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Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Friday, April 29, 2011

Did Sleep Apnea Hurt Fairley in the NFL Draft?

Defensive tackle Nick Fairley from Auburn was expected to be one of the top picks in the NFL draft this week. The heart and soul of the defense of last year's national champs, Fairley was expected to be picked up no later than number 8 by the Tennessee Titans, who were desperately in need of some defensive juice after last season's poor showing. However, some insiders expressed concern about his sleep apnea. Although he issued a press release showing that he was getting treatment for his sleep apnea using CPAP, he was passed over.

Perhaps officials with the Tennessee Titans were not convinced that Fairley's CPAP treatment would work. Perhaps they know that more than half of all sleep apnea sufferers give up CPAP treatment within the first year. Perhaps they might have been better persuaded by treatment using oral appliance therapy, which treats mild to moderate sleep apnea and has a much higher compliance rate than CPAP.

We will see how well Fairley's CPAP treatment works, and we wish him good luck in his career with the Detroit Lions.

If you have been diagnosed with sleep apnea and want to learn about treatment options that are more comfortable and therefore more likely to be complied with, please contact a local sleep dentist today.

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posted by Dr. Candelaria at 1:45 PM

Friday, April 22, 2011

Research Out of Spain Shows Sleep Apnea More Than Doubles Stroke Risk

According to research presented by researchers at the School of Medicine and the University of Navarra Hospital, people with serious sleep apnea are more than twice as likely to suffer an ischemic stroke than non-sleep apnea sufferers. The study is based on observations of 394 subjects over the age of 70 for six years. At the end of the study, 20 of the subjects had suffered a stroke.

An ischemic stroke--the most common form of stroke--is caused by an obstruction in the blood vessels, such as a blood clot or plaque that breaks off from a thicker blood vessel. This reinforces the results of another study showing that sleep apnea contributes to the prevalence of coronary artery disease and that sleep apnea sufferers are more likely to have soft arterial plaques that have a greater tendency to break off and cause blood vessel obstructions, including acute cardiac events and strokes.

This research again affirms the need for effective sleep apnea treatment. If you have been diagnosed with sleep apnea, your life is in danger, and every day you go untreated, this danger increases. To learn more about all sleep apnea treatment alternatives, please contact a local sleep dentist today.

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posted by Dr. Candelaria at 2:04 PM

Sunday, April 10, 2011

Newly Diagnosed With Heart Failure? Have a Sleep Test To Diagnose Sleep Apnea and Increase Your Survival Rate

A recent study "Sleep apnea testing and outcomes in a large cohort of Medicare beneficiaries with newly diagnosed heart failure" (see abstract below) in the American Journal of Critical Care Medicine showed better outcomes and higher survival rates when patients are tested for sleep apnea and then treated.

This study was among older patients on Medicare.

Medicare now covers oral appliances as well as CPAP.

The problem with CPAP therapy is that most patients do not tolerate it. When heart failure is a issue Dental Sleep Medicine and oral appliances can be a life saver.


Am J Respir Crit Care Med. 2011 Feb 15;183(4):539-46. Epub 2010 Jul 23.
Sleep apnea testing and outcomes in a large cohort of Medicare beneficiaries with newly diagnosed heart failure.

Javaheri S, Caref EB, Chen E, Tong KB, Abraham WT.

Sleepcare Diagnostics, Cincinnati, OH 45040, USA. javaheri@snorenomore.com
Abstract

RATIONALE: Previous studies have demonstrated a high prevalence of sleep apnea (SA) in patients with chronic heart failure (HF), which is associated with higher rates of morbidity, mortality, and health care use.

OBJECTIVES: To investigate the reported incidence, treatment, outcomes, and economic cost of SA in new-onset HF in a large U.S. database.

METHODS: This retrospective cohort study used the 2003 to 2005 Medicare Standard Analytical Files and included subjects with newly diagnosed HF from the first quarter of 2004, without prior diagnosis of SA, stratified by testing, diagnosis, and treatment status.

MEASUREMENTS AND MAIN RESULTS: Among a study population of 30,719 incident subjects with HF, only 1,263 (4%) were clinically suspected to have SA. Of these, 553 (2% of the total cohort) received SA testing, and 545 received treatment. After adjustment for age, sex, and comorbidities, subjects with HF who were tested, diagnosed, and treated for SA had a better 2-year survival rate compared with subjects with HF who were not tested (hazard ratio, 0.33 [95% confidence interval, 0.21-0.51], P < 0.0001). Similarly, among subjects who were tested and diagnosed, those who were treated had a better 2-year survival rate than those who were not treated (hazard ratio, 0.49 [95% confidence interval, 0.29-0.84], P = 0.009).

CONCLUSIONS: In Medicare beneficiaries with HF, comorbid SA is most often not tested and consequently subjects are underdiagnosed and not treated. Meanwhile, in the few subjects in whom a diagnosis of SA is established and treatment is executed, survival improves significantly. These results support the importance of SA testing and treatment for patients newly diagnosed with HF.

PMID: 20656940 [PubMed - indexed for MEDLINE]

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posted by Dr Shapira at 7:08 PM

Friday, April 8, 2011

Sleeping on Your Side May Reduce Snoring and Sleep Apnea

If your doctor is not taking your snoring seriously, he may respond to a request for snoring treatment by telling you to sleep on your side. It turns out this is a reasonable solution for some snorers and obstructive sleep apnea sufferers. According to a recent study conducted by sleep researchers in Israel, just over half of the sleep apnea patients evaluated were positional. In other words, for 54% of sleep apnea sufferers, they were affected by obstructive sleep apnea only when sleeping on their back, not when sleeping on their side. The other 46%, however, continued to suffer the same degree of sleep apnea no matter what position they slept in.

The main difference between the two groups of sleep apnea sufferers? Weight. According to the study, the non-positional sleep apnea sufferers tended to be significantly heavier and have a higher BMI than the positional sleep apnea sufferers. These people likely suffered airway collapse partly due to the weight of tissue pressing on their airway at night, pressure that continues no matter the orientation of the body during sleep.

It is unknown whether the population distribution in this relatively small population reflects the overall population, but for people suffering from mild or moderate sleep apnea, changing sleep position is one of a number of lifestyle changes that can be used to supplement oral appliance therapy in order to get you the maximum correction of your obstructive sleep apnea.

To learn more about the full range of sleep apnea treatment options, please contact a sleep dentist today.

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posted by Dr. Candelaria at 1:01 PM

Monday, April 4, 2011

New CPAP Alternative Publishes Positive Study Results

It looks like obstructive sleep apnea sufferers may soon have another option for sleep apnea treatment. The device, known as Provent, uses the body's own respiratory cycle to create the air pressure necessary to keep airways from closing during sleep.

Provent attempts to give patients the benefits of continuous positive airway pressure (CPAP) without the noisy device and uncomfortable mask. The device is described as an expiratory positive airway pressure (EPAP) device because its vent system uses the body's expiratory motion to maintain pressure that keeps airways open. To use the system, patients put one disposable device in each nostril. These nostril devices are secured with hypoallergenic adhesives that create a seal on the nostril. They have vents that allow you to breathe in, but close when you breathe out, creating a positive pressure that helps the airways to stay open.

In the preliminary results from this study, which is being conducted at 19 centers across the country, researchers compared people using the device with those using sham devices. Within the first week, the 127 people being treated with the Provent device showed significant improvement while the 123 people using sham treatment did not. At three months, the people using the Ventus device saw a 42.7% decrease in their apnea-hypopnea index (AHI), a measure of a person's degree of oxygen deprivation during sleep. In addition, their Epworth Sleepiness Scale (ESS) scores reduced from an average of 9.9 to 7.2. Perhaps most important for comparing the results for the device to CPAP, the median percentage of nights in which people used the device for the entire night was 88.2%.

It is nice to know that there may be another treatment option for people looking to treat their obstructive sleep apnea without CPAP. If you would like to learn more about the treatment options available for your sleep apnea, please contact a local sleep dentist today for more information.

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posted by Dr. Candelaria at 1:27 PM