Friday, July 19, 2013

CPAP Improves Sexual Function in Men With Sleep Apnea

June 18, 2012 (Boston, Massachusetts) — A new study confirms that erectile dysfunction (ED) is common in patients with obstructive sleep apnea (OSA) and indicates that continuous positive airway pressure (CPAP) therapy improves not only sexual function but satisfaction in many men.
Joseph W. Dombrowsky, MD, from the Sleep Disorders Center, Walter Reed National Military Medical Center in Bethesda, Maryland, reported the findings here at SLEEP 2012: Associated Professional Sleep Societies 26th Annual Meeting.

The sample included 92 men newly diagnosed with OSA by in-lab polysomnography who were initiating CPAP therapy. The men had an average age of 45.8 years, mean body mass index (BMI) of 29 kg/m2, and average apnea hypopnea index (AHI) of 38 events per hour, indicating "pretty significant apnea," Dr. Dombrowsky noted in an interview with Medscape Medical News.

"Surprising" Data
At baseline, 43.5% of the men had ED, defined as an International Index of Erectile Function (IIEF) domain score of less than 25. ED was mild in 24% of the men, moderate in 8%, and severe in 12%.
"We were surprised at how many of these relatively young men had ED," Dr. Dombrowsky said. "We were similarly surprised at how robust a clinically significant response the men had with CPAP therapy."

CPAP therapy led to a positive minimal clinically important difference (MCID) in 54.4% of men with mild ED, in 28.6% of those with moderate ED, and in 27.3% of those with severe ED.

In addition, researchers noted a trend toward statistically significant improvement in the IIEF sexual desire domain in all men, with and without ED (+39; 95% confidence interval [CI], -0.01 to 0.79; P = .07). The improvement was greater in those with regular CPAP use (+68; 95% CI, 0.06-1.3; P = .05).
"We didn't have the power to break it down and truly relate the improvement to CPAP adherence," Dr. Dombrowsky said. "It would be great if we could say more is better, but we didn't have the power to do that."

Given the small sample size of 92 men, "we couldn't really control for hypertension, diabetes, and BMI. Only 3.3% of the cohort had diabetes, and about 33% had hypertension, which is about what you see in a national cohort, so the data have some real-world applicability,” Dr. Dombrowsky noted.

"Interesting Study"
Why does CPAP seem to help ED? "It's unclear," Dr. Dombrowsky said. "Nothing has been nailed down yet, but we can postulate that improving oxygenation at night or sleeping better improves your energy and libido," he commented.

Asked for his thoughts on the study, Clete Kushida, MD, PhD, professor and medical director of the Stanford Sleep Medicine Center in Palo Alto, California, and past president of the American Academy of Sleep Medicine, told Medscape Medical News, "The results are interesting, but with a sample size of 92, we definitely want to see more studies."

"I don't recall there being a study looking at the impact of CPAP on ED in a systematic way and one that also included things like quality of life," he added.

The authors and Dr. Kushida have disclosed no relevant financial relationships.
SLEEP 2012: Associated Professional Sleep Societies 26th Annual Meeting. Abstract #0574. Presented June 13, 2012.

Wednesday, June 26, 2013

CPAP Improves Migraine Burden in Patients With Sleep Apnea

BARCELONA, Spain — For migraine sufferers with obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP) treatment can decrease the frequency of migraine attacks, their duration, and intensity. In addition, medication use and lost days from work were reduced, a study shows.

Presenting results here at the 23rd Meeting of the European Neurological Society (ENS), Hildegard Hidalgo, MD, from the Department of Neurology at Kamillus-Klinik in Asbach, Germany, said that 25% of patients with OSA also have migraines and that the frequency of OSA in patients with migraine is similar to that in the general population: about 12% in migraine without aura and about 7% in migraine with aura.

Migraine may be triggered by several factors, including foods, hormonal status, drugs, psychological state, sleep deficit or excess, sensory input, and environmental conditions, including altitude and hypoxia. In this prospective study, the researchers investigated the possible role of hypoxia during sleep and the long-term effects of CPAP therapy on migraine.

They screened 314 potential participants with OSA. Inclusion criteria were an apnea-hypopnea index (AHI) greater than 15 or greater than 5 with clinical symptoms (excessive daytime sleepiness, nonrefreshing sleep, sleep fragmentation, nocturia, decreased concentration, memory loss, or morning headaches), and a diagnosis of migraine according to International Classification of Headache Disorders, second edition, criteria. Additional inclusion criteria were being free of migraine prophylactic medications, oxygen therapy, or other central nervous system medications, and not having any other neurologic or psychiatric disorders. In-hospital video polysomnography was performed.

Of the 314 potential participants, 41 (13.1%) were included in the study, with an average age of 48.9 years and mean body mass index 30 ± 6.1 kg/m2 (20 women). They had a mean Epworth Sleepiness Scale score of 9.8 ± 4.8 and a mean AHI of 27.4 ± 25.4 episodes/hour at baseline. Twenty-one had migraine with aura, 19 had migraine without aura, and 1 had chronic migraine.

Thirty patients (73.2%) accepted CPAP therapy, with data on 24 at 1 year and on 18 at 2 years. Two patients dropped out because they did not accept CPAP long term, 3 were nonadherent (CPAP use <90%), and 7 were not accessible.

Improved Sleep Measures and Migraine Burden
Compared with baseline, polysomnography showed significant improvements at 1 year in AHI, mean duration of sleep-related breathing disorders, oxygen desaturation index (all P < .001), arousal index (P < .002), slow wave sleep (P = .031), and other measures. CPAP therapy significantly reduced migraine measures and disease burden.

Table. Migraine Measures and Disease Burden With CPAP
 
Migraine Measures At Diagnosis (n = 41) 1 Year (n = 24) 2 Years (n = 18)
Frequency of attacks (d/wk) 1.2 0.2 0.1
Attack duration (h) 22 3 3
Intensity 2.7 0.8 0.3
Burden of disease      
Medication intake (units/wk) 2.2 0.3 <0.1
Inability to work (d/mo) 1.2 0.3 0.3
Lost free days (d/mo) 2.1 0.4 0

Dr. Hidalgo concluded that CPAP is an effective therapy for both OSA and migraine in patients with both conditions. It improved nocturnal oxygen saturation, stabilized sleep, and increased slow wave sleep as a proportion of total sleep time. It also reduced the burden of migraine, so she recommended that symptoms of OSA should be considered in migraineurs.

A Single Treatment
Session moderator Pierre Maquet, MD, PhD, professor of neurology at the University of Li├Ęge in Belgium, who was not involved in the study, commented to Medscape Medical News that the study is interesting, especially because at least migraine with aura is recognized as a risk factor for stroke, as is apnea, "so it's nice to see that there is some way to treat both with a single treatment."

However, he pointed out that the study suffers from a lack of a control population, such as participants possibly receiving low-pressure CPAP as a sham treatment or periods of the night in which the CPAP is turned off. "So they can't assess which is the proportion of the effect which is due to the treatment and what's the proportion that is just due to placebo effect, he said.

He noted that the mere fact of having contact with patients over 2 years might explain part of the effect. "The more you see patients, the better they get," he said. A better experiment, he explained, may be a randomized, placebo-controlled, crossover study.

Nonetheless, Dr. Maquet said it makes sense that CPAP could aid migraines. Although no one knows the causes of migraines, they may involve a failure of energy metabolism in the neurons, so hypoxia could induce disruption of metabolism.

The study was not commercially funded. Dr. Hidalgo and Dr. Maquet have disclosed no relevant financial relationships.
23rd Meeting of the European Neurological Society (ENS). Abstract O314. Presented June 10, 2013.

Tuesday, June 25, 2013

VA looks to tighten sleep apnea rating schedule

The Department of Veterans Affairs is studying changes to disability ratings for obstructive sleep
apnea, particularly the 50-percent rating being awarded when VA physicians prescribe use of a CPAP, or continuous positive airway pressure machine, for sleep-deprived veterans.

“That’s definitely going to be the one they look at,” said Jonathan Hughes, a policy consultant for VA’s compensation service. “Because essentially there’s no functional impairment related to that” 50-percent rating for obstructive sleep apnea under the Veterans Affairs Schedule for Rating Disabilities (VASRD).

The good news for more than 114,000 veterans already drawing compensation for sleep apnea is their ratings would not be reduced with broad change to the rating schedule, Hughes explained. Current law prohibits that. Indeed, claimants still awaiting favorable decisions might not be impacted either because VASRD changes don’t happen quickly.

The only date Hughes could quote with certainty is that an ongoing effort to modernize the entire VASRD is to be completed by January 2016.

When interviewed Tuesday at VA headquarters in Washington D.C., Hughes had just delivered a briefing on sleep apnea at a public hearing of VA Advisory Committee on Disability Compensation. The panel, established in 2010, counsels the VA secretary on maintaining or readjusting the VASRD.
This day members wanted to know about sleep apnea including how the condition is rated in its various forms, how service-connection is established for a disorder largely associated with obesity, and what factors are behind the recent explosion of claims, as reported here in late May.

Mike Webster, a family law attorney in Florida, complained to the House Veterans Affairs Committee of widespread abuse of VA claims for sleep apnea. Since then, Webster has heard from staff on the veterans affairs oversight subcommittee that a “team” is looking into his allegations.

“Sleep apnea definitely has become more of an issue over the past several years,” Hughes said as he began his briefing. He gave some of the same data on sleep apnea cases published here, including that VA had rated 983 veterans for sleep apnea in 2001 and almost 25,000 last year. He added that 13 percent of roughly 427,000 veterans who served after 9/11, and draw VA disability compensation today, have service-connected sleep apnea.

“Thirteen percent? That’s staggering,” said committee member Dr. Michael Simberkoff, chief of staff of the VA New York Harbor Health System and a professor at New York University School of Medicine.

The advisory committee chairman, retired Army Lt. Gen. James Terry Scott, also chaired the 2007 Veterans’ Disability Benefits Commission. Scott asked colleagues to back his recommendation that VA Secretary Eric Shinseki commission the Institute of Medicine, part of the National Academies of Science, to conduct a study of sleep apnea in the veteran population.

“Short of a scientific study by a well-recognized and competent authority, I think we’re still working with rumor and innuendo,” Scott said after the briefing, which he said was “extremely informative and…put to rest a lot of different theories and conventional wisdoms.”

One issue addressed was conventional wisdom by some sleep disorder experts that sleep apnea is related to post-traumatic stress disorder.

“We haven’t seen any medical correlation between sleep apnea and PTSD,” Hughes said.  Still the most common path to a sleep apnea rating “is people who are overweight ... getting diagnosed” as they separate or retire.

“Why would they have sleep apnea during service,” asked the committee’s Deneise Turner-Lott, an administrative judge with the Mississippi Workers’ Compensation Commission. “I mean they are not overweight.”

Weight remains the most common cause of sleep apnea, Hughes said, even when diagnosed in service.

Another committee member asked Hughes to explain the link between sleep apnea and military service.

“I don’t think there is any medical link to service,” he said. “There is not something we can point to in service that actually causes sleep apnea.”

Hughes speculated that the rise in claims is related to heighten awareness of the condition among service members and veterans.

Committee member Mark W. Smith wanted to know why VA grants 50 percent disability compensation to vets who need a CPAP for a good night’s sleep. Hughes explained that the rating was set years ago based on studies that estimated “average impairment in earnings loss.”
Simberkoff noted that need for a CPAP means “continuous use of an external agent to maintain their health.”

But Smith followed up by comparing a CPAP to eyeglasses.

“If I don’t use my glasses, my earnings are going to be a hell of a lot less because I’m blind,” he said. “Once I put them on, no problem.” If CPAP “pretty much cures the problem, why would you give a service rating for it?”

Indeed, until VA and the Department of Defense integrated disability evaluation systems for members being medically retired, 99 percent of service members diagnosed with sleep apnea only got a zero percent rating from their branch of service, Hughes said.

But armed with an in-service diagnosis, separated members with sleep apnea can file claims with VA, and 88 percent are rated 50 percent disabled. That a rating level is assured once a CPAP is prescribed to keep the air passage clear during sleep, preventing interruptions in breathing or apneas, which lead to daytime drowsiness and cognitive impairment.

Hughes said a CPAP is not effective for treating persons with the less common “central” sleep apnea, which usually is caused by cardiac failure or neurologic disease and treated with drugs.

Hughes indicated VA benefit and health experts already were at work on reforming VASRD for respiratory illnesses including sleep apnea.

Hughes later said the jump to 50 percent when a CPAP is prescribed has no tie to functional impairment, and therefore “if anything is revised it would be that one. I don’t know if the other [percentages] will stay the same ... but that’s the significant part of the inquiry, the 50 percent.”

To comment, write Military Update, P.O. Box 231111, Centreville, VA, or email milupdate@aol.com or twitter: Tom Philpott @Military_Update

Monday, June 17, 2013

Sleep Apnea? Stick With Your CPAP

Obstructive sleep apnea is the most common type of apnea – which itself means “without breath.” In sleep apnea there are frequent cessations of breathing that last 10 seconds or more. One of the most successful treatments for obstructive sleep apnea is something known as CPAP, which stands for Continuous Positive Airway Pressure. A machine pushes air through the airway at a pressure high enough to keep the airway open during sleep. The problem is that the patient has to wear a mask of some sort, to deliver the air. There are many different masks, including nasal pillows, nasal masks, and full-face masks. But many patients find that any mask is troublesome to wear – and therefore it’s hard to follow the doctor’s advice to use CPAP.

A study from Brazil, has reported findings showing that CPAP is worthwhile. Over 400 men with, on average, more than 30 apnea episodes an hour, were allocated to CPAP or no treatment for 4 months. During this time the thickness of the cell layers lining the arteries decreased significantly. This indicates clearly an improvement in atherosclerosis, the degenerative artery disease that precedes heart attack, stroke, and peripheral arterial disease. Until now, atherosclerosis has not been proven a complication of sleep apnea. This may change.

Anyway, these new findings should make any obstructive sleep apnea sufferer think twice before abandoning his CPAP apparatus.

Thursday, June 6, 2013

Sleep Type Predicts Day and Night Batting Averages of Major League Baseball Players

It’s summer and baseball is one our favorite pastimes. Would you believe the sleep type of a major league baseball player actually predicts his day and night batting average? Sure enough, a study of 16 players from seven MLB teams (Houston Astros, Los Angeles Angels, Los Angeles Dodgers, Pittsburgh Pirates, St. Louis Cardinals, San Francisco Giants, and Toronto Blue Jays) indicate that “morning type” players—those who prefer to go to bed early and wake up early—had a higher batting average as compared to “evening type” players—those who prefer to stay up late and wake up late—in games that started before 2 pm. But, evening types had a higher batting average than morning types in games that started between 2 pm and 7:59 pm.

According to Dr. W. Christopher Winter, the principal investigator for the study and the medical Director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Virginia, “Our data, though not statistically significant due to low subject numbers, clearly shows a trend toward morning type batters hitting progressively worse as the day becomes later, and the evening type batters showing the opposite trend.”

So, a player’s sleep preference could actually impact his batting average. Wow.

The results from this study could potentially create a new way to evaluate athletic talent. Could this spill over into other professional sports? Say basketball and football. What about tennis and golf?

Pretty interesting. To read the article recently published in Sleep Review magazine, click here.

Tuesday, June 4, 2013

SleepSeeker by ResMed gives patients access to their therapy data

ResMed is proud to introduce SleepSeeker, a new online therapy-management tool from Wake Up to Sleep. Wake Up to Sleep is an interactive patient support community for people with sleep apnea. The program provides free tools and resources for every stage of a person’s journey. Whether an individual is just beginning to learn about sleep apnea or has been living with it for many years, the sleep coaches, supportive community and website can help patients live well on sleep apnea therapy.
Download Brochure
What is SleepSeeker?
SleepSeeker is a free online tool that allows patients to upload therapy data from their S9™ device (via an SD card) so they can view their usage, events and mask leak.
How can patients sign up?
Patients can register at WakeUpToSleep.com and become part of the community. Once they’re a registered member, they can access SleepSeeker for free!

What are the benefits of this tool?
SleepSeeker provides an easy way for patients to stay engaged in their therapy by giving them visibility into their progress. It also gives them the option to create plans, set goals and even challenge other users in order to stay motivated.
SleepSeeker—along with other support resources on WakeUpToSleep.com—helps patients get through the critical first weeks of therapy after titration. It can help decrease the number of callbacks you receive and lead to improved compliance and better health outcomes.
Learn more about SleepSeeker today.
Sincerely,
Wake Up to Sleep Team
WakeUpToSleep.com

Tuesday, May 28, 2013

CPAP, Could Improve Blood Sugar Levels, Study Finds

Treating sleep apnea doesn't just minimize daytime fatigue and disrupted sleep -- it could also help blood sugar levels, according to a small new study.

The findings, presented at a meeting of the American Thoracic Society, show that sleep apnea treatment is linked with better blood sugar levels among people with prediabetes.

"We have studied patients with sleep apnea and prediabetes, a condition defined as higher than normal blood glucose levels but not high enough to be considered diabetes," study researcher Dr. Sushmita Pamidi, M.D., of the Department of Medicine at McGill University, said in a statement. "We found that optimal treatment of sleep apnea with continuous positive airway pressure (CPAP) for two weeks led to significant improvements in glucose levels following an oral glucose challenge without affecting insulin secretion, suggesting an improvement in insulin sensitivity."

The study included 39 people who had both prediabetes and sleep apnea. Researchers had them do two weeks of either CPAP treatment (considered the best treatment for sleep apnea) or a placebo. At the start and end of the study, researchers tested the body's ability to use glucose with an oral glucose tolerance test.

Researchers found that the participants who underwent the CPAP treatment had better glucose metabolism. The findings add "to the current literature by demonstrating that CPAP treatment of sleep apnea in patients at risk for developing diabetes may lower this risk [of Type 2 diabetes], and an assessment for sleep apnea may be appropriate as part of the clinical evaluation of patients with prediabetes," Pamidi said in the statement.

Indeed, past research has shown strong associations between having sleep apnea and having a higher risk for metabolic disorders, including diabetes. Specifically, a study presented at the same meeting last year showed that Type 2 diabetes risk goes up when a person has moderate and severe obstructive sleep apnea.

Monday, May 13, 2013

Freedom to power your CPAP machine no matter where your world takes you!

CPAP therapy can be tough for those who have, up until they started therapy, enjoyed hunting, fishing and camping trips where power sources were not available. But your CPAP therapy doesn’t have to hold you back from those types of outdoor expeditions. The CPAP Shop now offers the C-100 battery, which can provide up to 30 hours of battery power. Now you can comply with your therapy and enjoy the outdoor over-night activities you don’t want to give up.

The C-100 battery is a 1.6 pound lithium ion battery with a scratch resistant shell that can be used any where in the world. It’s FAA approved and comes with a 6 month warranty. To give you an idea of it’s capabilities, the C-100 battery can power the following machines for these time periods on an average pressure of 10cm without the humidifier running:
  • Respironics System One CPAP Machine for 30 hours
  • ResMed S9 CPAP Machine for 22 hours
  • Devilbiss InteliPAP CPAP Machine for 16 hours
Depending on the requirements of your therapy, one battery could get you through an entire weekend.

What it comes with

When you purchase the C-100 battery, you get a soft carrying case and a number of attachments. These attachments include a recharger and connectors that will power most CPAP batteries on the market. Plus, you get a chord that will connect two batteries together for longer power times. The power times can almost double when two batteries are connected. The carrying case even has a pocket to hold the extra battery.

Most of the attachments will fit standard CPAP machines. The ResMed S8 and S9 and the Respironics System One require slightly different components. To find out what components you need for these machines, or what components your machine needs if it is different than the ones listed, just contact Respiratory Solutions for assistance. You can find any battery or cables you need on our website.

Don’t let your CPAP therapy keep you stuck indoors when the C-100 battery will let you continue to enjoy everything the great outdoors has to offer.

Thursday, May 2, 2013

Study: Sleep apnea severity is higher in African American men in certain age ranges

A new study suggests that obstructive sleep apnea severity is higher in African-American men in certain age ranges, even after controlling for body mass index (BMI).

"The results show that in certain age groups, after correcting for other demographic factors, the severity of sleep apnea as measured by the apnea-hypopnea index is higher in African-American males than Caucasian males," said James Rowley, PhD, the study's senior investigator, professor of medicine at Wayne State University School of Medicine in Detroit and Medical Director of the Detroit Receiving Hospital Sleep Disorders Center.

Results of multivariate linear regression models show that being an African-American man younger than 40 years of age increased the apnea-hypopnea index (AHI) by 3.21 breathing pauses per hour of sleep compared to a white man in the same age range with the same BMI. For participants between 50 and 59 years of age, being an African-American man increased AHI by 2.79 breathing events per hour of sleep. There was no difference in AHI between African-American and white women.


The researchers analyzed a prospectively collected database of 512 patients studied in the sleep center between July 1996 and February 1999. Inclusion criteria included patients at least 18 years of age, with an AHI greater than 5 events per hour of sleep and a full-night polysomnogram (PSG). Statistical analysis was performed to determine the association between race and AHI while controlling for the effect of confounders and effect modifiers, which included gender, age, BMI and comorbidities. The database included 340 African-American and 172 Caucasian patients.

According to the authors, the mechanism for a racial difference in sleep apnea severity is unclear. They suggested that potential mechanisms include anatomic differences that affect upper airway mechanics and collapsibility, as well as differences in the neurochemical control of breathing.

The American Academy of Sleep Medicine reports that obstructive sleep apnea is a common sleep illness affecting at least four percent of men and two 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 continuous positive airway pressure (CPAP) therapy.

Source: American Academy of Sleep Medicine

Friday, April 26, 2013

New Research May Strengthen Link between Sleep Apnea, ADHD in Kids

Data from a long-term sleep apnea study seems to strengthen the link between obstructive sleep apnea (OSA) and behavior and learning problems in children.
A review of data from a sleep apnea study involving 263 children between the ages of 6 and 11 indicates that children with OSA may suffer from higher rates attention-deficit hyperactivity disorder (ADHD), many instances of which go undiagnosed. OSA and ADHD are often shared in children, and previous research has suggested that children with sleep apnea experience higher rates of behavior problems and learning disabilities.
The initial study, known as the Tucson Children’s Assessment of Sleep Apnea Study, found that 21 children demonstrated persistent sleep apnea while another 23 developed signs of sleep apnea during the study. A recent five-year follow-up with the participants revealed some good news: 41 of the children who presented with signs of sleep apnea no longer experienced breathing problems during sleep.
However, children who showed signs of sleep apnea during the study also had a higher rate of behavior and learning problems. The full findings of the research, which was led by an assistant professor at the University of Tucson, will be published in the April issue of the journal Sleep.
If your child—or any member of your family—snores regularly or has other symptoms of sleep apnea, a knowledgeable dentist may be able to help. There are a number of comfortable and effective sleep apnea treatments available.
Left untreated, OSA can lead to worsening problems, including an increased risk for severe health problems such as hypertension and heart attack.
If you would like to learn more about sleep apnea diagnosis and treatment, please contact Respiratory Solutions

Monday, April 15, 2013

National Sleep Apnea Awareness Day - April 18th, 2013

The American Sleep Apnea Association calls upon all who are concerned about sleep apnea-health professionals, patients, and their advocates-to make special efforts on April 18 to alert the public to this serious, chronic, life-shortening disease. An estimated 18 million Americans or more are believed to have this disease, and three-quarters of them don’t know it.

Untreated sleep apnea in adults can lead to hypertension, chronic heart failure, stroke, sudden death, diabetes, depression, fibromyalgia, excessive daytime sleepiness, and could cause automobile accidents, and other serious and often fatal consequences.

Untreated sleep apnea in children can lead to hyperactivity, compromised immune systems (allergies), delayed cognitive development, and an inability to meet standard growth goals.

“Every day is sleep apnea awareness day at the ASAA (American Sleep Apnea Association),” said executive director Edward Grandi, “but we designated April 18th as Sleep Apnea Awareness Day because we believe that educating people about sleep apnea’s dangers is critical.”

April 18, 1981 is the day The Lancet, the respected British medical journal, published a ground-breaking article describing the invention of the Continuous Positive Airway Pressure (CPAP) machine by Dr. Colin Sullivan, an Australian respiratory physician and a professor of medicine at the University of Sydney.

“CPAP therapy revolutionized the treatment of sleep apnea,” Ed Grandi said.

Prior to Sullivan’s discovery, the only effective treatments for severe sleep apnea were, in some cases, radical weight loss or major surgery. The sleep world has come a long way with the modern transition from frightening procedures such as a tracheotomy to the current use of CPAP to help control breathing.

Sleep apnea’s most frequent form is obstructive sleep apnea when the sleeper’s tongue and soft palate fall back against the back of the throat closing off the airway so firmly that the sleeper doesn’t fully inhale in repeated episodes that last 10 seconds or longer. In severe sleep apnea patients, the episodes can recur hundreds of time during the night, giving rise to serious impairment due to repeated oxygen deficiency.

Since those early days of positive airway pressure therapy three decades ago, many refinements to the device have been introduced and there exist a variety of new therapies, with others in development.

None of the therapies, however, can help the 13 million-plus people who have sleep apnea and are unaware of their medical condition or don’t seek help early for themselves or their children. Symptoms may include regularly awakening exhausted after a full night’s sleep, snoring frequently or loudly, or being seriously overweight; however, some sufferers of sleep apnea have none of these characteristics. A sleep study conducted by qualified health care providers in a sleep laboratory or in the home bedroom is the only conclusive way to determine if a person has sleep apnea.

Tuesday, April 2, 2013

Treating sleep-disordered breathing in pregnancy may improve fetal health


DARIEN, IL – A new study suggests that treatment of mild sleep-disordered breathing with continuous positive airwaypressure (CPAP) therapy in pregnant women with preeclampsia improves fetal activity levels, a marker of fetal well-being.

Results show that the average number of fetal movements increased from 319 during a night without CPAP treatment to 592 during the subsequent night with CPAP therapy. During the course of the night without CPAP treatment, the number of fetal movements decreased steadily by 7.4 movements per hour. In contrast, the number of fetal movements increased by 12.6 per hour during the night with CPAP therapy.
"What would otherwise have been considered clinically unimportant or minor 'snoring' likely has major effects on the blood supply to the fetus, and that fetus in turn protects itself by reducing movements," said Colin Sullivan, PhD, the study's principal investigator. "This can be treated with readily available positive airway pressure therapy and suggests that measurement of fetal activity during a mother's sleep may be an important and practical method of assessing fetal well-being."

The three-part study, appearing in the January issue of the journal SLEEP, began with the validation of a fetal activity monitor against ultrasound in 20 normal, third-trimester pregnant women. The next phase of the study measured fetal movement overnight in 20 women with moderate to severe preeclampsia and 20 matched control subjects. Results show that the number of fetal movements during maternal sleep was significantly lower in the preeclampsia group (289) than the control group (689).

In the final phase of the study, fetal movement was measured on consecutive nights in 10 women with moderate to severe preeclampsia, the first night without treatment and the second night with nasal CPAP therapy. The women had mild sleep-disordered breathing with an apnea/hypopnea index of 7.0 breathing pauses per hour of sleep. A minimal mean CPAP pressure of 7 cm H2O was needed to eliminate upper airway obstruction and airflow limitation.

"Maternal SDB represents a unique opportunity to study the effect of in utero exposures on postnatal development and future risk. This has major implications for public health," Louise M. O'Brien, PhD, MS, associate professor at the University of Michigan, wrote in a commentary on the study. "It raises the possibility that a simple, noninvasive therapy for SDB may improve fetal well-being."

According to the authors, preeclampsia affects about five percent of pregnancies and is dangerous for the mother as well as a risk factor for fetal growth restriction. It involves the onset of high blood pressure and protein in the urine after the 20th week of pregnancy.


Tuesday, February 5, 2013

Nasty Flu Means a Nasty CPAP Mask

Viruses are small, independent particles, built of crystals and macromolecules. Unlike bacteria, they multiply only within one host cell. They transform protein of the host cell into proteins of their own. Activated oxygen or ozone is a natural molecule that is formed when a third atom of oxygen is introduced into the common two-atom molecule that makes up the air we breathe. This molecule becomes “super-charged” and has the ability to oxidize, or destroy many other molecules found in nature. Ozone destroys the flu virus and other viruses by diffusing through the protein coat resulting in killing of the virus. Sanitize CPAP equipment to kill any bacteria or virus that might be living in or on the equipment and mask.

During one of the worst flu seasons seen in many years, Sanitizing can play an extremely important role in keeping you healthy. The flu virus can be transmitted by touching contaminated surfaces. The next step in the transmission involves touching ones face or any object, like the CPAP mask that makes contact with the face. Sanatizing can break the chain of transmission by killing any virus that might be present on CPAP equipment before it contacts our face. Besides the flu virus, other pathogens can contaminate CPAP equipment, causing sinus infections and related respiratory problems. 

Citrus II CPAP Mask Wipes help keep your supplies clean and free of germs

http://www.respiratorysolutions.biz/Citrus-II-CPAP-Wipes-p/635871639.htm