Wednesday, March 31, 2010

Sleep Apnea and Resistant Hypertension

The March issue of Renal and Urology News reported on a new study linking reduced sleep duration with resistant hypertension (RH). RH patients are drug-resistant to hypertension medications.

The study was published in the April issue of the American Journal of Hypertension.

The researchers examined overnight PSG results for 151 patients.

Sixty-two patients had RH. Forty-nine patients had controlled hypertension (CH). And forty patients had normal blood pressure (BP).

The patients had equally severe obstructive sleep apnea (OSA). But patients with CH and normal BP had better sleep quality than those with RH.

Even after adjusting for age, gender, body mass index, apnea–hypopnea index, and diabetes, the differences were clear. On average, patients with RH slept 33.8 minutes less than those with CH. They slept 37.2 minutes less than those with normal BP.

Sleep efficiency, or total sleep time as a percent of time spent in bed, was also lower in RH patients. Drug-resistant patients had 7.9 percent and 10.2 percent lower efficiency than CH and normal BP patients, respectively.

The RH group spent 9.7 minutes less time in rapid eye movement (REM) sleep, which is when dreams occur, than the CH group. They spent 11.6 minutes less in REM sleep than the normal BP group.

The researchers noted that past studies have found that sleep deprivation can worsen arterial pressure and hypertension in humans and animals. Together with past studies, these results suggest that reduced sleep time may contribute to RH.

Last November, this blog reported on a study showing that oral appliance therapy can reduce hypertension in OSA patients.

Tuesday, March 30, 2010

Aging with Grace: Sleep Quality is Key

A recent Washington Post article highlighted tips for thriving in old age.

One important factor? Getting quality sleep.

With 40 turning into the new 30 and people living well into their 90s, it’s important to ensure a healthy life in the later years.

The article notes that sleep apnea is one of the main culprits of lower quality life in old age.

Sleep apnea, weight gain and aging often tie together.

While anyone can have sleep apnea, weight gain and aging increase one’s risk for the condition.

Unfortunately, gaining weight is a common part of aging. And once sleep apnea is present, losing weight can be difficult because the condition drains a person's energy.

Instead of trying to lose weight and treat sleep apnea later, make sure to get enough sleep in every stage of life.

In February, this blog reported on a study that found that men and women who slept more hours per night gained less weight in a one-year period.

Weight gain and the development of obesity were higher in men who slept less than six hours. Men who slept five hours were more affected by weight gain than those who slept five to six hours. Both men and women who slept seven hours had higher body mass indexes in 2007 than in 2006 compared to those who slept seven to eight hours per night.

Don’t damage your health by thinking you’ll have plenty of time to sleep when you’re old. Quality sleep is important at all points of life.

Monday, March 29, 2010

A Quick Look at Sleep Apnea for People on the Run

USA Weekend published a good overview of OSA this past weekend. The Official Blog of the AADSM provides useful patient information regularly.

While OSA is a serious medical condition, it is simpler to understand and treat than people realize.

It happens when the tissues in a person’s throat collapse during sleep, preventing airflow. When the person’s oxygen reaches a low level, the brain wakes the person up to breathe. Arousals can happen hundreds of times a night – leading to poor sleep quality.

OSA is an easy disease to overlook because it happens during sleep. Bed partners can help detect a sleep disorder like OSA. Signs to look for include loud snoring, morning headaches and excessive daytime sleepiness.

Oral appliance therapy is a popular treatment option for patients with mild to moderate sleep apnea. This option is performed by dentists trained in dental sleep medicine. A dental device used to treat OSA looks like a sports mouth guard but is worn during sleep.

Once diagnosed, sleep apnea is not hard to treat. Untreated sleep apnea can cause heath problems, so it is important to speak with a doctor. Sleep apnea increases a person’s risk for diabetes, obesity, heart disease and stroke. It also raises their risk for depression, attention and memory problems and driving accidents.

Thursday, March 25, 2010

Back to School: Dental Sleep Medicine Terms Explained – Part I

Confused about the commonly used acronyms of sleep medicine? Take out a pen or pencil and get ready to learn.

Obstructive sleep apnea (OSA) - A sleep-related breathing disorder (SBD) that occurs when the tissues in the throat collapse during sleep, causing a partial or complete halt in airflow.

Most pauses last between 10 and 30 seconds, but can persist for one minute or longer. They can happen hundreds of times a night.

The collapses lead to low blood-oxygen levels. When the oxygen drops too low, the brain arouses the body to breathe. This pattern can lead to excessive daytime sleepiness and other health problems.

Most people with OSA snore loudly and frequently, with periods of silence when airflow is blocked. They may make choking, snorting or gasping sounds when their airway reopens.

Polysomnogram (PSG) – Also known as a sleep test, a PSG helps determine the presence of OSA. A sleep specialist will conduct a PSG at a sleep center.

This blog post describes the sleep center experience in detail. Many sleep centers have a hotel-like feel to help visitors fall asleep easily despite being away from home.

In part, sleep specialists diagnose OSA based on the results described below.

Apnea-Hypopnea Index (AHI) – The average number of apneas (full breaks) and hypopneas (partial breaks) that occur per hour of sleep as measured by a PSG.

Mild OSA: AHI of 5-15
Involuntary sleepiness during activities that require little attention, such as watching TV or reading
Moderate OSA: AHI of 15-30
Involuntary sleepiness during activities that require some attention, such as meetings or presentations
Severe OSA: AHI of more than 30
Involuntary sleepiness during activities that require more active attention, such as talking or driving

Respiratory Disturbance Index (RDI) – Like the AHI, RDI counts the number of apneas and hypopneas in breathing per hour of sleep. It may also include respiratory events that disturb sleep but do not qualify as an apnea or hypopnea. The RDI may be higher than the AHI because of the extra events.

Oral Appliance Therapy (OAT) – Describes the treatment that qualified dentists can perform for patients who have been diagnosed with OSA at a sleep center. Oral appliances look like mouth guards, but are worn during sleep. These devices are portable, silent and non-invasive. They move the lower jaw forward to keep a patient’s airway open during sleep. Learn more about OAT here.

Source: American Academy of Sleep Medicine Fact Sheet

Image by Greenhem

Wednesday, March 24, 2010

Mars and Venus: Variations in Men and Women with Sleep Apnea

All is not equal in gender and sleep: A 2005 study published in SLEEP shows that men present differently than women when diagnosed with obstructive sleep apnea (OSA).

The study included 130 men and 130 women. They were matched for age and body mass index. They were also matched for Epworth Sleepiness Scale score and apnea-hypopnea index (AHI). An AHI is the average number of breaks in breathing that occur per hour of sleep.

The researchers compared the complaints and medical history of the two groups.

The results show that when diagnosed with sleep apnea, women and men have different medical problems.

Women were more likely than men to have a history of depression or hypothyroidism. Hypothyroidism happens when the thyroid gland under-produces certain hormones.

Four percent of men had a past diagnosis of hypothyroidism in contrast to 22 percent of women. Seven percent of men had a past diagnosis of depression in contrast to 21 percent of women.

Men were also less likely than women to complain of insomnia.

Five percent of men complained of insomnia in contrast to 17 percent of women.

The study notes that while people consider OSA a disease of “obese, middle-aged men,” it can affect anyone. In the U.S., four percent of men and two percent of women have OSA.

The researchers suggest testing for OSA in women who have depression, hypothyroidism, and/or insomnia.

Learn the risk factors of OSA here. Take the STOP questionnaire to gauge your risk.

Image by Bluedharma

Tuesday, March 23, 2010

Sleep Apnea and the Kidney

A new study in the journal Sleep and Breathing shows that treating sleep apnea might help protect a person’s kidney.

The kidney is the bean-shaped organ that keeps a person’s blood clean.

The study included 507 men. All of the men were 67 years or older.

They each took a sleep test and provided a urine sample.

The results indicate that low oxygen saturation can damage the kidney.

Nocturnal hypoxemia occurs when oxygen saturation falls below 90 percent during sleep. Obstructive sleep apnea (OSA) can cause this problem. When a person’s airway collapses, he or she will not get the normal level of oxygen.

The men who had lower levels of oxygen saturation during sleep had the highest albumin-to-creatinine ration (ACR) in their urine. High albumin excretion in urine can indicate kidney disease.

These results were independent of age, race and body mass index. OSA patients have a high rate of diabetes and hypertension. However, these results are independent of the two diseases.

The researchers suggest that sleep apnea treatment may help slow the progression of Chronic Kidney Disease.

Learn more about sleep apnea.

Monday, March 22, 2010

Preventing Problems Down the Road

"Untreated, sleep apnea leads to high blood pressure, heart attacks, strokes and diabetes," said Dr. Mark Rasmus in a recent Fox12Idaho interview. "We like to think that by treating sleep apnea, we can prevent further problems down the road."

Obstructive sleep apnea (OSA) is a serious medical condition. However, disease prevention is not the only reason for treating OSA.

Having sleep apnea can make you up to 15 times more likely to be involved in a deadly motor vehicle accident.

Earlier this month, the Official Blog of the AADSM reported on a study that found that bus drivers with OSA have a high rate of excessive daytime sleepiness. Seven percent of bus drivers in the study reported having an accident and 18 percent a near-miss accident due to sleepiness while working.

As Dr. Rasmus explains in the broadcast, there are several ways to control breathing problems during sleep.

Continuous Positive Airway Pressure (CPAP) is one option. CPAP keeps a person’s airway open during sleep by providing a steady stream of air through a mask. The mask attaches to a hose, which works like a reverse vacuum. CPAP is the gold-standard treatment for OSA.

Dentists can also treat OSA patients with oral appliances. This device moves the jaw forward during sleep to maintain a healthy level of airflow. Oral appliances look like sports mouth guards. They are a safe CPAP alternative.

Image by st0l1

Friday, March 19, 2010

OSA Patients at Risk for Gastrointestinal Conditions

More than 18 million Americans suffer from obstructive sleep apnea (OSA). A new study indicates that the majority of these people might also suffer from gastrointestinal (GI) conditions.

The research was presented at the annual meeting of the American Academy of Otolaryngology—Head and Neck Surgery Foundation in October 2009.

The findings indicate that conditions like reflux disease and heartburn commonly affect OSA patients.

The study included 42 adult patients with OSA. Of the patients, 47.6 percent had mild sleep apnea. More than 14 percent had moderate OSA. And 38.1 percent suffered from severe sleep apnea.

Every patient was examined for GI health.

The researchers observed GI findings in 83.3 percent of patients. More than 59 percent showed two or more GI conditions.

People with mild and moderate sleep apnea had the same risk for GI conditions as those with severe sleep apnea.

The researchers explained that it is “very uncommon” for gastroenterologists to recommend their patients for sleep apnea testing. More research in this area will help raise awareness of the tie between the two conditions.

The researchers recommended that patients who have OSA visit a gastroenterologist for additional exams.

Thursday, March 18, 2010

Treating Sleep Apnea to Raise Quality of Life

New research indicates that idiopathic pulmonary fibrosis (IPF) patients may have a high rate of obstructive sleep apnea (OSA).

The National Institute of Health explains that IPF is a condition in which a person’s lung tissue becomes thick and stiff, or scarred, over time. As the tissue becomes thicker, the lungs lose their ability to move oxygen into the bloodstream. As a result, the brain and other organs do not get enough oxygen. The cause is unknown and there is no cure.

A recent study in the journal Sleep and Breathing assessed the frequency of OSA in recently diagnosed IPF patients. None of the patients had begun treatment for IPF.

The study included 34 patients recently diagnosed with IPF, of which 13 were female and 21 were male. Patients’ ages ranged from 41 to 81 years.

Each patient spoke with a sleep specialist and took a sleep test at one of four sleep centers in Greece.

During the sleep test, 59 percent of the participants stopped breathing more than five times per hour. Their breathing worsened during REM sleep.

At the clinical interview, 20 percent of the patients reported excessive daytime sleepiness and 38 percent reported snoring. Twenty-three percent reported that someone had witnessed their sleep apnea.

Why are IPF patients vulnerable to OSA?

The researchers explain that restrictive pulmonary diseases like IPF can reduce the upper-airway stability, causing airway collapses. Reduced muscle activity between the ribs during REM sleep can escalate the problem.

The researchers believe that OSA in underdiagnosed in IPF patients because physicians are focused on other serious side effects of IPF. While IPF is a rapidly progressing disease with no cure, the researchers suggest that diagnosing and treating OSA could help improve the quality of life of IPF patients.

Wednesday, March 17, 2010

The Body Language of Sleep: How Sleep Deprivation Can Impair Recognition of Human Emotions

A new study in the journal SLEEP found that sleep deprivation might dull a person’s ability to judge facial expressions.

Past studies have found that this fragmented sleep can cause excessive daytime sleepiness, memory loss and poor cognitive function. Now, researchers believe that OSA might even affect patients’ ability to read facial expressions.

The study included 37 healthy participants, of which 21 were female. There ages ranged from 18 to 25 years old. Seventeen participants were randomly assigned to the control sleep control group (SC). The remaining 20 participants formed the total sleep deprivation group (TSD).

Members of both groups were asked to evaluate sad, happy and angry facial expressions. The expressions ranged from neutral to increasingly emotional.

The SC group took the test twice after sleep-rested conditions. The TSD group took the test once while sleep deprived and twice under sleep-rested conditions. The TSD participants did not sleep for 40 hours before their sleep-deprived test.

After sleep deprivation, the TSD was less able to acutely identify human emotions – specifically anger and happiness. Women were more affected than men were by sleep deprivation.

Many people with OSA think that they get the recommend hours of sleep. However, waking up throughout the night to breathe robs them of restorative sleep.

Learn how sleep apnea can affect the brain’s composition here.

Tuesday, March 16, 2010

Making Space for Social Media in Dental Sleep Medicine

Love reading the latest posts on the Official Blog of the American Academy of Dental Sleep Medicine?

Can’t wait for your next AADSM Twitter update?

Don’t miss out – become a fan of AADSM Facebook Page today!

– Be the first to hear about upcoming AADSM educational courses and events

– Find out who else is attending your academy event and tag pictures after the event

– Connect/Reconnect with other sleep apnea patients who are considering or currently using oral appliance therapy

– Access unmatched patient resources

- Connect/Reconnect with dental sleep medicine professionals currently treating or interested in treating sleep apnea with oral appliance therapy

– Learn about the most cutting-edge research in dental sleep medicine

Monday, March 15, 2010

Patient Story: New Hope Given for Severe Sleep Apnea

Following a sleep test, patients who suffer from severe sleep apnea will most likely begin treatment with Continuous Positive Airway Pressure (CPAP).

CPAP is the most effective treatment for severe sleep apnea patients. The American Academy of Sleep Medicine recommends oral appliance therapy (OAT) for severe sleep apnea treatment only if the patient cannot tolerate CPAP.

However, a new clinical case study indicates that oral appliances can effectively treat severe sleep apnea. Additionally, people who have no teeth may also be able to use the therapy.

The study included a 61-year-old woman from Turkey. The patient was Caucasian and had no teeth. Her husband recommended her for a sleep study because she stopped breathing during the night. She also experienced loud snoring and excessive daytime sleepiness – two common signs of OSA.

The woman took a sleep test, which indicated an Apnea-Hypopnea Index (AHI) of 97.7/hour. This number means that she stopped breathing almost 100 times per hour during sleep.

The woman initially received CPAP therapy but could not tolerate it. She did not want to undergo surgery, so her physician recommended her for OAT.

The woman received a custom-made oral appliance to accommodate her lack of teeth. The dental device kept her airway open to prevent collapses during sleep.

The patient took a follow-up sleep test her first night using the oral appliance and showed an AHI of 30.6. Thirty days after starting OAT, she took a third test and showed an AHI of 14.8. These results indicate that the OAT reduced her condition from severe to mild sleep apnea.

When CPAP cannot be tolerated, an oral appliance may be a safe and effective alternative treatment. If you suffer from sleep apnea, but cannot tolerate CPAP, don’t let your sleep apnea go untreated. Ask your physician about OAT. You can also find a dentist trained in OAT in your area here.

Friday, March 12, 2010

Sleep Apnea and Behavioral Therapy

Dr. Oz recently shared two behavior changes that can help obstructive sleep apnea (OSA) patients treat their condition: side-sleeping and losing weight.

OSA happens when the soft tissue in a person’s throat collapses during the night. Every time the airway collapses, the person wakes up to breathe, disrupting their sleep patterns.

Obese and overweight people often suffer from OSA because they have excess weight around their neck.

If you have sleep apnea, sleeping on your side can remove the pressure from your airway. Losing weight can decrease that pressure altogether.

The AASM recommends that sleep apnea patients combine weight loss with another treatment such as CPAP or oral appliance therapy.

Sleep apnea should not go untreated. Dr. Oz explains that it can cause daytime sleepiness, mood problems, memory loss, heart disease, stroke and death. OSA can also increase a person’s risk for obesity, diabetes and work or driving-related accidents.

Common signs of sleep apnea include loud snoring, daytime sleepiness and morning headaches. Visit a sleep center near you to find out if you have this sleep disorder.

Thursday, March 11, 2010

Launch of the Asian Academy of Dental Sleep Medicine

Dental sleep medicine (DSM) is a young area of practice, but many dentists have come to recognize its importance in the medical field.

An article in the February issue of the journal Sleep and Breathing reports that a new professional organization, the Asian Academy of Dental Sleep Medicine (AsiADSM), launched in October 2009 in Osaka, Japan.

The AsiADSM will join similar groups in the United States, Britain, Japan, South Korea, Germany, and Europe. These organization help train dentists to treat sleep disorders such as obstructive sleep apnea (OSA).

The Korean Academy of Dental Sleep Medicine and Japanese Academy of Dental Sleep Medicine first decided to create the AsiADSM in March 2009. Now a reality, four DSM societies from Korea, Japan, Taiwan and Thailand form the AsiADSM.

Developing the AsiADSM was a major step towards consolidating DSM research in Asia. Its founders hope to support the growth and quality of research and advance the role of dental sleep medicine in Asia.

Its members also plan to raise public awareness of sleep-related breathing disorders and oral appliance therapy (OAT).

OAT involves a trained dentist fitting his or her OSA patients with an oral appliance. This appliance helps move the jaw forward during sleep to maintain a healthy level of airflow. OAT is a safe and effective treatment for OSA.

The American Academy of Sleep Medicine (AASM) recently published guidelines for the treatment of Sleep Apnea. These guidelines indicate OAT for mild to moderate OSA patients if they prefer it to CPAP, cannot tolerate CPAP, or are unable to use positional therapy or weight loss to control their apnea.

Oral appliances (OAs) are also recommended for severe OSA patients if they cannot tolerate CPAP.

Tuesday, March 9, 2010

Sexual Dysfunction Screening Recommended for OSA Patients

A new study found that women with OSA have a high prevalence of sexual dysfunction. The study was published in the February issue of Sleep and Breathing.

It included 21 women with OSA. Each woman took a sleep test and produced a Respiratory Disturbance Index (RDI) of more than five. This number indicates that they all suffered from at least mild sleep apnea.

The women were ages 18 to 40. They were all pre-menopausal.

Eleven otherwise healthy women formed the control group. They did not show signs of sleep apnea and did not take a sleep study. They were also pre-menopausal.

All of the women took a Female Sexual Function Index (FSFI) questionnaire. They also took a mood test.

The FSFI has 19 items broken up into six domains, such as arousal and satisfaction.

The results indicated that how a woman rated her arousal depended on how many times she woke up throughout the night because of her sleep apnea. The higher the woman’s RDI, the lower her arousal rating.

There was no difference in the moods of the OSA patients and control subjects. Their similar moods indicated that the variance in arousal was independent of mood.

The numbers given for the six domains make up the FSFI score. A poor score is anything under 23. More than half of the female OSA patients had a score less than 23. In the control group, none of the women had a score lower than 23.

These results are supported by a small study in Turkey, which also found that women with OSA experience sexual dysfunction.

The researchers suggest that doctors screen their female OSA patients for sexual dysfunction.

Monday, March 8, 2010

Jump on the Bus: Treating Sleep Disorders to Keep Roads Safe

A new study published in the journal Sleep and Breathing found that bus drivers have a high rate of sleepiness and sleep-related accidents.
The study occurred in Edinburgh, UK. It included 677 drivers. Each driver took a sleep questionnaire. They had a median age of 42. Their average body mass index was 27, indicating excess body weight. Twenty-five of the drivers were female.

The researchers spoke with 456 drivers, of which 97 percent completed a questionnaire. Union officials approached 1,398 drivers, of which only 17 percent answered a questionnaire. In total, 677 drivers participated.

Nine percent of drivers reported falling asleep at the wheel at least once per month while working.

Seven percent of drivers reported having an accident and 18 percent a near-miss accident due to sleepiness while working.

Twelve percent of drivers reported ever having falling asleep at the wheel. Of these 77 drivers, 55 percent reported accidents and 52 percent reported near-miss accidents due to sleepiness.

Twenty percent of drivers reported an Epworth Sleepiness Score or more than 10. Drivers who scored less than 10 reported fewer sleep-related driving accidents and near-miss accidents than those drivers who reported more than 10.

Drivers were assured that answering the questionnaire, providing their name, and taking a sleep test would not jeopardize their job. The union supported the study, but the researchers had trouble getting drivers to participate. The drivers showed more caution when the union officials handed out the questionnaires.

The researchers suggest that the low rate of volunteering indicates concern for job loss. Because of the risks associated with undiagnosed and untreated sleep apnea, it is important that these fears are addressed.

The study indicates that 10 percent of bus drivers have OSA. Because the responses were self-reported, researchers note that the actual rate could be higher.

Image by Jungleboy

Friday, March 5, 2010

Relax: Sleep Doesn’t Have to Stress You Out

A new German study found that people who ground their teeth during sleep tended to feel more stressed at work and in their daily life. This stress, in turn, could cause more teeth grinding, or bruxism.

People who ground their teeth also tended to deal with stress in negative ways.

Bruxism happens when a person clenches or grinds his or her teeth together. It can occur during the waking or sleeping hours.

Many people with bruxism also have sleep apnea. In November, this blog reported on a new study that found that one in four sleep apnea patients suffers from teeth grinding.

An estimated 8 percent of the general population has bruxism.

The study involved 69 subjects, of which 48 had bruxism. The full study is available here.

The researchers used three German questionnaires to assess stress parameters and coping methods.

Teeth grinding activity was monitored for five straight nights and the results were analyzed using a computer-based method.

Significant correlations were found between teeth grinding and “daily problems,” “'trouble at work,” “fatigue,” “physical problems” and the coping-strategy “escape.”

It is important to treat sleep apnea and bruxism. Dr. Oz explains why here.

Dentists can help screen for and treat both diseases. Find-a-dentist near you.

Thursday, March 4, 2010

Study: Patients’ Lack of Concern is Cause for Concern

A new study published by the American Journal of Preventative Medicine found that only half of U.S. adults with pre-diabetes have tried to prevent the onset of type 2 diabetes in the last year.

It is important to treat sleep disorders, such as sleep apnea, which can cause or worsen diabetes.

In 2005 to 2006, 30 percent of U.S. adults had pre-diabetes but only 7 percent knew they had it. These results are from the National Health and Nutritional Examination Survey (NHANES).

This new study included more than 1,400 adults with pre-diabetes from the NHANES study.

Researchers asked participants if, in the past 12 months, they had:
- Tried to control or lose weight
- Reduced the amount of fat or calories they ate
- Increased their physical activity
- Been told by a doctor to do the above three activities

They were also asked if they had been screened for diabetes or high blood sugar in the past three years.

The results show that only half of the pre-diabetes patients made behavioral changes to decrease their risk for diabetes. Only one-third of patients had received counsel from their doctor on preventing diabetes.

According to the NHANES study, older men with a lower educational level had a higher risk of pre-diabetes. People with a high body mass index, blood pressure or waist size were also at risk for pre-diabetes.

Like diabetes, many people with OSA do not know they have the condition. You can take the STOP-Bang questionnaire and Epworth Sleepiness Scale to determine your risk. If these tests indicate that you have high risk for sleep apnea, you will want to visit a sleep center.

Wednesday, March 3, 2010

Trivializing Snoring: The Problem Popular Media Poses For OSA

Some medical experts believe that jokes about loud snoring on TV shows and movies have masked a serious medical condition, according to a recent Chicago Sun-Times article.

Popular media and everyday conversations can make light of snoring, and these experts worry that people do not know snoring can be a sign of sleep-disordered breathing.

Tuning-out snoring or sleeping in separate rooms can help spouses cope with the noise but may cover up a serious medical condition.

Loud snoring, along with excessive daytime sleepiness, can signal obstructive sleep apnea (OSA).

OSA causes a person to stop breathing during sleep. It occurs when the soft tissue in the upper airway collapses, preventing airflow. These collapses can occur hundreds of times a night. They often last 10 to 30 seconds, but can persist for more than a minute. Each episode causes the brain to wake up the sleeper, disturbing their sleep.

Dr. Phyllis Zee, director of Northwestern Memorial's Sleep Disorders Center explained why treatment is important.

Patients’ blood pressure tends to surge because of repetitively waking up at night. Couple this with the lack of proper oxygen, what once seemed like a laughable and mildly annoying trait can, over the course of untreated years, lead to heart disease and stroke, she said.

Yesterday, this blog reported on the “Stop-Bang Questionnaire.” These eight questions can help determine if you or someone you know suffers from sleep apnea. This tool can gauge a person’s risk for sleep apnea, but a physician should diagnose the condition at a sleep center.

Tuesday, March 2, 2010

“STOP” to Determine Your Risk for Sleep Apnea

Eighty to 90 percent of people suffering from sleep apnea do not know they have the condition.

The “Stop-Bang” tool was created to detect sleep apnea before surgery. A 2009 study confirmed that the "STOP questionnaire" can help predict a person’s risk for sleep apnea. It is a helpful screening tool for anyone who thinks he or she may suffer from sleep apnea.

These four, yes or no “STOP” questions can help you determine your risk:

S: Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?

T: Do you often feel tired, fatigued or sleepy during the day?

O: Has anyone observed you not breathing during sleep?

P: Do you have or have you been treated for high blood pressure?

You have a high risk of sleep apnea if you answered “yes” to two or more of these questions.

The questionnaire has an even higher predictive value when you answer four more questions from the “STOP-Bang” version:

B: Is your Body Mass Index more than 35 kg/m2?

A: Is your age more than 50 years old?

N: Is your neck circumference greater than 40 cm?

G: Is your gender male?

You have a high risk of sleep apnea if you answered “yes” to three or more of the eight STOP-Bang questions.

The Epworth Sleepiness Scale can also help you gauge your risk for sleep apnea. A sleep study is the only way to confirm that you have sleep apnea.

Source: Sleep Education
Image by Brittany Randolph

Monday, March 1, 2010

High Prevalence of Sleep Apnea in Adults With Down Syndrome

A 2009 study published in the Journal Sleep and Breathing found that sleep apnea may be underdiagnosed in Down syndrome patients.

A fertilized human egg normally has 23 pairs of chromosomes. Most people with Down syndrome have an extra copy of Chromosome 21. This condition can affect both mental and physical development.

In the general population, an estimated four percent of men and two percent of women suffer from obstructive sleep apnea (OSA). The researchers found a much higher prevalence in adults with Down syndrome.

The study involved 16 adults with Down syndrome. Fifteen of them were Caucasian. Their ages ranged from 19 to 56 years. Their sleep was evaluated during an overnight sleep study.

Results show that 94 percent of people with Down syndrome had OSA. Moderate OSA affected 88 percent, causing them to stop breathing more than 15 times per hour of sleep. Severe OSA affected 69 percent, causing them to stop breathing more than 30 times per hour.

Obesity increases a person’s risk for sleep apnea. In this study, body mass index (BMI) correlated with sleep apnea severity. Twelve of the 16 Down syndrome patients were obese.

While 94 percent of the people with Down syndrome had OSA, only one had been referred for clinical evaluation of the condition. Researchers suggest that OSA may be underdiagnosed in this group of people because OSA and Down syndrome have similar complications. Both conditions can cause excessive daytime sleepiness and impaired cognitive function.

A 2003 study in the journal SLEEP found that children with Down syndrome also have a high rate of OSA. The study involved 108 children with Down syndrome. Forty-two percent of the children had at least mild OSA. In contrast, two percent of children in the general population suffer from OSA.

People with Down syndrome often have physical features that increase their risk of OSA – a flat face and short neck, and poor muscle tone.

Sleep apnea is a serious medical condition that should be diagnosed at an AASM-accredited sleep center.


The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.