EIC Social Media Team
(0 comments, 121 posts)
This user hasn't shared any profile information
Posts by EIC Social Media Team
The Centers for Disease Control and Prevention estimate 50-70 million US adults have sleep or wakefulness disorder, and the root cause of these disorders for most is snoring. Many of these snorers have a serious sleep disorder called Obstructive Sleep Apnea (OSA). Snoring is one of the most common symptoms associated with mild obstructive sleep apnea, and is caused by soft tissues vibrating and obstructing the pharynx during sleep. However, most people who snore do not have OSA.
For both those who are just heavy snorers (called primary) and those who have mild OSA, a Brazilian study published recently has found exercises of the oropharyngeal, mouth and tongue significantly reduce the frequency of snoring by 36%. This study was published on the Online First section of CHEST, a journal published by the American College of Chest Physicians.
For the past 20 years, a number of nonsurgical treatments for snoring have been available such as avoiding alcohol, painkillers, sleeping on the back, and weight loss. Surgeries may include treatment for nasal problems, tissue reduction of the palate and upper airway. To add something so simple like mouth and tongue exercises should come as a great relief for those with mild OSA and primary snoring problems. These exercises in conjunction with other treatments should also help on a case-by-case basis.
According to the study, below are the exercises they recommended.
- Push the tip of your tongue against the roof of the mouth and slide it backward and forward;
- Suck the tongue upward against the roof of the mouth, and press the tongue against the roof of the mouth;
- Push back of your tongue against the bottom of the mouth at the same time keeping the tip of the tongue in contact with the bottom, front teeth.
- Elevate the back of the roof of the mouth and uvula while saying the vowel “A.”
“This study demonstrates a promising, noninvasive treatment for large populations suffering from snoring, the snorers and their bed partners, that are largely omitted from research and treatment,” said Barbara Phillips, MD, FCCP, President-Designate, American College of Chest Physicians, and Medical Director, Sleep Laboratory at the University of Kentucky College of Medicine.
To be honest, noninvasive approaches are always the first choice for patients with mild obstructive sleep apnea, and for those who snore, which are a lot of patients, this will be welcome news.
University of New South Wales (UNSW) researchers have answered the enduring question of how the brain processes hearing between our ears, which is essential for localizing sound, hearing in noisy conditions and protecting us from noise damage. This study should get many hearing specialists excited.
The landmark animal study also provides new insight into hearing loss and is likely to improve cochlear implants and hearing aids. A cochlear implant is a surgically implanted electronic hearing device that helps amplify sound for a profoundly deaf person or for someone with severe hearing.
The reason for cochlear implants is that they provide hearing to nearly deaf persons who have damaged sensory hair cells in their cochleas. In these patients, the implants provide enough hearing in order to understand speech. However, the quality of sound differs from natural hearing, because the brain receives less natural sound information to interpret it. Yet the implants offer enough for the patient to hear and understand speech and environmental sounds.
UNSW Professor Gary Housley, senior author of the research paper, said his team’s primary aim was to understand the biological process behind the ‘olivocochlear’ hearing control reflex. The professor added, “The balance of hearing between the ears and how we discriminate between sounds versus noise is dependent upon this neural reflex that links the cochlea of each ear via the brain’s auditory control centre.
The key to this finding is that the researchers were able to fully understand how the olivocochlear reflex works. Professor Housley stated, “When sound intensity increases, the olivocochlear reflex turns down the ‘cochlear amplifier’ to dynamically balance the input of each ear for optimal hearing, sound localisation and to protect hearing.”
Another important aspect of this study found that the cochlear’s outer hair cells, which amplify sound vibrations, also provide the sensory signal to the brain for dynamic feedback control of sound amplification, through a small group of auditory nerve/sensory fibers that were previously misunderstood.
The researchers, using mice, discovered how the olivocochlear reflex in each ear communicates with the cochlear auditory sensory fibers, and this feedback loop allows the brain to balance sound in the environment.
Professor’s Housley’s team further speculated that hearing loss humans experience from old age may be related to the gradual breakdown of these sensory fibers connected to the outer hair cells.
“A major limitation of hearing aids and cochlear implants is their inability to work in tandem and support good hearing in noisy conditions,” Professor Housley also added. “The ultimate goal is for cochlear implants in both ears to communicate with each other so that the brain can receive the most accurate soundscape possible.” This research helps hearing specialists improve cochlear implant devices so that we can create a more natural and effective learning device for those with hearing loss.
According to researchers at Ben-Gurion University of the Negev (BGU), they have developed an innovative approach to testing sleep quality using their new breath sound analysis (BSA). This is less expensive and invasive than current polysomnography (PSG) technology, which has been the gold standard as a sleep apnea test. The study has been published on PLOS Online.
“One of the main goals of sleep medicine today is to improve early diagnosis and treatment of the ‘flood’ ” of subjects presenting with sleep disorders,” says Prof. Yaniv Zigel Ph.D., head of the Biomedical Signal Processing Research Lab in BGU’s Department of Biomedical Engineering.
Prof. Zigel added, “We’ve developed a non-contact ‘breathing sound analysis’ algorithm that provides a reliable estimation of whole-night sleep evaluation for detection of sleep quality, snoring severity and Obstructive Sleep Apnea (OSA). It has the potential to reduce the cost and management of sleep disorders compared to PSG, the current standard of treatment, and could be used at home.”
Generally, the most accurate sleep apnea test has been the polysomnograph (PSG). PSG requires a night’s sleep at a sleep center, and subjects are connected to several kinds of equipment that monitor the heart rate, eye, leg and arm movement, breathing patterns, sleep patterns, and brain patterns. The data is processed and must be interpreted by a sleep specialist in order to reveal insights about sleep/wake states and many aspects of physiology. This procedure is time-consuming and costly.
After comparing the two studies, there were only minor average differences in the measurements between PSG and BSA. The researchers measured 150,000 individual time segments (epochs). From these segments, the BSA proved to be 83.3% accurate with 92.2% sensitivity measuring sleep as sleep. These percentages are high. “The results showed that sleep/wake activity and sleep quality parameters can be reliably estimated solely using breathing sound analysis,” says Prof. Ariel Tarasiuk of BGU’s Department of Physiology and head of the Sleep-Wake Disorders Unit, at Soroka University MedicalCenter.”
For obstructive sleep apnea specialists, there has been a shortage of new and accurate tests. This study highlights the potential–and much needed accuracy–of this innovative approach to measure sleep in research and clinical circumstances. Although there are already many advances with at-home evaluations, this technology clearly points to a more improved sleep apnea test for home studies.
Sleep insufficiency may be caused by many societal factors such as 24/7 access to technology and work schedules, but sleep disorders such as insomnia or obstructive sleep apnea also play an important role. The Centers for Disease Control and Prevention estimate 50-70 million US adults have sleep or wakefulness disorder. Such disorders affect our productivity, car accidents and risky behaviors, and they contribute to diabetes, cardiovascular disease and depression.
Researchers from Boston Children’s Hospital and Merck have discovered a way to collect data that represent sleep disorder symptoms by looking at the way people use Twitter. The researchers have created “digital phenotypes” that reflect behavior of someone with insomnia or another sleep disorder. A “digital phenotype” is simply an observable characteristic influenced by genetics or environment.
The research team used publically available data from Twitter to create a virtual test group of 896 active Twitter users whose tweets contained sleep-related words such as “can’t sleep,” “insomnia,” or hashtags #cantsleep, #teamnosleep, or the names of common sleep aids or medications. They then compared data from that test group to those of a second group of 934 users who did not tweet using sleep-related terms. From these tweets, researchers were able to discover larger populations with some sort of sleep disorder.
The use of big data in healthcare has been increasingly effective in predicting diseases, treating them and even curing some. So it’s no surprise that this study was published in the Journal of Medical Internet Research. This timely study is one of the first to look at links between social media use and sleep disorders.
Another interesting aspect of this study is they were able to assess sentiments expressed in users’ tweets—the tweets were hints that patients with sleep disorders may be at a greater risk for psychosocial issues.
Historically, research on sleep disorders has relied on survey methods. Someone calling you and asking you a list questions would be an example. Such methods are expensive, time intensive and often do not represent the larger U.S. population.
John S. Brownstein, who directs the hospital’s Computational Epidemiology Group, said: “We wanted to see if we could use new forms of online data, such as Twitter, to characterize the sleep disordered individual and possibly uncover new, previously-undescribed populations of patients suffering sleep problems.”
“These findings are preliminary and observational only, and need to be studied further,” Brownstein cautioned. “But they suggest that social media can be a useful addition to our toolkit for studying the patient experience and behavioral epidemiology of sleep disorders.”
Sleep disorders are increasingly affecting society, and besides insomnia, one underdiagnosed disorder is sleep apnea. From this study, there is hope that we’ll be able to help more people who suffer from this treatable condition too.
Nearly 37 million Americans suffer from sinusitis each year. Some of these people will have chronic sinusitis, a common condition in which the cavities around the nasal passages become inflamed and swollen—lasting anywhere from 10 days to 8 weeks.
For most people who suffer stuffy noses and sinus pressure from head colds, their experience is at most uncomfortable because these symptoms last a few days. But for a few others, these symptoms don’t go away within few days. For those with chronic sinusitis, these symptoms may drag on for weeks, and in the worst cases, even months. Fortunately, scientists have stumbled upon a potentially new and effective therapy that might address one of the underlying factors associated with managing chronic sinusitis.
The researchers of a recent study developed a simple method to make molecules called low-molecular-weight, arginine-rich peptides from an already-approved drug compound called protamine. Peptides are a type of amino acid and can create antibodies to boost the body’s immune system. In the lab tests, researchers increased nitric oxide production in mouse immune cells and cells that line airways, making them a good candidate for further development of antibodies to boost the immune system.
Nitric oxide (NO) plays a critical role in your body’s immune system. Scientists found that that a peptide molecule from protamine plays an important role as an antimicrobial agent that helps prevent sinus infections. One reason people have chronic sinusitis is that low levels of NO are lodged in the nasal passages. The NO has been linked to trigger and exacerbate this condition in just small amounts. As you recall, sinusitis may make breathing through your nose difficult and can also lead to facial pain and headaches. One therapeutic approach could involve boosting NO levels, and for Mark E. Meyerhoff and colleagues, they want to further test the possibilities of NO improving chronic sinusitis in adults.
Addressing underlying factors that contribute and improve chronic sinusitis are keys to improving this condition.
Sinusitis affects about one in eight adults in the US, and this translates into over 30 million annual diagnoses. With a cost of $11 billion per year for managing adult sinusitis, it is no surprise that a large part of this cost comes from antibiotic therapy. In fact, nearly one in five antibiotics prescribed for adults are for sinusitis, making it the fifth most common condition responsible for antibiotic therapy.
Yet a new guide published by The American Academy of Otolaryngology—Head and Neck Surgery has recently made changes for ENT specialists that will affect those figures concerning antibiotic therapy. To better serve those with sinusitis, the guide recommends improved doctor-patient communication as the key to offering other methods besides antibiotics that have similar results.
To further hammer this point home about doctor-patient relations, this updated clinical practice guideline identifies quality improvements, and makes explicit actionable recommendations for clinicians managing adult sinusitis, including a greater focus on patient education and patient preference as part of the larger equation.
Of recent, there has been a trend in getting medical professionals to improve the lack of communication between the practitioner and the patient, and those in the medical field are taking notice. Thus, it isn’t surprising to read about a new guideline on managing adult sinusitis by having better communication. In this essential guide, Richard M. Rosenfeld, MD, MPH, explained, “More than ever before, there is a prominent role for shared decision-making between patients and clinicians when managing adult sinusitis–especially in deciding whether to use antibiotics for acute bacterial sinusitis or to instead try ‘watchful waiting’ to see if a patient can fight the infection on his or her own.”
Besides being more restrained in prescribing antibiotics, Dr. Rosenfeld also emphasized the importance of shared decisions regarding sinusitis symptom relief options such as pain relievers, topical intranasal steroids, and nasal saline irrigation.
Other differences between the 2007 guideline and the 2015 update include:
- more explicit details about the role of alternatives to antibiotics;
- more recommendations for amoxicillin with or without clavulanate when antibiotics are prescribed, while the prior guideline recommended amoxicillin alone;
- more discussion about the management of acute and chronic sinusitis, including other procedures.
This clinical guideline for managing adult sinusitis was updated by a multi-disciplinary panel of experts in otolaryngology-head and neck surgery, infectious disease, family medicine, allergy and immunology, advanced practice nursing, and a consumer advocate.
New research has found that patients who have percutaneous coronary intervention (PCI) are at higher risk for obstructive sleep apnea (OSA). PCI, also known as angioplasty, is a procedure used to open blocked coronary arteries and restore blood flow to the heart without open-heart surgery.
One lead researcher, Luciano Drager, MD, PhD, of the University of São Paulo School of Medicine in Brazil, said: “Our findings, in a large, multicenter sample of patients, reinforce the known association between OSA and cardiovascular disease.” He added, “Nearly half of the patients in our study, who were treated with PCI for either myocardial infarctions or angina, had OSA.”
In this study, 1,305 participants had undergone PCI treatment. Most of the patients were male and came from Singapore, China and Hong Kong, India, Myanmar, and Brazil. The researchers performed an overnight sleep study on all subjects. From this test group, nearly half of the participants had moderate OSA and a little over one-fifth of the subjects had severe OSA.
For this group, the researchers administered two screening tools for OSA, and both tests offered highly differing results. From the Epworth Sleepiness Scale, only a quarter of the patients indicated a high risk for OSA. On the other test, the Berlin Questionnaire, only half of the patients were categorized as being at a higher risk for OSA. These tests suggest their unreliability. It is important to note that an estimated 80 percent of men and 93 percent of women with moderate to severe sleep apnea are undiagnosed. With such stakes involved, this study further suggests that there needs to be better tools to diagnose obstructive sleep apnea.
Besides the discrepancies in the screening tools, researchers found more connections between sleep apnea and heart disease problems. This connection has been made before, but this study further confirms this relationship. Dr. Drager added: “Earlier studies have shown strong relationships between sleep apnea and a number of cardiovascular conditions, including high blood pressure, arrhythmia, stroke and heart failure. Our study supports this strong association between OSA and heart disease and also suggests that the methods used to screen for OSA in patients with cardiovascular disease need to be improved.”
The importance of this study evaluates whether OSA contributes to the risk of several heart problems in patients who have undergone successful PCI. Dr. Drager’s research concludes that OSA does contribute to the risks of heart disease, especially for those who have had PCI treatment. He has also discovered that screening tools for OSA need to be better developed so that the highly undiagnosed population with obstructive sleep apnea can get early treatment.
also discovered that screening tools for OSA need to be better developed so that the highly undiagnosed population with obstructive sleep apnea can get early treatment.
Heavy snoring and sleep apnea may be linked to a decline in memory and thinking for younger people, according to a new study published in the issue of Neurology®, the medical journal of the American Academy of Neurology. This study also suggests that treating the disorder with a breathing machine may interrupt the decline.
Ricardo Osorio, MD, with the NYU Langone Medical Center in New York and key researcher of the study, said, “Abnormal breathing patterns during sleep such as heavy snoring and sleep apnea are common in the elderly, affecting about 52 percent of men and 26 percent of women.” The medical histories of 2,470 people ages 55 to 90 were reviewed. Researchers categorized patients in two categories: free of memory and thinking problems, in early stages of mild cognitive impairment (MCI), or with Alzheimer’s disease.
The researchers also looked at people with untreated sleep-breathing problems versus those without the problems and also untreated versus treated people with sleep-breathing problems.
The importance of this study shows that those with sleep-breathing problems were diagnosed with MCI, on average, nearly 10 years earlier than those participants who did not have sleep-breathing problems. For example, those who developed MCI or Alzheimer’s disease during the study had developed MCI at an average age of 77, compared to an average age of 90 for those who did not have sleep-breathing problems. Among that group, those who had sleep breathing problems also developed Alzheimer’s disease five years earlier than those who did not have sleep-breathing problems, at an average age of 83 versus 88.
The researchers found that those who were treated for sleep-breathing problems with a continuous positive airway pressure (CPAP) treatment were diagnosed with MCI about 10 years later than those whose problems were not treated, or at age 82 instead of age 72.
“The age of onset of MCI for people whose breathing problems were treated was almost identical to that of people who did not have any breathing problems at all,” Osorio said. “Given that so many older adults have sleep-breathing problems, these results are exciting — we need to examine whether using CPAP could possibly help prevent or delay memory and thinking problems.”
From this study sleep apnea and memory loss appear connected. Osorio said that, although more research is needed, many of the findings point towards the importance and benefits of sleep apnea treatment. One such treatment is CPAP because it may prevent, or at least delay mental decline for those with the sleeping disorder.
A recent study suggests that undiagnosed sleep disorders are common among middle-aged and older adults in the US, especially among certain minorities.
Researchers studied 2,230 ethnically diverse men and women between the ages of 54 and 93 years from six US communities. Using several tests such as the polysomnography, actigraphy and validated questionnaires during a three year period, the researchers found troubled sleeping patterns played a role in health disparities in the US.
The study indicated that black, Chines and Hispanic Americans were more likely to have sleeping problems than whites, including nighttime breathing problems characteristic of sleep apnea.
Results from this study indicate that about one-third of participants had moderate or severe sleep-disordered breathing measured by polysomnography (PSG). There are several screening tests for sleep disorders and the PSG is the gold standard for testing for sleeping disorders. From the other tests, thirty-one percent had fewer than six hours of sleep, while nearly one-quarter suffered from insomnia, and 14 percent had excessive daytime sleepiness.
“As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations,” said senior author Dr. Susan Redline, professor of medicine at Harvard Medical School and Division of Sleep Medicine at Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center in Boston.
After adjusting for sex and age, the report revealed blacks to be most likely to have the shortest sleep patterns, less than six hours, and they were more likely than whites to have sleep apnea, poor sleep quality, and daytime sleepiness. Hispanics and Chinese were more likely than whites to have sleep-disordered breathing and short sleep patterns, but Chinese were least likely to report having insomnia.
“Our findings underscore the very high prevalence of undiagnosed sleep disturbances in middle-aged and older adults, and identify racial/ethnic disparities that include differences in short sleep duration, sleep apnea and daytime sleepiness,” said lead author Dr. Xiaoli Chen, research fellow in the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston.
The results suggest that different kinds of sleep problems may contribute to health disparities among US adults. According to Dr. Chen and her colleagues, this is the first study that has linked sleep apnea, short sleep, and poor sleep, as well as subjective measures of insomnia and daytime sleepiness, to varying minorities in the U.S. population.
For those suffering with the disorder sleep apnea, an important device has entered the market to reduce this sleeping disorder. By implementing Inspire® Upper Airway Stimulation (UAS) therapy, researchers have significantly improved patients with obstructive sleep apnea (OSA), according to a recent study published in the New England Journal of Medicine. From this study, they found that patients with OSA could reduce their daytime sleepiness and reduce the severity of their condition by 70%.
Called the Stimulation Therapy for Apnea Reduction (STAR Trial), researchers from 22 medical centers in the US and Europe evaluated the effectiveness of upper airway stimulation for sleep apnea.
Let’s remember that OSA affects more than 8 million men and 4 million women in the US, and is twice as common in men. Characterized by repeated episodes of upper airways collapsing during sleep, this condition causes the sufferer to stop breathing on and off many times during sleep, sometimes for a minute or longer. And half of these suffers are overweight. If you have repeated episodes of sleep apnea can lead to daytime fatigue, and put you at risk for heart attack, stroke, high blood pressure and even death.
In this study, all patients had surgery to implant the device. This is how it works: During sleep, the device stimulates the nerve of the tongue, which enlarges and stabilizes the airways so that the patient can control his or her breathing.
One of the greatest advantages of this device is that it senses breathing patterns and then delivers mild stimulation to a patient’s airway muscles to keep the airway open during sleep. Patients also have a “controller” to turn on the device at night during sleep.
Using such sleep-disorder stimulation systems improved sleep apnea episodes by 68 to 70 percent, the research claims. Kathy Gaberson, one participant of the study, said, “My short-term memory has improved significantly, and the surgery has made a huge difference in my quality of life.” She later added, “My apnea episodes went from 23 times an hour to just two.”
In Gaberson’s case, improvements can be dramatic. While other treatments for OSA include weight loss, upper airway surgeries, oral appliances, and continuous positive airway pressure (CPAP).
Whether your general physician suggests the STAR therapy or CPAP or other surgeries, you should consult an ENT specialist for a second opinion.