Ethics in Accounting and Corporate Accounting Scandals Research Paper

Ethics in Accounting and Corporate Accounting Scandals - Research Paper Example The suggested course of action by the companies is also recommended in order to prevent unethical practices that lead to corporate scandals and eventual bankruptcy of the organizations. Introduction The accounting practices are based on the Generally Accepted Accounting Principles. Apart from the rule base practices, the importance of principle based practices have emerged in the field of accounting. This is due to the corporate scandals that have occurred over the years. These corporate scandals establish a link with the unethical practices in accounting. In different countries, the accounting practices are guided by different laws like the tax law in Germany, accounting law in Sweden, company law in USA, etc. The unethical practices in accounting have not only resulted into bankruptcy of the companies but also eroded the wealth of the investors. International Financial Reporting Standards, Sarbanes-Oxley Act have been implemented in order to prevent the unethical accounting practic es and subsequent corporate scandals. ... The accountability is much greater as compared to the compensation received for their role in accounting domain. The most important part of accounting is the code of ethics that is to be followed as a professional in this field. This leads to the concept of ethics in accounting (Duska, Duska and  Ragatz, 2011). Accounting ethics is a part of applied ethics which relates to the moral values and judgments that are applied in the role of accounting. The concept of accounting ethics was first introduced by Luca Pacioli, an Italian mathematician which was later endorsed by the government departments and even the private organizations. The training modules conducted by the companies while training the accountants and auditors include accounting ethics as an integral part. The wide range of accounting services and the news on the fall of big corporate houses like Enron have triggered an importance of following code of ethics in accounting field. Due to fraudulent accounting practices, mal -intention on the part of accountants, auditors and the management, the profession of accountants and the subjects of accounting have been badly criticized. Also the losses incurred by the companies due to unethical practices in accounting field have blown out of proportions (McPhail and  Walters, 2009). In order to avoid the similar devaluation of companies and bankruptcy in future, the institutions irrespective of government and private entities have stressed on the importance of accounting ethics and proper implementation of ethical practices by their accounting departments. The lack of ethical accounting leads to fraudulent accounting practices in the companies which may be due to manipulated or

Group Cohesion and Productivity (MGT 415) Essay Example | Topics and Well Written Essays - 250 words

Group Cohesion and Productivity (MGT 415) - Essay Example I had recently joined the organization and was not fully aware of the all the operations and technologies (Losh). The technology that was used in the organization was very advance. However, instructions and trainings were provided by the management, but many of us still had issues. This problem was resolved when a group project comprising of 6 team members were announced to us. Since, I was new in the organization I had to cope up with different things (Feldman and Arnold), and because of the other 5 members I was able to do so. Working in a team turned out to be helpful and effective as it allowed me and others to share knowledge and overcome shortfalls. The project successfully ended before the given deadline. On the contrary, a similar team project did not work very well a few weeks ago. The team members including me did not have a mutual understanding with each other; thus, the decisions were vague and did not turn out to be as efficient as the last project. The project also failed as the productions was in a deficit and also exceeded the time

Concept Analysis Coursework Example | Topics and Well Written Essays - 250 words - 1

Concept Analysis - Coursework Example According to McEwin and Wills (2014), antecedents are the happenings that took place before the manifestation of the idea while the consequences are the effects of the concept. For instance, for holism to take place, there has to exist a real nurse-patient relationship founded on trust and understanding. The nurse also requires expertise, outstanding communication skills and knowledge. Additionally, a precursor to the concept of risk is the cognitive capability to differentiate between options. The aptitude for cognitive reasoning is an antecedent to the risk concept (Fawcett, 2005). If an individual cannot use cognitive reasoning, he or she is not capable of making a recognition or discernment about the probable harm to him or herself and other people. For instance, young children cannot interpret and analyze information in their surrounding that would be harmful to them or would put them in risk; therefore, they cannot know that touching an iron box after use will burn them. It is an adult in this case who has cognitive thinking to understand that the kid is in danger. In this case, cognitive reasoning is an antecedent to the concept of risk (McEwin & Wills, 2014). Townsend, L., & Scanlany, J. (2001). Self-efficacy related to student nurses in the clinical setting: A concept analysis. International Journal of Nursing Education Scholarship, 8(1). doi:10.2202/1548-923X.2223 Permalink to

Group Cohesion and Productivity (MGT 415) Essay Example | Topics and Well Written Essays - 250 words

Group Cohesion and Productivity (MGT 415) - Essay Example I had recently joined the organization and was not fully aware of the all the operations and technologies (Losh). The technology that was used in the organization was very advance. However, instructions and trainings were provided by the management, but many of us still had issues. This problem was resolved when a group project comprising of 6 team members were announced to us. Since, I was new in the organization I had to cope up with different things (Feldman and Arnold), and because of the other 5 members I was able to do so. Working in a team turned out to be helpful and effective as it allowed me and others to share knowledge and overcome shortfalls. The project successfully ended before the given deadline. On the contrary, a similar team project did not work very well a few weeks ago. The team members including me did not have a mutual understanding with each other; thus, the decisions were vague and did not turn out to be as efficient as the last project. The project also failed as the productions was in a deficit and also exceeded the time

No need Essay Example | Topics and Well Written Essays - 1750 words

No need - Essay Example Power and trust play a vital role in decreasing as well as increasing the conflict. This leads to the purpose of this research paper, which is to understand the reason why do countries conflict with each other. This will occur by relating the importance of trust (defined as the number of treaties a countries sign with each other) in increasing or decreasing the conflict (violence attacks) between any two parties. To find an explanation to the reason why do countries conflict with each other? Four theories provide a clear answer to the question. The first theory indicates that the reason of conflict is that human motivation is by their self-interest and will harm each other to gain more resources. The second theory defines economical status and power as the main factors for conflict to exist. In addition, the third theory, illustrate that conflict is a fight over morals where they harm each other to reach a higher position. The last theory specifies the answer that countries should no t trust each other and act to preserve their own interest, not others interest. Indeed, the last theory provides the convenient answer to question the more mistrust the fear and security there are, leading to more conflict. To answer the question why do countries conflict? There is a creation of a connection between the number of treaties and the number of armed conflict between two countries or a country and its government. Then focus on 32 countries from a different region in the world that has armed conflict between the years 1975 to 2011. Furthermore, the focus is on the number of peace treaties that country has to sign at this time when there is a conflict. In addition, to know the relationship between the number of peace treaties and the number of armed conflict, there is use of large-n method. Linear regressions between the two variables are the point of attention and expect that the less trust (more peace treaties) between any two party the more conflict. Because if two part ies do not trust each other then they will fear each other and increase their security leading armed conflict to exist. The analysis results show that after measuring the variables, there is no relationship between the number of peace treaties and the number of armed conflict in all level of significance. Thus, the decision is to check if there exist factors that lead the hypothesis to fail by using the multi regression method, where the independent variables are the number of peace treaties, and the number of parties a country involve in conflict. Indeed, the result shows that there is a strong positive relationship between the number of parties and the number of armed conflict. In other words, the more parties that takes place the more conflict. The Process of the Research Paper To understand how is trust related to conflict there is a creation of a model to explain the connection between the Independent variable (trust) and dependent variable (conflict) in Micaville’s hypo thesis, which is the less the trust the more conflicts. If there is less trust between any two parties, then both parties fear each other. For example, if party A do not trust party B then party A fails to predict party B actions and this make party A fear party B. Indeed, with the appearance of fear, party A increases its security and advances its military power in order to protect its resources from party B. This example is similar to the model where both party A and party B do not trust each

A Comparison of Nurses Essay Example for Free

A Comparison of Nurses Essay A Comparison of Nurses Educated at the Associate-Degree Level versus the Baccalaureate-Degree Level A career in nursing has many possibilities and depending on where one is employed there may be different educational requirements. There are many nurses in the workforce with only their associate’s degree in nursing, but as time passes it seems that the baccalaureate degree is becoming more of an expectation. This brings up the question- is there a difference in the competency of the associate-level nurse from the baccalaureate-level nurse? Studies are showing that there is a difference and patient outcomes are affected by this difference. Differences between the Associate Degree in Nursing and the Baccalaureate Degree in Nursing In order to compare the competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level, one must first compare the requirements to obtain these degrees. The Associate’s Degree in Nursing, abbreviated ADN, is a two-year degree usually earned through a community college. It requires 60 credit hours to complete and upon completion the graduate can apply for licensure through the state in which they will practice. The Bachelors of Science in Nursing, also called BSN, is a four-year degree obtained at a university. It includes the same areas of study and has the same license upon completion of the NCLEX as the ADN nurse, but delves further into nursing theory as well as pathophysiology and technical skills. Many employers require the bachelor’s degree for higher positions in nursing such as clinical managers and nurse specialists. Differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level As explained above the bachelor’s degree in nursing requires two more years of education and a much deeper study of nursing theory and pathophysiology than the associate’s degree. The question is does this extra education and focus on nursing theory make a BSN nurse more competent than an ADN nurse. Research suggests there is a significant effect of nurse experience and a significant effect of the percentage of BSN nurses in each hospital (Kendall-Gallagher, Aiken, Sloane Cimiotti, 2011) in regards to better patient outcomes. To understand the difference one must look at the basic nursing process and how knowledge of nursing theory and pathophysiology affects it. The basic process taught in nursing school in providing patient care is assessment, plan, intervention and evaluation. Assessment is one the first things a nursing student learns. The associate-level and bachelor-level nurse will both have learned this skill in the very first days of nursing school. Both nurses will also be competent with the last step, evaluation of the interventions. The advantage a BSN nurse will have lies in the middle two steps- plan and intervention. The plan and interventions a nurse provides is affected by their decision-making skills and this is based on their education. Plan and Intervention. To determine a patient’s plan of care, one looks at the abnormal assessments and then uses their knowledge of pathophysiology to determine the plan of care. While the BSN nurse will not necessarily have more clinical hours in assessing the patient, they will have taken more classes in pathophysiology than the ADN nurse and therefore may notice a disease process more readily than the ADN nurse. This is where the interventions will occur. Interventions are determined by the nurse based on their decision-making skills. Decision-Making Skills Nursing is a field in which one is given a great amount of autonomy. Therefore much of a patient’s care is affected by a nurse’s decision-making skills. One’s ability to make decisions is affected by many things including past experiences, environment and education. The focus here is education and how the additional study for the BSN affects nurses’ decision-making skills. The BSN nurse will have studied pathophysiology and nursing theory in greater depth than the ADN nurse. This extra knowledge is then applied to the decisions a nurse makes for their patient. These decisions have a great impact on patient outcomes and recent studies have indicated that there is decreased morbidity, mortality, and failure-to-rescue rates in hospitals that employ larger percentages of baccalaureate prepared nurses (Altman, 2011). Effect of baccalaureate-degree level nurses on patient outcomes In the acute situation the BSN nurse can use their knowledge of pathophysiology in addition to their decision-making skills to decrease morbidity and mortality. Taking into account the greater picture, a more holistic approach based on the BSN nurse’s familiarity with nursing theory, will improve patient outcomes. For example let’s look at a hospital admission for a congestive heart failure exacerbation. Both the ADN and BSN nurse will assess the patient and notice classic signs like shortness of breath and edema. Both nurses will plan on diuresis and paying close attention to respiratory status. The difference will come with the holistic approach that a BSN nurse is more likely to take. The emphasis on the nursing theories that a BSN nurse has studied will allow them to look at the patient as a whole, rather than dealing with only stabilization of symptoms. The knowledge of nursing theory the BSN nurse has will allow them to delve further into why this patient admitted and what they can do to prevent a readmission. The BSN nurse asks questions as to what caused the exacerbation. It may be that the patient needs more teaching on diet and medication compliance. They will ask the patient about their home situation. It’s possible the patient is having financial burdens that have kept them from filling their prescriptions. The BSN nurse is more likely to look at the home situation. The patient may have depression with the diagnosis and need some resources for social support. In regards to King’s theory, nursing’s central goal is to help individuals maintain their health so that they can function in their roles (Creasia, 180). By helping the patient function in their role, the nurse empowers the patient to lead a healthier life. The patient is sent home educated with the resources needed to lead a healthy life and therefore reduces unnecessary hospital admissions. This in turn allows the space available for hospital admissions that are necessary and leads to a healthier community. REFERENCES Altmann, Tanya K. (2011). Registered nurses returning to school for a  bachelors degree in nursing: Issues emerging from a meta-analysis of the research. Contemporary Nurse: A Journal for the Australian Nursing Profession, 39, (2): 256-72. Creasia, J; Friberg, E. (2011). Conceptual Foundations: The Bridge to Professional Nursing Practice. (5th Edition). St. Louis, Missouri: Mosby, Inc. , an affiliate of Elsevier Inc. Kendall-Gallagher, Deborah; Aiken, Linda H. ; Sloane, Douglas M. ; Cimiotti, Jeannie P. (2011). Nurse Specialty Certification, Inpatient Mortality, and Failure to Rescue. Journal of Nursing Scholarship, 43, 188-94.

Case study of sleep disorder and sleep apnea

Case study of sleep disorder and sleep apnea Sleep disorder is one of the most vital problem face by many people in life. Mostly face by older generations and adults. Sleeping is controlled by hypothalamus which is one of the part of a human brain system. Body temperature in some way controls the activities of ones body, playing a role like a switch for on/off. Higher temperature brings alertness while lower temperature causes sleep. Sleep disorder comes in many different forms like Bruxism, Delayed sleep phase syndrome (DSPS), Cataplexy Rapid eye movement behavior disorder (RBD), insomnia, sleep apnea, night terrors, nightmares and somnambulism. Interfering with normal sleeping habits frequently and continuously can be listed as sleep disorder. Sleep disorder are capable of influencing emotional, physical and mental health of a human being. Moreover, sleeping disorder not only causes trouble to the victim but the person staying in the same house at them. Polysomnography is one of the a test commonly use to test for sleep disor ders. Before the 20th century, sleeping problems are face by many people and theres no cure and research about it but till this century, due to the rapidly increasing knowledge of mankind, many research have been brought up just to find solutions for all diseases. In the UK, most of the research are mainly focus on sleep apnea but not others as a proof that they are lagging on knowledge of sleep medicine and possibility of treatment in other sleeping disorders. There are some general principles of treatment that could be find worldwide but mostly in US. Treatments for sleeping disorders can generally be grouped into four different categories that are behavioural/ psychotherapeutic treatments, rehabilitation, medications and other somatic treatments. Treatments such as this does not provides a 100% success and not suitable for all sleeping disorders. History of different people and medical reports of everyone is so greatly different so it is best to say that specific treatment are given to specific patients diagnosis. Disorders such as narcolepsy are best treated pharmacologically. Chronic sleep disorder influenced 70% of children development and psychologically while sleep-phase disruption affects adolescents who could not attend regular school schedules. Effective treatment will begin with careful diagnosis and modifications in sleeping hygiene may reduced the problem. It si said that special equipments are used for several disorders( obst ructive apnea). Research also shows that some sleep disorders are also found to be compromise glucose metabolism. Sleeping is absolutely the essential thing for a normal and healthy lifestyle, according to the United States, roughly about 40 million suffer from long term sleep disorder while nearly 20 million experience mild/ occasional sleep problems. Sleeping disorder suddenly became an important issue because many more people are facing it and body needs sleep to survive because study shown that sleep is essential for immune system and maintaining the ability to fight against diseases and sickness. Learning, growing, functions of brains also comes from the amount of rest absorb because it is said that sleeping helps regenerate and repair cells. Sleep apnea. Sleep apnea is one of the most well-known sleep disorder face by many and said to be one of the most dangerous disorder to be faced compare to others. Another name for sleep apnea is call sleeping breathing disorder. This disorder is a serious sleep disorder that occurs when a persons breathing is influenced by some activities during sleep. Untreated sleep apnea patients will normally face stop breathing repeatedly during their sleep almost hundreds of time. Facing this disorders means that the brain and body are not getting enough oxygen. There are actually two different kind of sleep apnea: Obstructive sleep apnea(OSA) and Central sleep apnea. OSA is more common of the two forms of apnea and normal the causes is a blockage of the airway usually the soft tissue in the back of the throat collapses during sleep while Central sleep apnea is unlike OSA where theres no blockage but the brain fails to signal the muscle to breath which will due to instant instability in the respiratory con trol centre. After having modern research from scientist, sleep apnea can affect anyone at any age even children, the causes of having sleep apnea are gender(mostly male) , being overweight, older after the age of forty, having a large neck size, large tonsils, family history and some other problems. Having untreated sleep apnea could cause quite severe effects like high blood pressure, stroke, heart failure, diabetes, depression and worsening of ADHD. Having poor performances in activities in many different places could be one of the sign of facing sleep apnea. Sleep apnea can be explained in terms like breathing pauses can last from a few seconds to minutes. This disorder often occurs to 5 to 30 times or more per hour. Normally, normal breathing starts again with a loud snort or choking sound which can be easily detect by family members sleeping around them. Sleep apnea often goes undiagnosed while doctor usually cant detect this symptoms so soon. Obstructive sleep apnea is very common with overweight people and happens randomly too, when a person who has sleep apnea tries to breathe, any air that squeezes past the blockage will produces a loud snoring. Some research found out that Central sleep apnea happens less but random while it mostly occur on people that have certain medical conditions or is using certain medicines. Regardless of type, an individual who has sleep apnea will rarely be aware of themselves having difficuly breathing during sleep and even upon awakening. This problems mostly are being recognized as a problem by other wi tnessing the individual. Some treatments can be found to treat Obstructive sleep apnea which involve the lifestyle changes, such as avoiding drinking alcohol or muscle relaxants, weight lost and quitting smoking. Sleeping at a 30-degree elevation of the upper body or higher can be use as a recliner that helps prevent the gravitational collapse of airway while sleeping on a side as opposed to the sleeping on the back theory are also recommended as treatment for sleep apnea because the gravitational component is smaller for lateral position while some people are benefiting through various kinds of oral appliances to keep the airway open. Theres a treatment called Continuous positive airway pressure(CPAP) while other surgical procedures to remove/tighten tissue while widen the airway. Snoring does not actually mean a person is having sleep apnea but mostly overweight people who snores loudly and hardly during sleeping could actually mean sleep apnea. In US, researches revealed that people with OSA has tissue lo ss in brain regions that store memory(hippocampus) which somehow linking OSA to memory loss. Scientists discovered that people that has OSA mammillary bodies are 20 percent smaller than normal people mostly on the left region of the body which is because of repeated drops of oxygen that lead to brain injury. In pure central sleep apnea or known as Cheyne-Stokes respiration, the brains respiratory control centres are imbalanced during sleep while the blood levels of carbon dioxide is higher compare to normal people sleeping and the level of oxygen is lower. The sleeper will stop breathing and then starts breathing again. No effort made to breath, no chest movement and no struggling. In central sleep apnea, the basic neurological controls for breathing rate cant functions and fail to provide signal to inhale. Some people are facing the combination of both type of sleep apnea. Combinations of obstructive sleep apnea and central apnea by loss of central respiratory drive during sleep in OSA. The presence of central sleep apnea without an obstructive component is a common result of abuse by owing to the characteristic respiratory depression that are mainly cause by large doses of narcotics. Obstructive Sleep Apnea can be determine by having a sleep test which is called polysomnography which is usally done to diagnose sleep apnea. Actually there a two kinds of polysomnography, an overnight polysomnography test that involves monitoring brain waves, muscle tension, eye movement, respiration, oxygen level in the blood and having audio monitoring. The second kind of polysomnography test is called a home monitoring test. A sleep Technologist sticks you up with all the electrodes and instructs you on how to record your sleep with a computerized polysomnography that user can take it home and return the computerized polysomnography in the morning. These test are painless test that are covered by insurance. Sleep apnea can be treated in many ways but for severe apnea, there is a Bi-level (Bi-PAP) machine that is different in that it blows air at different pressures. Thats when a person inhales, the pressure is higher while exhaling the pressure is lower. Your own doctor will measure the pressure and a home healthcare company will set the apparatus hence providing training user to use and maintenance it. Tracheostomy is the only treatment available until early 1980s. Its a surgical procedure where a small hole is cut in the neck and a tube with a valve is inserted into the specific hole. During the day, the valve is closed so that the patient can speak while the valve is open at night to avoid obstructions. This treatment is now the last resort for sleep apnea for you must be extremely sick to require this. Uvulo-palato-pharyngoplasty (UPPP) is the treatment available today which means plastic surgery of the pharynx(the pharynx is the joint opening of the gullet and windpipe). This surgery is usually done for patients that cannot tolerate with nasal CPAP. This surgery has help around 50% people and still others do not. Laser Assisted Uvuloplasty(LAUP) is a surgical procedure that remove the uvula and surrounding tissue that open the airway behind the palate. This procedure is said to be used to relieve snoring while somehow successfully treating sleep apnea, before doing this surgical treatment, make sure you have a doctor that has experience doing this procedure with extreme knowledge about sleep apnea. The latest treatment for sleep apnea will be called somnoplasty, getting approvable from US Food and Drug Administration, this treatment uses radio waves to shrink tissue in air passages and almost eliminating all snoring problems. This special and safe procedure is called radiofrequenc y volumetric tissue reduction of the palate. This radiofrequency treatment involves piercing the tongue, throat or soft palate with a electrode needle(special needle specific for this treatment) that is connected to a radio frequency generator. The inner tissue is then heated to about 158 to 176 degrees and takes approximately nearly half an hour. The inner tissues are shrinking while the outer tissue such as taste buds are left intact. Several treatments may be required. This treatment should only be carry out after doing a lot of research and getting the advantages and disadvantages of each different treatment, because some might have side effects. In summary of sleep apnea, the causes of sleep apnea maybe family historical backgrounds but it might be also connected to the body weight of each individual. Make sure to take care of own body after over the age of forty and having large tonsils or tongue might causes sleep apnea. Sleep apnea is one of the most dangerous sleeping disorder that can actually kills the patient instantly because this sleeping disorder interrupts a person during their sleep and the patient wouldnt even know what happen after they get awaken due to lack of oxygen. Sleep apnea prevents breathing from happening and causes lower level of oxygen to be transported to all part of body. There are two kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea happens when blockage of airway occur while central sleep apnea happens when the brain fails to signal the muscles to breath to intake and exhale oxygen and carbon dioxide in and out of the body. Sleep apnea prevents natur al sleeping hence causing high blood pressure, stroke, heart failure, diabetes, depression and many more. Sleep apnea cannot be left untreated because if a human stops breathing, high chance that the person might just die. There are a few variety of treatments for sleep apnea including continuous positive airway pressure(CPAP), variable positive airway pressure(VPAP), automatic positive airway pressure(APAP), Bi-level(Bi-PAP)machine, TRACHEOSTOMY, UVULOPALATOPHARYNGOPLASTY(UPPP), MANDIBULAR MYOTOMY, LASER ASSISTED UVULOPLASTY(LAUP) and RADIO FREQUENCY(RF) PRODECURE OR SOMNOPLASTY. All these treatment are mainly focusing on removal of uvula, cutting bone in anterior portion of mandible or having a small hole to let air diffuse in. CASE STUDY: SLEEP APNEA Sleep apnea is a common but potentially dangerous sleep disorder which can be characterized by repeated pauses in your breathing while asleep. These pauses can last from a few seconds to minutes and can occur thirty or more times per hour. Apneic events usually stop with a loud snort, snore or choking sound which can often momentarily wake you up which will then cause regular breathing to resume. From the research of Emily Cashman, BS, RRT, the clinical training manager at ResMed in Poway, Calif, diabetes and obstructive sleep apnea (OSA) are common disorders that often coexist. In fact, they are equally prevalent within the U.S. adult population.  OSA can affect anyone, including children. However, the population typically associated with the disorder includes overweight adults who snore heavily. Sleep apnea is more common in men, and 50% of type 2 diabetic men also have OSA. There are many treatments for sleep apnea. Any practitioner can identify OSA symptoms. Patients are then r eferred to a sleep specialist, and an overnight polysomnography is conducted in a sleep laboratory or the patients home. The standard treatment is continuous positive airway pressure (CPAP). The air pressure functions like a splint for the upper airway to prevent apneas from occurring and keep the airway from collapsing. This permits normal breathing to continue during sleep, normal sleep patterns to emerge, sleep to become restorative, and the patient to feel better. The impact is often immediate and dramatic. The success of treatment is measured by the reduction of respiratory disturbance to normal levels, the elimination of symptoms such as fatigue and depression, and improvement in the patients subjective feeling of well-being. Effective treatment will eliminate snoring and apnea events and has demonstrated decreases in blood pressure and post-prandial glucose levels within 30 days. OSA is often overlooked and misdiagnosed. Complaints of fatigue and sleepiness are attributed to lifestyle, stress, other medical conditions (such as diabetes), or side effects from medications. Sleep apnea should be investigated when patients present classic symptoms. Theres a 61-year-old man called J.B who is a busy physician and has had type 2 diabetes for 11 years. He suffers from gastroesophageal reflux disease daily and has moderate depression. For 11 years, he has maintained a weight of 210-220 lb (BMI of 31 kg/m2), and he does not have hypertension or hypercholesterolemia. J.B. has no other known diabetes complications. He uses a low-carbohydrate meal plan and a bicycle exercise program. However, he snores and reports being excessively sleepy all the time. Type 2 diabetes is a chronic (lifelong) disease marked by high levels of sugar (glucose) in the blood. It is also the most common form of diabetes. J.B. has no family history of diabetes or sleep apnea. During the past year, he has not been able to get his plasma glucose levels to < 200 mg/dl. His haemoglobin A1c  ( A1C) has been 7.5% (lab norm) on the past two visits. The patient denies polyuria or nocturia. He is in bed for ∠¼ 8 hours per night. His wife does not complain about his nighttime snoring, but she describes herself as a heavy sleeper.The bed partner is often the first to complain of sleep apnea. In this case, J.B.s wife is not bothered. However, fellow physicians who travel with J.B. on medical mission trips joke and complain about his snoring and gasping. J.B. now requests a private room for these trips to avoid the complaints. He did not share this information with his diabetes care team. J.B. is excessively sleepy, yet he sleeps ∠¼ 8 hours nightly. Colleagues and family who sleep in adjacent rooms have told him that he snores and gasps throughout the night. Published research demonstrates that 50% of men with type 2 diabetes have sleep apnea. These factors are sufficient to suspect sleep apnea and inquire further. J.B.s fatigue and sleepiness finally led him to refer him self to a sleep lab in August 2005. Because he is a physician, he felt certain he had sleep apnea by the time he contacted his friend, the medical director of the sleep lab. The vast majority of patients are referred to a sleep lab or sleep specialist by their physician for further evaluation of symptoms. It is common for patients to complete a Berlin Questionnaire, a simple validated 10-item questionnaire certified by the American College of Physicians. Questions focus on BMI, snoring, sleepiness, and blood pressure. J.B.s results for the Berlin Questionnaire indicated a borderline acceptable BMI, severe snoring, severe daytime sleepiness, and an acceptable blood pressure. These results indicate a high risk in two categories of the Berlin Questionnaire, suggesting a strong likelihood of sleep apnea. J.B. underwent a sleep study and, because of the severity of his sleep apnea, a split night protocol was initiated. This means that the first portion of the sleep study (diagnostic) was so severe that the patient was placed on CPAP therapy for the second portion of the night (titration). An apnea/hypopnea index (AHI) of 51 was reported during the diagnostic portion of the study, indicating severe obstructive sleep apnea. Although some patients are able to reduce their AHI to normal levels with weight loss, few patients are able to maintain this type of weight loss. CPAP therapy is the gold standard sleep apnea treatment. CPAP therapy ranges from 4 to 20 cm H20 pressure. J.B. required a pressure of 8 cm H20. The pressure needed to resolve 95% of apneic events throughout the night determines this therapeutic pressure. J.B. went home with a prescription for CPAP, and a local home care dealer delivered his therapy that day. He has slept with CPAP every night since. He reports feeling great, and his family members have noticed a huge difference in his enthusiasm and energy. From the research, it is known that CPAP treatment can improve insulin responsiveness without a significant change in obesity. This occurred in J.B.s case. Although his weight and diet have not changed, his glucose levels have improved dramatically and are now consistently < 150 mg/dl. His A1C was 6.5% 9 months after initiating CPAP therapy, and his medications have been reduced. It is a great news for him and his family. SUMMARY In fact, people that have diabetes will probably suffered from sleep apnea. Sleep apnea is very common in diabetic populations but typically goes undiagnosed. Sleep deprivation from any cause increases blood glucose, blood pressure, and triglycerides, causes higher evening cortisol levels, reduces serum leptin secretion, and increases inflammatory cytokines. Patients with chronic snoring and untreated sleep apnea have a higher risk of both stroke and cardiovascular disease. Although most of these patients do have a higher BMI as well as low activity levels and hypertension, it is also possible for patients with normal BMIs and without hypertension to present with snoring and sleep apnea. Sleep apnea can be associated with recent weight gain. Tiredness can cause people to eat for stimulation and skip exercise. Over time, these habits result in obesity, which can worsen sleep apnea, leading to a progression in severity of both conditions.Treating sleep deprivation rapidly reverses thes e metabolic abnormalities. The reasons for this are complex but seem to include increased sympathetic nervous system activity and adrenal cortisol and catecholamine output. Well, sleep apnea can cause hypertension, nevertheless hypertension is not required for suspicion of sleep apnea. Besides that, treating sleep apnea with CPAP therapy can improve glycemic control and blood pressure. Berlin Questionnaire can also easily conducts an assessment for sleep apnea.