Posts tagged obstructive sleep apnea
As sleep disorders become more and more prevalent, so does the risk from not treating them. It’s important to have these disorders diagnosed; otherwise it will evolve into something much worse. In a new study by the American Academy of Neurology, their research suggests that sleep disorders, like insomnia and oversleeping, may increase stroke risk.
Patients and Stroke Risk
A stroke is essentially an attack within the brain that happens when blood vessels are blocked or the brain starts to bleed. It can cause weakness, dizziness, slurred speech, vision problem and numbness. According to the Center for Disease Control (CDC), more than 800,000 people in the United States have a stroke each year, and on average, one American dies every 4 minutes from a stroke.
Disorders, like insomnia and oversleeping, are common among patients who have suffered from a stroke. However, research shows that they also can act as a telling sign. According to Dirk M. Hermann, MD, of the University Hospital Essen, and study author, “People with sleep disorders may be more likely to have another stroke or other negative outcomes than people without sleep problems, such as having to go to a nursing home after leaving the hospital.”
This study stresses the importance of getting tested. Without testing, patients are left undiagnosed and untreated for their sleeping disorders. The negative outcomes of insomnia include depression, daytime sleepiness, fatigue, and irritability. Oversleeping has been known to cause diabetes, obesity, and headaches.
The most common treatment for sleep disorder is a continuous positive airway pressure machine (CPAP). This treatment has proven itself success for resolving sleep disorder. The researchers also note that stroke risk in patients with sleep disorder decreased after receiving this treatment.
Stroke risk certainly increases the longer one waits to be treated. The researchers hope that the study will make more patients aware of the issue.
Sleep disorders like sleep apnea are dangerous if left untreated. New studies suggest that the risks to those who develop the disorder are becoming greater and greater every day. One such study, reported in the “Journal of Hepatology,” suggests that obstructive sleep apnea (OSA) contributes a great deal to non-alcoholic fatty liver disease (NAFLD) in adults and children.
What Is NAFLD?
Non-alcoholic fatty liver disease (NAFLD) is a condition where fat builds up in the liver. This may be due to a resistance to insulin and a metabolic syndrome. This disorder usually shows up in a high percentage of those with obesity. This is a liver disease that is not caused by alcohol, hence the name.
It is unhealthy to have too much fat stored in the liver. This causes the liver to swell up, scarring is developed, and can lead to liver cancer or failure. There aren’t that many symptoms with NAFLD. Typically the disorder causes the following:
- Spider-like blood vessels
- Ascites (abdominal swelling)
- Abdominal discomfort.
How Sleep Apnea Causes Liver Disease
Due to low levels of oxygen during sleep, many patients with sleep apnea develop oxidative stress, which means that their body has trouble detoxifying the harmful effects of free radicals. This can speed up the progression of NAFLD, and eventually lead to a worst disease called non-alcoholic steatohepatitis (NASH).
Lead investigator Shikha Sundaram, MD, MSCI, of the Children’s Hospital Colorado, University of Colorado School of Medicine stated, “According to recent reports, pediatric NAFLD patients with OSA/hypoxia have more advanced liver disease and fibrosis, supporting a role for OSA/hypoxia in the development of NASH. However, the mechanisms underlying this relationship have not yet been explained.”
The disease affects 30% of the general population in Western countries, and about 9.6% of all children. With the growing issue of obesity, this condition could potentially affect more people every year.
The researcher’s findings showed that patients with severe liver disease also had a serious case of OSA. They hope that correlation between the two conditions will lead to finding a way to treat patients. “We definitely need trials designed to investigate whether CPAP treatment may significantly affect NAFLD progression in this age range. The only randomized controlled trial was of relatively short duration, performed on adult patients with mild OSA/hypoxia and normal baseline transaminases, and apparently did not demonstrate any impact on steatosis, NASH or liver fibrosis,” says Dr. Sundaram.
According to new research, one of every four pregnant women suffer from obstructive sleep apnea (OSA). Unfortunately, pregnant women with OSA are more likely to be left untreated because it is not seen as a danger to either the mother or child. However, this new research suggest that OSA can be the cause of several symptoms in pregnant women. Now, researchers are recommending that doctors diagnose this condition as gestational sleep apnea.
Doctors Ignore OSA in Pregnant Women
Doctors are ignoring OSA in pregnant women because they attribute difficulty breathing during sleep, as well as daytime fatigue, to their pregnancy. Doctors are usually unwilling to refer pregnant patients to an ENT specialist, believing that symptoms will subside after their child is born. Some researchers believe that this thinking is a misstep in helping pregnant women with gestational sleep apnea.
Prof. Yehuda Ginosar, director of the Mother and Child Anesthesia Unit at the Hebrew University, and co-author of the study, states that “Currently there is a lack of uniform criteria to diagnose, treat and classify OSA in the pregnant population, which in turn complicates efforts to determine the risk factors for, and complications of, gestational sleep apnea.”
The Risk of Gestational Sleep Apnea
Without proper diagnosis and treatment of Gestational Sleep Apnea, pregnant women are left at risk. Not only do they suffer from both difficulty breathing during sleep and daytime fatigue, but the disorder is known to cause several complications in their condition, including high blood pressure, high blood sugar, and heart disease.
When non-pregnant adults are diagnosed with OSA, they are treated with continuous positive airway pressure (PAP machine) to relieve their symptoms. Researchers stress the importance of diagnosing pregnant women so that they might receive the same treatment. Without proper action, women and their babies are at risk.
Dr. Suzanne Karan, co-author of the study and Associate Professor of Anesthesiology and Director of the Anesthesiology Respiratory Physiology Laboratory at the University of Rochester School of Medicine, sends out a call to action for doctors, stating, “The time has come for our profession to wake up to the diagnosis of Gestational Sleep Apnea. This will allow us to research obstructive sleep apnea in pregnant women more effectively, and to develop and implement more effective treatments.”
Parents constantly worry about their child’s development. They stress over their child’s health, as well as their emotional state of being. However, what if their health and emotions were tied together? One study suggests that sleep loss in children increases their risk for emotional disorders.
Scientists for the University of Houston recently revealed the long-term effects of sleep loss. Without an adequate amount of sleep, children are at risk for developing depression and anxiety as they grow up. These are serious conditions that can have severe consequences down the line.
According to the Center for Disease Control (CDC), more than 1 out of 20 Americans, 12 years of age and older, reported current depression in 2009–2012. Depression comes with a variety of emotional symptoms. This includes a loss of appetite, loss of interest, sadness and hopelessness, insomnia, and thoughts of death or suicide.
While occasional anxiety is common among people, conditions such as general anxiety, panic, and social anxiety disorder can deeply affect one’s quality of life. Symptoms of this condition can affect the way people operate within the world around them, as they are in constant fear. Intense worry, attacks of fear, and an inability to interact with others, are just some of the issues people with anxiety have to deal with on a daily basis.
How Sleep Loss Affects Children Emotionally
Candice Alfano, a clinical psychologist and associate psychology professor at the University of Houston, says that the study’s purpose was to determine “how children appraise, express, regulate and later recall emotional experiences, both when sleep is adequate and when it is inadequate.”
The study tested 50 children, between the ages of 7 to 11, by restricting their sleep. They found that the children not only began to show sign of negative emotions, but were less impacted by positive experiences. Sleep loss seemed to have affected how they view things emotionally, putting a negative veil over everything they did, and making activities less exciting.
In the end, Alfano suggested that “Continually experiencing inadequate sleep can eventually lead to depression, anxiety and other types of emotional problems. Parents, therefore, need to think about sleep as an essential component of overall health in the same way they do nutrition, dental hygiene and physical activity. If your child has problems waking up in the morning or is sleepy during the day, then their nighttime sleep is probably inadequate. This can result for several reasons, such as a bedtime that is too late, non-restful sleep during the night, or an inconsistent sleep schedule.”
Sleep disorders, like sleep apnea, can have a negative impact on your health. Prolonged suffering has been known to cause diabetes and cognitive deficiencies, as well as affect your overall quality of life. New research suggests that heart patients who have some form of sleeping disorder are at risk of developing further complication—and even death.
The Risk to Heart Patients
All 241 of the patients who participated in the study successfully underwent a procedure called percutaneous coronary intervention (PCI). The procedure is meant to treat acute coronary syndrome (ACS), a condition where the blood supplied to the heart is blocked. PCI seeks to remove the blockage and reopen blocked arteries.
The goal of the study was to gather more data on the link between sleep apnea and heart disease. “Sleep-disordered breathing, which includes snoring and sleep apnea, has long been recognized as an important risk factor for heart disease. However, there is limited awareness of sleep-disordered breathing among cardiologists who care for PCI patients,” said Toru Mazaki, M.D., study author and chief physician of the Department of Cardiology, Kobe Central Hospital, Kobe, Japan.
When the patients were hospitalized for the surgical procedure, researchers examined their breathing during the night. For the next 5.6 years, the patients’ health was monitored for any further complications. Here is what they found:
- 3 percent had sleep-disordered breathing.
- 4 percent of those with sleep-disordered breathing had major cardiovascular events.
- Only 7.8 percent of those without sleep-disordered breathing had major cardiovascular events.
These cardiovascular events include deaths, strokes, recurrent ACS, and heart failure. The research shows that there may be a link between the two disorders, even after the person has taken care of their heart issue.
Sleep disorders are becoming a prevalent problem for many people. The researchers hope that other doctors see sleep disorder as a warning signal for heart patients. “Doctors and patients should consider sleep studies post-PCI to rule out sleep-disordered breathing or take necessary precautions to restore healthy breathing during sleep,” says Dr. Mazaki.
The doctors even suggest that hospitalized heart patients who have undergone surgery should be routinely tested for sleep-disordered breathing. More research still needs to be done, and hopefully doctors can treat patients before their sleep disorder leads to more complications.
As parents raise their children they often worry about the state of their well-being. Thoughts such as how they are sleeping throughout the night, and how well they are preforming in school, are examples of everyday concerns. Sometimes, those concerns are one in the same. Sleep apnea in children is a growing issue, and a recent study shows that learning challenges are also on the rise.
How Sleep Apnea in Children Affects Schoolwork
Scientists from the University of Chicago brought together 1,359 public school children ages 5 to 7 years, those with and those without a pre-existing snoring condition. The students were separated into four groups based on the severity of their sleep apnea.
They underwent sleep assessment questionnaires, an overnight sleep study and a measurement of their cognitive functions. Scientist found that even snoring has a detrimental effect on a child’s memory and language and his ability to understand and pay attention. Sleep apnea in children increases the chance of developing these cognitive defects.
How to Prevent Sleep Apnea in Children
The results of the study were presented at the ATS 2016 International Conference where Leila Gozal, MD, MSc, from the University of Chicago, states, “Our findings provide further justification for exploration and development of simple cognitive batteries that can be coupled to the current clinical evaluation of children with habitual snoring such as to better guide the management of the decision-making process.”
If you are a parent worried that your child is at risk for sleep apnea, here are some common symptoms you can look for:
- Enlarged tonsils or adenoids.
- Snoring, pauses in breathing, snorts, or gasping.
- Trouble sleeping.
- Daytime sleepiness.
- Behavioral problems.
- Learning difficulties.
The study shows that sleep apnea in children can lead to cognitive difficulties, which slow the progress of your child’s development. An ENT physician specializes in helping patients with sleep apnea symptoms. Consider having your child evaluated by a local ENT physician, so that the state of their well-being is less of a concern in the back of your mind.
The first multicenter-prospective study on the relationship between cancer and sleep-disordered breathing recently occurred. Crucial findings were discovered. The study revealed a link between untreated sleep apnea and an increased aggressiveness of malignant cutaneous melanoma.
Researching Melanoma Aggressiveness
Most research into sleep apnea establishes that there is a relationship between the disorder and heart disease. However, the researchers who conducted the multicenter study wanted to know if the condition could also be related to cancer.
According to the CDC, in 2012 alone, more than 1.5 million American were diagnosed with cancer, and more than 500,000 Americans died of this disease. Globally, 14.1 million new cancer cases were diagnosed in 2012. Every day scientists are trying to learn more about this prevalent illness.
The new study involved 24 teaching hospitals that are part of the Spanish Sleep and Breathing Network. The researchers examined the progress of 412 patients with confirmed cases of cutaneous malignant melanoma. Patients with melanoma were chosen because this form of cancer can be easily observed and measured.
Patients underwent a sleep study, and researchers discovered that those with the most aggressive cancers were more likely to have a severe case of obstructive sleep apnea.
“Based on our study, it seems a relationship between sleep apnea and cancer may also exist. It is very important, however, that people with sleep apnea do not infer that they will necessarily develop cancer,” said lead author, Miguel Ángel Martinez-Garcia, MD, PhD, from Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Dr. Martinez-Garcia suggests that “People who snore, frequently wake up at night or have daytime sleepiness should see a sleep specialist, especially if they have other risk factors for cancer or already have cancer. Physicians—especially dermatologists, cancer surgeons and medical oncologists—should ask their patients about potential sleep apnea symptoms, and refer them for a sleep study if they have these symptoms.”
While more research is needed, this research hints at a link between the two conditions. Hopefully more doctors, like the ones who participated in this study, will learn more about the relationship between melanoma and sleep apnea.
Delaying treatment of obstructive sleep apnea can affect your daily life. Impaired breathing leads to difficulty sleeping, which leads to daytime sleepiness. However, not treating your sleep apnea can result in disastrous consequences. According to a recent study, commercial drivers who failed to properly manage their obstructive sleep apnea were more likely to cause truck crashes.
Untreated Sleep Apnea and Truck Crashes
The recent research is considered the largest study related to obstructive sleep apnea and crash risk among drivers of commercial motor vehicles. Scientists gathered 1,613 truck drivers with obstructive sleep apnea, and an equal number who do not (the control group), to participate in the study. Their hope was to find out how well truck drivers with sleep apnea performed on the road—when they consistently used treatment.
The truck drivers with obstructive sleep apnea were prescribed positive airway pressure therapy, otherwise known as PAP therapy. The researchers decided to give the drivers an automatic-adjusting machine that could be used at home or in the truck sleeper berth while on the road. The drivers who consistently followed through with the treatment performed just as well on the road as the control group. However, the rate of preventable truck crashes was five times higher among those who did not actively use their PAP therapy.
A common symptom of untreated sleep apnea is daytime sleepiness. This could be the cause of the rise in preventable truck crashes among drivers with sleep apnea.
Consequences of Neglected Treatment
“This study emphasizes that untreated obstructive sleep apnea is a pervasive threat to transportation safety,” said American Academy of Sleep Medicine’s President Dr. Nathaniel Watson, who was not a part of the study.
Dr. Watson is not the only one who feels this way. Schneider, the North American trucking firm that researchers used to gather data for the study, terminated the drivers who did not adhere to sleep apnea treatments. However, they seem to be one of the few companies actively monitoring truck drivers with sleep apnea. Most trucking firms are not required by the Federal Motor Carrier Safety Administration (FMCSA) to institute mandatory sleep apnea screening. This is something medical experts are recommending needs to be changed.
Did you know approximately 5.7 million Americans suffer from heart failure every year? This is a staggering number. If you are a patient dealing with this condition, you might want to also monitor your sleep. Sleep apnea can harshly affect your heart. However, there is positive news. A new study suggests that treatment of sleep apnea may help improve progress in patients with heart failure.
Treating Both Sleep Apnea and Heart Failure
Heart failure is a condition in which the heart grows weaker. When this happens, the heart cannot pump enough blood that the body needs in order to function properly. This may cause fatigue, shortness of breath and fluid build-up in several parts of the body.
Most patients with heart failure are constantly in and out of hospitals. According to research recently published in the American Journal of Cardiology, treatment of sleep apnea may help patients with the condition.
Researchers tested 70 patients with both sleep apnea and heart failure. Of those 70 patients, 37 actively used a treatment that helps breathing, called Positive Airway Pressure (PAP) Therapy. The other 34 patients where non-compliant—and did not use the PAP ventilation machine.
A common problem with patients who undergo PAP therapy is that they don’t commit. Many find the mask required for the treatment to be uncomfortable, leading them to discontinue further treatment. However, those who did continue using PAP therapy experienced positive results.
“Our research showed that early recognition and treatment of patients hospitalized with decompensated congestive heart failure is associated with a reduction in readmissions, for patients who use their positive airway pressure (PAP) therapy on a regular basis,” said first author Sunil Sharma, M.D., FAASM, Associate Professor of Pulmonary Medicine in the Sidney Kimmel Medical College at Thomas Jefferson University.
These results heavily indicate that sleep apnea and heart failure may be connected. “Physicians should be on the lookout for sleep apnea in patients with heart failure with the goal of diagnosing and treating early, which might help prevent readmissions and emergency room visits,” Dr. Sharma said. While more research needs to be done to validate these findings, this research puts patients and doctors on alert.
If you are at risk for obstructive sleep apnea (OSA), your doctor is usually the first person to tell you. However, what if this information came from an unlikely source? Like your dentist. A new study shows that the size of your tongue and tonsils could be affecting how much you sleep.
The Research into Oversized Tongue and Tonsils
OSA is the most common form of sleep apnea. The disorder usually causes difficulty breathing, excessive snoring, and unexplained daytime sleepiness. Most people are not even aware that they are suffering from the condition. As with many OSA cases, a complete or partial obstruction of the upper airways causes the disorder.
Thikriat Al-Jewari, an orthodontic researcher at the University at Buffalo, New York, led a new study that suggests your dentist might have an opportunity to identify signs of OSA. The study finds that abnormally large tongue indentations and tonsils are frequent indicators of the condition.
Researchers analyzed and tested over 200 patients at the dental clinics at the University of Dammam’s College of Dentistry in the Kingdom of Saudi Arabia for OSA. Testing for common signs of OSA, and using the Berlin Questionnaire—one of the most validated tests for OSA—they discovered 23 percent of their patients were at risk for OSA. Of those at risk, the most common symptoms were large tongue and tonsils.
Many people who suffer from the condition go undiagnosed and untreated. Unfortunately, patients who remain untreated can endure a worse fate. OSA has been linked to cardiovascular disease, diabetes, depression and more. Al-Jewari’s findings are a crucial step in getting people with OSA the help they need.
“Dentists see into their patient’s mouths more than physicians do and the signs are easy to identify,” says Al-Jewair. He goes on to suggest that if dentists are properly trained to identify signs of an oversized tongue and tonsils, they can point patients in the right direction. Dentists are by no means qualified to give a diagnosis on the matter. However, having these professional look out for the signs of the disorder can significantly help solve the problem of patients who go undiagnosed and continue to live with OSA.