Sleep apnea and heart problems

This article explains heart problems that can be caused by obstructive sleep apnea.

A common sleep problem is bad for your heart, and the number of people that have it has increased by double digits over the past decade.  Studies suggest as many as 26 percent of all Americans may have mild to severe sleep apnea, and only about 10 percent are aware that they have it.
So, as many as 75 million people have a condition that many of know little about.  Sleep apnea is a condition that intrudes into daily living by causing snoring, daytime sleepiness, headache, and poor concentration, but it also can lead to potentially deadly cardiac issues.
Let’s take a look at some of the heart problems that studies have shown sleep apnea can cause:

1. Atrial fibrillation.  Traditional treatment for the irregular heart rhythm called atrial fibrillation consists of blood thinners, medications, and an invasive, expensive procedure called ablation.  There may be a more natural approach.  Atrial fibrillation has been cured in people who are overweight and have sleep apnea.  The treatment consists of weight loss, and sometimes using a device called CPAP to improve oxygen levels during sleep.  According to the Sleep Heart Health Study, the likelihood of developing afib if you have untreated sleep apnea increases fivefold, and treatment improves the likelihood that your rhythm will stay regular into the future.   
2. Hypertension.  There is no doubt that undiagnosed and untreated obstructive sleep apnea can result in high blood pressure.  In addition, apnea can make hypertension very difficult to treat with medication, and one-third of people with a condition called resistant hypertension have undiagnosed sleep apnea. Again, weight loss and using a CPAP mask as prescribed by a sleep specialist can make a huge difference
3. Stroke.  Obstructive sleep apnea (called OSA), has been shown to increase the risk of both stroke and premature dementia.  An analysis published just this month in the journal PLOS One demonstrated that treating the condition with CPAP was associated with a lower incidence of stroke and cardiac events.       
4. Coronary artery disease.  Not only does untreated OSA worsen atherosclerotic coronary disease  (the blockages that cause heart attacks), it also messes with metabolism, worsening cholesterol and sugar levels. This can lead to fatal heart attacks.   Reggie White, the Philadelphia Eagle great, died at age 43, most likely from OSA.
5. Pulmonary hypertension. This condition, in which blood pressure in the lungs can be markedly elevated, is another cardiovascular disease with a well-established relationship to OSA.  Sleep apnea is also associated with congestive heart failure, and inflammation that may have an impact on other non-cardiac problems such as Parkinson’s disease.

Obstructive sleep apnea is often associated with being overweight, and losing weight can be a cure.   If you are a guy with a neck size over 18 inches, or a woman with a neck measuring more than 17 inches, there is an increased chance that you may have OSA.  It is more common in men than women, with up to 34% of men and 17% of women having undiagnosed OSA.

Central sleep apnea, the less common type, and is not related to weight. 

The only way to diagnose sleep apnea is to have a sleep study.  For years, this had to be done in a clinic, but now more people are being screened at home.

Treatment with a CPAP machine requires wearing a mask over your nose or mouth while sleeping, a deal breaker for many.  Newer technologies including smaller masks and mouth appliances have improved treatment, so if this fear has prevented you from getting checked out, it may be a good time to reconsider.

Seeing a sleep specialist now may avert the need to see a cardiologist in the future. 

Read more here

Health effects of sleep apnea

This article discusses the effects of sleep apnea beyond snoring.

According to the American Sleep Apnea Association, about 22 million Americans have sleep apnea and about 80 percent of those cases are undiagnosed. Sleep apnea is an involuntary sleep disorder in which breathing repeatedly stops and starts.

Sleep apnea can occur when tissue in the back of the throat blocks the airway. If the airway is blocked, the amount of oxygen delivered to the body’s organs is reduced. When blood-oxygen levels drop low enough, the body wakes itself up. Sometimes it happens so fast that it goes unnoticed to the sleeper. People with sleep apnea can stop breathing hundreds of times during the night and often for a minute or longer.

Sleep apnea can have serious and life-shortening consequences if it is not treated. These include high blood pressure, heart disease, stroke, memory problems, diabetes and depression.

Symptoms of sleep apnea:

• loud snoring
• fatigue
• insomnia
• persistent daytime sleepiness
• awakening out of breath during the night
• frequently waking in the morning with a dry mouth or a headache

The most widely used treatment for sleep apnea is a Continuous Positive Airway Pressure (CPAP) machine. The CPAP has a mask that goes over the nose, or sometimes nose and mouth, during sleep and supplies pressurized air that flows into the person’s throat. The increased air pressure keeps the airway open. Sometimes people still struggle with sleep apnea even after they use a CPAP. In those cases, surgery may be needed.

Sleep apnea is sometimes caused by the back of the tongue or tonsils blocking the airway. In these cases, an uvulopalatopharyngoplasty (UVPPP) is required. UVPPP involves shortening the soft palate and removing the tonsils, and it has been the most common sleep apnea surgical procedure performed in the past 25 years. In addition, robotic-assisted resection of the base of tongue is a minimally invasive approach to remove obstructive tongue tissue blocking the airway. After this surgery, sleep apnea is often corrected. At Long Beach Memorial, the da Vinci Si Robotic Surgical System is used to remove redundant tongue tissue and is performed in conjunction with the UVPPP to help our patients get a good night’s rest.

In order to properly diagnose sleep apnea, a physician must conduct a sleep study in a sleep lab, usually overnight. A sleep study monitors activity during sleep such as measuring brain waves, heart rate and rhythm, breathing patterns and oxygen levels.

Read more here

Study: CPAP use may reverse negative changes in brain stem activity

A study shows that treating sleep apnea with a CPAP may reverse brain stem activity. -JR

Sleep apnea treatment may reverse changes in brain stem activity associated with increased risk of heart disease, a new study suggests.

The findings "highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues [heart disease] associated with obstructive sleep apnea," the researchers concluded. CPAP stands for continuous positive airway pressure.

Previous research suggests that people with obstructive sleep apnea have greater activity in nerves associated with stress response, which can lead to high blood pressure and heart problems. This increased nerve activity is due to altered brain stem function caused by sleep apnea, earlier studies have shown.

In this small study, published recently in the Journal of Neurophysiology, Australian researchers found that CPAP treatment reduced that nerve activity by restoring normal brain stem function.

The study included 13 sleep apnea patients who were assessed before and after six months of CPAP treatment.

"These data strongly suggest that functional and anatomical changes within the brain stem, which we believe underlie the elevated sympathetic activity in individuals with untreated obstructive sleep apnea, can be restored to healthy levels by CPAP treatment," the University of Sydney researchers wrote.

In obstructive sleep apnea, muscles in the airway collapse during sleep and block breathing. A CPAP device keeps airways open by delivering a steady flow of air while patients sleep.

Read more here

CPAP can help adults with sleep apnea and depressive symptoms

Depressive symptoms in adults with sleep apnea are improved when the person uses a CPAP.

A new study shows that depressive symptoms are extremely common in people who have obstructive sleep apnea, and these symptoms improve significantly when sleep apnea is treated with continuous positive airway pressure therapy.

Results show that nearly 73 percent of sleep apnea patients (213 of 293 patients) had clinically significant depressive symptoms at baseline, with a similar symptom prevalence between men and women. These symptoms increased progressively and independently with sleep apnea severity.

However, clinically significant depressive symptoms remained in only 4 percent of the sleep apnea patients who adhered to CPAP therapy for 3 months (9 of 228 patients). Of the 41 treatment adherent patients who reported baseline feelings of self-harm or that they would be "better dead," none reported persisting suicidal thoughts at the 3-month follow-up.

"Effective treatment of obstructive sleep apnea resulted in substantial improvement in depressive symptoms, including suicidal ideation," said senior author David R. Hillman, MD, clinical professor at the University of Western Australia and sleep physician at the Sir Charles Gairdner Hospital in Perth. "The findings highlight the potential for sleep apnea, a notoriously underdiagnosed condition, to be misdiagnosed as depression."

Study results are published in the September issue of the Journal of Clinical Sleep Medicine.

The American Academy of Sleep Medicine reports that obstructive sleep apnea (OSA) is a common sleep disease afflicting at least 25 million adults in the U.S. Untreated sleep apnea increases the risk of other chronic health problems including heart disease, high blood pressure, Type 2 diabetes, stroke and depression.

The study group comprised 426 new patients referred to a hospital sleep center for evaluation of suspected sleep apnea, including 243 males and 183 females. Participants had a mean age of 52 years. Depressive symptoms were assessed using the validated Patient Health Questionnaire (PHQ-9), and the presence of obstructive sleep apnea was determined objectively using overnight, in-lab polysomnography. Of the 293 patients who were diagnosed with sleep apnea and prescribed CPAP therapy, 228 were treatment adherent, which was defined as using CPAP therapy for an average of 5 hours or more per night for 3 months.

According to the authors, the results emphasize the importance of screening people with depressive symptoms for obstructive sleep apnea. These patients should be asked about common sleep apnea symptoms including habitual snoring, witnessed breathing pauses, disrupted sleep, and excessive daytime sleepiness.

Read more here

---

Sleep apnea treatment does not affect a person's sex life.

A study shows that sleep apnea treatment will not hamper your sex life.

Your sex life is unlikely to suffer because of sleep apnea treatment, according to a new study.

People with sleep apnea experience periods of disrupted breathing throughout sleep. This can lead to daytime fatigue, high blood pressure and other health conditions.

The gold standard of sleep apnea treatment involves going to bed wearing a mask or nosepiece with a hose that's attached to a machine that provides a steady stream of air to keep the airways open during sleep. This is called continuous positive airway pressure (CPAP).

Many patients who use CPAP believe it makes them less sexually attractive, which may make them less likely to comply with treatment, according to the researchers from Rosalind Franklin University in Chicago.

To find out more about how CPAP affects patients' sex lives, the researchers surveyed 52 patients who were prescribed the treatment. Of those patients, 27 were compliant (meaning they used CPAP more than four hours a night on 70 percent of nights) and 25 were not compliant.

All were asked 10 questions related to physical and emotional aspects of lovemaking, the researchers said.

After adjusting for other factors, the investigators found that compliant and non-compliant patients had similar sexual quality-of-life scores.

The findings, published Oct. 21 in the journal Chest, will be presented at the annual meeting of the American College of Chest Physicians in Austin, Texas.

"This study suggests that CPAP compliance does not impair sexual quality of life in patients with sleep apnea," Dr. Mark Rosen, medical director of the college, said in an association news release.

Erectile dysfunction is common in men with sleep apnea, but previous research has shown that CPAP improves erectile dysfunction in these patients, according to the college.

Read more here

Study: Treated sleep apnea reduces hospital readmission rate in cardiac patients

A study claims that the hospital readmission rate for hospitalized cardiac patients is lower if their sleep apnea is treated.

A study of hospitalized cardiac patients is the first to show that effective treatment with positive airway pressure therapy reduces 30-day hospital readmission rates and emergency department visits in patients with both heart disease and sleep apnea. The results underscore the importance of the "Stop the Snore" campaign of the National Healthy Sleep Awareness Project, a collaboration between the Centers for Disease Control and Prevention, American Academy of Sleep Medicine, Sleep Research Society and other partners.

Results show that none of the cardiac patients with sleep apnea who had adequate adherence to PAP therapy were readmitted to the hospital or visited the emergency department for a heart problem within 30 days from discharge. In contrast, hospital readmission or emergency department visits occurred in 30 percent of cardiac patients with sleep apnea who had partial PAP use and 29 percent who did not use PAP therapy.

"Finding a reduced 30-day cardiac readmission rate in PAP-adherent patients is important for improving both patient care and hospital finances," said principal investigator and senior author Dr. Richard J. Schwab, Professor in the Department of Medicine and co-director of the Penn Sleep Center at the University of Pennsylvania Medical Center in Philadelphia.

The study results are published in the Oct. 15 issue of the Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

"Severe sleep apnea is solidly associated with serious cardiovascular outcomes, such as heart failure, heart attacks, and heart-related deaths," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "This study is a clarion call to detect, diagnose, and especially to treat sleep apnea in patients who are hospitalized for heart problems. Doing so is a win-win-win move; it improves the patient's quality of life, improves health outcomes, and reduces the resources used to manage heart diseases."

The "Stop the Snore" campaign was launched recently to encourage people to talk to a doctor about the warning signs for obstructive sleep apnea, which afflicts at least 25 million adults in the U.S. Sleep apnea warning signs include snoring and choking, gasping or silent breathing pauses during sleep. Pledge to stop the snore athttp://www.stopsnoringpledge.org.

The study involved 104 consecutive patients who reported symptoms of sleep apnea while being hospitalized for a cardiac condition such as heart failure, arrhythmias or myocardial infarction. They were evaluated for sleep apnea using an in-hospital, portable sleep study. Results show that 78 percent of the cardiac patients had sleep apnea (81/104). Eighty percent of sleep apnea cases were predominantly obstructive sleep apnea (65/81), and 20 percent were predominantly central sleep apnea (16/81).

Participants who were diagnosed with sleep apnea were started on PAP therapy, and compliance data were collected via modem or data card. Adequate treatment adherence was defined as using PAP therapy four or more hours per night on at least 70 percent of nights. Thirty-day hospital readmission was defined as a hospitalization or visit to the emergency department for a cardiac cause more than 48 hours after discharge.

According to the authors, reducing hospital readmission rates for cardiac patients is essential for the provision of cost-effective care. They noted that the average total cost per heart failure hospitalization ranges from $13,000 to $18,000. Furthermore, the Centers for Medicare and Medicaid Services (CMS) withholds hospital reimbursement for the care of patients readmitted within 30 days after hospital discharge.

Read more here

Study: Seniors helped by sleep apnea treatment

A study claims that seniors are helped by sleep apnea treatments such as a CPAP.

A new study finds that continuous positive airway pressure (CPAP) is an effective treatment for seniors with sleep apnea.

CPAP is widely used to treat moderate to severe obstructive sleep apnea, a condition in which the airway relaxes and narrows during sleep, causing breathing problems and interrupted sleep that leads to daytime drowsiness.

CPAP keeps the airway open by pushing a stream of air through a patient's nose via a mask that is worn during sleep. Previous research has shown that CPAP benefits middle-aged adults with sleep apnea, but there had been no studies on whether it was useful and cost-effective in seniors.

This new study of 278 sleep apnea patients aged 65 and older in the United Kingdom found that CPAP reduced their levels of daytime sleepiness and their health care costs.

"Sleep apnea can be hugely damaging to patients' quality of life and increase their risk of road accidents, heart disease and other conditions. Lots of older people might benefit from this treatment," study co-lead author Mary Morrell, a professor at the National Heart and Lung Institute at Imperial College London, said in a college news release.

"Many patients feel rejuvenated after using CPAP because they're able to sleep much better, and it may even improve their brain function," Morrell added.

"We think low oxygen levels at night [because of interrupted breathing] might accelerate cognitive [mental] decline in old people, and studies have found that sleep apnea causes changes in the gray matter in the brain. We're currently researching whether treatment can prevent or reverse those changes," she noted.

CPAP should be offered to seniors with sleep apnea, and more needs to be done to raise awareness of the condition, the study authors said. The study is published in the Aug. 27 online edition of The Lancet Respiratory Medicine.

Read more here

All about sleep apnea

This article provides much information on sleep apnea, including signs you may have it, and what you should do to get checked if you think you might have sleep apnea.

Think you might have sleep apnea? Not sure what the symptoms are? It's a growing sleep disorder that people are more and more being affected by.

Sleep apnea affects some 18 million Americans and around 850,000 Canadians. The etymology of the word apnea translates into the suspension of breathing or the absence of respiration. Pauses can last anywhere from a few seconds to a few minutes, this can occur up to 30 times per hour in some cases.

Obstructive sleep apnea can be mild, moderate or severe. The severe form of this ailment can progressively degenerate, leading in some cases to death in patients. Sleep apnea often goes undiagnosed as extreme snoring. Both sexes experience sleep apnea but it is more common in males than females. Certain racial groups are also more prone to this condition, Hispanics have higher rates of sleep apnea than Caucasians.

Common Sleep Apnea Statistics

The Sleep Disorders Guide has provided the following research information.

- 1 in every 15 Americans has sleep apnea

- University of California’s San Diego campus discovered 17 percent of the 54 African Americans had obstructive sleep apnea. The 346 Caucasians tested only had an 8 percent indicator

- 1 in 50 Americans are undiagnosed

- obstructive sleep apnea patients are at an increased rate for traffic incidents

- People driving drowsy is responsible for 100,000 car accidents, 40,000 injuries and up to 1,550 deaths per year if your bed partner has this condition you are unlikely to get any sleep

- stroke, hypertension and heart disease are all linked to sufferers of sleep apnea

A lack of proper sleep has been linked to cognitive problems in the workforce and decreases in educational achievement. Memory and complex decision making skills are also affected at an increased rate leading to occupational accidents and fatalities.

Fatalities Caused By Sleep Disorders

The impact of getting a lack of sleep can not be underestimated. Medical resident students work longer hours than most hospital staff. During the first year residency med students usually work a 24 hour shift every third night they can work up to 96 hours in some cases. Columbia University’s College of Physicians and Surgeons states that medical student hours can not exceed 80 hours per week with at least 24 consecutive hours free from duty in a week. These guidelines are often not adhered to with priority shifts and hours going to senior staff. The Accreditation Council for Graduate Medical Education found that residents who worked more than 80 hours per week were at risk for making significant medical errors that led to negatively impacting patients. Sleep related fatigue is a leading cause of medical errors facing hospitals and patients.

The Three Mile Island incident of 1979 resulted in a cooling malfunction in reactor #2, radioactive gas was released, fortunately there were no fatalities. Cooling to the reactor was eventually restored, this incident was thought to have been caused by lack of sleep of the plant employees. The occupational damage from lack of sleep ended up costing $975 million back in March 28th of 1979.

The Exxon Valdez Oil Spill was one of the worst environmental disasters in U.S. history. The 987 foot long oil tanker ran aground a reef in Prince William Sound, Alaska releasing 10.8 million gallons of crude oil into the Pacific ocean. The oil spill ended costing $3.8 billion to clean up. This incident again was related to the ships crew suffering from lack of sleep.

Who Is At Risk For Sleep Apnea?

The Centers for Disease Control and Prevention (CDC) states that one-third of U.S. adults or 34.9 percent are obese. The medical costs for treating obese people amounted to $147 billion in 2008 U.S. dollars. The male gender and certain racial groups are more at risk for sleep apnea than other demographics. Blacks are at a 47.8% increased risk of obesity compared to 42.5% for Hispanics. Whites have a 32.6% obesity rate compared to 10.8% for Asians.

Obesity and socioeconomic status go hand in hand when it comes to obesity. Blacks and Mexican Americans are prime candidates for the battle of the bulge. Among women obesity levels rise with education levels. Women with a college degree had a 23.4% obesity rate compared to 42.1% of women without a high school diploma. Men and women with college degrees have significantly lower rates of obesity. The common denominator is the more education people have the more income they earn and the healthier food they can purchase.

Simply put people with higher incomes are able to afford organic or natural foods. GM staple crops like GM corn are modified to produce higher yields. A Norway research study fed rats GM corn for 90 days, the end result was the rats feeding on the GM corn grew obese, in contrast to the rats fed on the non-GM diet. The physiology of rats is similar to humans, if rats grow obese from a GM diet than humans eating the same type of food will also become obese. Nutrient levels in today’s crops have decreased significantly since WWII, modern day food simply does not have the nutritional density it once did. A lack of nutrient dense crops results in people eating large quantities of food, the more food a person consumes to make up for the lack of nutrients the more weight they put on. Mexican Americans and Blacks from lower economic levels live in areas with an abundance of fast food outlets and grocery stores that do not have access to the organic food market because of the higher prices, this makes this demographic prime candidates for sleep apnea.

Diagnosing Sleep Apnea

The most direct method to diagnose sleep apnea is at a sleep clinic managed by qualified sleep technicians. The clinical name for the study of sleep is called polysomnography, this test measures brain wave activity, heart rate, breathing and eye and leg movements. Patients undergoing this study check in during the evening into a private room that has a video camera, the sleep room is adjacent to the monitoring room where the sleep technician monitors the patient. Sensors are placed on the legs of the individual to monitor restlessness at night. A sensor belt is placed around the abdomen and waist to monitor breathing, additional sensors are placed near the mouth and nose to measure the respiratory rate.

The final step in polysomnography is the attachment of a Continuous positive airway pressure (CPAP) device that attaches to the mouth of the patient. The CPAP machine supplies light air pressure through the mouth or nose, this pressure is enough to keep the airway open so the patient can breathe properly while sleeping. If the presence of obstructive sleep apnea is documented during the night the sleep technician will re-enter the room and apply a CPAP mask that is attached to a CPAP machine. The sleep technician will wait for the patient to enter a deep sleep before gradually determining the minimum airflow to keep the airway open. The technician will also monitor the patients other vitals for symptoms of sleep apnea. A definitive diagnosis can be made later by a physician sleep specialist that is dedicated to the study of sleep medicine.

CPAP is the most widely accepted and effective machine to treat sleep apnea today. If you think you may be a sufferer of sleep apnea consult your physician regarding making an appointment at a sleep clinic.

Read more here

Sleep apnea treatment helps Texas child with night terrors

This article tells the story of one Texas child whose night terrors were helped by sleep apnea treatment.

Sleep apnea is a serious sleep disorder that occurs when a persons sleep is interrupted by their breathing being paused. In many cases sleep apnea goes undiagnosed and it's very common among children.

One family shares their battle with us, we were introduced to the Weedon family of Longview.
Six-year-old Emma was not sleeping through the night since she was nine-months old, waking up sometimes every 30 minutes, she was having night terrors and it was giving her anxiety.

"Her mother Misty Weedon noticed that Emma had some difficulty staying still in her Pre-K school," said Dr .RV Ghuge, Sleep Medicine Institute of Texas. "We were starting kindergarten and I was afraid that someone was going to try to look at her and say that she had ADHD."

After several visits with their pediatrician the Weedon family just figured to contact Dr. Ghuge with the Sleep Medicine Institute of Texas. "Her parents just refused to allow her to be on medications for that, they wanted to explore other alternatives and look at root cause of these problems and they were convinced that sleep was the problem," said Dr. Ghuge.

A sleep test showed what was happening when Emma closed her eyes for bedtime was irregular, from her breathing pattern, teeth grinding and moaning. Emma was diagnosed with sleep apnea a little over a year ago.

She has to wear a CPAP breathing mask while she sleeps, every night. "I put it on and breathe through it and I have better dreams," said little Emma.

"When we did her sleep test she has shown tremendous improvement in her breathing at night and her teeth grinding and the oxygen that she was losing before," said Dr. Ghuge.

"She wasn't growing, since she's been on her CPAP she's grown three inches and that's been in the past year," said Misty Weedon.

After treating her sleep disorder Emma can sleep eight to nine hours.

Read more here

Does weight gain cause sleep apnea, or does sleep apnea cause weight gain?

This article discusses the link between sleep apnea and weight gain, and other serious consequences of untreated sleep apnea.

When you know that "apnea" is the Greek word for "without breath," you begin to understand how scary sleep apnea can be. Sleeping without breath? That just can't be good for you … and it's not. Because its main symptoms (snoring and daytime fatigue) are easily overlooked, it is one of the most undiagnosed sleep disorders in the country, according to Health Magazine.

Sleep apnea has been shown to be related to a host of health concerns, including hypertension and heart disease, but when it comes to the relationship between sleep apnea and weight gain, which comes first? Does weight gain cause sleep apnea, or does sleep apnea cause weight gain?

In one of those great anatomical double-whammies, the answer to that question is "yes" and "yes." The National Heart, Lung, and Blood Institute explains that sleep apnea happens when you're asleep and your upper respiratory passages relax. For most of us, that's no big deal. For some people, though, that can cause problems. It may be because their airways are more narrow, their tongues are too big, or their tonsils are too large. And it may be because they are overweight. If you're carrying extra soft fat tissue, it can actually thicken the walls of your windpipe, making it narrower and increasing your risk for sleep apnea. So yes, gaining weight can contribute to getting sleep apnea.

But it doesn't stop there. Because sleep apnea means that you never (and I mean, never) get a good night's sleep, the idea of any exercise seems absurd. It would be like having a newborn baby that doesn't ever grow up. Actually, it would be worse than that because even newborns will let you sleep for a couple of hours at a time. Sleep apnea doesn't. You can wake up gasping for breath every few minutes all night long, or you can just snort and snore and roll over many times in the course of sleep cycle. Either way, you don't ever run a full sleep cycle; your body never really gets the rest it needs to rebuild or rejuvenate. You are exhausted all the time. You know you need to exercise to lose some weight so you can sleep better, but you're out of breath just walking to your car; how in the world are you going to walk around the block or take the stairs instead of the elevator?

And just to add insult to injury, a 2004 PLOS study revealed that sleep-deprived people had higher levels of ghrelin, the hormone our body produces to stimulate appetite, and reduced levels of leptin, the hormone our bodies make to suppress appetite. So, yes, sleep apnea can contribute to gaining weight.

So what's an overweight, sleep-deprived person to do? Don't despair; there are options. Traditional sleep apnea treatments such as CPACs (continuous positive airway compressors) can be helpful. Some people learn to sleep with them all night, every night. Others can never really get quite comfortable with it, but it might be just enough to get them moving in the right direction. Even just walking to the end of the street helps, and many sleep apnea patients enjoy bike riding because it lessens the pressure on their joints. The key is to tackle both issues – weight gain and sleep apnea – together, as improvements in one condition often yield improvements in the other. Just as the two worsen together, so they also improve together. Small changes can make a big impact over time, so the important thing is to talk to you doctor, don't give up, and take it one small step at a time.

If you feel like you never get a good night's sleep, sleep apnea could be to blame. Ask your doctor for more information, and remember that St. Francis offers a Sleep Disorder Center that can help identify the source of your sleeplessness.

Read more here

CPAP adherence improved by family support

Family support may improve a person's adherence to CPAP treatment for sleep apnea.

A new study suggests that people with obstructive sleep apnea (OSA) who are single or have unsupportive family relationships may be less likely to adhere to continuous positive airway pressure (CPAP) therapy.

Results show that individuals who were married or living with a partner had better CPAP adherence after the first three months of treatment than individuals who were single. Higher ratings of family relationship quality also were associated with better adherence. Results were adjusted for potential confounding factors including age, gender and body mass index.

"This is the first study to explore the role of family factors in CPAP adherence," said lead author Faith Luyster, PhD, research assistant professor in the School of Nursing at the University of Pittsburgh. "Having healthy relationships with family members can create an environment that supports the patient's use of CPAP."

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Monday, June 2, in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.

The study group comprised 253 patients with OSA who were participating in a CPAP adherence intervention trial. Relationship status at baseline was identified, and family relationship quality was assessed using the 12-item General Functioning subscale of the Family Assessment Device. Treatment adherence was measured objectively, and was defined as average hours of CPAP use per night during a three month follow-up period.

According to Luyster, the results provide a potential target for interventions to improve CPAP adherence.

"Family-based CPAP adherence interventions may help patients who would benefit from family support during the initial treatment period," she said.

The American Academy of Sleep Medicine reports that obstructive sleep apnea is a common sleep illness affecting up to seven percent of men and five percent of women. It involves repetitive episodes of complete or partial upper airway obstruction occurring during sleep despite an ongoing effort to breathe. The most effective treatment option for OSA is CPAP therapy, which helps to keep the airway open by providing a stream of air through a mask that is worn during sleep.

Read more here

Tips to get a better night's sleep

This article provides seven tips on how to get a better night's sleep, and discusses the importance of getting a good night's sleep.

"Extreme sleep deprivation may affect brain health in later life."

"Sleep may aid chronic pain sufferers."

"Sleep apnea linked with blood sugar levels"

Dr. Paul Walting, a sleep specialist in the Department of Neurology at Baystate Medical Center, acknowledged the media attention “a good night’s sleep” is getting today.

“We are learning more and more, especially with increased research being published, that lack of sleep appears to be associated with a variety of medical problems from cardiovascular disease to Alzheimer’s. We also know that lack of sleep is associated with an increase in accidents and injuries, and for kids it can affect their school performance,” Walting said. “There are so many reasons to be sleep deprived today from overwork to staying up late and watching television or surfing the Internet on your computer, to medical reasons such as a sleep disorder.”

The body requires a good night’s sleep to gain energy for the day, which is essential for cognition, mood and overall health, he added.

According to the National Sleep Foundation, newborns should be getting 12-18 hours of sleep, infants 3-11 months need 14-15 hours, toddlers 1-3 years should get 12-14 hours, preschoolers 3-5 years need 11-13 hours, school-age children 5-10 years require 10-11 hours, teens 10-17 need 8.5-9.25 hours, while adults can survive with 7-9 hours of good ZZZs.

Baystate Medical Center’s Neurodiagnostics and Sleep Center and the
American Academy of Sleep Medicine offer the following additional tips on how to get a good night’s sleep:

• Avoid nicotine, alcohol, food or drinks that contain caffeine, and any medicine that has a stimulant prior to bedtime.


• Follow a consistent bedtime routine.


• Establish a relaxing setting at bedtime.


• Avoid any rigorous exercise within two hours of your bedtime.


• Make your bedroom quiet, dark and a little bit cool.


• Don’t watch the clock at night, but use an alarm to help wake you up.


• Get up at the same time every morning.

Some people with sleep deprivation are not actually suffering from a sleep disorder that Walting and other physicians in Baystate’s Sleep Clinic treat, such as sleep apnea, insomnia or narcolepsy. Instead, it may just be a matter of prioritizing sleep over other activities.

For those with a significant sleep disorder, like Teresita Alicea, a former criminal defense attorney in Springfield, there is treatment.

“I was falling asleep in front of some of my guests that I had over for dinner or even in the afternoon,” said Alicea.

After constantly being exhausted, Alicea had enough and in 2009, after retiring from work, she decided to have a sleep study at Baystate Medical Center. The diagnosis was sleep apnea.

“After they did the testing, they found out my breathing stopped 102 times per hour,” said Alicea. Since getting her BiPAP breathing machine and face mask, she now stops breathing just 0.7x per hour.

“I’m like a new person. I can sit through a concert, I can read a book, I don’t fall asleep in conversation anymore,” she said.

One of the most common sleep disorders, sleep apnea affects more than 18 million Americans, with the most common treatment being CPAP and BiPAP machines, which some patients cannot tolerate.

Now, there is good news for those who find the machines troublesome. The FDA in May approved a pacemaker-like device that can be implanted into the chest region which zaps airways open with an electrical current. The new device, to be available on the market later this year, is for those with moderate to severe obstructive sleep apnea. The new device is not for everyone, and patients should consult with their physician about its safety and viability for them.

Read more here

CPAPs can help people with asthma

A study looks into how CPAP machines can help people with asthma
.

More than 25 million Americans suffer from asthma. They use steroids, inhalers, and pills to help control symptoms. But soon there may be a new way: it’s not a drug but a device used for sleep disorders.

Professor Kurt Stoecker spends many late nights grading papers, but some nights his asthma gets the best of him.

"You can't sleep, that kind of thing. It's a tightness in your chest, and then you cough," Stoecker said.

He was diagnosed with asthma at age 16. He's used steroids and inhalers, but now he's trying something new.

As part of a clinical trial, doctors are testing whether treatment with a CPAP machine can improve symptoms in asthma patients by making their airways less reactive.

"At nighttime, their muscles that are around their windpipes are not being allowed to relax. In essence, they're working almost 24 hours a day," Mario Castro, MD, MPH, Professor of Medicine and Pediatrics, Washington University School of Medicine said.

The CPAP pushes gentle air down the windpipe, forcing the muscles to relax. It's typically used for patients with sleep apnea, but doctors say it could be the first drug-free option for asthma.

In the 12-week study, patients used the device for at least four hours a day with no serious side effects.

"The most exciting thing is that it's not a drug. This is a device," Dr. Castro said.

Read more here

Risks of sleep apnea - stroke, heart attack, pneumonia, dementia.

This article discusses the risks associated with untreated sleep apnea. My only comment for this article  is that "Sleep hygiene" does NOT treat sleep apnea. - JR

Sleep Apnea: The Real Risks Involved

Subscribe FreeBy Mike Tuttle · March 27, 2014 

"18 million Americans suffer from it. It can lead to both physical and psychological problems. Perhaps you, as many do, have it and aren’t even aware of it.

Sleep apnea is a sleep disorder that is characterized by snoring and pauses in breathing at night, waking the person momentarily before they fall back asleep. This disruption of sleep can occur several times a night, 5 to 30 times or more in just one hour. A person, both adults and children alike, can suffer from this disorder for years, even decades, before realizing it.

Studies have shown that sleep apnea can lead to problems like irritability, daytime fatigue, depression, hypertension, heart attack, and stroke, but recent studies have shown that the risks are actually more serious than, well, a heart attack. And while obesity can lead to this disorder, the disorder itself can lead to obesity.

The authors of a review posted in The Lancet Diabetes & Endocrinology journal wrote, “Metabolic health … is largely dependent on behavioral factors such as dietary habits and physical activity. In the past few years, sleep loss as a disorder characterizing the 24-hour lifestyle of modern societies has increasingly been shown to represent an additional behavioral factor adversely affecting metabolic health.”

...

“Our findings show that sleep apnea is an independent risk factor for incident pneumonia,” theysaid. “Our results also demonstrated an exposure-response relation in patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity.”

Heart disease, dementia, diabetes … the negative effects continue to mount up. However, along with the worrisome research comes some hope.

Continuous positive airway pressure devices, or CPAP machines, are currently the most common treatment out there. They consist of a plastic facial mask, which the patient wears at night, connected by a flexible tube to a small bedside machine. Using air pressure, it keeps the patient’s airways open during sleep.

“We know that obstructive sleep apnea is a potential cause of high blood pressure, and we know that CPAP use is associated with reductions in blood pressure in people with hypertension,” sayssleep specialist Vishesh K. Kapur, MD. “And now there is reasonable evidence that this treatment can prevent high blood pressure in patients who don’t already have it.”

Modern CPAP machines also come with a built-in humidifier to help prevent dryness in the throat/nasal passages."

...

Read more here

Those with sleep apnea are more likely to develop pneumonia

People who have sleep apnea are more likely to develop pneumonia.

People with sleep apnea may be at greater risk for developing pneumonia, according to a new study. And the more severe the sleep apnea, the greater the risk, the research suggests.

"This study showed that sleep apnea is an independent risk factor for incident pneumonia," wrote Dr. Vincent Yi-Fong Su and Dr. Kun-Ta Chou of the department of chest medicine at Taipei Veterans General Hospital in Taiwan. "Our results also demonstrated an exposure-response relation in that patients with more severe sleep apnea may have a higher risk of pneumonia than patients with sleep apnea of milder severity."

The sleep disorder causes the upper airway to become blocked, cutting off oxygen during sleep. The researchers said this increases the risk for aspiration, or inhaling contents or fluid from the throat into the lungs. This can put people at greater risk for pneumonia.

The 11-year study, published March 3 in CMAJ, involved 34,100 patients. Close to 7,000 of these participants had sleep apnea, and about 27,000 did not.

The researchers found that more than 9 percent of the sleep apnea group developed pneumonia, compared to less than 8 percent of those without the sleep disorder. The risk was higher among patients using continuous positive airway pressure (CPAP) therapy, considered the gold standard for treating sleep apnea.

However, those who developed pneumonia were older and had other health problems, such as heart disease, diabetes and dementia.

While the study showed an association between sleep apnea and pneumonia risk, it did not prove a cause-and-effect link.

Read more here

Study: Sleep apnea can worsen if diabetes is not treated

A study claims that a person who has diabetes can worsen their sleep apnea if their diabetes is untreated.

People with diabetes and sleep apnea could worsen their diabetes if the sleep disorder isn't properly treated, a new University of Chicago study says.

Published in the Diabetes Journal, the study looked at 115 people with Type 2 diabetes and sleep apnea to examine the impact of sleep apnea on someone's metabolic rate and control of blood sugars.

Sleep apnea causes pauses in breathing during sleep, and is known to raise the risk of Type 2 diabetes.

Patients who had interrupted breathing during REM sleep had worse long-term effects on their blood sugar control, the researchers found.

The researchers found that best results aren't achieved from the typical treatment, using continuous positive airway pressure (CPAP) for four hours.

Some patients remove their CPAP mask in the night because of discomfort, but can miss the REM sleep period that often occurs in the hours before waking.

Patients who had CPAP for seven hours, receiving the air during REM sleep, would have a better blood sugar control long-term, the study found.

Read more here

Losing weight can help you lose sleep apnea

A study shows that losing weight can help a person lose sleep apnea.

Losing weight -- and keeping it off -- could help sleep apnea from getting worse and could even reverse it, a small new study suggests.

Researchers from Finland found that maintaining weight loss of as little as 5 percentis associated with improvement in obstructive sleep apnea, which is a sleep disorder characterized by pauses in breathing during sleep leading to disrupted sleep.

The findings confirm sleep apnea treatment guidelines issued last year by the American College of Physicians, which say that the very first treatment for sleep apnea among overweight people should be weight loss, and the second treatment option should be continuous positive airway pressure (CPAP).

For the new study, published in the journal Sleep Medicine, researchers followed 57 people who were obese and had mild obstructive sleep apnea. The participants were randomly assigned to one of two groups: One group underwent a year-long lifestyle intervention program, while the other group just received general diet and exercise information. The researchers specifically wanted to see how a 5 percent weight loss would potentially affect sleep apnea.

Researchers followed up with the participants four years later (after the year-long intervention program), and found that 20 were "successful" in achieving 5 percent weight loss, while 27 were "unsuccessful" in achieving 5 percent weight loss. The ones who did lose the weight had an improved apnea-hypopnea index (an indicator of sleep apnea severity, which is calculated by dividing the number of pauses of breathing by hours of sleep) compared with those who didn't lose the weight.

Plus, people who lost the weight were less likely to have their obstructive sleep apnea progress over the follow-up period than those who didn't lose the weight, researchers found. 

Read more here