The Veterans Administration announced that from 2008 to 2010, the number of veterans who receive benefits for sleep apnea increased by 60%, and that more than 20% of military veterans suffer from the sleeping disorder, compared to the estimate of 5% for those not in the military.
Although one of the main causes can be excess weight, the VA doctors suspect that repeat deployments to Iraq and Afghanistan are exposing the military service members to dust and smoke which are contributing to the increase in cases.
More than 63,000 veterans receive benefits for sleep apnea, which can cause daytime drowsiness, heart disease, and even strokes. The most common treatment is the continuous positive airway pressure (CPAP) mask. Although the Social Security Administration recognizes sleep apnea as a disability and pays benefits to those who can’t work, the VA says veterans can receive benefits and hold jobs.
The Department of Veterans Affairs is expected to spend approximately $500 million a year to treat veterans with sleep apnea, and it is expected to rise in the upcoming years. Considering that sleep apnea is linked to serious conditions such as heart disease, diabetes, hypertension, obesity, and daytime sleepiness, which can cause memory loss and decrease work productivity, it is critical that these veterans receive appropriate care.
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According to a study in the October issue of the Archives of Otolaryngology — Head & Neck Surgery, there is a questionnaire available to help identify patients undergoing surgery to identify whether they have obstructive sleep apnea (OSA), and whether they are at a higher risk for post-operative complications of the heart and lungs.
The questionnaire was administered by a team led by Tajender S. Vasu, M.D., of the Thomas Jefferson University Hospital in Philadelphia to 135 patients who were about to undergo elective surgery. The study compared the number of patients with high and low OSA with those that had post-op complications using the questionnaire called the “STOP-BANG,” which is an acronym for identifiable signs of OSA: Snoring, Tiredness during the day, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference and Gender.
Of the 41.5% of patients that had high risk scores for OSA from the questionnaire, 19.6% had post-op complications, compared to 1.3% who had low OSA scores. The study was able to demonstrate that a high risk score for OSA on the STOP-BANG test is associated with post surgical complications, providing physicians with a means to identify those patients prior to their surgery.
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Snoring from sleep apnea can have dangerous consequences. For years physicians have known that chronic snoring can cause daytime symptoms of fatigue that affect cognitive function and memory loss due to the interruption in sleep it causes. A new study out of Australia from the Institute for Breathing and Sleep at Melbourne’s Austin Health reveals not just an impact in function. Snoring while you sleep could be the cause of brain damage.
During the Australian study, brain scans of 60 people in their mid 40’s who were recently diagnosed with sleep apnea, a common sleep disorder, showed “a decreased amount of gray matter” compared to healthy sleepers. Sleep apnea is caused by the airways collapsing while asleep at night, pausing breathing and forcing sleep apnea sufferers from rousing from a deep sleep, sometimes “hundreds of times a night,” according to Dr. O’Donoghue of Austin Health. This pause results in the brain being deprived of oxygen as well as “surges in blood pressure”.
Since the scans showed decreased amount of grey matter in the brain, it meant there was damage in certain areas. According to O’Donoghue, the damage was evident in two pockets of the brain, one that handles memory and the other known to allow smooth movement and changes in attention during complex tasks. Earlier studies have showed that this part of the brain is activated during a driving task, and therefore may explain why sleep apnea patients have an increased risk of car accidents.
“What specific part of sleep apnea might cause these changes we can’t say, but we can see the changes that have occurred…The take home message is if you complain of these sort of symptoms it is not a good idea to ignore it, you should seek help,” Dr. O’Donoghue said.
This research was presented at the 22nd Annual Scientific Meeting of the Australasian Sleep Association and Australasian Sleep Technologists Association Conference, in Christchurch, New Zealand.
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A troubling study was released last week by the American Automobile Association (AAA) Foundation for Traffic Safety which found that of 2,000 American drivers polled, one-third admitted to falling asleep or nodding off while they were driving in the past year. The results of the study were much more severe than expected, which was released in conjunction with the organization’s “Drowsy Driving Prevention Week” November 8th-14th, 2010.
While this particular study did not attempt to specify the reasons behind America’s growing drowsiness issue, we know from past research that there is a common link between the snoring disorder, sleep apnea and a higher rate of car and truck crashes. Two years ago, a study published in the medical journal Thorax and conducted by Vancouver Coastal Health Research Institute and University of British Columbia revealed that sleep apnea patients are at double the risk of being in a car crash, and are three to five times more likely to be in a serious car crash involving personal injury.
The National Highway Traffic Safety Administration estimates that drowsy driving results in 1,550 deaths, 71,000 injuries and more than 100,000 accidents each year. Fifty-seven percent of drowsy driving crashes involved the driver drifting into other lanes or even off the road.
Additional findings from the AAA study include these worrisome statistics:
- More than half (55%) of those drivers who reported having fallen asleep while driving in the past year said that it occurred on a high-speed divided highway.
- More than half (59%) had only been driving for less than an hour before they nodded off. Only 20% had been driving for three hours or more.
- 26% reported that it happened between 12 noon and 5pm.
These findings point to the importance of getting snorers the treatment they need to keep themselves and the rest of the public safe. The sleep loss associated with snoring impairs a person’s ability to perform tasks involving memory, learning, reasoning, mathematical processes and severely impacts reaction time in drivers. In addition, since heavy snoring can carry great health risks — especially sleep apnea which causes a person to be startled awake numerous times throughout the night because they stop breathing — it is a responsible choice to seek treatment by a snoring specialist.
To learn more about the diagnosis and treatment of snoring and sleep apnea, visit Eos Sleep’s FAQ section. If you or someone you know suffers from the daytime symptoms of snoring, don’t hesitate to seek treatment. If you are in the New York tri-state area, schedule your evaluation and contact us today.
To read more of AAA’s study and the impact of drowsy driving, visit http://drowsydriving.org.
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Results of recent study indicate that Obstructive Sleep Apnea (OSA) patients who use CPAP (Continuous Positive Airway Pressure) for their treatment of the disorder show a noticeable improvement in memory. Research presented at the SLEEP 2010 annual meeting of Associated Professional Sleep Societies in San Antonio showed results that indicated that OSA patients who were being treated with CPAP therapy outperformed patients who were not receiving treatment by correctly identifying more photographs after one night of sleep.
The study divided 135 adults between the ages of 33 and 65 years into three groups. Seventy-eight people who were diagnosed with OSA and had been using CPAP therapy for three or more weeks comprised the experimental group. The baseline group included 50 people who were diagnosed with OSA but had not been using CPAP. The final group of 30 people who tested negative for OSA comprised the control group.
All participants were monitored overnight by in-lab polysomnography and were shown 20 photographs the night before their sleep. The next morning they were shown 20 pairs of photographs which contained a photo that had been presented the night before, and one that was similar but not shown to them. Participants picked which photo in each pair was the one that they had seen before.
The lead author of the research abstract was Ammar Tahir of the Memory Laboratory in the department of psychology at the University of Notre Dame in South Bend, IN. He was surprised by the findings. “The most surprising result of our study, thus far, is the noticeable improvement in memory that CPAP patients experience,” he said. “These results suggest the success of CPAP therapy in regenerating obstructive sleep apnea patients’ memory deficits.”
OSA is a sleep-related breathing disorder that occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and obstruct the upper airway, leading to pauses in breathing that can reduce blood flow to the brain. Most people with OSA snore loudly and frequently, and suffer from many symptoms of daytime fatigue including memory loss. OSA can be dangerous in that it affects the heart and lungs and is linked to cardiovascular disease, stroke and high blood pressure.
Although some patients complain about the discomfort of wearing a mask while they sleep, CPAP therapy is the most favored treatment of OSA by physicians because of the results it provides. This study indicates that improved memory is yet another benefit to the therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restores normal oxygen levels.
Another interesting discovery from the study indicated that the OSA group using CPAP out-performed the control group without OSA the on the memory tasks. Researchers believe that this is an important finding that could provide direction for future research to study the effect of CPAP therapy on brain function and memory processes.
Learn more about obstructive sleep apnea and the CPAP treatment.
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Add “metabolic syndrome” to the growing list of health risks and symptoms caused by or linked to snoring. In a study just released in the December issue of the journal SLEEP, it was found that adults were two times more likely to develop metabolic syndrome if they snored loudly during sleep.
Metabolic syndrome is a group of combined risk factors that indicate a person may have an increased chance of developing coronary artery disease, stroke, and type 2 diabetes. The syndrome is becoming common in the United States and is related to obesity. Two of the most common risk factors associated with the syndrome are extra weight around the middle of the body (central obesity), and insulin resistance, in which the body cannot use insulin effectively.
Led by researcher, Wendy Troxel of the University of Philadelphia, the study followed 812 adults (ages 47-74; 36% African American; 67% female) in an “ongoing, community-based prospective.” This was the first prospective study to link metabolic syndrome with snoring, as well as with the sleep disorders difficulty falling asleep (DFA), unrefreshing sleep and insomnia. Those studied were free of metabolic syndrome at the start, had completed a baseline sleep questionnaire, and participated in a metabolic syndrome evaluation three years after the baseline. A subset of 290 participants were measured for their apnea-hypopnea index (AHI) using a portable monitor.
The study examined the risk of developing factors of metabolic syndrome according to participant’s individual snoring and sleep symptoms and insomnia. Sleep complaints have been highly prevalent with cardiovascular disease (CVD), and interestingly, 14 percent of the participants developed metabolic syndrome while they were participating in the study.
The results of the study indicated that those who snored loudly were twice as likely to develop metabolic syndrome, and also predicted specific metabolic abnormalities such as hyperglycemia and low high-density lipoprotein cholesterol. Even when adjusted for AHI or the number of metabolic abnormalities at baseline, loud snoring remained a significant predictor of metabolic syndrome, whereas difficulty falling asleep, unrefreshing sleep and insomnia had less significance. It is believed that evaluating sleep symptoms will help physicians identify patients at risk for developing metabolic syndrome.
To read more about the research results, visit SLEEP.
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According to a new article in the Journal of Neuroscience, scientists in Toronto believe that they have been able to isolate a hormone that is produced when there is frequent interruption in breathing during sleep, such as what happens during a sleep apnea event.
Scientists from the University of Toronto simulated repeated obstruction of the airways in short 15 second intervals in rats by restricting air into their lungs repeatedly. What they found was that these repeated restrictions of breathing, or “apneas” caused the rats’ brains to gradually trigger more forceful contractions of their lungs, therefore causing progressively deeper breath intakes.
According to Dr. John Peever, lead author of the study and Associate Professor of Neuroscience, the study showed “that repeated disruption of normal lung activity — what happens during sleep apnea — triggers a form of learning that helps you breathe better.” He believes that this could be harnessed “to help overcome the breathing insufficiency that typifies sleep apnea.”
This study also found that the brain chemical noradrenaline allows this change in breathing to occur. It is what is required to cause brain plasticity and helps the brain to adjust to breathing more effectively when there are interruptions in breathing that occur over and over again such as when someone has sleep apnea.
The findings of this study are important because they suggest that drugs that affect noradrenaline levels in the brain may help improve breathing in patients suffering from sleep apnea, perhaps even the creation of a “sleep apnea pill” in the future.
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For many years the medical community has known that obesity is a major cause of snoring which causes sleep deprivation. Now there is proof that a lack of sleep can actually lead to obesity. It is a circle that can start in childhood and gets more vicious as we age if it goes untreated.
A professor in the Department of Psychiatry and director of Sleep Disorders Center at Sacré-Coeur Hospital, Jacques Montplaisir, conducted an analysis of 1,138 children and found that 26 percent who didn’t sleep enough were overweight, 18.5 percent carried extra weight, and 7.4 percent were obese.
The weight gain is due to hormones that are secreted when there is not enough sleep. As Montplaisir explained, “When we sleep less, our stomach secretes more of the hormone that stimulates appetite, and we also produce less of the hormone whose function is to reduce the intake of food.” According to Montplaisir, naps don’t make up for the lack of a good nights sleep.
For snorers, this problem is compounded because snoring leads to a lack of sleep, and it is often caused because the snorer is overweight or obese. In these cases, often a lifestyle change such as diet and exercise can help. However when snoring is also due to a physical cause such as obstruction or chronic infection, it is important for the snorer to seek medical treatment from a snoring specialist.
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When you have a cold or an allergic reaction that causes your sinus passages to become inflamed and clogged, breathing through your nose becomes difficult and uncomfortable, especially at night. Here are 5 tips you can do to help ease your snoring in order to get a better, more restful sleep.
- Sleep on your side. Snoring occurs when your tongue drops to the back of your throat when the muscles relax, which causes a vibration that makes noise. Sleeping on your side as opposed to your back will help prevent that.
- Elevate your head. By using an extra pillow, your sinuses can drain, and congestion will not pool in your nasal passages as much as it would if you sleep flat on one pillow.
- Run a humidifier while you sleep to keep the air moist.
- Avoid antihistamines that contain a sedative, as well as alcohol and sleeping pills which relax the upper airways, causing an increased airway resistance and snoring.
- Before bed use menthol rub on your chest and apply directly under your nose, which will help keep your nasal passages clear.
In order to get enough oxygen when you’re asleep, your body’s natural reaction is to breathe through your mouth, which commonly causes snoring. Unfortunately, snoring can prevent you from getting a full restful night of sleep, so important, especially when your body’s immune system is fighting a cold. In addition, snoring can acerbate soreness in your throat, and cause it to be dryer and feel scratchier. Make sure you get enough sleep so you can get healthy faster, by getting to bed earlier than usual and resting when you need to.
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Mood swings, hot flashes and night sweats are just some of the symptoms that women face in those years of life between peri- and post-menopause. But what many don’t realize is another condition, sleep apnea, becomes more common in women as they go through menopause, with the majority of those experiencing more apnea episodes in their later post-menopause years. In addition, in the menopause years, the episodes are also more severe.
While hot flashes are commonly the target of blame for women who report sleep deprived nights, the underlying cause of their sleepless nights and corresponding daytime fatigue may actually be sleep apnea for many. Clinical researchers at the University of Toronto and St. Michael’s Hospital believe that post-menopausal sleep apnea is likely due to decreased levels of female hormones.
Research conducted at St. Michael’s Hospital Sleep Laboratory compared 290 pre- and 400 post-menopausal women, and ruled out obvious other causes of apnea such as obesity and neck size. They found that 47 percent of post-menopausal women suffered from sleep apnea, compared to 21 percent of pre-menopausal women, and that the condition was more severe in the post-menopausal group. Dr. David Dancey, of the University of Toronto and St. Michael’s Hospital where is a Fellow of Clinical Research in its sleep lab stated, “We think the difference may be due to the lower levels of estrogen and progesterone caused by menopause.” The study excluded women who experienced menopause at an early age or who underwent hormone therapy.
Although this in-depth study was conducted over a decade ago, there has been little attention paid to the risk of sleep apnea in menopausal women, or to those who suspect they may have it, but are reluctant to get treatment. This is unfortunate because in addition to the daytime symptoms brought on by fatigue such as poor concentration and job performance, memory loss and more; sleep apnea is a serious condition that can lead to lung and heart problems, and even stroke.
With the latest advances in technology, diagnosis and treatment have never been more convenient. For example, with the new home sleep study, many patients are no longer required to stay overnight at a sleep lab to get their testing done, and may do so in the comfort of their own home. Also for many, a cumbersome CPAP machine is no longer the “gold standard” in apnea treatment. The Pillar® Procedure and Balloonplasty™ are just some treatments that can be accomplished with an office visit to a snoring specialist.
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