John Steinbeck biography

Born on February 27, 1902, in Salinas, California, John Steinbeck dropped out of college and worked as a manual laborer before achieving success as a writer. His 1939 novel, The Grapes of Wrath, about the migration of a family from the Oklahoma Dust Bowl to California, won a Pulitzer Prize and a National Book Award. Steinbeck served as a war correspondent during World War II, and was awarded the Nobel Prize for Literature in 1962. He died in New York City in 1968.

Early Years

Famed novelist John Ernst Steinbeck Jr. was born on February 27, 1902, in Salinas, California. His books, including his landmark work The Grapes of Wrath (1939), often dealt with social and economic issues. Steinbeck was raised with modest means. His father, John Ernst Steinbeck, tried his hand at several different jobs to keep his family fed: He owned a feed-and-grain store, managed a flour plant and served as treasurer of Monterey County. His mother, Olive Hamilton Steinbeck, was a former schoolteacher.

For the most part, Steinbeck—who grew up with three sisters—had a happy childhood. He was shy, but smart, and formed an early appreciation for the land, and in particular California's Salinas Valley, which would greatly inform his later writing. According to accounts, Steinbeck decided to become a writer at the age of 14, often locking himself in his bedroom to write poems and stories. In 1919, Steinbeck enrolled at Stanford University—a decision that had more to do with pleasing his parents than anything else—but the budding writer would prove to have little use for college.

Over the next six years, Steinbeck drifted in and out of school, eventually dropping out for good in 1925, without a degree.

Early Career

Following Stanford, Steinbeck tried to make a go of it as a freelance writer. He briefly moved to New York City, where he found work as a construction worker and a newspaper reporter, but then scurried back to California, where he took a job as a caretaker in Lake Tahoe. It was during this time that Steinbeck wrote his first novel, Cup of Gold (1929), and met and married his first wife, Carol Henning. Over the following decade, with Carol's support and paycheck, he continued to pour himself into his writing.

Steinbeck's follow-up novels, The Pastures of Heaven (1932) and To a God Unknown (1933), received tepid reviews. It wasn't until Tortilla Flat (1935), a humorous novel about paisano life in the Monterey region, was released that the writer achieved real success. Steinbeck struck a more serious tone with In Dubious Battle (1936), Of Mice and Men (1937) and The Long Valley (1938), a collection of short stories.

Widely considered Steinbeck's finest and most ambitious novel, The Grapes of Wrath was published in 1939. Telling the story of a dispossessed Oklahoma family and their struggle to carve out a new life in California at the height of the Great Depression, the book captured the mood and angst of the nation during this time period.

Later Life

Following that great success, John Steinbeck served as a war correspondent for the New York Herald Tribune during World War II. Around this same time, he traveled to Mexico to collect marine life with friend Edward F. Ricketts, a marine biologist. Their collaboration resulted in the book Sea of Cortez (1941), which describes marine life in the Gulf of California.

Steinbeck continued to write in his later years, with credits including Cannery Row (1945), Burning Bright (1950), East of Eden (1952), The Winter of Our Discontent (1961) and Travels with Charley: In Search of America (1962). Also in 1962, the author received the Nobel Prize for Literature—"for his realistic and imaginative writings, combining as they do sympathetic humour and keen social perception"

Steinbeck died of heart disease on December 20, 1968, at his home in New York City.

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Six Deceptively Gentle Dog Breeds

6 Deceptively Gentle Dog Breeds, You know how the saying goes: Never judge a book by its cover. The same can be said of dogs, believe it or not. While some breeds may appear rough and tumble from the outside, you might actually be surprised how many of those breeds that appear menacing are, in fact, nothing but cuddly pups just waiting to be loved.

                                              Six Deceptively Gentle Dog Breeds

We contacted the American Kennel Club to find out what some of the most popular "deceptively docile" dog breeds are. Here's a list of the top six.

View All Photos of the 6 Deceptively Gentle Dog Breeds
Great Dane
With their large and strong build, Great Danes may appear intimidating at first, but the breed is actually known as a "gentle giant" due to their calm and loving dispositions. These dogs make great family pets, needing minimal grooming and daily exercise, according to the AKC.

Mastiff
Although they're one of the biggest breeds recognized by the AKC, Mastiffs are actually gentle and loyal companions to their owners. They love being around people, and tend to bond closely with their families

Saint Bernard
Powerful and muscular are two words that might seem obvious to call a Saint Bernard - but did you know they also have a mellow temperament, do really well with children and make great family pets?

Leonberger
The Leonberger is often compared to a lion, although in actuality they are known for their calm, gentle and sweet nature. They are friendly and love kids, and have a profuse coat that tends to shed lots.

Newfoundland
Another breed known for its largeness, Newfoundlands are incredible workers with sweet dispositions and a tendency towards being a devoted companion.

Irish Wolfhound
Large, muscular and the tallest of dogs, Irish Wolfhounds are really quite loving. Though originally bred for hunting wolves and elk, today they make great family pets.

By: Cheryl Lock | Pet360.com

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Mein Kampf Adolf Hitler autobiographical manifesto

Mein Kampf  is an autobiographical manifesto by Nazi leader Adolf Hitler, in which he outlines his political ideology and future plans for Germany. Volume 1 of Mein Kampf was published in 1925 and Volume 2 in 1926.The book was edited by the former Hieronymite friar Bernhard Stempfle, who later died during the Night of the Long Knives.

Hitler began dictating the book to his deputy Rudolf Hess while imprisoned for what he considered to be "political crimes" following his failed Putsch in Munich in November 1923. Although Hitler received many visitors initially, he soon devoted himself entirely to the book. As he continued, Hitler realized that it would have to be a two-volume work, with the first volume scheduled for release in early 1925. The governor of Landsberg noted at the time that "he [Hitler] hopes the book will run into many editions, thus enabling him to fulfill his financial obligations and to defray the expenses incurred at the time of his trial."

Hitler originally wanted to call his forthcoming book Viereinhalb Jahre (des Kampfes) gegen Lüge, Dummheit und Feigheit, or Four and a Half Years (of Struggle) Against Lies, Stupidity and Cowardice. Max Amann, head of the Franz Eher Verlag and Hitler's publisher, is said to have suggested the much shorter "Mein Kampf" or "My Struggle".

Analysis

In Mein Kampf, Hitler used the main thesis of "the Jewish peril", which posits a Jewish conspiracy to gain world leadership. The narrative describes the process by which he became increasingly antisemitic and militaristic, especially during his years in Vienna. Yet, the deeper origins of his anti-semitism remain a mystery. He speaks of not having met a Jew until he arrived in Vienna, and that at first his attitude was liberal and tolerant. When he first encountered the anti-semitic press, he says, he dismissed it as unworthy of serious consideration. Later he accepted the same anti-semitic views, which became crucial in his program of national reconstruction of Germany.

Mein Kampf has also been studied as a work on political theory. For example, Hitler announces his hatred of what he believed to be the world's twin evils: Communism and Judaism. The new territory that Germany needed to obtain would properly nurture the "historic destiny" of the German people; this goal, which Hitler referred to as Lebensraum (living space), explains why Hitler aggressively expanded Germany eastward, specifically the invasions of Czechoslovakia and Poland, before he launched his attack against Russia. In Mein Kampf Hitler openly states that the future of Germany "has to lie in the acquisition of land in the East at the expense of Russia."

During his work, Hitler blamed Germany's chief woes on the parliament of the Weimar Republic, the Jews, and Social Democrats, as well as Marxists. He announced that he wanted to completely destroy the parliamentary system, believing it to be corrupt in principle, as those who reach power are inherent opportunists.

Antisemitism

While historians diverge on the exact date Hitler decided to exterminate the Jewish people, few place the decision before the mid 1930s.First published in 1925, Mein Kampf shows the ideas that crafted Hitler's historical grievances and ambitions for creating a New Order.

The racial laws to which Hitler referred resonate directly with his ideas in Mein Kampf. In his first edition of Mein Kampf, Hitler stated that the destruction of the weak and sick is far more humane than their protection. However, apart from his allusion to humane treatment, Hitler saw a purpose in destroying "the weak" in order to provide the proper space and purity for the strong.

Popularity

Although Hitler originally wrote this book mostly for the followers of National Socialism, it grew in popularity. From the royalties, Hitler was able to afford a Mercedes automobile while still imprisoned. Moreover, he accumulated a tax debt of 405,500 Reichsmark (about US$ 8 million today, or €6 million) from the sale of about 240,000 copies by the time he became chancellor in 1933 (at which time his debt was waived).

After Hitler rose to power, the book gained enormous popularity. (Two other books written by party members, Gottfried Feder's Breaking The Interest Slavery and Alfred Rosenberg's The Myth of the Twentieth Century, have since lapsed into comparative literary obscurity, and no translation of Feder's book from the original German is known.) The book was in high demand in libraries and often reviewed and quoted in other publications. Hitler had made about 1.2 million Reichsmarks from the income of his book in 1933, when the average annual income of a teacher was about 4,800 Mark.During Hitler's years in power, the book was given free to every newlywed couple and every soldier fighting at the front .By the end of the war, about 10 million copies of the book had been sold or distributed in Germany.

Contemporary criticisms

Mein Kampf, due to its racist content and the historical effect of Nazism upon Europe during World War II and the Holocaust, is considered a highly controversial book. Criticism has not come solely from opponents of Nazism. Italian Fascist dictator and Nazi ally Benito Mussolini was also critical of the book, saying that it was "a boring tome that I have never been able to read" and remarked that Hitler's beliefs, as expressed in the book, were "little more than commonplace clichés."

One direct opponent of National Socialism, Konrad Heiden, observed that the content of Mein Kampf is essentially a political argument with other members of the Nazi Party who had appeared to be Hitler's friends, but whom he was actually denouncing in the book's content — sometimes by not even including references to them.

In The Second World War, Winston Churchill wrote that he felt that after Hitler's ascension to power, no other book deserved more intensive scrutiny.

The American literary theorist and philosopher Kenneth Burke wrote a rhetorical analysis of the work, The Rhetoric of Hitler's "Battle", which revealed its underlying message of aggressive intent.

Publication history

Early German editions

While Hitler was in power (1933–1945), Mein Kampf came to be available in three common editions. The first, the Volksausgabe or People's Edition, featured the original cover on the dust jacket and was navy blue underneath with a gold swastika eagle embossed on the cover. The Hochzeitsausgabe, or Wedding Edition, in a slipcase with the seal of the province embossed in gold onto a parchment-like cover was given free to marrying couples. In 1940, the Tornister-Ausgabe was released. This edition was a compact, but unabridged, version in a red cover and was released by the post office, available to be sent to loved ones fighting at the front. These three editions combined both volumes into the same book.

A special edition was published in 1939 in honour of Hitler's 50th birthday. This edition was known as the Jubiläumsausgabe, or Anniversary Issue. It came in both dark blue and bright red boards with a gold sword on the cover. This work contained both volumes one and two. It was considered a deluxe version, relative to the smaller and more common Volksausgabe.

The book could also be purchased as a two-volume set during Hitler's reign, and was available in soft cover and hardcover. The soft cover edition contained the original cover (as pictured at the top of this article). The hardcover edition had a leather spine with cloth-covered boards. The cover and spine contained an image of three brown oak leaves.

Mein Kampf English translations

Dugdale abridgment

The first English translation was an abridgment by Edgar Dugdale who started work on it in 1931, at the prompting of his wife, Blanche. When he learned that the London publishing firm of Hurst & Blackett had secured the rights to publish an abridgment in the United Kingdom, he offered it for free in April 1933. However, a local Nazi representative insisted that the translation be further abridged before publication, so it was held back from the public until October 13, 1933, although excerpts were allowed to run in The Times in late July. It was published by Hurst & Blackett as part of "The Paternoster Library".

In America, Houghton Mifflin secured the rights to the Dugdale abridgment on July 29, 1933. The only differences between the American and British versions are that the title was translated My Struggle in the UK and My Battle in America; and that Dugdale is credited as translator in the U.S. edition, while the British version withheld his name. Both Dugdale and his wife were active in the Zionist movement; Blanche was the niece of Lord Balfour, and they wished to avoid publicity.
Murphy translation

One of the first complete English translations of Mein Kampf was by James Murphy in 1939. It was the only English translation approved by the Third Reich. The version published by Hutchison & Co. in association with Hurst & Blackett, Ltd (London) in 1939 of the combined volumes I and II is profusely illustrated with many full page drawings and photographs. The opening line, "It has turned out fortunate for me to-day that destiny appointed Braunau-on-the-Inn to be my birthplace," is characteristic of Hitler's sense of destiny that began to develop in the early 1920s. Hurst & Blackett ceased publishing the Murphy translation in 1942 when the original plates were destroyed by German bombing, but it is still published and available in facsimile editions and also on the Internet.An audio reading of volume one is also available online.
Reynal and Hitchcock translation

Houghton and Mifflin licensed Reynal & Hitchcock the rights to publish a full unexpurgated translation in 1938. It was translated by a committee of men from the New School for Social Research and appeared on February 28, 1939.
Stackpole translation and controversy

The small Pennsylvania firm of Stackpole and Sons released its own unexpurgated translation by William Soskin on the same day as Houghton Mifflin, amid much legal wrangling. The Second Circuit Court of Appeals ruled in Houghton Mifflin's favour that June and ordered Stackpole to stop selling their version,but litigation followed for a few more years until the case was finally resolved in September 1941.

Among other things, Stackpole argued that Hitler could not have legally transferred his right to a copyright in the United States to Eher Verlag in 1925, because he was not a citizen of any country. Houghton Mifflin v. Stackpole was a minor landmark in American copyright law, definitively establishing that stateless persons have the same copyright status in the United States that any other foreigner would. In the three months that Stackpole's version was available it sold 12,000 copies.
Cranston translation and controversy

Houghton Mifflin's abridged English translation left out some of Hitler's more anti-Semitic and militaristic statements. This motivated Alan Cranston, an American reporter for United Press International in Germany (and later a U.S. Senator from California), to publish his own abridged and annotated translation. Cranston believed this version more accurately reflected the contents of the book and Hitler's intentions. In 1939, Cranston was sued by Hitler's publisher for copyright infringement, and a Connecticut judge ruled in Hitler's favour. By the time the publication of Cranston's version was stopped, 500,000 copies had already been sold.Today, the profits and proceeds are given to various charities.

Manheim translation

Houghton Mifflin published a translation by Ralph Manheim in 1943. They did this to avoid having to share their profits with Reynal & Hitchcock, and to increase sales by offering a more readable translation. The Manheim translation was first published in the United Kingdom by Hurst & Blackett in 1969 amid some controversy.
Excerpts

In addition to the above translations and abridgments, the following collections of excerpts were available in English before the start of the war:

1936 : Central Germany, May 7, 1936 - Confidential- A Translation of Some of the More Important Passages of Hitler's Mein Kampf (1925 edition)

Germany's Foreign Policy as Stated in Mein Kampf by Adolf Hitler FOE pamphlet n.38

1939 Mein Kampf: An Unexpurgated Digest

1939 Mein Kampf: A New Unexpurgated Translation Condensed with Critical Comments and Explanatory Notes

Official Nazi translation

A previously unknown English translation was released in 2008, which was prepared by the official Nazi printing office, the Franz Eher Verlag. In 1939, the Nazi propaganda ministry hired James Murphy to create an English version of Mein Kampf, which they hoped to use to promote Nazi goals in English-speaking countries. While Murphy was in Germany, he became less enchanted with Nazi ideology and made some statements that the Propaganda Ministry disliked. As a result, they asked him to leave Germany immediately. He was not able to take any of his notes but later sent his wife back to obtain his partial translation. These notes were later used to create the Murphy translation. The Nazi government did not abandon their English translation efforts. They used their own staff to finish the translation and it was published in very small numbers in Germany. At least one copy found its way to a British/American POW camp. It is the only official English translation produced by the Nazi government and printed on Nazi printing presses.

The angry ranting of an obscure, small-party politician, the first volume of Mein Kampf was virtually ignored when it was originally published in 1925. Likewise the second volume, which appeared in 1926. The book details Hitler's childhood, the "betrayal" of Germany in World War I, the desire for revenge against France, the need for lebensraum for the German people, and the means by which the National Socialist party can gain power. It also includes Hitler's racist agenda and his glorification of the "Aryan" race. The few outside the Nazi party who read it dismissed it as nonsense, not believing that anyone could--or would--carry out its radical, terrorist programs. As Hitler and the Nazis gained power, first party members and then the general public were pressured to buy the book. By the time Hitler became chancellor of the Third Reich in 1933, the book stood atop the German bestseller lists. Had the book been taken seriously when it was first published, perhaps the 20th century would have been very different.This is best - selling book on kindle and ranks in top 20 Best-sellersbooks.

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Destination weddings dream weddings

Destination weddings allow couples to have intimate celebrations with just a few guests or a larger wedding with as many as 200 friends and family members. A destination wedding allows you to spend quality time with your guests in a relaxing setting over three or four days, making memories for years to come.

Destination weddings are typically less expensive for couples than traditional celebrations, as guests usually pay for their own travel and accommodations.

The Destination Wedding Experience

The cost of a traditional ceremony and reception at a banquet hall or hotel can be outrageous - and last only a few hours. Planning a destination wedding can cost considerably less, often include more, and are affordable for every budget.

A destination wedding allows couples to:

Choose a beautiful, unique destination wedding venue - in the sand in Jamaica, on a cliff overlooking turquoise waters in Antigua, in a charming chapel in Mexico, or like royalty in a European castle or luxury private villa

Have a reception you desire - whether it's a simple dinner after the ceremony or lavish reception in a ballroom, there are plenty of options for fabulous entertainment and customizable wedding packages in all price ranges

Combine planning your honeymoon and wedding - venture off to another resort or destination for time alone after the wedding weekend

Spend three to seven days creating unforgettable memories with your closest friends and family

Whether it's an intimate celebration for just the two of you, or a grand ceremony and reception for 150 of your family and friends, DestinationWeddings.com has your perfect destination.

Your Certified Destination Wedding Specialist

Planning a destination wedding on your own can be frustrating and stressful. Your Certified Destination Wedding Specialist will eliminate the worry and stress for you and your guests as they:

Listen to your vision to help you select the perfect location for your destination wedding
Serve as a helpful liaison between you and the wedding coordinator at your chosen hotel or resort when planning your details

Guide you expertly through the entire planning process as a result of continuously visiting new and existing properties
   
Secure the best perks and offers for you through their vast knowledge of our resort partners
Arrange all of the travel details for you and your guests

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GoPro cameras : GoPro HERO3 + Silver Edition Camera

The GoPro HERO3+ Silver Edition Camera is 15% smaller and lighter than its predecessor, the HERO3. It also features faster built-in Wi-Fi than the HERO3. The HERO3+ is designed for recording a variety of adventure sports and it comes with a rugged housing that is waterproof down to a depth of 131' (40m). The camera captures Full HD 1920 x 1080p video at 60 fps, as well as 1280 x 720p at 120 fps. It supports both NTSC and PAL video systems as well. For still images, the HERO3+ supports up to 10MP photos with a burst rate of up to 10 fps.

The HERO3+ is compatible with the optional Wi-Fi Remote, LCD Touch BacPac and Battery BacPac (all sold separately). It comes with two mounts to get you started, but it's also compatible with a variety of mounting accessories for most outdoor adventure and action sports. The HERO3+ camera features an ultra wide angle glass lens, a low-light image sensor and a microSD card slot. There's a built-in mono microphone and a port for optional accessories including the 3.5mm Stereo Mic Adapter and Composite A/V Adapter, which are both sold separately.

GoPro cameras : GoPro HERO3 + Silver Edition Camera

To ensure you get the best shot possible, the HERO3+ is equipped with advanced capture settings including Looping Video, Continuous Photo and White Balance. Plus, it supports time-lapse recording. The HERO3+ also works with the improved GoPro Studio 2.0 software, which allows you to easily create professional-quality videos with your GoPro content. The camera's other features include enhanced low-light performance and a rechargeable lithium-ion battery, which lasts 30% longer than the HERO3 battery.

Small & Lightweight

The HERO3+ Silver Edition is 15% smaller and lighter than previous models, making it ultra-mountable, wearable and versatile.

2x More Powerful

With 2x the performance of its predecessor, the HERO3+ Silver Edition captures high-quality 1080p/60 and 720p/120 video. Plus, it offers dramatically improved low-light performance.

Professional Video Quality

High-resolution, high-frame rate 1080p/60, 960p/60 and 720p/120 video modes result in professional quality footage and allow for liquid-smooth slow motion playback.

Powerful Photo Capture

The HERO3+ Silver Edition captures 10MP stills at up to 10 frames per second - perfect for fast-action sequences. Time Lapse mode enables automatic photo capture at 0.5, 1, 2, 5, 10, 30 or 60 sec intervals.

Enhanced Low-Light Performance

Thanks to a vastly upgraded sensor, the HERO3+ Silver Edition delivers remarkable low-light performance and overall enhanced image quality.

Sharper Images with Less Distortion

Enjoy crisper, clearer footage with reduced distortion. The HERO3+ Silver Edition provides increased image sharpness and 3x reduction in imaging artifacts.

Improved Audio

Sound quality is as important as image quality. The HERO3+ Silver Edition features upgraded audio performance, capturing even the most subtle of sounds - whether you're recording voices, music, engine noise, etc. Advanced wind-noise reduction technology also keeps the audio clearer during high-speed activities.

30% Longer Battery Life

Featuring a 30% increase in battery life, you can go longer and capture more with the HERO3+ Silver Edition.

Control, View & Share 4x Faster

With 4x faster Wi-Fi connectivity to the GoPro App, you can preview content in near real-time and share your photos and videos quicker than ever. The GoPro App makes it easy to control your camera remotely with a smartphone or tablet. Plus, you can preview, playback and share your favorite shots via email, text, Facebook, Instagram and more. You'll also be able to enjoy enhanced connectivity to the optional Wi-Fi Remote, which enables control of up to 50 cameras from distances of up to 600' (180m).

Spot Meter
Spot Meter is ideal for filming within a dark space with the camera pointed towards a brighter setting, such as filming outdoors from within a car.

Looping Video

Looping Video records a continuous video loop that overwrites itself until you press the shutter button to stop it. It's ideal for saving space on your memory card while waiting to catch a moment of action.

One Button
Upon powering on, the camera automatically begins recording video or capturing Time Lapse photos thanks to the One Button feature.

GoPro HERO3+ Silver Edition Camera

Standard Housing
Higher Capacity Lithium-Ion Battery
Quick Release Buckle
Vertical Quick Release Buckle
Curved Adhesive Mount
Flat Adhesive Mount
3-Way Pivot Arm
USB Charging Cable
1-Year Limited Warranty 

GoPro HERO3+ Silver Edition Camera Product Highlights

Full HD 1920 x 1080p Recording at 60 fps
HD 1280 x 720p Recording at 120 fps
Capture up to 10MP Photos at 10 fps
Ultra Wide Angle Glass Lens
Camera Housing Waterproof to 131'

Built-In Wi-Fi & GoPro App Ready
Compatible with Optional Wi-Fi Remote
Provides Enhanced Low-Light Performance
HERO3+ Is 15% Smaller Than HERO3
Battery Lasts 30% Longer Than HERO3

Easy to mount, easy to use, good suggestion to buy a spare battery. Waterproof case worked well on the icy & wet ski days. Small & easy to pack. Good to get a hard non crushable case with room for accessories!

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Las Vegas hotels reviews

Las Vegas hotels, Hotels in Las Vegas

1. Bellaigio hotel

Bellaigio hotel, 3600 Las Vegas Blvd S, Las Vegas, NV 89109

Bellagio is located in the heart of the Las Vegas Strip, and overlooks a Mediterranean-blue lake in which fountains perform a magnificent ballet choreographed to music and lights.The lobby displays an 18-foot ceiling coffer filled with exquisite glass sculpture. Bellagio Conservatory and Botanical Gardens display changes with the four seasons and Chinese New Year. An onsite Gallery of Fine Art, featuring works by world-renowned artists (general admission is $15).

The outdoor pool area resembles a Mediterranean villa, and includes a courtyard, whirlpools, and cabanas for rent. Guests can try their luck in the 100,000 square foot casino including the race and sports book. A full-service spa & salon offers world therapies, beauty treatments, a fitness center, and fitness classes. Live entertainment includes 'O' by Cirque du Soleil. The resort's retail promenade, Via Bellagio, includes the luxury shops of Giorgio Armani, Gucci, Tiffany & Co., Prada, Fred Leighton, Chanel, Dior, Yves Saint Laurent, Bottega Veneta and Fendi.Amenities include a full-service business center, valet parking, concierge, and wedding services.

Bellagio offers 19 restaurants including two AAA Five Diamond restaurants (Picasso and Le Cirque), 16 Sommeliers, and a record 4 Master Sommeliers. Fine dining options include Le Cirque, Circo, Prime Steakhouse, Picasso, Michael Mina and Jasmine. Contemporary dining options include Todd English's Olives, Sensi, Noodles, FIX and Yellowtail Japanese Restaurant & Lounge. Casual dining options include Cafe Bellagio, the Buffet, and the Pool Cafe.

2. Venetian All Suite Resort Hotel Casino, Las Vegas

Venetian All Suite Resort Hotel Casino, Las Vegas 3355 Las Vegas Blvd S, Las Vegas, NV 89109

With such a spectacular setting, it's clear from the minute you arrive that this is an all-suite, five-diamond resort destination with something extra. Located on the world-famous Las Vegas Strip and approximately four miles from McCarran Airport, The Venetian triumphs in recreating the glory of Venice. Suites start at 650 square feet, nearly twice the size as a typical Las Vegas hotel room.

The Palazzo is steps away and offers guests more amenities and features to enjoy. Faithful replications of the Doge's Palace, the Bridge of Sighs, the Campanile Tower, and St. Mark's Square offer awe-inspiring sights and sounds true to the crown jewel of Europe. Don't miss the quarter-mile Grand Canal set in a frescoed sunset sky where gondoliers serenade their passengers on the romantic ride of a lifetime. Features such as the 134,000-square-foot Canyon Ranch SpaClub, the more than 80 international boutiques of The Grand Canal Shoppes, an opulent casino featuring all your table and slot games, a five-acre pool deck, menus created by celebrity chefs including Emeril Lagasse, Wolfgang Puck, David Burke, Thomas Keller, and Mario Batali, and the entertainment of Tim McGraw and Faith Hill December 2012 to April 2013, Rock of Ages, and Rita Rudner guarantee every visit to The Venetian will be unforgettable.

Starting January 1, 2012 guests are subject to a $20 Daily Resort Fee plus tax, which includes the following amenities: daily access to the complete fitness center located inside the Canyon Ranch SpaClub for up to two guests, unlimited in-suite high-speed Internet access, unlimited local and toll-free telephone calls, daily newspaper, free boarding pass printing, one free regular coffee at Cafe Presse and a 2-for-1 well drink, house wine, or domestic beer at La Scena, Oculus, Laguna, Fusion or Salute lounges. Must be 21 years of age. Management reserves all rights.

3. Mandalay Bay Resort & Casino, Las Vegas

Mandalay Bay Resort & Casino, Las Vegas 3950 Las Vegas Blvd S, Las Vegas, NV 89119

The hotel at Mandalay Bay ushers in a new model of understated luxury, affording guests a haven of sophistication and service on par with the best boutique hotels in the world. Its elegantly appointed suites and stylish lobby areas set a tone of confident discretion, while its carefully tailored roster of amenities provide an unparalleled atmosphere for attending to both business and pleasure.The 725-square-foot guest suites in THEhotel are a touch above the rest, stylishly outfitted with down comforters, high-thread-count sheets, pillow-top mattresses and 32-inch flatscreen TVs. 

                                  Mandalay Bay Resort & Casino, Las Vegas
The spacious bathrooms offer luxurious towels, double sinks and plasma televisions. Meanwhile, the sectioned-off sitting rooms are equipped with a 42-inch plasma TV, and high-speed wireless Internet connection.On the top of THEhotel is MIX, featuring an eclectic menu and the best views of the Vegas strip. Tempt your palate with inventive cocktails from a hot spot indoors, with DJs spinning and bartenders mixing. Or gaze down at the town from the 64th floor through floor-to-ceiling windows at a breathtaking view of the Strip. MIX takes the modern feel of THEhotel to spectacular new heights.

The guests at THEhotel also have access to all the exotic luxury of Mandalay Bay Resort & Casino: 11 acres of beachside bliss, 135,000 square feet of casino, award-winning dining, luxurious spa relaxation, a shark-themed aquarium and the ultimate in Vegas nightlife.The recent $30 million poolside renovation showcases 2,700 tons of sparkling sand beaches lined with plush foliage, waterfalls, fountains and a wave pool. And with a lazy flowing river, upscale, European-style bathing at Moorea Beach club and private cabanas, the most sought-after poolside paradise in Vegas is at the Mandalay's beach.

4. Caesars Palace Las Vegas, Las Vegas

Caesars Palace Las Vegas, Las Vegas.3570 Las Vegas Blvd S, Las Vegas, NV 89109

A tribute to Roman opulence, Caesars Palace specializes in providing entertainment and pampering services fit for the gods. It is located on the Strip, approximately four miles north of McCarren International Airport. The Forum Shops at Caesars Palace offer some of the best shopping in world. The property's amenities include the new Qua Baths and Spa, a luxurious retreat with an array of unique treatments and services, including Roman Baths. The Garden of the Gods Pool Oasis features four pools and two whirlpools.

The 129,000-square-foot casino offers slot machines, table games, poker, keno, and a race and sports book. The Coliseum at Caesars Palace is a 4,000-seat stadium that is home to Bette Midler, Cher, and other events. Two onsite shopping venues hold more than 120 stores. The property also features a wedding chapel, a beauty salon, 24-hour room service, tour assistance, golfing arrangements, dry cleaning and laundry services, and a business center. Dining includes Augustus Cafe, Bradley Ogden, Beijing Noodle 9, Nero's, the Cafe Lago Buffet, the Cypress Street Marketplace, Sea Harbour, Hyakumi, the Mesa Grill, Rao's, and the Restaurant Guy Savoy.

Payard Patisserie & Bistro, a joint venture between Caesers Palace and world-famous Pastry Chef Francois Payard, opened in November of 2007. Nightlife options include several bars and lounges. Pure nightclub offers a new standard in Las Vegas nightlife, with Strip views and two stories of decadence. All Classic rooms feature high-speed Internet access (fee applies), voicemail, safes, hairdryers, climate control, Nintendo games (fee applies). The Augustus Tower rooms offer a new definition of luxury with flat-panel TVs in the bed and bath areas. Must be 21 years old to check into the hotel.

5. Mirage Hotel & Casino, Las Vegas

Mirage Hotel & Casino, Las Vegas 3400 Las Vegas Blvd S, Las Vegas, NV 89109

The newly renovated Mirage Hotel and Casino boasts an indoor rainforest, a dolphin habitat, and one of the most famous spectacles in Las Vegas-an erupting volcano!. The hotel is located at the heart of the Strip.The entrance of the hotel is home to a lagoon with waterfalls and a 54-foot high volcano that spews smoke and fire 100 feet above the water once an hour nightly.

Siegfried and Roy's Secret Garden and Dolphin Habitat features dolphins swimming in the two and one-half million-gallon pools. Also created for the Mirage by Siegfried and Roy is the White Tiger Habitat, a tropical environment featuring the exotic cats. The 20,000-gallon saltwater aquarium in the lobby features 1,000 coral reef creatures. The 100-foot atrium houses a tropical rainforest. The casino offers slot machines, poker tables, table games, a high-limit lounge, and a race and sports book.Live entertainment includes the new show LOVE by Cirque du Soleil.

Mirage is also home to Celebrity Impressionist/Singer/Comedian/Ventriloquist Terry Fator, and touring headline entertainers and the Beatles-themed Abbey Road Bar.

Image by Angelinas 
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First impressions of the Samsung Galaxy 5

Samsung Galaxy 5 reviews, The Samsung Galaxy S5 probably isn't the reinvention of the smartphone. But unlike last year's Galaxy S4, there's a good chance some of the new features announced could be of actual use to normal human beings.

Of course, a few minutes with the Galaxy S5 wasn't enough time to reach a full verdict on the phone, but it was enough to get a basic feel for what Samsung's (SSNLF) latest offering can and can't do.

Display

The 5.1 inch display has the same 1080p resolution as last year's 5-inch screen, but due to some new technology, it's definitely brighter, which at the very least, makes everything look nicer. And according to Samsung, the special technology which makes that screen brighter also improves performance in direct sunlight. At the expense of your battery, of course.

Fingerprint Scanner

Like the iPhone 5S, the fingerprint scanner is probably the most eye-catching of the new features, which adds an extra level of security and/or convenience to the device. While it does require you to swipe your whole finger pad over the sensor (unlike the iPhone, which simply lets you place it on the sensor), it worked smoothly the few times I was able to use it.

Power Saver

Battery life matters! Samsung put a slightly bigger battery in the Galaxy S5, but the more important thing was to offer up a useful power saver feature which lets you know what parts of the phone to turn off, and how much battery life that will gain you. It's most extreme mode will actually shut down LTE, cut you off from the vast majority of your apps, and turn the screen grey scale, apparently allowing it to last for days without a charge

Camera

Samsung's new phase detection auto-focus means that the camera is now capable of a nice blur effect in the background when you photograph an object up close. The shutter was reasonably fast with bright indoor light, though it did seem to have trouble handling a couple of weird lighting situations and slowed down considerably. How much the image quality has or hasn't improved over the S4 is still to be determined, however.

Weatherproofing

There was no way to really test how worthy the water and dust-resistant features were (save for dumping a bottle of water on it?), but if the weatherproofing is half as good as Samsung claims it is, everyone wins.

Hardware Design

The hardware design of the phone isn't much better, or even different, than it has been in years' past. If you like it, you like it. (I don't.) The texture and material used on the back is much improved and makes the phone feel less cheap when you're holding it, but the colors to choose from are mildly depressing. And when it comes to size and pocketability, at this point, everyone should already know what they're getting into when they buy a 5-inch phone. The Galaxy S5 is big, but it's not completely unwieldy.

Software Design

Samsung's TouchWiz UI is back in its same fundamental form, but it does look better, visually speaking. Fonts and icons generally look cleaner, but everything is still organized in the same manner as past TouchWiz iterations. That said, it doesn't seem like a huge improvement over anything offered up by the likes of Google (GOOG, Fortune 500), Apple (AAPL, Fortune 500), Nokia (NOK), or even HTC. And Samsung still hasn't done much to improve the experience running two apps side-by-side.

Heart Rate Monitor

I mean, I guess it's cool Samsung put this on the phone? It doesn't detract from anything at all, but this sensor definitely seems more useful in its new Gear Fit wearable.

At the very least, many of the features included in the Galaxy S5 have more potential than the new features included in last year's model. To what extent that potential is realized will take a little more hands-on time however.

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Samsung launches Galaxy S5 smartphone

Samsung launches Galaxy S5 smartphone, Samsung unveiled the Galaxy S5 smartphone -- an improved, but not radically different, successor to last year's Galaxy S4.

Still, Samsung had a few tricks up its sleeve for its top-of-the-line Android phone. Samsung claims that the Galaxy S5 is weatherproof and resistant to water and dust. The phone's display can adapt to extreme bright and dim settings. The Galaxy S5 also has an on-board heart rate sensor and a fingerprint scanner on the home button.

Compared to last year's model, the Samsung Galaxy S5 has a bigger screen (5.1 inches), a faster processor (2 GHz) and a bigger battery. But none of those represent dramatic improvements. Its screen is 2% bigger, the processor is 5% faster and the battery is 8% larger than on the Galaxy S4.

One potentially big improvement is the camera, now with 16 megapixels, up from 13 a year ago. It can capture ultra-high defiition video and has an incredibly fast shutter -- capable of snapping photos in 1/3 of a second.

                                                                 Samsung S5

But there are a few tradeoffs. The Galaxy S5 is ever so slightly heavier (a half ounce), fatter and larger than its predecessor.

Last year's Galaxy S4 never lived up to its incredible hype, and sales were a disappointment. It's still the best-selling Android smartphone, but Samsung's reputation has taken a big hit after essentially tweaking the previous year's Galaxy S3 and calling it the next best thing. Samsung also drew criticism for adding numerous quirky but largely useless features to the Galaxy S4, including eye scrolling, finger hovering to preview items and video pausing when you take your eyes off the screen

This year, Samsung tried to dial down excitement about the newest edition. Forgoing the kind of splashy Radio City Music Hall launch event that it threw last year, it instead introduced the S5 at a much more subdued press conference at the Mobile World Congress trade show in Barcelona, Spain.

"With the Galaxy S5, Samsung is going back to basics to focus on delivering the capabilities that matter most to our consumers," said JK Shin, head of Samsung's mobile divison. "Consumers are looking for mobile tools that inspire and support them as they improve their everyday lives."

 As part of that "back to basics" approach, Samsung's new additions to the Galaxy S5 were mostly practical features.

Mimicking a feature that debuted on the Apple (AAPL, Fortune 500) iPhone 5S, Samsung's Galaxy S5 home button doubles as a fingerprint sensor. Unlike the iPhone, which allows its owner to simply touch the home button to unlock the screen, a Galaxy S5's owner has to swipe down on the reader. But it can be used for other applications as well, including authenticating payments made with eBay's (EBAY, Fortune 500) PayPal.

The pulse monitor sits at the back of the phone, next to the flash. Rest your finger on it, and the screen displays your heart rate. It also works in conjunction with Samsung's new Galaxy Gear 2 smartwatch and its corresponding fitness apps.

The battery got a nice improvement, but Samsung added some power-saving features as well. When the battery is about to die, Samsung will turn screen to black and white and shut down all unnecessary features, including most wireless communications.

Samsung says the Galaxy S5 is completely protected against dust, and can resist water up to 1 meter for up to 30 minutes. Those kind of features had previously been reserved for special, ruggedized phones, including Caterpillar's (CAT, Fortune 500) B15 smartphone and Samsung's Galaxy S4 "Active."

Perhaps the most useful feature is the Galaxy S5's display, which automatically adjusts its settings when indoors and outdoors -- not just the screen's brightness, as most phones do. The Galaxy S5 will change the color saturation and contrast too, so that it provides a legible picture when in direct sunlight.

Samsung said the Galaxy S5 would be available in April. 

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What Is Sleep Apnea?

What Is Sleep Apnea?, Sleep apnea (AP-ne-ah) 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 may occur 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. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep.

image : Obstructive sleep apnea. Sleeping during airway obstruction at the palate, tongue and epiglottis. Oxygen is labeled with blue arrows and carbon dioxide is labeled with yellow arrows. Note that oxygen cannot enter below the obstruction and likewise carbon dioxide cannot escape.

As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.
Overview

Sleep apnea often goes undiagnosed. Doctors usually can't detect the condition during routine office visits. Also, no blood test can help diagnose the condition.

Most people who have sleep apnea don't know they have it because it only occurs during sleep. A family member or bed partner might be the first to notice signs of sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea. In this condition, the airway collapses or becomes blocked during sleep. This causes shallow breathing or breathing pauses.

When you try to breathe, any air that squeezes past the blockage can cause loud snoring. Obstructive sleep apnea is more common in people who are overweight, but it can affect anyone. For example, small children who have enlarged tonsil tissues in their throats may have obstructive sleep apnea.

The animation below shows how obstructive sleep apnea occurs. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.

Central sleep apnea is a less common type of sleep apnea. This disorder occurs if the area of your brain that controls your breathing doesn't send the correct signals to your breathing muscles. As a result, you'll make no effort to breathe for brief periods.

Central sleep apnea can affect anyone. However, it's more common in people who have certain medical conditions or use certain medicines.

Central sleep apnea can occur with obstructive sleep apnea or alone. Snoring typically doesn't happen with central sleep apnea.

This article mainly focuses on obstructive sleep apnea.
Outlook

Untreated sleep apnea can:

Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetesexternal link icon

Increase the risk of, or worsen, heart failure
Make arrhythmias (ah-RITH-me-ahs), or irregular heartbeats, more likely
Increase the chance of having work-related or driving accidents

Sleep apnea is a chronic condition that requires long-term management. Lifestyle changes, mouthpieces, surgery, and breathing devices can successfully treat sleep apnea in many people.

Other Names for Sleep Apnea

Central sleep apnea
Obstructive sleep apnea
Sleep-disordered breathing

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All about Sleep apnea

Sleep apnea (or sleep apnoea in British English; /æpˈniːə/) is a type of sleep disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep. Each pause in breathing, called an apnea, can last from at least ten seconds to several minutes, and may occur 5 to 30 times or more an hour. Similarly, each abnormally shallow breathing event is called a hypopnea. Sleep apnea is often diagnosed with an overnight sleep test called a polysomnogram, or "sleep study".

                                                    Obstructive sleep apnea

There are three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively. In CSA, breathing is interrupted by a lack of respiratory effort; in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common.

Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body (sequelae). Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

Sleep apnea affects not only adults but some children as well.As stated by El-Ad, "patients complain about excessive daytime sleepiness (EDS) and impaired alertness".In other words, common effects of sleep apnea include daytime fatigue, a slower reaction time, and vision problems. Moreover, patients are examined using “standard test batteries” in order to further identify parts of the brain that are affected by sleep apnea. Tests have shown that certain parts of the brain cause different effects. The “executive functioning” part of the brain affects the way the patient plans and initiates tasks.Second, the part of the brain that deals with attention causes difficulty in paying attention, working effectively and processing information when in a waking state.Thirdly, the part of the brain that uses memory and learning is also affected.Due to the disruption in daytime cognitive state, behavioral effects are also present. This includes moodiness, belligerence, as well as a decrease in attentiveness and drive.Another symptom of sleep apnea is waking up in sleep paralysis. In severe cases, the fear of sleep due to sleep paralysis can lead to insomnia. These effects become very hard to deal with, thus the development of depression may transpire.There is also increasing evidence that sleep apnea may also lead to liver function impairment, particularly fatty liver diseases (see steatosis).Finally, because there are many factors that could lead to some of the effects previously listed, some patients are not aware that they suffer from sleep apnea and are either misdiagnosed, or just ignore the symptoms altogether.

Sleep apnea Diagnosis

The diagnosis of sleep apnea is based on the conjoint evaluation of clinical symptoms (e.g. excessive daytime sleepiness and fatigue) and of the results of a formal sleep study (polysomnography, or reduced channels home based test). The latter aims at establishing an "objective" diagnosis indicator linked to the quantity of apneic events per hour of sleep (Apnea Hypopnea Index(AHI), or Respiratory Disturbance Index (RDI)), associated to a formal threshold, above which a patient is considered as suffering from sleep apnea, and the severity of their sleep apnea can then be quantified. Mild OSA (Obstructive Sleep Apneas) ranges from 5 to 14.9 events per hour of sleep, moderate OSA falls in the range of 15–29.9 events per hour of sleep, and severe OSA would be a patient having over 30 events per hour of sleep.

Nevertheless, due to the number and variability in the actual symptoms and nature of apneic events (e.g., hypopnea vs apnea, central vs obstructive), the variability of patients' physiologies, and the intrinsic imperfections of the experimental setups and methods, this field is opened to debate. Within this context, the definition of an apneic event depends on several factors (e.g. patient's age) and account for this variability through a multi-criteria decision rule described in several, sometimes conflicting, guidelines.One example of a commonly adopted definition of an apnea (for an adult) includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2) or a blood oxygen desaturation of 3–4% or greater, or both arousal and desaturation.

Oximetry

Oximetry, which may be performed overnight in a patient's home, is an easier alternative to formal sleep study (polysomnography). In one study, normal overnight oximetry was very sensitive and so if normal, sleep apnea was unlikely.In addition, home oximetry may be equally effective in guiding prescription for automatically self-adjusting continuous positive airway pressure.

Sleep apnea Classification

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is the most common category of sleep-disordered breathing. The muscle tone of the body ordinarily relaxes during sleep, and at the level of the throat the human airway is composed of collapsible walls of soft tissue which can obstruct breathing during sleep. Mild occasional sleep apnea, such as many people experience during an upper respiratory infection, may not be important, but chronic severe obstructive sleep apnea requires treatment to prevent low blood oxygen (hypoxemia), sleep deprivation, and other complications.

Individuals with low muscle tone and soft tissue around the airway (e.g., because of obesity) and structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea. The elderly are more likely to have OSA than young people. Men are more likely to suffer sleep apnea than women and children are, though it is not uncommon in the last two population groups.

The risk of OSA rises with increasing body weight, active smoking and age. In addition, patients with diabetes or "borderline" diabetes have up to three times the risk of having OSA.

Common symptoms include loud snoring, restless sleep, and sleepiness during the daytime. Diagnostic tests include home oximetry or polysomnography in a sleep clinic.

Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking. Many people benefit from sleeping at a 30-degree elevation of the upper body or higher, as if in a recliner. Doing so helps prevent the gravitational collapse of the airway. Lateral positions (sleeping on a side), as opposed to supine positions (sleeping on the back), are also recommended as a treatment for sleep apnea,largely because the gravitational component is smaller in the lateral position. Some people benefit from various kinds of oral appliances to keep the airway open during sleep. Continuous positive airway pressure (CPAP) is the most effective treatment for severe obstructive sleep apnea but oral appliances are considered a first line approach equal to CPAP for mild to moderate sleep apnea according to the AASM parameters of care. There are also surgical procedures to remove and tighten tissue and widen the airway.

Snoring is a common finding in people with this syndrome. Snoring is the turbulent sound of air moving through the back of the mouth, nose, and throat. Although not everyone who snores is experiencing difficulty breathing, snoring in combination with other conditions such as overweight and obesity has been found to be highly predictive of OSA risk.The loudness of the snoring is not indicative of the severity of obstruction, however. If the upper airways are tremendously obstructed, there may not be enough air movement to make much sound. Even the loudest snoring does not mean that an individual has sleep apnea syndrome. The sign that is most suggestive of sleep apneas occurs when snoring stops.

Other indicators include (but are not limited to): hypersomnolence, obesity BMI >30, large neck circumference (16 in (410 mm) in women, 17 in (430 mm) in men), enlarged tonsils and large tongue volume, micrognathia, morning headaches, irritability/mood-swings/depression, learning and/or memory difficulties, and sexual dysfunction.

The term "sleep-disordered breathing" is commonly used in the U.S. to describe the full range of breathing problems during sleep in which not enough air reaches the lungs (hypopnea and apnea). Sleep-disordered breathing is associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep deprived driving accidents.When high blood pressure is caused by OSA, it is distinctive in that, unlike most cases of high blood pressure (so-called essential hypertension), the readings do not drop significantly when the individual is sleeping. Stroke is associated with obstructive sleep apnea.

It has been revealed that people with OSA show tissue loss in brain regions that help store memory, thus linking OSA with memory loss.Using magnetic resonance imaging (MRI), the scientists discovered that sleep apnea patients' mammillary bodies were nearly 20 percent smaller, particularly on the left side. One of the key investigators hypothesized that repeated drops in oxygen lead to the brain injury.

Central sleep apnea

In pure central sleep apnea or Cheyne–Stokes respiration, the brain's respiratory control centers are imbalanced during sleep. Blood levels of carbon dioxide, and the neurological feedback mechanism that monitors them, do not react quickly enough to maintain an even respiratory rate, with the entire system cycling between apnea and hyperpnea, even during wakefulness. The sleeper stops breathing and then starts again. There is no effort made to breathe during the pause in breathing: there are no chest movements and no struggling. After the episode of apnea, breathing may be faster (hyperpnea) for a period of time, a compensatory mechanism to blow off retained waste gases and absorb more oxygen.

While sleeping, a normal individual is "at rest" as far as cardiovascular workload is concerned. Breathing is regular in a healthy person during sleep, and oxygen levels and carbon dioxide levels in the bloodstream stay fairly constant. The respiratory drive is so strong that even conscious efforts to hold one's breath do not overcome it. Any sudden drop in oxygen or excess of carbon dioxide (even if tiny) strongly stimulates the brain's respiratory centers to breathe.

In central sleep apnea, the basic neurological controls for breathing rate malfunction and fail to give the signal to inhale, causing the individual to miss one or more cycles of breathing. If the pause in breathing is long enough, the percentage of oxygen in the circulation will drop to a lower than normal level (hypoxaemia) and the concentration of carbon dioxide will build to a higher than normal level (hypercapnia). In turn, these conditions of hypoxia and hypercapnia will trigger additional effects on the body. Brain cells need constant oxygen to live, and if the level of blood oxygen goes low enough for long enough, the consequences of brain damage and even death will occur. Fortunately, central sleep apnea is more often a chronic condition that causes much milder effects than sudden death. The exact effects of the condition will depend on how severe the apnea is and on the individual characteristics of the person having the apnea. Several examples are discussed below, and more about the nature of the condition is presented in the section on Clinical Details.

In any person, hypoxia and hypercapnia have certain common effects on the body. The heart rate will increase, unless there are such severe co-existing problems with the heart muscle itself or the autonomic nervous system that makes this compensatory increase impossible. The more translucent areas of the body will show a bluish or dusky cast from cyanosis, which is the change in hue that occurs owing to lack of oxygen in the blood ("turning blue"). Overdoses of drugs that are respiratory depressants (such as heroin, and other opiates) kill by damping the activity of the brain's respiratory control centers. In central sleep apnea, the effects of sleep alone can remove the brain's mandate for the body to breathe.

    Normal Respiratory Drive: After exhalation, the blood level of oxygen decreases and that of carbon dioxide increases. Exchange of gases with a lungful of fresh air is necessary to replenish oxygen and rid the bloodstream of built-up carbon dioxide. Oxygen and carbon dioxide receptors in the blood stream (called chemoreceptors) send nerve impulses to the brain, which then signals reflex opening of the larynx (so that the opening between the vocal cords enlarges) and movements of the rib cage muscles and diaphragm. These muscles expand the thorax (chest cavity) so that a partial vacuum is made within the lungs and air rushes in to fill it.
    Physiologic effects of central apnea: During central apneas, the central respiratory drive is absent, and the brain does not respond to changing blood levels of the respiratory gases. No breath is taken despite the normal signals to inhale. The immediate effects of central sleep apnea on the body depend on how long the failure to breathe endures. At worst, central sleep apnea may cause sudden death. Short of death, drops in blood oxygen may trigger seizures, even in the absence of epilepsy. In people with epilepsy, the hypoxia caused by apnea may trigger seizures that had previously been well controlled by medications.[verification needed] In other words, a seizure disorder may become unstable in the presence of sleep apnea. In adults with coronary artery disease, a severe drop in blood oxygen level can cause angina, arrhythmias, or heart attacks (myocardial infarction). Longstanding recurrent episodes of apnea, over months and years, may cause an increase in carbon dioxide levels that can change the pH of the blood enough to cause a metabolic acidosis.

Mixed apnea and complex sleep apnea

Some people with sleep apnea have a combination of both types. When obstructive sleep apnea syndrome is severe and longstanding, episodes of central apnea sometimes develop. The exact mechanism of the loss of central respiratory drive during sleep in OSA is unknown but is most commonly related to acid–base and CO2 feedback malfunctions stemming from heart failure. There is a constellation of diseases and symptoms relating to body mass, cardiovascular, respiratory, and occasionally, neurological dysfunction that have a synergistic effect in sleep-disordered breathing. In some cases, a side effect from the lack of sleep is a mild case of Excessive Daytime Sleepiness (EDS) where the subject has had minimal sleep and this extreme fatigue over time takes its toll on the subject. The presence of central sleep apnea without an obstructive component is a common result of chronic opiate use (or abuse) owing to the characteristic respiratory depression caused by large doses of narcotics.

Complex sleep apnea has recently been described by researchers as a novel presentation of sleep apnea.[dubious – discuss] Patients with complex sleep apnea exhibit OSA, but upon application of positive airway pressure the patient exhibits persistent central sleep apnea. This central apnea is most commonly noted while on CPAP therapy after the obstructive component has been eliminated. This has long been seen in sleep laboratories and has historically been managed either by CPAP or BiLevel therapy. Adaptive servo-ventilation (ASV) modes of therapy have been introduced to attempt to manage this complex sleep apnea. Studies have demonstrated marginally superior performance of the adaptive servo ventilators in treating Cheyne–Stokes breathing; however, no longitudinal studies have yet been published, nor have any results been generated that suggest any differential outcomes versus standard CPAP therapy. At the AARC 2006 in Las Vegas, NV, researchers reported successful treatment of hundreds of patients on ASV therapy; however, these results have not been reported in peer-reviewed publications as of July 2007.

It is suggested that transient central apnea produced during CPAP titration (the so-called "complex sleep apnea") is "…transient and self-limited."The central apneas may in fact be secondary to sleep fragmentation during the titration process. As of July 2007, there has been no alternate convincing evidence produced that these central sleep apnea events associated with CPAP therapy for obstructive sleep apnea are of any significant pathophysiologic importance.

It has been proposed to add dead space to positive airway pressure for treatment of complex sleep-disordered breathing.
Treatment

Treatment often starts with behavioral therapy. Many patients are told to avoid alcohol, sleeping pills, and other sedatives, which can relax throat muscles, contributing to the collapse of the airway at night.As sleep apnea is inherently worse in the supine position for many patients (positional sleep apnea), sleeping on one's side is often advised.

Possibly owing to changes in pulmonary oxygen stores, sleeping on one's side (as opposed to on one's back) has been found to be helpful for central sleep apnea with Cheyne–Stokes respiration.

Continuous positive airway pressure

For moderate to severe sleep apnea, the most common treatment is the use of a continuous positive airway pressure (CPAP) or automatic positive airway pressure (APAP) device which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat. The patient typically wears a plastic facial mask, which is connected by a flexible tube to a small bedside CPAP machine.The CPAP machine generates the required air pressure to keep the patient's airways open during sleep. While pure CPAP machines require one to input a desired pressure (usually determined in an overnight sleep study), an APAP machine will automatically titrate the air pressure as needed to minimize apneas and hypopneas. Advanced models may warm or humidify the air and monitor the patient's breathing to ensure proper treatment.

Although CPAP therapy is extremely effective in reducing apneas and less expensive than other treatments, some patients find it extremely uncomfortable. Many patients refuse to continue the therapy or fail to use their CPAP machines on a nightly basis, especially in the long term.One way to ensure CPAP therapy remains comfortable and effective for patients is to carefully consider the right CPAP face mask to be used. CPAP masks come in different shapes, sizes and materials to ensure effective treatment for obstructive sleep apnea. It is important to select the right mask to fit each patient.

It is not clear that CPAP reduces hypertension or cardiovascular events in patients who do not have daytime sleepiness; however, the lack of benefit may be partly due to noncompliance with therapy.

Sleep apnea medications

There is limited evidence for medication but acetazolamide "may be considered" for the treatment of central sleep apnea; it also found that zolpidem and triazolam may be considered for the treatment of central sleep apnea, but "only if the patient does not have underlying risk factors for respiratory depression".Low doses of oxygen are also used as a treatment for hypoxia but are discouraged due to side effects.
Oral appliances

General dentists can fabricate an oral appliance. The oral appliance, called a mandibular advancement splint, is a custom-made mouthpiece that shifts the lower jaw forward and opens the bite slightly, which opens up the airway. Oral appliance therapy (OAT) is usually successful in patients with mild to moderate obstructive sleep apnea.OAT is a relatively new treatment option for sleep apnea in the United States, but it is much more common in Canada and Europe.

Sleep apnea Surgery

Several surgical procedures (sleep surgery) are used to treat sleep apnea, although they are normally a second line of treatment for those who reject CPAP treatment or are not helped by it. Surgical treatment for obstructive sleep apnea needs to be individualized to address all anatomical areas of obstruction. Often, correction of the nasal passages needs to be performed in addition to correction of the oropharynx passage. Septoplasty and turbinate surgery may improve the nasal airway. Tonsillectomy and uvulopalatopharyngoplasty (UPPP or UP3) are available to address pharyngeal obstruction. Base-of-tongue advancement by means of advancing the genial tubercle of the mandible may help with the lower pharynx. Many other treatments are available, including hyoid bone myotomy and suspension and various radiofrequency

Other surgery options may attempt to shrink or stiffen excess tissue in the mouth or throat; procedures done at either a doctor's office or a hospital. Small shots or other treatments, sometimes in a series, are used for shrinkage, while the insertion of a small piece of stiff plastic is used in the case of surgery whose goal is to stiffen tissues.

The Pillar Procedure is a minimally invasive treatment for snoring and obstructive sleep apnea. This procedure was FDA indicated in 2004. During this procedure, three to six or more Dacron (the material used in permanent sutures) strips are inserted into the soft palate, using a modified syringe and local anesthetic. While the procedure was initially approved for the insertion of three "pillars" into the soft palate, it was found that there was a significant dosage response to more pillars, with appropriate candidates. After this brief and virtually painless outpatient operation, which usually lasts no more than 30 minutes, the soft palate is more rigid and snoring and sleep apnea can be reduced. This procedure addresses one of the most common causes of snoring and sleep apnea — vibration or collapse of the soft palate (the soft part of the roof of the mouth). If there are other factors contributing to snoring or sleep apnea, such as the nasal airway or an enlarged tongue, it will likely need to be combined with other treatments to be more effective.

The Stanford Center for Excellence in Sleep Disorders Medicine achieved a 95% cure rate of sleep apnea patients by surgery.Maxillomandibular advancement (MMA) is considered the most effective surgery for sleep apnea patients,because it increases the posterior airway space (PAS). The main benefit of the operation is that the oxygen saturation in the arterial blood increases. In a study published in 2008, 93.3.% of surgery patients achieved an adequate quality of life based on the Functional Outcomes of Sleep Questionnaire (FOSQ).Surgery led to a significant increase in general productivity, social outcome, activity level, vigilance, intimacy, and intercourse.Overall risks of MMA surgery are low: The Stanford University Sleep Disorders Center found 4 failures in a series of 177 patients, or about one out of 44 patients. However, health professionals are often unsure as to who should be referred for surgery and when to do so: some factors in referral may include failed use of CPAP or device use; anatomy which favors rather than impeding surgery; or significant craniofacial abnormalities which hinder device use.Maxillomandibular advancement surgery is often combined with Genioglossus Advancement, as both are skeletal surgeries for sleep apnea.

Several inpatient and outpatient procedures use sedation. Many drugs and agents used during surgery to relieve pain and to depress consciousness remain in the body at low amounts for hours or even days afterwards. In an individual with either central, obstructive or mixed sleep apnea, these low doses may be enough to cause life-threatening irregularities in breathing or collapses in a patient’s airways.Use of analgesics and sedatives in these patients postoperatively should therefore be minimized or avoided.

Surgery on the mouth and throat, as well as dental surgery and procedures, can result in postoperative swelling of the lining of the mouth and other areas that affect the airway. Even when the surgical procedure is designed to improve the airway, such as tonsillectomy and adenoidectomy or tongue reduction, swelling may negate some of the effects in the immediate postoperative period. Once the swelling resolves and the palate becomes tightened by postoperative scarring, however, the full benefit of the surgery may be noticed.

A sleep apnea patient undergoing any medical treatment must make sure his or her doctor and anesthetist are informed about the sleep apnea. Alternative and emergency procedures may be necessary to maintain the airway of sleep apnea patients.If an individual suspects he or she may have sleep apnea, communication with their doctor about possible preprocedure screening may be in order.
Alternative treatments

Other studies have also suggested that strengthening the muscles around the upper airway may combat sleep apnea. A 2001 study investigated changes after Tongue Muscle Training (ZMT®) in respiratory parameters during night-time sleep of patients with increased respiratory disease index. 40 sleep apnea patients, which up to this time had been treated with nCPAP, underwent electrostimulation of the suprahyoidal musculature for 5 weeks with a special EMS-device. The apnea, hypopnea and desaturation indexes were reduced in 26 of the 40 patients (65%) by an average of approximately one half.A 2005 study in the British Medical Journal found that learning and practicing the didgeridoo helped reduce snoring and sleep apnea as well as daytime sleepiness. This appears to work by strengthening muscles in the upper airway, thus reducing their tendency to collapse during sleep. A 2009 study published in the American Journal of Respiratory and Clinical Care Medicine found that patients who practiced a series of tongue and throat exercises for 30 minutes a day showed a marked decline in sleep apnea symptoms after three months. Patients experienced an average of 39% fewer apnea episodes after successfully completing the treatments.

Cannabis derivatives have also been studied in the treatment of sleep apnea. A 2002 study found that orally administered THC was able to stabilize respiration in rats and bulldogs during all sleep stages, decreasing apnea indexes during NREM and REM sleep stages by 42% and 58% respectively.A 2013 proof of concept trial found that dronabinol (synthetic THC) was able to reduce apnea indexes by 32% on average in the 17 human subjects that were studied.Lead study author Dr. David Carley subsequently received a $5 million grant from the National Institutes of Health (NIH) to conduct a Phase II clinical trial.
Epidemiology

The Wisconsin Sleep Cohort Study estimated in 1993 that roughly one in every 15 Americans was affected by at least moderate sleep apnea.It also estimated that in middle-age as many as nine percent of women and 24 percent of men were affected, undiagnosed and untreated.

The costs of untreated sleep apnea reach further than just health issues. It is estimated that in the U.S. the average untreated sleep apnea patient's annual health care costs $1,336 more than an individual without sleep apnea. This may cause $3.4 billion/year in additional medical costs. Whether medical cost savings occur with treatment of sleep apnea remains to be determined.

Prognosis

A 2012 study has shown that hypoxia (an inadequate supply of oxygen) that characterizes sleep apnea promotes angiogenesis which increase vascular and tumor growth, which in turn results in a 4.8 times higher incidence of cancer mortality.

Sleep apnea History

The clinical picture of this condition has long been recognized as a character trait, without an understanding of the disease process. The term "Pickwickian syndrome" that is sometimes used for the syndrome was coined by the famous early 20th century physician, William Osler, who must have been a reader of Charles Dickens. The description of Joe, "the fat boy" in Dickens's novel The Pickwick Papers, is an accurate clinical picture of an adult with obstructive sleep apnea syndrome.

The early reports of obstructive sleep apnea in the medical literature described individuals who were very severely affected, often presenting with severe hypoxemia, hypercapnia and congestive heart failure.

The management of obstructive sleep apnea was revolutionized with the introduction of continuous positive airway pressure (CPAP), first described in 1981 by Colin Sullivan and associates in Sydney, Australia. The first models were bulky and noisy, but the design was rapidly improved and by the late 1980s CPAP was widely adopted. The availability of an effective treatment stimulated an aggressive search for affected individuals and led to the establishment of hundreds of specialized clinics dedicated to the diagnosis and treatment of sleep disorders. Though many types of sleep problems are recognized, the vast majority of patients attending these centers have sleep-disordered breathing.

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Family sues Petco afterwards boy dies from "rat-bite fever"

A San Diego ancestors is suing Petco afterwards the afterlife of their 10-year-old son from a bacterial infection they say he apprenticed from his pet rat.

Attorney John Gomez told The Associated Press on Tuesday that his close filed the accusation Monday in San Diego County gluttonous an bearding bulk for the adversity endured by the Pankey family, whose son, Aidan, died June 12, 2013, hours afterwards he was rushed to the hospital with astringent abdomen pains.

The San Diego County Medical Examiner's Office disqualified that the account of afterlife was streptobacillus moniliformis infection, frequently accepted as rat-bite fever, afterwards acknowledgment to an adulterated rat.

The banker in a account bidding its condolences.

"We are acutely afflicted by the Pankey family's adverse loss," Petco said in a statement. "The bloom and assurance of bodies and pets is consistently a top priority, and we booty the family's apropos actual seriously."

The boy's grandmother purchased the man rat, which Aidan called Alex, because her alone grandson capital a acquaintance for his changeable pet rat, Gomez said. The boy took the rat home May 27, 2013, and woke up the night of June 11 in astringent affliction with a agitation and abdomen problems. He was pale, apathetic and could almost walk, according to the lawsuit. He died at 1:09 a.m. the abutting day.

"He was a bright, energetic, friendly, blessed kid who absolutely had a above-mentioned rat, who was a female, and he had this abstraction in his adolescent arch of accepting his changeable rat get married," Gomez said.

The accusation was not filed until now because attorneys were apprehension the lab after-effects from the federal Centers for Ache Control, which activated the rat to affirm it was infected, Gomez said. The bureau could not anon affirm the after-effects Tuesday.

Gomez said the Pankey ancestors was not giving interviews, but they are devastated by the afterlife of their alone son and appetite to accession acquaintance amid parents.

"It's a bureau to ensure this doesn't appear again," Gomez said of the lawsuit. "Apparently there was some breakdown in procedures. They appetite tighter controls."

According to the lawsuit, the rat appeared safe. But the accusation says Petco should accept accepted about the rodent's bloom and did not abundantly analysis for the disease. It additionally says that apathy led to the boy's death, which has acquired his parents, Andrew Pankey and Vanessa Sauer, affecting and bread-and-butter hardship, and that the banker did not column able warnings about the abeyant risks, abnormally for children.

Petco Beastly Supplies Inc. said it is "in the action of investigating these claims and will acknowledge appropriately back we accept added information."

According to the CDC, bodies can arrangement rat-bite agitation from bites or scratches from adulterated rodents, such as rats, mice and gerbils, or alike aloof by administration an beastly with the ache afterwards a chaw or scratch. It can additionally be apprenticed by arresting aliment or alcohol attenuated with the bacteria. It is not advance from actuality to person.

Antibiotics, such as penicillin, are awful able at alleviative rat-bite fever, and it is rarely fatal, according to the CDC.

The CDC says those at college accident of application the affliction are bodies with pet rats or who assignment with rats in laboratories or pet stores, or alive in rat-infested buildings. The bureau recommends that bodies who handle rats or apple-pie their cages abrasion careful gloves, ablution their easily consistently and abstain affecting their mouths with their easily afterwards actuality in acquaintance with rodents.

Petco additionally mentions bactericide measures for rat-bite agitation in advice it posts online and provides in stores. The aggregation warns that all rats are abeyant carriers and that abundant women, accouchement beneath the age of 5 and bodies with attenuated allowed systems should acquaintance their doctor afore affairs a rat and "should accede not accepting a rat as a pet."

Only about 200 cases of rat-bite agitation had been accurate in the United States as of 2004, according to the Center for Aliment Security and Public Bloom at Iowa State University. Scientists accept the ache may be underdiagnosed because it is adamantine to ascertain and responds to frequently acclimated antibiotics. But the cardinal of cases, they say, may be increasing, abnormally amid children, with the growing acceptance of rats as pets.

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