Wednesday, December 29, 2010

Two New Studies Incentivize Weight Loss in 2011

United Press International (UPI) reports that researchers are studying a potentially life-threatening correlation among obstructive sleep apnea (OSA) and obesity.

Scientists at the Lynn Health Science Research Institute in Oklahoma City are recruiting volunteers for the study of obesity and OSA, a disorder that causes pauses in breathing during sleep.

Obesity has been found to be the main cause of OSA, mostly because obese people have larger tonsils and tongues, which interfere with air flow during sleep.

Seventy percent of sleep apnea patients are obese, researchers say.

According to Kelly Shepherd, a research fellow from Australia, and one of the researchers working at the Lynn Health Science Research Institute, those who suffer from OSA can stop breathing from five to 130 times per hour. They are at risk for heart attacks, car wrecks, depression and lost work productivity caused by daytime sleepiness, she said.

Drowsy driving has become a major public health concern as obesity rates rise.

The LA Times reported last week that a new study in the American Journal of Emergency Medicine found that obese drivers are more likely to die in a serious car wreck than drivers of normal weight.

Researchers at the University at Buffalo in New York examined drivers' body sizes and the number of car crash deaths between 2000 and 2005 from data in the Fatality Analysis Reporting System. The study calculated an increased risk factor of dying at 21 percent for moderately obese drivers and 56 percent for morbidly obese drivers.

"Many people think they just sleep badly and wake up feeling terrible the next day," said Shepherd. "Many don't know why."

Experts estimate that 80 to 90 percent of people with OSA are undiagnosed and untreated.

Learn more about OSA here. Sleep apnea can be diagnosed at an AASM-accredited sleep center.

Image by John K.

Monday, December 27, 2010

Zaps for ZZZs: Scientists Shock the Tongue to Keep Air Flowing

The Associated Press reports that a new implant might be able to block obstructive sleep apnea (OSA).

Scientists are testing to see if an implanted pacemaker-like device might help certain sufferers keep their airways open by zapping the tongue during sleep.

OSA occurs when the tongue and upper-airway collapse during sleep, blocking the airway – sometimes for a minute or more repeatedly throughout the night.

The experimental implant intends to stimulate the nerve that controls the base of the tongue with a mild electrical current during sleep to make it stay toned and in place like it does during the day.

Three companies are already developing implants and planning studies to test the results.

"In this kind of research, we're not looking for little changes," says Dr. Meir Kryger, a sleep medicine specialist at Gaylord Hospital in Connecticut, who is helping to lead Inspire's study. "What we're looking for is actually cure."

The American Academy of Sleep Medicine (AASM) estimates that more than 18 million Americans suffer from sleep apnea.

One patient who had success with the early testing of hypoglossal nerve stimulation was Rik Krohn, 67, of suburban Minneapolis.

"It got to the point where I'd dread going to bed," says Krohn. Sleep studies showed his apnea was awakening him an average of 35 times an hour. He tried five different CPAP masks unsuccessfully before giving up in frustration, and surgeons turned him away.

These experiments are only now beginning, with a handful of implants performed so far — and while it's an interesting concept, frustrated patients should try some proven steps first, cautions, Dr. Amy Atkeson of Columbia University Medical Center in New York.

The American Academy of Sleep medicine recommends weight loss, oral appliance therapy, and CPAP for OSA treatment.

Image by Tiago Daniel

Wednesday, December 15, 2010

Snoring: Fixing what a Punch in the Shoulder Can't Solve

According to a recent New York Times piece, treating snoring and sleep apnea often requires trial and error.

A common misconception about sleep apnea is that it only affects older, overweight men. But sleep apnea can affect anyone, even children.

The article tells how Dr. Elizabeth Walton, a 43-year-old mother of two, has a common and sometimes embarrassing health problem – snoring.

“We laugh and joke about snoring,” said Dr. Nancy A. Collop, president elect of the American Academy of Sleep Medicine, “but it can be pretty annoying and disruptive to couples.”

Almost half of the adult population snores at least occasionally and for half of them, snoring may be a sign of sleep apnea, a serious medical condition.

After trying CPAP and finally settling on opal appliance therapy, Dr. Walton, and her partner, are both sleeping better.

Because Dr. Walton has obstructive sleep apnea (OSA) instead of primary snoring, medical insurance has covered most of her treatments.

Oral appliances are custom-made mouthguards that move your lower jaw forward to open your airway during sleep.

A dentist who specializes in sleep medicine fits an appliance to your mouth, usually for $1,500 to $3,000. That price should include all follow-up visits and any adjustments that need to be made, said Dr. Sheri Katz, president of the American Academy of Dental Sleep Medicine. Medicare reimburses patients for oral appliance therapy if they meet certain medical criteria.

Studies show that custom-fit appliances ease mild to moderate sleep apnea in about 75 percent of patients and snoring in 80 to 90 percent of patients who use them regularly, said Dr. Katz.

Friday, December 3, 2010

Putting a Name to Sleep Apnea: NAMES Screening Tool a Success

Sleep experts estimate that 80 to 90 percent of obstructive sleep apnea (OSA) patients are undiagnosed and untreated.

Many patients do not know they have a problem because they are unaware that they wake up throughout the night to breathe. Bed partners often detect OSA because of the loud snoring that can accompany the breathing disorder.

Because dentists see patients on a regular basis, they frequently screen patients for sleep apnea. If screening shows the patient is at risk for OSA, he or she will then go to sleep physician for a diagnosis and treatment.

A new study in the journal Sleep and Breathing examined a new screening method that combined symptoms with a physical exam to predict the presence of sleep apnea. The NAMES assessment looked at neck circumference, airway classification, related diseases, Epworth scale, and snoring.

By including self-reported historical factors with physical exam findings, researchers were able to better screen for OSA.

The study included 150 adult subjects. They had never been diagnosed with sleep apnea but were referred to sleep center because they showed signs of the condition.

The study results indicate that the NAMES assessment is an effective, inexpensive screening strategy for screening patients for moderate to severe OSA.

Another screening tool includes STOP.

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.