Archive for July, 2017

Man in his forties (40s) snoring in bed with type 2 diabetes and OSA.

Sleep Apnea and Type 2 Diabetes Prove a Deadly Combination

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Man in his forties (40s) snoring in bed with type 2 diabetes and OSA.

Blindness is a big risk for those with type 2 diabetes and OSA.

Of the 29 million adults with diabetes, 90 to 95 percent of all diagnosed cases have type 2 diabetes, according to the CDC. Another large percentage of adults with this disease also have obstructive sleep apnea (OSA), which may or may not be the cause of type 2 diabetes. OSA is a condition that makes it hard to sleep, causing snoring and interrupted breathing during the night. These symptoms occur when you have a blockage in your throat during sleep, due to a large neck or small airways. Overall, OSA makes it difficult to breathe at night.

Researchers continue to look for the link between type 2 diabetes and OSA through several studies. The most recent study looking into the connection between the two reveals a startling discovery. Left untreated, people with both type 2 diabetes and OSA are at greater risk. These patients can develop a condition that causes blindness.

Diabetic Retinopathy

Around 40 to 50 percent of patients with diabetes have diabetic retinopathy, the most common form of diabetic eye disease. In fact, this condition is the leading cause of blindness in the western world. High blood sugar levels can cause damage to the blood vessels in your retina. When this occurs, the blood vessels will either:

  • Swell and leak
  • Close, stopping blood flow
  • Or grow abnormal blood vessels

You can find out more from the American Academy of Ophthalmology by clicking here.

How the Condition Develops With Type 2 Diabetes and Sleep Apnea

The study at the University of Birmingham is the first to look at the impact of OSA on diabetic retinopathy. It also leads towards the theory that OSA can cause or worsen your diabetes. The researchers tested 230 patients with Type 2 diabetes, accessing them for both OSA and diabetic retinopathy.

“Firstly, we showed that sight-threatening diabetic retinopathy was more common in patients with both Type 2 diabetes and OSA compared to those with Type 2 diabetes but without OSA,” states Doctor Abd Tahrani. Dr. Tahrani is the corresponding author of the University of Birmingham’s Institute of Metabolism and System Research.

“However, more importantly, we have shown that patients with OSA and Type 2 diabetes, compared to those with diabetes only, are at increased risk of developing advanced diabetic retinopathy over a period of three years and seven months.”

Researchers found that the prevalence of diabetic retinopathy was 42.9 percent in those with OSA. This is higher than the prevalence in those with just type 2 diabetes. Meanwhile, after reviewing the patients 43 months later, the researchers discovered that those with OSA were 18.4 percent more likely to develop a moderate to severe case of the disease.

“Our findings are important because improved understanding of the pathogenesis of diabetic retinopathy is important in order to identify new treatments,” states Dr. Tahrani.

“Following our research, it is important that clinicians treating patients with Type 2 diabetes are aware that their patients who also have OSA are particularly at increased risk of developing advance retinopathy and, hence, appropriate preventative measures should be put in place.

Different Cochlear implant devices used for hearing preservation.

Hearing Preservation: Keeping Cochlear Implants in Working Order

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Different Cochlear implant devices used for hearing preservation.

There may be better methods to hearing preservation for those with cochlear implants.

Hearing aids are enough to combat mild-to-moderate damage. While this option works for a majority of people with hearing loss, it simply isn’t enough for those who have suffered trauma to their hearing nerve. In the case of nerve deafness, a cochlear implant is necessary for hearing preservation.

People with this severe degree of deafness need as much help as they can get. That’s why scientists strive to improve the technology that returns hearing to normal. Let’s look at the latest study from the Mount Sinai Hospital, which narrows down the best practice for cochlear implants.

Hearing Preservation: Finding the Better Option

Cochlear implants are medical devices that connect directly to the auditory ear. By bypassing the damaged structures of the inner ear, the implant can improve the hearing of people with severe hearing loss. They help more than 188,000 people worldwide.

Lead investigator and researcher at Mount Sinai, George Wanna, MD, Site Chair, Department of Otolaryngology-Head and Neck Surgery at New York Eye and Ear Infirmary of Mount Sinai (NYEE) and Mount Sinai Beth Israel, found that a certain design of cochlear implants worked better than others. After examining 230 patients with every type of cochlear implant, Dr. Wanna’s team of researchers discovered that implants without wires in the electrode worked best.

These implants are called lateral wall electrodes. Not only do they provide better hearing for those wearing them but they do less damage to the ear. The device is less likely to cause internal fractures to the inner ear, making it less traumatic. In order to prove this point even further, the team tested several different brands of the same cochlear implant, finding the same results.

Dr. Wanna had this to say about the study, “”This is the largest clinical study done in the world on conventional electrodes and will have major implications for doctors and their patients who need their long-term hearing restored. This study is a breakthrough for patients with hearing loss, and improvements in practice and techniques will allow them to enjoy many hearing benefits such as music enjoyment, listening in complex environments, and sound localization.”

Other Findings

The research team at Mount Sinai also made another important discovery – the best surgical approach to inserting the cochlear implant. Most implants are surgically inserted under the skin and behind the ear by drilling through the bone. What the research team found was that other options, without drilling through the bone were better.

The two surgical approaches the team examined are called the “round window” and “cochleostomy.” The round window approach involves surgeons opening the membrane without removing the bone or drilling into the inner ear. On the other hand, the cochleostomy approach does drill into the bone.

“The cochleostomy approach causes fibrosis and scarring, leading to hearing loss over time,” said Dr. Wanna. “Our results also revealed that using oral steroids also helped in the long term to preserve hearing by preventing inflammation.”

Dr. Wanna and his team hope surgeons will put this information to good. This research can help by giving patients the best implants available for hearing preservation. “This is an exciting time in this field, and the advancement in hearing technology and continued improvements in techniques and outcomes will benefit patients and their families,” said Dr. Wanna.

Sick boy in a hospital bed with poor sleep health, which can contribute to post surgical pain.

Poor Sleep Health Results in Pain After Surgery

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Sick boy in a hospital bed with poor sleep health, which can contribute to post surgical pain.

Poor sleep health can affect children after surgery.

There are a number of things that your child goes through as they grow up. Many of these situations involve their health, requiring that they undergo pediatric surgery to remedy whatever ills them. However, what are the after effects of surgery on a child? One study published in The Journal of Pain hopes to find the answer. Researchers discovered that 20 percent of children experience persistent pain after surgery. What is more revealing is that poor sleep health may be the cause.

How Rest Helps the Body

Sleep is important for many reasons as it plays a crucial role in rejuvenating the body’s basic functions and your overall health. The more rest your body receives, the healthier your brain, emotional well-being, physical health, and quality of life will be. For example, sleep maintains a good balance of hormones, especially the ones that control hunger and your blood pressure. Poor sleep health can cause your body to suffer, leaving it at risk for issues like obesity, heart disease, or high blood pressure.

The CDC recommends that children, ages 3-5 years old, receive at least 10-13 hours a day. Meanwhile, older kids, ages 6-12 years old, should sleep for 9-12 hours a day. The CDC states that “Signs of poor sleep quality include not feeling rested even after getting enough sleep, repeatedly waking up during the night, and experiencing symptoms of sleep disorders (such as snoring or gasping for air). Improving sleep quality may be helped by better sleep habits or being diagnosed and treated for any sleep disorder you may have.” For more recommendations by the CDC, click here.

Evaluating Poor Sleep Health in Kids

Researchers from the University of Washington and Seattle Children’s Hospital studied 66 children who underwent major surgery. Over a four-month period, the researchers monitored the sleep patterns of the subjects. They wanted to access the relationship between sleep and pain, and see if poor sleep health is associated with greater pain after surgery. To some extents they were correct.

“Poor sleep quality predicted greater subsequent pain intensity the next day and our findings suggest that poor sleep quality may continue to influence the experience of post-surgical pain in children even four months after surgery,” said lead author Jennifer Rabbits, MB, ChB, Department of Anesthesiology at Seattle Children’s Hospital.

On average, most of the children returned to an adequate quality of sleep four months after surgery. However, looking at the children individually revealed the connect to sleep and pain. Rabbits and the rest of the study’s authors hope that this will show how important sleep quality is. If improve their sleeping habits after major surgery, it could aid in reducing post-surgical pain and recovery.

Aside to post-surgical recovery, good quality sleep has proven necessary in improving many other aspects of your health. Other studies have shown that sleep can stimulate your brain’s ability to learn and reduce stress. If you want your child to remain healthy, make sure their sleep schedule is consistent and they aren’t distracted by electronic devices during the night. This will help them stick to better sleeping habits and maintain their overall quality of life.

Students writing while their classmate is sleeping due to irregular sleep.

Irregular Sleep Leaves College Students at a Disadvantage

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Students writing while their classmate is sleeping due to irregular sleep.

Irregular sleep affects the grades of college students.

The pressures of college life can take a toll on our habits. Some students suffer through late nights in order to cram for tomorrow’s big test. Others are beholden to their class schedule, waking up and going to sleep at different times of the day. This kind of lifestyle leads to irregular sleep patterns, which some researchers are saying holds negative effects.

To understand the importance of our sleep patterns, we have to look at circadian rhythms. Our circadian rhythms are physical, mental, and behavioral changes that react to your body’s natural internal clock. Effectively, these rhythms dictate several aspects of our body. Mainly, they change when we are ready to go to sleep and when we are most alert.

Normally, circadian rhythms regulate what time we wake up and go to sleep. This is based on the amount of light in our given environment. When the sun rises we wake up, and when it’s dark, our body is ready to go to sleep. However, after a thorough analysis of sleep patterns, researchers at Brigham and Women’s Hospital found that a disruption of these rhythms affects the academic performance of students.

Factoring in Irregular Sleep

For this study, the Brigham and Women’s Hospital gathered 61 full-time undergraduates from Harvard College. The participants used sleep diaries to record their activities. The main factors the team was looking for include the following:

  • Sleep Regularity
  • Sleep Duration
  • Quality of Sleep
  • Sleep-Wake Times
  • Academic Performance

“Our results indicate that going to sleep and waking up at approximately the same time is as important as the number of hours one sleeps,” stated Andrew J. K. Phillips, Ph.D., biophysicist at the Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital and lead author on the paper. “Sleep regularity is a potentially important and modifiable factor independent from sleep duration,” Phillips said.

School Grades

“We found that the body clock was shifted nearly three hours later in students with irregular schedules as compared to those who slept at more consistent times each night, stated Charles A. Czeisler, Ph.D., MD, Director of the Sleep Health Institute at Brigham and Women’s Hospital, and senior author on the paper.

“For the students whose sleep and wake times were inconsistent, classes and exams that were scheduled for 9 a.m. were, therefore, occurring at 6 am according to their body clock, at a time when performance is impaired. Ironically, they didn’t save any time because, in the end, they slept just as much as those on a more regular schedule,” continued Czeisler.

Too many changes to the circadian clock can disrupt the body. The process takes some time to adjust to the new schedule of students. As a reaction, the melatonin that your body needs to wake releases much later.

“Regular sleepers got significantly higher light levels during the daytime, and significantly lower light levels at night than irregular sleepers who slept more during daytime hours and less during nighttime hours.”

Researchers suggest that fixing irregular sleep requires that students are exposed to more natural light and avoid using electronic devices at night. They should also stick to a better schedule for when to go to bed and wake up.

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