Monday, September 27, 2010

Cost of Obesity Weighs Down on North Americans

Researchers at George Washington University recently published data on the individual costs of being overweight and obese in the United States. It is the first-ever report on the individual cost of having excess weight.

According to the study, the annual cost of being obese in the U.S. is $4,879 for women and $2,646 for men. The researchers analyzed prior research to determine the "real-life costs" of obesity. They examined loss of productivity at work, employee sick days and the need for additional gasoline, among other factors.

Taking into account the economic value of lost life pushed the annual cost of obesity to $8,365 for women and $6,518 for men.

The study notes that obesity increases a person’s risk for sleep apnea. Losing weight has been shown to improve sleep apnea, but the AASM recommends that weight loss be combined with CPAP or oral appliance therapy. Treatment should be directed by a sleep physician.

Obesity also raises the prevalence of type II diabetes, hypertension, cardiovascular disease, asthma, certain types of cancer, and other conditions.

A new report from the Organization for Economic Cooperation and Development found that Americans have the highest rate of obesity in the world.

The report notes that the lifespan of an obese person is up to 8 to 10 years shorter than that of a normal-weight person.

Unfortunately, obesity is a problem that is being adopting by children. This Montreal Gazette article reported on a new Canadian study that found most pediatricians believe parents are not taking their child’s weight seriously.

The study included 860 pediatricians. When asked to identify key barriers to child weight loss, more than 60 percent of the surveyed doctors noted:

- Parents who are overweight themselves
- Parents who become defensive when the topic of their child’s weight is raised
- Parents who show little interest in helping their child lose weight

Not sure if you have a weight problem. Check your body mass index here.

Thursday, September 23, 2010

Sleep Apnea Screening Tool Now Available in Thai

A new study published in the journal Sleep and Breathing tested the reliability and validity of the Thai version of the Epworth sleepiness scale (ESS). The ESS is a simple questionnaire used to screen for obstructive sleep apnea (OSA). You can take the ESS here for free.

The researchers also assed the relationship between the ESS score and the severity of OSA.

This study involved 228 subjects - 149 males and 79 females. Thirty-two healthy volunteers and 39 snorers made up the control group. After polysomnography, 126 were diagnosed with obstructive sleep apnea (OSA).

Scores between the two groups were significantly different. The average ESS score for control subjects was 6. In contrast, OSA patients scored about a 10.

Thirty-one OSA patients were successfully treated with CPAP or upper-airway surgery. They took the ESS 3-6 months after treatment. Their ESS scores decreased significantly.

The researchers concluded that the Thai version of the ESS successfully screens for OSA. It can also asses response to treatment. However, the tool was unable to differentiate severity levels of sleep apnea.

The authors recommend combining the Thai ESS with a more comprehensive clinical evaluation.

In April, this blog reported that the ESS was successfully translated into Korean.

Wednesday, September 15, 2010

A Decade of Weight Loss and Still Shedding Pounds

The Biggest Loser is gearing up for Season Ten of its popular weight loss reality TV show. This year’s season premier will air September 21 at 8/7c on NBC.

According to this press release, Nationwide Medical and Philips Respironics will pair up for a third season of testing and treating the contestants.

Last year, the SleepEducation blog reported that all 16 candidates had obstructive sleep apnea. Former AASM President Dr. Clete Kushida worked with the contestants to ensure that they received the maximum benefit from ongoing treatment.

Like in Season Nine, contestants will continue to receive assistance once their time on the show comes to an end.

Obesity increases risk for this sleep-related breathing disorder because excess weight around the neck can cut off airflow during sleep.

Losing weight can help people treat their condition. But the American Academy of Sleep Medicine recommends that sleep apnea patients combine weight loss with CPAP treatment or oral appliance therapy.

You should talk to your doctor to develop a healthy weight-loss plan that is right for you. Sleep apnea is a potentially life-threatening condition. Diagnosis and treatment are available at an AASM-accredited sleep center.

Monday, September 13, 2010

Vikings Player Tackles His Obstrucitve Sleep Apnea

According to Kevin Seifert’s recent ESPN blog post, Minnesota Vikings’ player Percy Harvin recently started treating his obstructive sleep apnea.

Harvin experienced a migraine and lost consciousness during practice on August 19. The doctors gave him an overnight sleep test, which showed that his troubles were rooted in sleep. Harvin’s results indicated that his breathing frequently stopped for up to ten seconds, depriving him of oxygen.

He told NBCSports.com that he no longer takes his migraine medication, which he blames for his collapse. Instead, he uses continuous positive airway pressure (CPAP) to treat his OSA. This device pumps air into his nose to regulate his breathing during sleep.

Sleep apnea is a common problem in professional football players.

In June, this blog reported on a new study from the journal SLEEP that found that more than 19 percent of NFL players might have sleep apnea.

The study included 137 NFL players from six teams. Each athlete took an at-home sleep test. This test determined if a player stopped breathing during his sleep. It also measured how often the pauses occurred and for how long.

Five percent of the players had moderate to severe sleep apnea. Fourteen percent had a mild form of the condition.

The NFL players also took a sleep questionnaire. Snoring was reported by 100 percent of the players. Observed pauses in breathing and daytime sleepiness were reported by 25 percent.

Experts estimate that sleep apnea affects four percent of men in the general population. They suspect that 18 million Americans have the condition.

Image by Brandi Korte

Wednesday, September 8, 2010

Why Some Kids Can’t Get Enough Shuteye

Dr. Richard Kravitz, director of Duke’s Pediatric Sleep Laboratory, recently discussed pediatric sleep apnea on DukeHealth.org.

Dr. Kravitz noted that obstructive sleep apnea (OSA), in which the airway becomes partially or completely blocked during sleep, occurs in one to three percent of otherwise healthy children. It prevents a child from getting restful sleep

OSA is most common in children two to seven years of age, but it can also affect infants and adolescents. While the most common cause of OSA in children is enlarged adenoids and tonsils, obesity is an increasingly common culprit. Children with Down syndrome also experience a high risk.

Signs of sleep apnea include loud, frequent snoring and pauses in breath followed by gasps. Dr. Kravitz explained that snoring appears in 10 percent of otherwise healthy children and does not always indicate OSA.

Restless tossing and turning may also reflect sleep troubles.

Untreated OSA can cause physical and behavioral problems including daytime sleepiness, excessive napping, behavior changes, hyperactivity, concentration troubles, poor growth, bedwetting, high blood pressure and cardiac problems.

Diagnosis of sleep apnea takes place at a sleep center. A sleep test will monitor how many times a child stops breathing during sleep. The test also monitors brainwaves, heartbeats, and oxygen and carbon dioxide levels. These factors provide evidence of airway obstruction.

An article in today’s Chicago Tribune reported on how some hospitals have created sleep centers specifically designed for children’s needs. Many traditional sleep centers also treat children.

Sleep center rooms look similar to bedrooms. A parent is encouraged to spend the night with their child to provide comfort and confirm how closely the night of observed sleep reflected home sleep patterns.

After a diagnosis, there are several treatment options. Weight loss, tonsil removal, continuous positive airway pressure, and oral appliances are several common treatments.

A list of sleep centers is available here.

Thursday, September 2, 2010

Sleep Apnea Worsens Insulin Resistance in Teens

A new study in the Sept. 1 issue of SLEEP indicates that obstructive sleep apnea (OSA) worsens insulin resistance in obese teens. Insulin resistance is a risk factor for type 2 diabetes.

OSA has been linked to diabetes and cardiovascular problems. Obesity increases a person’s risk for sleep apnea, but after adjusting for obesity, sleep apnea is an independent risk factor for insulin resistance and hypertension in adults.

The researchers hypothesized that OSA was associated with worse insulin resistance.

The study included 98 children, of which 42 were female and 56 were male.

“Prepubertal” children were seven years of age on average. There were 37 prepubertal children.

“Pubertal” children were 13 years on average. There were 61 pubertal children.

Each child took an overnight sleep test and had their insulin resistance assessed.

The results?

In obese pubertal children, OSA was associated with worse insulin resistance, putting them at greater risk for developing type 2 diabetes.

Wednesday, September 1, 2010

Sunshine State Asks Sleepy Drivers to Stay Off the Roads

The state of Florida's first "Drowsy Driving Awareness Week” takes place September 6-10. Gov. Charlie Crist signed into law the “RonShay Dugans Act.” It aims to create greater awareness about the dangers of drowsy driving, making Florida the 18th state to do so.

The definition of drowsy driving varies from state to state, but every state's definition revolves around the concept of a fatigued driver.

Excessive daytime sleepiness (EDS) can cause impaired reaction time, memory problems, mood changes and driving accidents. It can increase a person’s risk for deadly motor vehicle accidents by 15 times.

Motor vehicle accidents due to “drowsy driving” account for $48 billion in medical costs each year. The National Highway Traffic Safety Administration says drowsy driving is responsible for about 100,000 car crashes a year.

Drowsy driving can be as dangerous as drunk driving. Current legislation recommends that commercial drivers get screened and treated for obstructive sleep apnea (OSA), a common cause of EDS. But there are many non-commercial drivers who do not know that they have OSA.

Florida’s drowsy driving week honors an eight-year old Tallahassee girl. ABC reported that RonShay Dugans was going to the Boys and Girls Club in a bus in 2008 when a drowsy driver behind the wheel of a cement truck slammed into the back of the bus and killed her.

Chief Leroy Smith of the Florida Highway Patrol told ABC that it's no different than driving under the influence. “With regard to drowsy driving, it is just as dangerous as drunk driving just as alcohol and drugs could impair one’s normal faculties, so could sleepiness and drowsiness. It could also slow one’s reaction time.”

RonShay’s adoptive father, Perry West, said RonShay’s legacy is an important reminder for all drivers. “We are reminded every day when we get up in the morning of just what we lost and so with this we are also mindful of the price that was paid to get this legislation passed.”

In 2003, New Jersey was the first state to pass a law aimed specifically at fatal accidents involving sleepy motorists - estimated at about 1,500 a year nationwide. Such drivers can now be charged with vehicular homicide. That offense is punishable in New Jersey by up to 10years in prison and a $100,000 fine.

Learn more about the risks of drowsy driving here.

Disclaimer

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.