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Posts Tagged ‘OSA’

Sleep Apnea Can Worsen Blood Sugar Control in People with Type 2 Diabetes

April 2nd, 2014 Raquel Rothe

Researchers at the University of Chicago found that sleep apnea can worsen blood sugar control in people with Type 2 diabetes.

The findings provide another good reason for people with sleep apnea to wear a CPAP mask that helps assure uninterrupted breathing, the standard treatment for the condition, throughout the night. It is well known that sleep apnea, which causes breathing pauses and dangerous drops in oxygen during sleep, sharply raises the risk of Type 2 diabetes. More severe cases of sleep apnea are generally associated with poorer blood sugar control in diabetics

As originally reported on the American Diabetes Association web site (and published in Diabetes Care), disruption during the REM phase of sleep had the most detrimental effects on long-term blood sugar control. The problem, says Dr. Babak Mokhlesi, an author of the study “Association of Obstructive Sleep Apnea in Rapid Eye Movement Sleep with Reduced Glycemic Control in Type 2 Diabetes: Therapeutic Implications”, is that most REM sleep occurs in the early morning hours before waking, at a time when many patients remove their CPAP mask.

“In type 2 diabetes, OSA during REM sleep may influence long-term glycemic control,” writes Mokhlesi, director of the sleep disorders center at the University of Chicago, in the study’s abstract. “The metabolic benefits of CPAP therapy may not be achieved with the typical adherence of 4 h per night.”

http://www.sleepdt.com/sleep-apnea-can-worsen-blood-sugar-control-in-people-with-type-2-diabetes/

Sleep apnea may hold hidden dangers for women

March 12th, 2014 Raquel Rothe

Sleep apnea may hold hidden dangers for women

Monday 28 October 2013 – 3am PST

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Sleep apnea may hold hidden dangers for women

A new study on sleep apnea reveals there could be some hidden dangers – particularly for women who have the condition – where breathing is interrupted during sleep. Women with sleep apnea may appear healthy, but they have subtle symptoms so their sleep problem is often misdiagnosed.

Now, new research, led by the University of California Los Angeles (UCLA) School of Nursing, shows that the body’s autonomic responses, which normally control blood pressure, heart rate, sweating and other basic functions, are not as strong in people with obstructive sleep apnea, and even less so in women.

Obstructive sleep apnea is a serious condition that happens when the person is asleep, sometimes hundreds of times a night. When it occurs, blood oxygen drops and eventually damages many cells of the body.

There are over 20 million adult Americans living with the condition, note the researchers, who explain that it is linked with several serious health problems and also early death.

Women are much less likely to be diagnosed with obstructive sleep apnea than men.

Lead researcher Dr. Paul Macey says:

“We now know that sleep apnea is a precursor to bigger health issues. And for women in particular, the results could be deadly.”

Early detection and intervention needed

Dr. Macey and his colleagues describe their work in a recent online issue of PLOS ONE.

For their study, the team recruited 94 adult men and women, comprising 37 newly diagnosed, untreated obstructive sleep (OSA) patients and 57 healthy volunteers to act as controls.

The three groups had their heart rates measured as they went through three different physical challenges:

  • The Valsalva maneuver – where they had to breathe out hard while keeping the mouth closed
  • A hand-grip challenge – where they had to just squeeze hard with one hand
  • A cold pressor challenge – where the right foot is inserted into near-freezing water for a minute.

The team notes the main results:

“Heart rate responses showed lower amplitude, delayed onset and slower rate changes in OSA patients over healthy controls, and impairments may be more pronounced in females.”

Dr. Macey adds:

“This may mean that women are more likely to develop symptoms of heart disease, as well as other consequences of poor adaptation to daily physical tasks. Early detection and treatment may be needed to protect against damage to the brain and other organs.”

The team now intends to investigate if the usual treatments for OSA, such as continuous positive airway pressure (CPAP), help to improve the autonomic responses.

CPAP is where a machine helps the OSA patient breathe more easily while asleep.

Funds from the National Institutes of Health and the National Institute of Nursing Research helped finance the study.

In another study published recently, researchers from Brigham and Women’s Hospital in Boston, MA, found that sleep apnea is linked to early sign of heart failure.

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American Academy of Sleep Medicine Statement on the Use of Provigil

August 15th, 2012 Raquel Rothe

American Academy of Sleep Medicine Statement on the Use of Provigil



American Academy of Sleep Medicine
Thursday, July 19, 2012

FOR IMMEDIATE RELEASE
CONTACT: Thomas Heffron, 630-737-9700, ext. 9327 – theffron@aasmnet.org

DARIEN, IL – July 19, 2012 – A segment on the newsmagazine show Nightline reported people taking the prescription medication Provigil as a “smart drug,” to maintain wakefulness and promote cognitive enhancement.  The American Academy of Sleep Medicine (AASM) emphasizes that Provigil should be used only under the supervision of a doctor for the treatment of excessive sleepiness caused by narcolepsy, obstructive sleep apnea or shift work disorder.  Provigil is a schedule IV controlled substance that carries risk for abuse and dependence.

Provigil, which comprises the drug modafinil, is a stimulant that originally received FDA approval in 1998.  A variation of the medication, marketed as Nuvigil and composed of armodafinil, was approved by the FDA in 2007.

Both drugs are approved only for the treatment of three sleep disorders that compromise daytime alertness.  Provigil should not be prescribed off-label or purchased independently by consumers for cognitive or performance enhancement. There is little evidence to support the use of Provigil or any other drug to improve learning and memory, and no medication provides such benefits without side effects.

Potential side effects from taking Provigil include headache, upset stomach and dizziness.  Although much less common, more serious side effects may occur, including severe rash or allergic reaction affecting the liver or blood cells.

It is important for patients to take Provigil under the supervision of a licensed physician who knows their medical history and has record of other medications that they are taking.

According to the AASM, getting a sufficient amount of nightly sleep is the safest and healthiest way to promote optimal mental and physical performance during the day.  Although individual sleep needs vary, most adults need about seven to eight hours of nightly sleep to feel alert and well-rested during the day.

About Provigil and Sleep Disorders

Provigil is approved by the FDA for the treatment of excessive daytime sleepiness related to narcolepsy, shift work disorder and obstructive sleep apnea.  Narcolepsy is a form of hypersomnia that commonly involves the sudden onset of irresistible sleep, and shift work sleep disorder is a circadian rhythm sleep disorder that occurs due to a work schedule that takes place during the normal sleep period.

Obstructive sleep apnea is a sleep-related breathing disorder that involves repeated breathing pauses during sleep; these disruptions impair sleep quality and promote daytime sleepiness.  The primary treatment for OSA is continuous positive airway pressure (CPAP) therapy, which restores normal breathing during sleep.  Provigil is not a replacement for CPAP or any other treatment prescribed for OSA.

About the AASM

The AASM is a professional membership society that is the leader in setting standards and promoting excellence in sleep medicine health care, education and research (www.aasmnet.org).

Words to expand your sleep vocabulary-#8

June 22nd, 2011 Raquel Rothe

Macroglossia

Macroglossia refers to an abnormally large tongue that may obstruct the airway and lead to sleep apnea. In children, macroglossia may be associated with Down’s syndrome, glycogen storage disease, or congenital hypothyroidism.

5 Ways to Live With Your CPAP Machine Adjusting to CPAP can help people with sleep apnea sleep better. Here’s how to do it.

May 2nd, 2011 Raquel Rothe

Focus on the health benefits of your CPAP.   Adjusting to CPAP can make your sleep — and life – better, especially if you have severe sleep apnea. Read on to get sleep specialists’ top five tips on how you can make peace with the device.

http://www.webmd.com/sleep-disorders/sleep-apnea/features/cpap-machine?ecd=wnl_slw_021011

Sleep disorders: How many hours of sleep do you get on average?

March 24th, 2011 Raquel Rothe

Sex and sleep-Sexsomnia

February 12th, 2011 admin

ADVANCE Perspective: SLEEP

Published June 24, 2010 12:33 PM by Vern Enge

In your sleep lab on a daily basis, you are probably most comfortable detecting obstructive sleep apnea, restless legs syndrome, and parasomnias like sleepwalking and sleep eating.
You are an expert at titrating CPAP equipment to make sure your patients can get a good night’s sleep.

But how comfortable are you at discussing embarrassing topics like sleep sex, a.k.a. sexsomnia? This is a sleep disorder possibly more common than one might expect. One study earlier this year found 7.6 percent of 832 respondents in one sleep clinic survey admitted they had initiated sexual activity with a partner while asleep and had no recollection of it. They discovered their involuntary actions only when told by their bed partners.

Three of four people self-reporting sleep sex are males, according to health reporter Jenifer Goodwin.

Having sex while asleep is listed as a common complaint of patients

Sleep disorders and work performance-Abstract

November 5th, 2010 admin

J Sleep Res. 2010 Sep 30. doi: 10.1111/j.1365-2869.2010.00890.x. [Epub ahead of print]
Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll.
Swanson LM, Arnedt JT, Rosekind MR, Belenky G, Balkin TJ, Drake C.

Department of Psychiatry, University of Michigan, Ann Arbor, MI Alertness Solutions, Cupertino, CA Sleep Performance Research Center, Washington State University, WA Department of Behavioral Biology, Walter Reed Institute of Research, Silver Spring, MD Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI, USA.
Abstract
Chronic sleep deprivation is common among workers, and has been associated with negative work outcomes, including absenteeism and occupational accidents. The objective of the present study is to characterize reciprocal relationships between sleep and work. Specifically, we examined how sleep impacts work performance and how work affects sleep in individuals not at-risk for a sleep disorder; assessed work performance outcomes for individuals at-risk for sleep disorders, including insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS); and characterized work performance impairments in shift workers (SW) at-risk for shift work sleep disorders relative to SW and day workers. One-thousand Americans who work 30 h per week or more were asked questions about employment, work performance and sleep in the National Sleep Foundation’s 2008 Sleep in America telephone poll. Long work hours were associated with shorter sleep times, and shorter sleep times were associated with more work impairments. Thirty-seven percent of respondents were classified as at-risk for any sleep disorder. These individuals had more negative work outcomes as compared with those not at-risk for a sleep disorder. Presenteeism was a significant problem for individuals with insomnia symptoms, OSA and RLS as compared with respondents not at-risk. These results suggest that long work hours may contribute to chronic sleep loss, which may in turn result in work impairment. Risk for sleep disorders substantially increases the likelihood of negative work outcomes, including occupational accidents, absenteeism and presenteeism.

© 2010 European Sleep Research Societ

Snoring in Kids Linked to Poor Academics

October 7th, 2010 admin

Sleep Well
with Michael Breus, PhD, ABSM
Sleep disorders include a range of problems — from insomnia to narcolepsy — and affect millions of Americans. Dr. Michael Breus shares information and advice on sleep disorder and insomnia treatments and causes.
Tuesday, September 7, 2010
Snoring in Kids Linked to Poor Academics

Jupiterimages
A recent observation made in Australia could have significant meaning in the United States: Children who snore and have a bad night’s sleep could be lowering their IQ.
The domino effect goes something like this:
A child has trouble breathing at night, which explains the snoring and sparks a bad night’s sleep.
The labored breathing ultimately leads to a lack of oxygen.
A bad night’s sleep translates to being constantly tired and unable to concentrate or learn new things easily.
This in turn exacerbates developmental delays, poor memory and behavioral problems in terms of attention, low frustration tolerance and poor impulse control.
Over time, prolonged poor sleep can affect a child’s IQ and education.
I get asked about snoring children on a regular basis. Is it normal? Is it considered the same as an adult who snores?
Between 10 and 20 percent of normal children snore on a regular or intermittent basis, making the line between “normal” snoring and “abnormal” snoring seem a bit fuzzy. It’s when snoring hampers restful sleep that it should be addressed, as in adults. But there are a few things unique to snoring children.
In 2002, the American Academy of Pediatrics recommended that all children be screened for snoring and that a diagnosis be conducted to determine if a child is experiencing normal (primary) snoring or obstructive sleep apnea (OSA) syndrome. About one to three percent of children not only snore, but also suffer from breathing problems during their sleep.
First, speak with your pediatrician to get an accurate diagnosis. Though obstructive sleep apnea among adults is commonly discussed, it’s true that children can suffer from the same condition. And they won’t necessarily grow out of it.
Although most younger children with OSA are not overweight, which is typically associated with OSA, it’s key to determine if weight is a contributing factor. Now that childhood obesity is growing at an alarming rate — with 1 out of 3 kids today considered overweight or obese — it’s no surprise to me that more kids are getting diagnosed with OSA. Other underlying medical conditions, especially allergies or asthma, could also be to blame, in which case a nasal steroid spray could help improve nasal obstruction and OSA symptoms in children that also have allergies. If GERD (gastroenterological reflux disorder) is a factor, this condition could also be treated.
There could be other reasons, though, that are unique to children. A child could have been born with a small jaw or a small airway that makes it hard to breathe fully. There’s also the possibility that the muscles, and the nerves controlling those muscles, are not well integrated during sleep and therefore do not open the airway enough.
And then there’s the chance that a child has enlarged tonsils and adenoids that prevent normal breathing. This last possibility, in fact, is very common among youngsters. When the problems are significant enough, parents can choose to have their child’s tonsils and adenoids removed. According to the National Center for Health Statistics, more than 263,000 children in the U.S. have tonsillectomies each year and sleep apnea is a major reason.
Getting to the bottom of a child’s constant snoring that affects his or her quality of life is critical during those early developmental years. But aside from addressing any medical conditions triggering the problem, it’s also important to instill good sleep habits — or hygiene — in your children from as early an age as possible. If you teach your children how to prepare for sleep and to embrace it as an healthy component to life (and that they need their sleep to enjoy their days maximally), then they will naturally lower their risk for sleep disorders and grow into adults who experience restful, rejuvenating nights on a routine basis– maybe more so than their own parents!
No one likes a cranky, overtired child. Or an adult in that same state for that matter!
Here’s another way to look at it: If your kids can increase their mood and happiness, and possibly even their IQ, through more restful sleep, wouldn’t you want to encourage that?
Sweet Dreams,
Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

What is obstructive sleep apnea?

September 12th, 2010 Raquel Rothe

So you never have energy and you are tired most days…..you may have obstructive sleep apnea (OSA).

OSA is a serious, potentially life-threatening disorder that occurs during sleep, and that may lead to life-threatening conditions. The upper airway repeatedly collapses, causing cessation of breathing (apnea-air flow is blocked) or inadequate breathing (hypopnea) and sleep fragmentation. The sleep fragmentation results in chronic daytime sleepiness.

Identifications:

Are you sleepy during the day?
Do you have disruptive snoring at night?
Do you have pauses in breathing during the night?
Do you have pauses in breathing during the night?
Do you wake yourself up choking or gasping?
Obesity
Large neck (less than 17″-men, less than 16″-women)
Restless sleep
Diagnosis: If you have these signs and symptoms, they could be indicative of sleep apnea. Report these signs and symptoms to your healthcare professional as you may need to undergo a diagnostic sleep study. This test is painless and provides information about how a patient breathes during sleep. The data that is collected will enable the physician to determine the type and severity of sleep apnea, along with your treatment options.

Potential Consequences if OSA is left untreated: Now you know you have sleep apnea but not sure you want it treated? “I think I will be fine without wearing that mask. I’ve slept this way most of my life”.
Decreased quality of life
OSA patients, prior to diagnosis and treatment, consume 2 1/2 times more health care resources that patients without OSA
Hypertension (high blood pressure)
Cardiac arrhythmias (irregularities in heart rate/rhythm)
Stroke
Heart Attack
Diabetes
Increased risk of motor vehicle and work-related accidents due to sleepiness
Interventions could include Positive Airway Pressure (PAP) therapy, surgery, body position modification, oral appliances, lifestyle changes such as weight loss (if needed), good sleep hygiene, and avoidance of alcohol, sedatives and hypnotics. Your health depends on your intervention to improve your quality of life. At Sleep EZ, we provide a home-like environment that is relaxing so if you need to undergo diagnostic testing for sleep apnea your experience is more comfortable. Remember, it’s your insurance, it’s your choice where to be tested. Sleep EZ “Diagnostic excellence in a serene setting”