The AADSM Blog Has Been Relocated

Thank you for following the AADSM blog. We’ve moved the location of this blog to the patient resources section of the newly revamped AADSM.org, the official website of the American Academy of Sleep Medicine. Visit the new AADSM blog to continue to follow the latest news and research in dental sleep medicine and related fields.

Common Symptoms of OSA Patients Vary By Age and Gender

A new study in the journal Sleep and Breathing examined obstructive sleep apnea (OSA) symptoms common to different age and gender groups. The study used demographic, subjective complaints and medical history.

Data was collected from 23,806 patients. Patients ranged from 21 to 80 years of age. The group was divided into 24 groups by gender and 5-year age intervals. Each patient took an overnight sleep study between the years 2000 and 2009.

The researchers found the gender-specific relationship between AHI and age. They then used this data to determine the best fitting AHIs for each age and gender group.

The study showed that OSA characteristics are not uniform across gender and age. They may also vary between obese and non-obese patients. These findings should be taken into account in the clinicians’ diagnosis of OSA.

Seventy percent of patients had an AHI greater than 10, indicating the presence of at least mild OSA. Men had consistently higher AHI than women. The best fitting AHI cutoff point increased with age in both genders. Results showed that in obese men, AHI increased from age 20 to 40 years and remained stable thereafter. Alternatively, there was a linear increase in AHI with age in both obese and non-obese women.

The results indicate that OSA severity varies with age and gender, with women having less severe syndrome in all ages. Obesity and snoring are OSA predictors in men and women of all ages. Excessive daytime sleepiness and hypertension were OSA predictors all participants except for women 21 to 40 years of age.

Read more about age and OSA here.

Virtual Choir 2.0 Praises the Beauty of Sleep

Dr. Larry Barsh, founder of Snoring Isn’t Sexy, posted a fascinating video on his blog recently. The video spotlights Eric Whitacre’s Virtual Choir 2.0 ‘Sleep’ – an interesting twist on traditional music.

Sleep disorders affect 50-70 million Americans. Obstructive sleep apnea (OSA) alone causes breathing problems for more than 18 million Americans. While 80 to 90 percent of OSA patients are undiagnosed and untreated, there are numerous treatments available:

Oral appliance therapy: a custom-fit mouth guard may move the jaw and tongue forward to increase airflow.

Upper-airway surgery: jaw adjustments or the removal of the tonsils may improve airflow.

Positive airway pressure: a steady stream of airflow is provided via a nose and mouth mask to keep the airway open.

Behavior therapy: Side-sleeping and losing weight via diet and exercise can reduce sleep apnea in conjunction with the above three treatments.

Find a sleep center. Find a dentist qualified in dental sleep medicine.

President Obama Calls Attention to Air Traffic Safety

President Obama drew attention to the issue of air traffic safety today on Good Morning America. The dangers of shift work is receiving growing awareness as several air traffic controllers have fallen asleep on the job recently. The effects of shift work, and sleep disorders like insomnia and obstructive sleep apnea, can cause dangerous working situations. Sleep deprivation has been found to increase the risk of work-related accidents in transportation and medical industries.

Pediatric Sleep Apnea Treatment Effective Two Years Later

A new study in the journal Sleep and Breathing found that rapid maxillary expansion (RME) was effective in treating obstructive sleep apnea (OSA) in children. The results of the treatment were apparent two years after treatment ended. RME involves widening the jaws using oral appliances.

The researchers evaluated the objective and subjective data over a 36-month follow-up period to determine whether RME is effective in the long-term treatment of OSA. The study included 14 children. The children's mean age was 6.6 years at entry and 9.7 years at the end of follow-up. Each child underwent an orthodontic assessment to detect possible jaw deviation from normal occlusion: deep bite, retrusive bite and crossbite.

A high angle face can cause breathing problems for children. Another common cause of OSA is large tonsils or adenoids. Removing the tonsils or readjusting the jaw line can help children breathe more easily during sleep.

All 14 children completed a 12-month therapeutic trial using RME and 10 enrolled in the follow-up study. Of the 10 children, five were male and five were female. The ten children took an overnight polysomnography (PSG) to test for the presence of OSA at baseline, after one year of treatment, and two years after treatment completion.

Results show that the apnea-hypopnea index (AHI) decreased and the clinical symptoms had resolved by the end of the treatment period. Twenty-four months after the end of the treatment, no significant changes in the AHI or in other variables were observed.

The researchers concluded that RME may be a useful approach in children with malocclusion and OSA, as the effects of such treatment were found to persist 24 months after the end of treatment.

Learn more about children and sleep here.

Driver Fatigue Investigated After NYC Bus Crash

In Dr. David Volpi's recent Huffington Post article, he writes that last week's bus accident that killed 15 people after crashing near the Bronx, NY, has raised multiple questions for federal investigators. The National Transportation Safety Board will investigate if the bus driver was so fatigued he was incapable of driving properly.

Dr. Volpi notes that there is no question that fatigue might have contributed to this crash since it is a major cause of crashes -- not just for buses, but for trucks, airplanes, trains and boating accidents, as well.

Drowsy driving is more prevalent than previously expected. Last fall, the American Automobile Association (AAA) Foundation for Traffic Safety polled 2,000 drivers. One-third of them admitted to either nodding off or completely falling asleep while they were driving in the past year.

More than half of those polled by AAA reported they fell asleep on a high-speed highway. Although it might seem more common to doze off during long car rides, 59 percent said they'd been driving under an hour before they had fallen asleep. Drowsy driving can happen at any time. Twenty-six percent reported that it happened in the middle of the day, between noon and 5 p.m.

The National Highway Traffic Safety Administration estimates that drowsy driving "results in 1,550 deaths, 71,000 injuries and more than 100,000 accidents each year" and that 57 percent of driving crashes caused by fatigue involved the driver drifting into other lanes or even off the road.

Motor vehicle accidents due to “drowsy driving” account for $48 billion in medical costs each year.

To prevent drowsy driving, the American Academy of Sleep Medicine recommends the following tips:

• Get a full night of seven to eight hours of sleep before driving.
• Avoid driving late at night.
• Avoid driving alone.
• On a long trip, share the driving with another passenger.
• Pull over at a rest stop and take a nap.
• Use caffeine for a short-term boost.
• Take a short nap after consuming caffeine to maximize the effect.
• Arrange for someone to give you a ride home after working a late shift.

Learn more about drowsy driving here.

Can OSA Jeopardize Brain Power?

The association between moderate to severe obstructive sleep apnea (OSA) and impaired neurocognitive function is well established. It is unclear whether this association is related to low oxygen levels or the repeated arousals during sleep.

A new study in the journal Sleep and Breathing examined the association between cogitative function and OSA.

Researchers aimed to describe verbal memory and executive function in adults using the Berlin Questionnaire. It also investigated the relationship between cognitive function and OSA severity. .
They study included 290 adults with an average age of 48 years. Fifty-five percent of participants were female. They received the Berlin Questionnaire by mail and demonstrated a high-risk for OSA.

Participants’ verbal memory was assessed by Rey Auditory Verbal Learning Test and executive function by the Stroop test. OSA severity indicators were measured by polysomnography (PSG).

Results show that average oxygen saturation was the indicator of OSA severity most strongly associated with cognitive function. Researchers found that adults at high risk of OSA demonstrated verbal memory and executive function impairments.

Find out if OSA is affecting your brain power.

Image by Rich Lyons