent ogre. If the party seems too powerful to kill, she’ll offer to hire out her warriors as mercenaries (100 GP a day or best offer).
8. Survival Check or Hazard: A miles-wide area of canyons and plateaus. It’s easy to get lost or hit a dead end in the canyons, while staying on the plateaus requires crossing the occasional abyss.
9. Path Choice: Entrance to a long tunnel which leads in the general direction of the PCs’ travel, but descends. Various side passages lead back to the surface while the main tunnel goes to the underdark.
10. Beneficial location: An empty tower with ominous gargoyles up top. They’re actually non-animate stone gargoyles. However all the wood floors are rotten and will collapse under more than #500 weight (characters get saves to avoid falling). The top floor (unless it’s damaged) has a weather-stained permanent summoning circle which can be activated to summon an imp who will answer one question per day: the imp can cast Scry to try to answer the question. Before answering each question, the imp will demand the answer to a personal question about the asker’s life.
11. Ruin: A sloping round tower, three hundred feet tall, completely solid (no inside space). An outside spiral staircase leads to a thirty-foot-wide platform on top, protected by battlements. On the platform are the signs of many old campfires. This is a safe place to camp (except in lightning storms). The bottom of the tower has a gnawed appearance because local peasants have removed stones for their building projects.
12. Tracks: An unseasonal path of quickly-melting snow which leads to encounter 6.
1: Plot advancing creature: Depends on the group. Let’s say a monk who’s challenging the monk PC to duel for an available position in the heirarchy: someone murdered the Grand Master of Flowers.
2: Intelligent creature: A paladin from a well-known paladin order. He tells the PCs that he has fought through Hell and returned with a book of devil truenames, and he is fleeing from a pack of vengeful devils. He will accept any help: fight his pursuers (encounter 5); escort him to his destination, which is a holy priory; take his book from him for safekeeping; etc. He is actually a blackguard and he is on his way to sell the book to a devil in a ruined priory.
3: Unintelligent creature: Ghosts of an extinct dwarf clan. They snipe at the party with their ghostly flintlock rifles; from their ancient dwarven curses, it appears that they think the PCs are goblins. They are nearly mindless and cannot be reasoned with. When down to 1/2 HP, each starts retreating to a jumble of bones and treasure in a valley about a mile away. If the bones are blessed, the ghosts will rest.
4: Ambush creature: Hungry wyvern family; will try to fly off with the first PC casualty. Target horses preferentially.
5: Beneficial creature: A troop of paladins searching for the blackguard who stole their book of devil truenames. They will bless and heal friendly PCs and will offer a reward for the book’s return.
6: Weather: Unseasonal snowstorm which follows and surrounds a pack of 7 ravenous winter wolves. Under moonlight, the wolves turn into 7 cursed and miserably cold brothers.
7. Lair: A small tribe of sheep-raising ogres, unusually well-supplied with wool kilts, led by Queen Morag, a relatively industrious and intelligent ogre. If the party seems too powerful to kill, she’ll offer to hire out her warriors as mercenaries (100 GP a day or best offer).
8. Survival Check or Hazard: A miles-wide area of canyons and plateaus. It’s easy to get lost or hit a dead end in the canyons, while staying on the plateaus requires crossing the occasional abyss.
9. Path Choice: Entrance to a long tunnel which leads in the general direction of the PCs’ travel, but descends. Various side passages lead back to the surface while the main tunnel goes to the underdark.
10. Beneficial location: An empty tower with ominous gargoyles up top. They’re actually non-animate stone gargoyles. However all the wood floors are rotten and will collapse under more than #500 weight (characters get saves to avoid falling). The top floor (unless it’s damaged) has a weather-stained permanent summoning circle which can be activated to summon an imp who will answer one question per day: the imp can cast Scry to try to answer the question. Before answering each question, the imp will demand the answer to a personal question about the asker’s life.
11. Ruin: A sloping round tower, three hundred feet tall, completely solid (no inside space). An outside spiral staircase leads to a thirty-foot-wide platform on top, protected by battlements. On the platform are the signs of many old campfires. This is a safe place to camp (except in lightning storms). The bottom of the tower has a gnawed appearance because local peasants have removed stones for their building projects.
12. Tracks: An unseasonal path of quickly-melting snow which leads to encounter 6.