Engels And The Industrial Revolution - 1146 Words

The Industrial Revolution, which began in England, brought on many advancements in the production of textiles. This revolution that improved the manufacturing industry’s ability to produce goods in mass quantity with less labor should have been a way that the industrial worker’s lives improved. However, the opposite occurred. Engels describes a competitive working environment where workers competed to make enough money to survive with their families. Their survival only led to more suffering of neglect, poverty, and squalor. Engels book, Condtion of the Working Class in England, 1845, is a detailed account of the proletariat who were oppressed by the bourgeoisie. Engels wrote a dismally detailed account of the working class place during the Industrial Revolution in England, placing the workers in the cities as subhuman, expendable, and economically less expensive to maintain than a slave. Engels depicts the Industrial Revolution centralizing capital and people. The peop le were divided by property owning upper class, the bourgeoisie, and the lower class of working people, the proletariat. The division of these two groups of people grew each day as the Industrial Revolution continued. Engels describes in his Introduction chapter, a barbarous indifference of the working class and capital as the weapon used against them. The bourgeoisie justified social inequality, described by Engels as social murder, as a natural act. Engels wrote, â€Å"Population becomes centralized just asShow MoreRelatedThe Shaping Of The Modern World Essay1407 Words   |  6 PagesShaping of the Modern World 10/31/16  ​Question #5: The Growth and dominance of Capitalism and the Industrial Revolution transformed the world. Explain the different positions and outlooks on capitalism and the Industrial Revolution taken by Adam Smith, Karl Marx, and Friedrich Engels. ​The growth, influence, and power of the world surrounds itself around capitalism and the Industrial Revolution. Capitalism is best described as the economic and political system where different countries trade. ItRead MoreBourgeoisie And Industrialism1154 Words   |  5 Pagesproduction, and the Proletariat, members of the working class. These two social classes propelled the Industrial Revolution in Europe. The two images titled Orphaned Girls and Boys in a Welfare Institution, present an idealized situation of the Industrial Revolution and argue that the Bourgeoisie depended on the labor of the Proletariat for economic prosperity and survival. The Industrial Revolution began in England during the early nineteenth century when demand for iron and coal dramatically increasedRead MoreThe Industrial Revolution Of The 19th Century927 Words   |  4 PagesEurope in the nineteenth-century was rapidly evolving into a more modernized society, and many political and cultural ideas were developing during this change. The Industrial Revolution triggered an enormous increase of the standard of living throughout most of Europe and North America. The transformation from the old style of hand made production to the new factory system caused many industries to build factories. This caused many people of the working class to move to the factories in search ofRead MoreThe Social Conditions Of The 19th Century Essay1320 Words   |  6 Pagesthe French and Industrial Revolutions. These world changing events are mostly causing plagues for the working class. These 19th century conditions cause the people to revolt against the social reforms of the existing world and reveal the need for a new social structure. The newly emerging Industrial revolution results in a shift within economic classes, which are the bourgeoisie and proletariat. The 19th century’s conditions are a result of the Industrial Revolution, French Revolution, and UrbanizationRead MoreThe Rise Of The Industrial Revolution1349 Words   |  6 PagesDuring the height of the Industrial Revolution in Europe, specifically England, was a period of mass sufferings, child induced labor, and food shortages all due to the rapid growth of urbanization and industrialization, in which a large population of the people from rural areas migrated to cities and towns out of necessity for work, â€Å"half of the population of England and Wales was living in towns by 1850.† This was all witnessed by Karl Marx and Freidrich Engels when they were living in England inRead MoreMan versus Machine 933 Words   |  4 Pages In the 19th century, the Industrial Revolution brought wealth and power to Great Britain. Many changes occurred in Britain that helped it as a country while other things brought the people within Britain down. Factories and other labor works were introduced to the people in Britain. Many argue that this change impacted the economy and social life of those individuals living in Europe. Many individuals wrote on behalf of the change, some going for it and others going against it. One major controversyRead MoreThe Industrial Revolution During The 19th Century955 Words   |  4 Pagesvast changes in its way of life. The Industrial Revolution took Europeans from the rural countryside into the urban powerhouses as the continent experienced a sudden shift in everyday living, economic structure, and social hierarchy. This sudden change in how Europe was ran from an economic standpoint caused yet another rift between the proletariats and bourgeoisies. Life became difficult for the newly fou nded working class of Europe as shown in Friedrich Engels’ The Condition of the Working ClassRead More Karl Marx and His Radical Views Essay1169 Words   |  5 Pagesto the University of Dayton, â€Å"the human person is part of a larger history of life on this planet. Through technology humans have the power to have an immense effect on that life.†[ii] The people of his time found that the impact of the Industrial Revolution would further man’s success within this world and would ensure his success as a species. Marx was extremely radical in finding that this was a positive impact on humans in nature. In order to understand why his views were considered radicalRead MoreThe Basic Concepts Of Marxism1460 Words   |  6 Pagesto back my thesis. Karl Marx and Friedrich Engels in their political philosophy The Communist Manifesto explain how people in society are divided into two classes, either the property-owning bourgeois or the labor-making proletariats, and the class antagonism that erupts between the two groups (Marx Engels). The bourgeoisies owned the most of society; they owned the property, capital, labour and all other factors of production and more (Marx Engels). On the other hand, the proletariats own nothingRead More Industrial Revolution in the City Essay1193 Words   |  5 PagesIndustrial Revolution in the City The Industrial Revolution was a period of great change for the country of England. Products went from being produced in households and by small businesses to being mass-produced by large industries. Products became cheaper and living conditions improved, but not at first for the working class. Terrible working conditions and hard lives sums up the status of the working class during the Industrial Revolution. The working class put in long hours and hard work

History and Its Effects on the Future - 2143 Words

History and Its Effects on The Future According to definition, History is a narrative of events in the order in which they happened with their causes and effects, a record of past events. Throughout history many events have further evolved the human race, providing different ideas, policies, political laws and ways, and even scientific advances that further pushed the boundaries of human life to where they are today. The future is very much affected by the past and this is clearly present throughout the later Middle Ages all the way to the 18th century. The achievements of this time period in religion, exploration, science, culture, and arts are some of the most important achievements throughout history. In the 1400s the demand for†¦show more content†¦This was a very important time for religion and religious differences. When mentioning the Reformation, an invention that changed history as it was known came about, the Printing Press. Until the mid-fifteenth century, the only way in the West to reproduce any ki nd of text was to copy it laboriously by hand. This introduced errors or improved the original text as the writer saw fit, thus two different copies of the same text could read differently. Two fifteenth-century inventions revolutionized the availability of books. First, movable metal type was introduced around 1450, and after that time printed books first began to appear. Equally important, cheap manufactured paper replaced expensive sheepskin. The introduction and spread of printing throughout Europe made it much easier for peace to share their thoughts and discoveries with others. The Printing press revolutionized books and text in history because it added a more accurate way for writers, scientists, and just about anyone who writes to preserve their work in a much more accurate form and add the ability to present their works to a broader audience. As you can see the printing press was the start of something that is still used in todays society, as shown by the ability to ma ke copies and vast publishing. In the late 1500s and through most of the 1600s a time called The Scientific Revolution came about in the European society. With this time came remarkableShow MoreRelatedAnalysis of Karl Marxs Quotation, Men Make History but Under Conditions Inherited From the Past1272 Words   |  5 PagesHistorical Quotations Men make history but under conditions inherited from the past. ~Karl Marx Karl Marx is famously known for man revolutionary theories regarding society, capitalism, and communism. He wrote and published the Communist Manifesto in 1848. He is a theorist and activist whose theories and ideas are very firmly directly rooted in history and in honoring the past. Marx was also a man who firmly believed that those who did not acknowledge and learn from history would be doomed to repeatRead MoreBenefits And Concerns Of Predictive Genetic Testing998 Words   |  4 Pageshave a family history of the disorder. In this paper, I will highlight the benefits and concerns of predictive genetic testing, discuss how it will affect society, and argue that those with a family history of mental illnesses such as bipolar disorder should have predictive genetic testing so that, if necessary, the disorder can be treated early and prevent any adverse effects. Opposing Stance It is unethical for predictive genetic testing to be done on those with a family history of bipolar disorderRead MoreClimate Change : A Changing For A Brighter Future1485 Words   |  6 PagesClimate Change: A Changing For A Brighter Future About 4.543 billion years ago, planet earth was created. As the years went on, the earth was starting to support life. Anything from bacterias, insects, animals and humans were starting to prosper and this was becoming a problem for the earth. As the earth was starting to support new forms of live, many of it resources were being used up and as a result, problems were arising. Problems such as is there enough water, food and resources were questionsRead MoreThe Contrasting Roles of Historians and Scientists Essay1328 Words   |  6 Pagesreveal discoveries that are meant to bring significant changes to the future. This is presented in the assertion that â€Å"The historian’s task is to understand the past; the human scientist, by contrast, is looking to change the future.† This appears to be false considering that both the historian and the human scientist require a satisfactory comprehension of past events, as their roles necessitate a desire to change the future. The respective areas of knowledge of the historian and human scientistRead MoreRandom1474 Words   |  6 Pagespersonal diet journal. 3. You will need to download the document and continue to update it as you move through the course. At the end of unit 7, you will submit the completed document into Dropbox for grading. 4. Discuss how family history, personal health history, exercise habits, and nutritional choices affect your personal nutrition and activity habits. 5. Develop two (2) short-term and two (2) long-term goals (SMART Goals) for improving or maintaining your diet, and activity level. 6Read MoreAlexander The Great Of The Russian Empire969 Words   |  4 PagesThere are few topics in history that garner more attention and study than Alexander the Great. Almost everyone in the western world has heard of Alexander in school, books, or in other cultural depictions. However, his effect on the history of the world cannot be overstated. Alexander’s empire had an effect on people from the Balkans to Egypt, and from Babylon to India. His empire resolved the long standing conflict between the Persians and Greeks, established multiple cities across the Middle EastRead MoreThe Stock Market Is The Leading Influence On Price Setting And Trade Markets1526 Words   |  7 PagesThe stock market is one of the leading influences on price setting and trade markets. It can have both positive and negative effects on prices and movement in trade both domestically and internationally. The United States stock market has had a long history of influence not only on our economy , but also on a global scale. Currently, the stock market has been slight downturn, due to falling oil prices and agricultural commodities. Which allows for cheaper products for the consumers. It is clearRead MoreThe Emperors Club Reflection Paper1516 Words   |  7 PagesReflection Paper 1 Dec. 5, 2012 Thesis: Past is both past and not past. How we perceive and act in the future is completely up to us. If I was asked to describe studying history, all I can say is one word, Dà ©jà   vu. Dà ©jà   vu is a French word meaning â€Å"already seen†. This phenomenon strikes when an occurrence you are currently experiencing seemed to have occurred in the past. It is that moment when an event flashes back right in front you and you seem to know what was going to happen next. HoweverRead MoreEffects Of Adolescence Female Cannabinoid Exposure On Male Offspring1412 Words   |  6 PagesThe topic of this article is the effects of adolescence female cannabinoid exposure on male offspring’s response to opiates. The particular study is important because marijuana is one of the most abused drugs among females. Since women have babies it is important to understand any potential health risk of the cannabinoid exposure on their offspring. Previous studies have shown increased risks of anxiety and depression, as well as decreased motivation and reading comprehension skills (Brynes, 20 12Read MoreBailouts Effect on Economy770 Words   |  3 Pagesbailing out the various banks in the 2008 financial crisis. First, what bailouts are is explained. Then, the history of bailouts in the US is told. Finally, the effects of the recent bailouts are analyzed. Because billions of dollars are spent on bailouts, they need to be understood by the public by knowing their history and their effects on the economy to ensure informed decisions in the future on whether or not banks should be allowed to fail. A bailout is the process of offering money to a failing

Night Creature Crescent Moon Chapter 10 Free Essays

â€Å"Cassandra, this is ridiculous.† â€Å"Try the powder; then tell me it doesn’t work.† â€Å"Fine. We will write a custom essay sample on Night Creature: Crescent Moon Chapter 10 or any similar topic only for you Order Now † I stuffed the bag into another pocket. â€Å"Thanks.† â€Å"That’s what I’m here for.† â€Å"I’ll – uh – be staying at the Ruelle place from now on.† She lifted her brows. â€Å"How did you manage that?† â€Å"My boss.† I shrugged. â€Å"You know where I can get some camping equipment?† There were a few things I didn’t have – like mosquito netting. It had been a while since I’d gone anywhere this tropical. Cassandra gave me an address. I wrote out my cell phone number. â€Å"In case you need me.† Although what she’d need me for, I had no idea. Still she smiled as if I’d just given her a gift beyond rubies and walked me to the door. â€Å"You aren’t going to be there alone?† she asked. â€Å"Probably not,† I muttered, and headed for the hotel. I checked out, got directions to the address Cassandra had given me, charged what I needed, and drove to the mansion. On the porch sat my camping equipment I don’t know how Frank had gotten the stuff here that fast, and I didn’t care. He was the greatest. As soon as I’d unloaded, a sudden compulsion to do something proactive made me head into the swamp. If I was going to take a look around, I wanted to do it in the daytime. I found the location of last night’s â€Å"incident† without too much trouble. Yellow crime scene tape stands out pretty well amid the swaying grass and cypress trees. I resisted the urge to tear it down. Behavior like that could earn me a few days in a cell. I spent far too long in the swamp. The place was both wild and tranquil, steamy with heat, yet filled with cool water. I saw birds I’d never seen before, plants, trees, flowers, fish. I was captivated, entranced, mesmerized, which was the only reason I didn’t notice the sun falling down. I discovered a field of fire irises and used the pocketknife I’d just purchased to saw through a few stalks. As I gathered them into my arms, something caught my eye. Thinking I’d see the tip of a tail once again disappearing into the swamp, I gaped at the shape of a man in the shad-ows of a cypress tree. I knew that silhouette – the broad shoulders, the slim waist, the tousled hair. â€Å"Adam?† I blinked and he was gone. Which was impossible. Nobody could move that fast I tightened my fingers on the knife, then hurried to the tree and walked around the huge trunk. There was nothing, no one, yet still I felt†¦ something, and it wasn’t friendly. I stared upward, cringing at the idea of a man dropping from the tree and landing on me. Ail I saw was branches and moss; nevertheless, I cursed. Dusk hovered on the horizon. With one last wary glance at the swamp, I folded the knife and put it in my pocket, then clasped the irises close to my chest and headed for home at a near run. Along with the thunder of my own frantic feet – now encased in unfashionable but practical hiking boots – I could have sworn I heard footsteps behind me. I was officially paranoid. As I burst out of the foliage and into the yard, the house seemed to stare back at me with a smirk. Not only was I paranoid but a little crazy also. I ran inside and slammed the door, locking it behind me. No wonder the house seemed to be laughing. What good would a locked door do me when all the windows were broken? Why on earth was I out here without a gun? From what I’d gathered on the Internet, it wasn’t hard to buy one. No waiting period, no registration, no background check. God, I loved the South. First chance I had, ; I was using some of Frank’s money on a pistol. A thud from the second floor had my heart racing as fast as my feet had. I should have stayed in the city, but then I’d never find out anything. With a sense of deja vu, I turned toward the steps. Adam Ruelle stood at the bottom, holding the lantern I’d bought, wearing the usual frayed khakis. This time a white tank top covered his chest, the lack of sleeves only emphasizing the ropy muscles of his arms. Confused, I glanced out the window, toward the swamp, where I could have sworn I’d seen him not more than fifteen minutes ago. â€Å"What are you doing here?† â€Å"I could ask you de same thing.† He set the lantern next to my backpack, sleeping bag, and portable stove. â€Å"This is my house.† â€Å"Not while I’m renting the place.† He frowned. â€Å"You rented it?† â€Å"My employer did. I need to be close to the area where the – â€Å"I broke off. He didn’t seem to notice, staring at the flowers I clutched to my chest. â€Å"You shouldn’t have brought those.† I lowered my arms, stared at the crushed blooms. â€Å"Why?† â€Å"They attract – † He yanked them out of my hands. â€Å"Animals.† Before I could say anything, do anything, he opened the front door, walked to the dock, and tossed the fire irises as far away as he could before striding back inside. â€Å"You’re kidding,† I murmured. â€Å"I don’t kid.† I wasn’t surprised. The man hadn’t cracked a smile since I’d met him. â€Å"Someone left one on my bed at the hotel.† Had that someone been him? If so, why leave the flower then and take them away from me now? I was so confused. Adam appeared deep in thought, more worried about the fire iris on my bed than I had been. Which couldn’t be good. â€Å"I was told those flowers were bad luck,† I said. â€Å"I figured someone didn’t much care for me.† His eyes flicked to mine, the bright blue a beacon in the hazy light from the lantern. â€Å"Who you think it was?† â€Å"No idea I’d just gotten into town at the time. How could I have pissed off anyone that fast?† â€Å"It’s a gift,† he muttered. â€Å"Thanks.† I plucked a stray red petal off my shirt and rubbed it between my thumb and forefinger. A spicy aroma arose, like cinnamon atop a bonfire. I could understand why an animal might be attracted to them. I was. â€Å"At least I’m not nuts,† I murmured. â€Å"No?† I narrowed my gaze. â€Å"I could have sworn someone was following me just now. But maybe it was†¦ something.† He scowled. â€Å"What did you see?† â€Å"Well, I thought I saw you, but that must have been a trick of the light You were here. Right?† â€Å"Right,† he agreed, though he didn’t sound convinced. Which was as bizarre as my seeing him in the first place. Didn’t he know where he’d been? â€Å"The police think you’re dead.† â€Å"They aren’t the only ones.† â€Å"You like being a ghost?† A long moment passed, the silence broken only by a faint splash from the swamp. He went to the window and ‘ his whisper came out of the darkness. â€Å"I don’t mind.† He seemed so sad, so alone. I’d been there, hell, I still was, and while sometimes I liked it, more and more lately I didn’t. I couldn’t help myself. I inched in close and touched his arm. â€Å"You seem real enough to me.† He stiffened and I yanked my hand away, but he caught it in a swift, catlike movement as he turned. I didn’t have time to think, let alone escape, even if I’d wanted to. He wrapped his long, strong arm around my back and kissed me. I was so shocked, I let him. Or maybe I let him because the man kissed as if he did little else but. Tongue, lips, teeth, he devoured. Nothing gentle in this kiss, all wet heat and lust. He twined his fingers in my hair; I dug mine into his shoulders and held on. He tasted of mint, as if he’d just brushed his teeth. I ran my tongue along the straight, white expanse and he moaned, then nipped my lip. A shudder ran through me. His kiss was as rough as his hands, and I relished it I didn’t know why. Simon had been gentle in all things, especially lovemaking. Maybe that was why. He wasn’t Simon, and this wasn’t love. I didn’t want it to be. I’d had my shot. One man, one woman, forever. I believed that. A woman like me didn’t get two soul mates. Did anyone? Since Simon was dead, I was doomed to be alone. But that didn’t mean I couldn’t have this. I ran my palms over his arms, let my thumbs trace his collarbone, tangled my fingers in his hair. His skin was so soft over muscles so hard. I wanted to trace every inch of him. I was overcome with a sudden urge to drop to my knees and score the ripples of his abdomen with my teeth. I’d never seen a man put together so well, not that I’d seen all that many. His erection brushed my stomach; my gasp was captured by his mouth as his hand dipped inside my shirt, slid under my bra, his palm cupping my breast, testing the weight, thumb teasing one nipple even as his lower body skimmed softly against mine. He kept kissing me; I couldn’t think. I wanted nothing more than to feel his heat, his strength, his life. How could I ever have thought him a ghost? Suddenly he tore away; I nearly fell. He stared at me wide-eyed, his mouth wet and swollen, as he shoved a hand through his tangled hair. I’d tangled it. I wanted to do so again. â€Å"I shouldn’t have†¦Ã¢â‚¬  He made a vague gesture in my direction. I swallowed. I could still taste him. â€Å"Why did you?† He snorted. â€Å"Have you looked in de mirror lately?† â€Å"I don’t – I mean, I’m not – â€Å" â€Å"You are.† â€Å"What?† â€Å"Sexy.† I laughed. â€Å"You must be more deprived than I am.† The corner of his mouth lifted. â€Å"I’m sure that’s true.† No one had ever called me sexy. Simon had loved me, but he’d been more interested in my mind than my body. We’d been colleagues, friends, then lovers. The sex had been good. This had been – Catastrophic? Mind-bending? Life altering? Or just – Wrong. I didn’t know this man. Not really. Everything I’d heard about him should make me wary. Most, if not all, of the bodies had been found on his property; why wasn’t he a suspect? Then again, the police were blaming animals. Unless Adam Ruelle planned to shape-shift beneath the crescent moon, he was innocent. At least of the Honey Island Swamp killings. â€Å"Diana?† I started as Adam brushed my hair from my face. His fingertips grazed my cheek, and I resisted the urge to rub my skin against his and purr. What was the matter with me? â€Å"You should take your things and go back to wherever it is you came from.† That was the second time he’d told me as much. I stared into his bright blue eyes. â€Å"It didn’t feel like you wanted me to go.† â€Å"What I want and what’s best for de both of us are two different things.† â€Å"I don’t understand.† I waited for him to explain. When he didn’t, I let out an exasperated sigh and turned away. He grabbed my hand and yanked me back, catching me when I stumbled, aligning our bodies just right all over again. His jaw tightened. â€Å"What I want is to lie you down on , de ground, right here, or maybe shove you against de wall, right there, and take you until you can’t argue with me anymore† As if he couldn’t help himself, he leaned forward, brushed his lips to the swell of my breast exposed by our acrobatics. â€Å"I want to mark you with my teeth.† He scraped the sensitive skin just under my collarbone. â€Å"Bury myself in you.† He pulled me more tightly against him. I should have been insulted; instead I was interested. â€Å"Over and over and over again. Me, you. You, me.† He punctuated each hoarse whisper with a thrust of his hips. â€Å"I’ll be inside you day and night until you don’t know where you begin and I end.† Leaning over, he nuzzled my cheek, put his mouth to the curve of my neck, and suckled my skin hard enough to leave the mark he’d spoken of. Then he lifted his head and his whisper brushed the moist imprint, making me shiver. â€Å"Are you afraid enough to run now?† Afraid? No. Amused out of my mind? You betcha. He stilled against me – hard, hot, his pulse beating out of time with mine. The intimacy of our position, his words, my feelings for a stranger, should have made me bolt. Instead I lifted my gaze and let him see that I wanted the same thing, too. He cursed and swung away to stare out the window once more. I wasn’t sure what to say. Had the entire interlude been an attempt to make me flee? If so, he was the best actor on the planet I could swear I’d tasted desire, and how could he fake a hard-on? Dumb question. He was a guy. They could get a hard on in a stiff breeze. Or so I’d heard. A man like Adam Ruelle was not only out of my league but also out of my realm of experience, seeing as I’d only known one man intimately in my life. â€Å"You intend to stay?† Adam murmured. â€Å"Damn straight† He couldn’t get rid of me that easily. He took a deep breath, let it out slowly, and faced me. â€Å"You’ll need another guide.† â€Å"I don’t need anything.† Except you, my treacherous body whispered. I ignored it; I’d gotten very good at that over the past few years. Til do it.† For an instant I thought he meant do it, and why wouldn’t I? We had, after all, practically done it standing up. Then I understood he was talking about guiding me into the swamp. â€Å"No.† â€Å"You want to see my land, you go with me. Always. Never alone. You understand, cher?† I understood. There were things out there I didn’t want to meet alone. But did I want to meet them with Adam Ruelle? I wasn’t sure. Still, what choice did I have? As he’d pointed out, this was his land. My boss might have rented the house, but I didn’t recall anything about the swamp. â€Å"Don’t call me cher,† I said between my teeth. His mouth lifted into a ghost of a smile. â€Å"I guess that means yes.† How to cite Night Creature: Crescent Moon Chapter 10, Essay examples

SLEEP APNEA Essay Example For Students

SLEEP APNEA Essay SLEEP APNEAWhat is Sleep Apnea?The Greek word apnea literally means without breath. There are three types of sleep apnea: obstructive, central, and mixed; of the three, Obstructive Sleep Apnea (OSA) is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. Obstructive sleep apnea is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed sleep apnea is a combination of the two. With each apnea event, the brain briefly awakes sleep apnea victims from sleep in order for them to resume breathing, therefore sleep is extremely fragmented and of poor quality. Sleep apnea is very common and affects more than twelve million Amer icans. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences. Untreated, sleep apnea can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues. How is Sleep Apnea treated? There is currently no proven drug therapy for sleep apnea. However, there are 4 basic approaches to treatment, which are not mutually exclusive: 1. Modification of circumstances which may be causing sleep apnea or making it worse. This would include weight loss, avoidance of alcohol and sedative drugs, trying to sleep only on your side and stopping smoking. It would also help to improve nasal breathing if this problem exists; sometimes this can be done with some simple medication and occasionally it requires an operation. Finally it is important to avoid sleep deprivation. 2. Use Continuous Positive Airway Pressure (CPAP) in the upper airway to support and hold the airway open. This involves wearing a close fitting mask over the nose, which is attached to a supply of continuously flowing air via a flexible plastic hose from a medical air pump that sits on the floor or bedside table. The flow of air into the mask creates a dilating pressure that is transmitted from the mask through the nose into the upper airway. This positive pressure dilates the upper airway so the breathing is not interrupted. When a sleep apnea patient no longer has obstructed breaths they are able to sleep continuously and hence th eir quality of sleep improves dramatically. An added benefit is that when the upper airway is dilated sufficiently there shouldnt be any further snoring. The amount of airflow and hence the amount of pressure is determined by your doctor. To date this has been the most successful and well-studied treatment for sleep apnea. This type of treatment almost always works regardless of the underlying cause of the sleep apnea. It is usually well tolerated and does not have any serious side effects. The treatment is not covered by the provincial health care plan, but is covered by some third party insurance companies 3. One of the reasons for the upper airway to become narrowed at night is because the tongue falls posteriorly, especially in the supine position. Since the tongue is attached to mandible this can be a significant problem in people with retrognathia and/or a very large tongue. It is possible to use a dental splint at night that effectively prevents the jaw and tongue from moving back when someone lies down and goes to sleep. There has been less experience with this type of treatment compared to CPAP. Since the upper airway can be narrowed for different reasons, this approach may not work for all patients. The splint may put some strain on the temporal mandibular joint, causing some discomfort. There are now many types of dental splints available but few have been extensively studied so that we are not able to predict the rate or degree of success with this type of treatment yet. It would be important to have follow-up investigations to ensure the sleep apnea is adequately treated if this type of treatment is selected. Patients should consult with dentists or orthodontists that are knowledgeable about sleep apnea. 4. A surgical operation on the back of the throat to remove redundant soft tissue in an attempt to increase the size of the upper airway can be performed. It usually involves removal of the part of the soft palate that hangs down in the back of th e throat, as well as the tonsils if present, and other soft tissue if it is felt to be excessive. The operation is referred to as an uvulopalatopharyngoplasty (UPPP) and was initially described as an operation to improve heavy snoring. It is usually quite successful at decreasing the loudness of snoring but is not always successful at improving sleep apnea. There is currently no method that is widely available to predict which patients stand to benefit from this surgery. It is likely going to be less successful for patients with retrognathia. The surgery should not be considered as an option for patients with severe sleep apnea. Like dental appliances there should be some follow-up after surgery to ensure there has been a significant improvement in the severity of the sleep apnea. This surgery can be performed traditionally under general anesthesia in a hospital operating theatre. Short-term results suggest a 50% chance of improvement (defined as a 50% reduction in the AHI). Longer term studies suggest that some patients relapse and their sleep apnea is no longer controlled. Part of the reason for this may be weight gain. More recently this type of surgery is being offered to patients in an outpatient setting using local anesthesia and laser assistance. While this looks like a promising treatment for snoring there are no well-controlled, long-term studies that can demonstrate a role for it in patients suffering from significant sleep apnea. One would expect the results might be similar to the standard UPPP. Currently neither type of operation should be considered as an option for treatment unless patients are unable or unwilling to tolerate CPAP. Who should be treated? In most circumstances treatment should be reserved for those patients with particularly troublesome symptoms. What is troublesome for one patient may not be to another so that only general rules can be stated. Sometimes the patient with sleep apnea may not be the best person to decide whether th eir symptoms are severe or significant. Many patients with sleep apnea have had the problem for several years so they may have lost their proper perception of what a normal night of sleep feels like, or how sleepy during the day they really are. The most important symptom and indeed what often finally brings people to medical attention is daytime sleepiness. Falling asleep at work or school, an inability to concentrate doing normal tasks, unable to watch TV or to read are all common reasons for treatment. Unrefreshing sleep or just always having to fight the urge to sleep are good reasons to treat this disorder. Sometimes it affects someones mood and personality. If sleepiness affects the ability of anyone to operate a motor vehicle or power machinery then obviously treatment is mandatory. A minority of patients have severe sleep apnea (frequent events and/or events long enough to allow a significant drop in the oxygen level). A very few of these people may not have a lot of obvious symptoms (although in general the worse the sleep apnea is at night the more pronounced are the daytime symptoms). Your doctor will take all of this information into consideration as well as your other medical history before recommending therapy and which therapy in particular. The Evaluation Process An evaluation at the Sleep Disorders Center begins with an initial consultation with the director of the Center. In many instances, one visit is sufficient for a diagnosis to be made and a treatment plan formulated. For some patients, however, more extensive testing is required. If an all-night sleep study is required, it is performed at our laboratory in The Presbyterian Hospital /Columbia-Presbyterian Medical Center. The all-night sleep study is a safe and completely painless technique by which physiological functions in sleep are measured. Patients spend one or more nights in a private and comfortable laboratory during which a series of measurements are taken with sophisticated moni toring devices. Patients arrive at the laboratory in the evening and leave the following morning; it is usually not necessary to miss a day of work. In the course of your night at the sleep laboratory, over 1000 pages of data are collected, along with a complete video-tape record. This data is thoroughly reviewed by our expert staff and when necessary, by additional consultants. 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