Our Sleep Apnea Blog | I Hate CPAP

Research Suggests Link between Sleep Disorders and Schizophrenia

2012-01-24T11:21:00.000-08:00

Sleep disorders have long been linked to mental health problems including depression, anxiety, attention deficit hyperactivity disorder and bipolar disorder among others. A recent University of Oxford study suggests there may also be a link between sleep disorders and schizophrenia.

The causes of schizophrenia are not understood, although some genetic predispositions are thought to play a role. However, many schizophrenia patients suffer from sleeping problems.

While sleeping problems can be triggered by lifestyle factors, genetics and medications, Oxford researchers found that sleep disorders seem to exist in schizophrenics regardless of these factors. The study, which was led by Professor Russell Foster and published in the Dec. 22, 2011, issue of The British Journal of Psychiatry, compared the sleep patterns of 20 diagnosed schizophrenics and 20 otherwise healthy individuals.

Over a six-week span, researchers monitored daily motor activity and exposure to light, as well as weekly melatonin levels. All of the schizophrenia patients had varying sleep patterns, required more time to fall asleep, and slept for longer periods of time.

The melatonin levels of the schizophrenics who participated in the study showed that 50 percent of the schizophrenia group had delayed sleep-wake cycles that were out of sync with the day-night sleep cycles of healthy participants. The other 50 percent of the schizophrenic patients in the study were more closely synchronized with the day-night cycle, but still demonstrated sleep irregularities.

While the study did not demonstrate a cause for the link between sleep disorders and schizophrenia, conditions such as cardiovascular disease and metabolic disorders are also common in both schizophrenics and those who suffer from sleep disorders such as obstructive sleep apnea.

If you believe you suffer from the symptoms of sleep apnea or another sleep disorder, a dentist specializing in sleep disorders may be able to help you diagnose and treat the cause of your condition.

Please contact us to locate a qualified sleep disorder dentist near you.

Increased Sleep Apnea Awareness, Testing brings Rise in Insurance Spending

2012-01-16T08:35:00.000-08:00

As awareness about the symptoms and risks of sleep apnea—particularly obstructive sleep apnea (OSA)—have increased, so has insurer spending on diagnosis and treatment.

According to a Jan. 16 National Public Radio (NPR) report that cites information from the Office of the Inspector General, Medicare payments for sleep testing skyrocketed from $62 million in 2001 to $235 million in 2009. Meanwhile, the number of accredited sleep disorder diagnosis labs has quadrupled over the past 10 years, according to the American Academy of Sleep Medicine.

While many health insurance policies cover sleep apnea testing and treatment, some insurers have expressed concern that a number of physicians are ordering sleep testing without basic exams first.

“We are spending more and more money on sleep testing and treatment, and like anything else in health care, there are unscrupulous people out there who are more than happy to do testing and treatment that might be of questionable value,” said Dr. Fred Holt, medical director of Blue Cross Blue Shield in North Carolina, in the NPR report.

Although insurance providers may not be happy about the rise in sometimes costly sleep apnea testing, sleep apnea can contribute to severe health complications if not treated. Among the potential dangers of sleep apnea are an increased risk for hypertension, heart disease, stroke, heart attack, diabetes, high blood pressure and depression among other health problems.

The National Institutes of Health currently estimates that more than 12 million Americans have a diagnosed form of sleep apnea, with millions of more Americans suffering from undiagnosed sleep apnea. The sheer volume of people who may have this dangerous sleep disorder is why many physicians who specialize in sleep apnea believe the costs are worth the tests necessary to diagnose the disorder and save lives.

“It’s just sad when you walk through the hospital and you see these patients with heart failure—the person might be 35 years old, he’s 350 pounds—but no one’s thinking that he has sleep apnea, which he statistically does,” said Dr. David Gross, medical director of the sleep lab at the National Rehabilitation Hospital in Washington, D.C., in the NPR story.

Fortunately, there are a number of effective sleep apnea treatment options.

If you believe you or a loved one suffer from the symptoms of sleep apnea, please contact a dentist near you who specializes in diagnosing and treating OSA and other sleep disorders.

First FDA-Approved Wireless Home Sleep Apnea Test gets Spotlight at Electronics Show

2012-01-11T11:41:00.001-08:00

The first wireless home test for obstructive sleep apnea (OSA) to receive approval by the Food and Drug Administration (FDA) is currently being showcased at the annual International Consumer Electronics Show in Las Vegas.

Produced by NovaSom, the AccuSom home sleep test is designed to monitor symptoms of OSA, an underdiagnosed sleep disorder than can lead to severe health complications including an increased risk for heart attack, stroke and hypertension among other problems if not treated. Nearly 18 million Americans have OSA, and another 15 million are thought to have undiagnosed OSA.

The first FDA-approved wireless home sleep test, AccuSom is a roughly smart phone-size cardio-respiratory monitor that features a multichannel sensor to track the factors essential to accurate OSA diagnosis including:

Oxygen saturation
Pulse rate
Respiration airflow
Respiration effort
Snoring

AccuSom is capable of testing patients over multiple sleep cycles, which can more effectively identify the symptoms of OSA than one-night tests in sleep laboratories. The device collects then transfers your individual sleep data to a platform used by your physician for interpretation and diagnosis.

AccuSom requires a prescription from your physician. After being prescribed, the AccuSom unit is mailed directly to you and self-administered at home. The device uses voice prompts to steer you through the testing process.

Although NovaSom claims the AccuSom device is appropriate for approximately 80 percent of prospective sleep apnea patients, AccuSom may not be the best diagnostic tool for everyone. It is important to consult with a physician specializing in sleep apnea diagnosis and treatment if you believe you or a loved one suffers from sleep apnea symptoms.

To learn more about obstructive sleep apnea and sleep apnea treatment options, please contact a dentist near you who specializes in sleep disorders.

Researchers Collaborate on More Comfortable Device to Test for Sleep Apnea

2012-01-03T07:38:00.001-08:00

There are a number of treatment options available for the various forms of sleep apnea, and most of them are more comfortable for sleep apnea sufferers than continuous positive airway pressure (CPAP) devices, which have long been the standard.

Testing for sleep apnea, however, can be a cumbersome undertaking for patients, and it often involves wearing a harness, belts and a labyrinth of wires while also attempting to doze in a clinical setting. As Melvin Keierleber, who has sleep apnea and is employed by a sleep study facility, said in a Jan. 1 article about sleep apnea testing in the Fort Worth Star-Telegram, “It’s not very conducive for sleep.”

But bioengineering researchers with the University of Texas at Arlington are working with the University of Texas Southwestern Medical Center at Dallas and the Fort Worth-based Sleep Consultants to design diagnostic equipment that is effective, comfortable and may be used at a patient’s home.

The team is preparing to test a portable device equipped with ultrasonic sensors, which are attached to a patient’s neck and monitor sound waves to determine whether the patient’s airway is open and how frequently breathing is interrupted. The device allows the patient to settle into his or her regular state of interrupted sleep patterns and can measure multiple sleep cycles.

If you or a loved one suffers from sleep apnea symptoms, please contact a dentist near you who specializes in diagnosing and treating sleep disorders.

A Ticklish Treatment for Baby with Sleep Apnea

2011-12-29T11:17:00.000-08:00

Like many infants born prematurely, Benn Norris suffers from sleep apnea. Because sleep apnea treatment options for babies are limited, Benn’s mother, Sanchia Norris, employs a unique tactic to rouse her son when his breathing stops during sleep: tickling.

According to a Dec. 28 article in London’s The Daily Mail, a breathing monitor sounds an alarm when Benn’s respiration is interrupted. His mother then responds to restart his breathing.

“I have to stimulate him in some way to wake him up which kickstarts him into breathing again,” Sanchia Norris says in the article. “I either tickle him on the soles of his feet, or under his chin and on his stomach. It is enough to start him breathing again.”

Sleep apnea in premature newborns is often caused by weak or underdeveloped muscles that help maintain an open airway. Most infants with sleep apnea grow out of the condition; however the dangers of sleep apnea are life-threatening.

Treatment for infants with sleep apnea involves attentiveness and physical stimulation, such as the method used by Sanchia Norris. In extreme cases of infant sleep apnea, breathing machines may be used.

Common forms of treatment for adult sleep apnea—such as oral appliances or continuous positive airway pressure (CPAP) devices—are not viable options for babies.

If you or a loved one suffer from sleep apnea symptoms, a dentist who specializes in sleep apnea may be able to help determine the cause of your condition and recommend a safe and effective treatment.

Please contact us to locate a qualified sleep apnea dentist near you.

Untreated Sleep Apnea Poses Risks to Sufferers and Innocent People

2011-12-28T09:14:00.000-08:00

Sleep disorders, and in particular obstructive sleep apnea (OSA), have received much media attention of late as an advisory panel to the Federal Motor Carrier Safety Administration recently recommended sleep apnea screenings for commercial truck drivers and a new study indicated that nearly half of all police officers have symptoms of sleep disorders.

Sleep apnea and other sleep disorders pose health hazards to the individuals who suffer from them, but when they affect those who operate heavy machinery or work in the public service sector, innocent people can also be adversely impacted.

Many articles and much commentary surrounding sleep disorders and professions such as truck drivers and police focus on sleep apnea symptoms and risks. While it is certainly important to acknowledge these factors, it is also important to understand that there are a number of treatment options available that allow those with OSA to function safely and normally during their waking hours.

Sleep apnea treatment is not limited to continuous positive airway pressure (CPAP) devices. Although CPAP has proven effective at helping those with OSA maintain unobstructed airways, many patients find the CPAP masks uncomfortable and stop using the devices.

An increasing number of patients are successfully treating sleep apnea and other sleep disorders with the use of oral appliances. There are a number of dentists nationwide who specialize in sleep apnea diagnosis and treatment. A consultation with one of these dentists can help determine the cause of your sleep disorder and indicate the best treatment option for your individual condition.

If you believe you or a loved one suffers from sleep apnea or another sleep disorder, please contact a qualified sleep apnea dentist near you.

Social Support May Help Sleep Apnea Sufferers Stick to Treatment

2011-12-13T08:21:00.000-08:00

Although the use of a continuous positive airway pressure (CPAP) device can be effective in treating obstructive sleep apnea (OSA), many people who try CPAP do not continue its use long-term.

Ongoing research being conducted at the Penn State College of Medicine, however, indicates that OSA sufferers are more likely to adhere to sleep apnea treatment if a partner or parent is actively involved. Researchers reviewed 80 studies regarding sleep apnea treatment to determine key factors that triggered patients to seek sleep apnea diagnosis and treatment, as well as circumstances that affected patients’ likelihood to stick to treatment.

“Collectively, these studies suggest that patients who experience difficulties and proactively seek solutions to resolve problems are more likely to be adherent than those who use passive coping styles,” states the report published in the December issue of Sleep Medicine Reviews. Researchers also noted that patients who have access to social support, such as a partner or parent, are more likely to adhere to treatment long-term.

While the research focuses primarily on CPAP use, their findings may be of use to those who seek other forms of sleep apnea treatment. Numerous studies on people with various forms of addiction or other physical health problems have found that individuals who have access to social support—including regular phone calls, group meetings, routine conversations with family or spouses, or scheduled appointments with doctors and other healthcare providers—have an increased likelihood of following through on their treatment.

If you believe you or a loved one suffers from sleep apnea symptoms, please contact a dentist near you who specializes in diagnosing and treating sleep disorders. Left untreated, obstructive sleep apnea can lead to life-threatening health problems.

Teeth Grinding During Sleep can be Indicator of Sleep Apnea

2011-12-06T13:45:00.001-08:00

Loud, chronic snoring is the symptom most commonly associated with sleep apnea.

But teeth grinding can also accompany obstructive sleep apnea (OSA) and other sleep disorders. In addition to serving as a potential warning sign of sleep apnea, sleep-related bruxism—grinding your teeth while you sleep—can also lead to tooth and jaw problems.

Nighttime teeth grinding can cause premature wear on your teeth, as well as place excessive pressure on your jaw and the connective network of joints, muscles, tendons, nerves and bones between your jaw and your skull. According to a Dec. 6 CNN Health blog titled “Teeth-grinding could signal sleep problems,” early recognition of sleep-related bruxism could also prove helpful in diagnosing sleep disorders and allow for earlier treatment, which would reduce the risk of the dangerous health conditions associated with sleep apnea.

Teeth grinding during sleep occurs in approximately 14 to 17 percent of children, according to the blog, and seems to be hereditary. If sleep apnea or other sleep disorders also run in the family, sleep-related bruxism may warrant additional testing for OSA.

For some patients, treatment options such as custom-fit oral appliances can be effective in both maintaining a positive airway and eliminating teeth grinding.

If you experience snoring, teeth grinding or other symptoms of sleep apnea, please contact a dentist near you who specializes in sleep apnea diagnosis and treatment.

Sleep Apnea Diagnosis Can Make Health And Life Insurance Extremely Expensive. Insurance Agents Have Experienced Problems Insuring Clients

2011-12-04T09:13:00.000-08:00

Sleep Apnea Diagnosis Can Make Health And Life Insurance Extremely Expensive. Insurance Agents Have Experienced Problems Insuring Clients Diagnosed With Sleep Apnea.

Adverse Insurance Ratings can be avoided by doing off the grid sleep studies.

Sleep Apnea is a dangerous problem that can lead to heart attacks, strokes, excessive daytime sleepiness, short-term memory loss and increases in motor vehicle accidents. It is essential to diagnose and treat sleep apnea. One study showed a 36% decrease in 8 year survival comparing treated and untreated sleep apnea. Learn more about the dangers of sleep apnea @ http://www.ihatecpap.com/sleep_apnea_dangers.html

A problem frequently experienced is that the cost of health, life and disability insurance policies can increase exponentially following diagnosis of sleep apnea. This is problematic for owners of small businesses and wealthy individuals who utilize life insurance to protect their estates.

Financially savvy patients are turning to off the record sleep studies. Patients pay for their sleep studies and treatment in cash to avoid any footprints of the diagnosis. Patient’s records may be identified only by numerical accounts or convenient name misspellings or addition of new names can protect patient’s identities. (Example Barack Obama could become Eric B Obama).

Cash payment secures patient privacy. HIPPA regulations theoretically protect our personal medical information. When obtaining new insurance you forfeit these HIPPA rights in order to qualify for coverage. Insurance benefits can be denied in the future if there is a record of undisclosed illness.

There are two primary treatments for sleep apnea, CPAP and Oral Appliances. Severe Sleep Apnea especially in morbidly obese patients is usually CPAP initially and an Oral Appliance for patients who don’t tolerate CPAP. Studies have shown that the majority of patients reject CPAP and prefer comfortable oral appliances when offered a choice of treatments. Learn more about Oral Appliance therapy for Sleep Apnea at http://www.ihatecpap.com.

Patients who are interested in off the grid sleep studies can contact Dr Ira L Shapira, a Gurnee, Il dentist who has been treating Sleep Apnea with oral appliances since the early 1980’s. As a Visiting Assistant Professor at Rush Medical Schools Sleep Center he did research on jaw position and Sleep Apnea.

Dr Shapira is a Diplomate of the American Board of Dental Sleep Medicine and practices Dental Sleep Medicine at Delany Dental Care in Gurnee and at Chicagoland Dental Sleep Medicine Associates in Skokie, Schaumburg and Vernon Hills. In Skokie his practice is located in American Sleep Medicine and in Vernon Hills he utilizes the office of Sleep and Behavioral Medicine.

http://www.delanydentalcare.com/sleep_apnea.html

http://www.chicagoland.ihatecpap.com/

Dr Shapira realizes the importance of accurate diagnosis and treatment of sleep apnea but also understands the financial impact a diagnosis of sleep apnea can create. Working to create both value and privacy for his patients he arranges for off the grid sleep studies. Baseline studies are essential for diagnosis and titration sleep studies insure treatment efficacy. Post-treatment studies are essential for Oral Appliance Therapy and for CPAP therapy.

Special off the grid pricing has been arranged for Dr Shapira’s sleep patients desiring privacy. Contact Dr Shapira at 1-8-NO-PAP-MASK or at 847-623-5530 for more information on insuring your medical privacy.

Dr Shapira stresses that avoiding sleep studies can have serious medical consequences. Diagnosis and Treatment are the most important medical considerations.

Importance of REM Sleep Another Reason to Seek Sleep Apnea Treatment

2011-11-28T15:06:00.001-08:00

There are a number of reasons why it’s important to treat sleep apnea, many of them related to the fact that sleep apnea can increase your risk for severe health problems including hypertension, heart attack, stroke and high blood pressure.

Sometimes ignored in the wake of these potentially life-threatening complications is the fact that sleep apnea prevents those who suffer from the condition from receiving a good night’s sleep. Sleep apnea is especially disruptive to rapid eye movement (REM) sleep, the state of deep sleep associated with dreaming.

And recent research conducted at the University of California at Berkeley indicates that REM sleep is integral for reasons other than leaving you refreshed and alert. According to researchers, dreaming eases the stress associated with painful memories.

“During REM sleep, memories are being reactivated, put in perspective, and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed,” said Els van der Helm, one of the study’s lead authors. The study was published in the Nov. 23 edition of Current Biology.

Research focused on 35 adult participants divided into two groups. The members of each group viewed 150 images intended to trigger emotions twice, 12 hours apart, as a magnetic resonance imaging (MRI) scanner measured their brain activity.

Half of the participants looked at the images in the morning and evening, remaining awake between the viewings. The other 50 percent viewed the images in the evening and the next morning, following a full night’s sleep.

Those who slept between the viewings reported a lessened emotional reaction on second exposure to the images. Researchers also recorded brain activity while participants slept and found that certain electrical activity patterns decreased during REM sleep, indicating that reduced levels of brain neurochemicals associated with stress tempered emotional reactions.

The benefits of deep, REM sleep are just another reason to seek diagnosis and treatment for sleep apnea if you suffer any symptoms of this dangerous sleep disorder.

If you experience chronic snoring or other symptoms of sleep apnea, please contact a dentist near you who specializes in sleep disorders.

You Don’t Have to Bear Sleep Apnea

2011-11-18T13:33:00.001-08:00

Recently, a Japanese-developed robotic pillow that resembles a stuffed polar bear has received attention as a potential treatment for snoring and sleep apnea.

The bear pillow, which you can see in this video, features a sensor that detects the decibel levels of your snoring. When your snoring reaches a preset level, the bear’s paw moves to brush your face, ostensibly stopping your snoring and returning you to restful sleep.

The device also monitors blood-oxygen levels, and if its sensors detect that your levels are too low, the bear’s paw will also be activated.

Although the bear pillow is being touted as a sleep apnea treatment, its effectiveness is questionable at best. The bear pillow, known as Jukusui-kun, which translates as “deep sleep,” does not address the cause of sleep apnea, which is most often an airway obstruction.

In addition to not treating the cause, the bear pillow may also jar an individual back into consciousness. Proven sleep apnea treatments are designed to maintain your airflow while allowing you to sleep through the night.

If you suffer from snoring and other symptoms of sleep apnea, there are effective treatment options available. To learn more about sleep apnea diagnosis and treatment, please contact a dentist who specializes in sleep disorders near you.

Sleep Apnea and Driving Dangers

2011-11-15T07:42:00.001-08:00

As the health risks of sleep apnea have become apparent and an increasing number of effective treatment options become have become available, more people have been willing to seek diagnosis and help for this dangerous sleep disorder.

Individuals in one demographic group, however, may actually purposely conceal the symptoms of sleep apnea for fear of losing their jobs. Truckers interviewed for a recent sleep apnea article in the Springfield, Mo., News-Leader said reporting snoring or other signs of sleep apnea can result in difficulty being cleared to drive.

One of the side-effects of sleep apnea is drowsiness during waking hours, a complication that is of concern to the Federal Motor Carrier Safety Administration (FMCSA), which oversees commercial trucking. A 2002 study sponsored by the FMCSA indicated that nearly one-third of commercial truck drivers may suffer from sleep apnea.

Truckers who hold commercial driver’s licenses (CDLs) undergo physical exams and sleep screenings every other year. Drivers already diagnosed with sleep apnea undergo annual evaluations.

The sleep-related segments of these reviews entail questionnaires about sleeping habits and sleep disorder symptoms, as well as a physical trial known as the Maintenance of Wakefulness Test, which monitors a subject’s ability to remain alert in a quiet, dimly lit room for extended periods.

One trucker interviewed for the Nov. 14 News-Leader story said, “Anybody with a CDL knows you’re never supposed to tell the medical doctor that you snore. If you have sleep apnea, you’re a liability to the company.”

Unfortunately, failure to seek sleep apnea treatment can result in hazards to both the individual with the sleep disorder and others who are put at risk when someone who suffers from sleep apnea drives while drowsy.

If you experience the symptoms of sleep apnea, there are a number of successful treatment options available. To learn more about sleep apnea diagnosis and treatment, please contact a dentist who specializes in sleep apnea near you.

Study Finds Link between Sleep Apnea, Obesity and Cognitive Abilities in Kids

2011-11-04T08:45:00.000-07:00

Individually, sleep apnea, obesity and cognitive problems can be a source of behavior problems and dysfunction in children. But new research indicates these conditions may be connected and can actually aggravate the effects of one another.

A study conducted at the University of Chicago Comer Children’s Hospital and Pritzker School of Medicine focused on more than 350 children between the ages of 6 and 10. The children underwent testing related to sleep, cognitive skills and body weight, and researchers discovered that the three factors have an interactive association.

For example, cognitive abilities can be negatively impacted by problems such as sleep disorders and obesity. Likewise, according to the study published in this week’s American Journal of Respiratory and Critical Care Medicine, “poorer integrative mental processing may place a child at a bigger risk for adverse health outcomes.”

Although the study did not establish the causal relationship between sleep apnea, obesity and cognitive skills, the research is notable for being the first to probe all three factors simultaneously. Previous studies have evaluated the conditions separately, although prior research has also indicated a link between sleep disorders and obesity.

This study suggests that when physicians examine children’s obesity issues, they should also screen for cognitive problems and sleep disorders, especially sleep apnea.

To learn more about sleep apnea diagnosis and sleep apnea treatment for children, please contact a dentist who specializes in sleep disorders near you.

Sleep Apnea and a Mediterranean Diet

2011-10-31T10:10:00.000-07:00

A widely reported recent study suggests that eating a Mediterranean diet along with engaging in regular physical activity can help relieve some symptoms of sleep apnea.

The study’s findings were published recently in the European Respiratory Journal and indicated that sleep apnea patients who followed a Mediterranean diet experienced fewer breathing interruptions during rapid-eye-movement (REM) sleep, a stage of deep sleep that typically accounts for about one-quarter of total sleeping time. But just what does a Mediterranean diet entail?

A Mediterranean diet includes staples of meals originating in Mediterranean nations such as Italy, Greece, Cyprus and Spain. Mediterranean dishes often feature fresh ingredients over processed foods and include more vegetables, fruits, legumes and grains, and less red meat.

Ingredients commonly used in a Mediterranean diet include:

Broccoli
Chickpeas
Eggplant
Fish
Olive oil
Nuts
Peppers
Red wine (in moderation, of course)
Spinach
Tomatoes

A Mediterranean diet also favors organic flavorings over artificial ones. This includes the use of fresh basil, oregano, lemon, rosemary and garlic, among others.

In addition to seeming to reduce some sleep apnea symptoms, a Mediterranean diet has other health benefits as well. Foods in the Mediterranean diet tend to be low in saturated fat and high in flavonoids and antioxidants, which are thought to help prevent cancer.

To learn more about sleep apnea treatment options, please contact a dentist who specializes in sleep disorders near you.

Study Finds High Rate of Sleep Apnea Among Veterans with PTSD, Brain Injuries

2011-10-28T11:56:00.000-07:00

Sleep disorders—including sleep apnea—are common among American veterans of the wars in Afghanistan and Iraq, according to a recent study conducted at the Walter Reed Army Medical Center in Washington, DC.

Research focused on 317 soldiers with post-traumatic stress disorder (PTSD), traumatic brain injuries or both. The study found that nearly half of the soldiers reported insomnia and more than half suffered from sleep apnea.

Researchers followed 135 soldiers with PTSD, 116 veterans with traumatic brain injuries (TBI) and 66 soldiers with both conditions. According to the study, the findings of which were reported at the recent annual meeting of the American College of Chest Physicians, 56 percent of the soldiers suffered from obstructive sleep apnea, while 49 percent experienced insomnia.

Meanwhile, 71 percent of the war veterans who participated in the research experienced fragmented nighttime sleep, and 87 percent were hypersomniac, or drowsy during waking hours.

Sleep apnea was more common in soldiers with PTSD than in those who suffered brain injuries. Seventy-eight percent of soldiers with PTSD were diagnosed with sleep apnea.

If sleep apnea treatment is not pursued, the condition can lead to progressive and potentially fatal health problems.

To learn more about sleep apnea and sleep apnea treatment, please contact a dentist near you who specializes in sleep disorder treatment.

Resistant Hypertension? New Article in Hypertension Identifies Sleep Apnea As The Most Common Secondary Cause Of Resistant Hypertension

2011-10-28T11:53:00.000-07:00

Treatment of Sleep Apnea is extremely important with hypertension. Effective treatment with oral appliances or CPAP is extremely important in patients with resistant hypertension. The abstract can be found below.

Treatment of Sleep Apnea is essential. If you or your loved one are one of the 60% of patients who do not tolerate CPAP call today to schedule an appointment for a comfortable oral appliance.

Hypertension. 2011 Nov;58(5):811-7. Epub 2011 Oct 3.
Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.
Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, de Paula LK, Amaro AC, Amodeo C, Bortolotto LA, Krieger EM, Bradley TD, Lorenzi-Filho G.
Source
Sleep Laboratory, Pulmonary Division, Heart Institute, Av Enéas Carvalho de Aguiar 44, São Paulo, Brazil. geraldo.lorenzi@incor.usp.br.
Abstract
Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood pressure and reduce cardiovascular risk. However, there are no studies systematically evaluating secondary causes of hypertension according to the Seventh Joint National Committee. Consecutive patients with resistant hypertension were investigated for known causes of hypertension irrespective of symptoms and signs, including aortic coarctation, Cushing syndrome, obstructive sleep apnea, drugs, pheochromocytoma, primary aldosteronism, renal parenchymal disease, renovascular hypertension, and thyroid disorders. Among 125 patients (age: 52±1 years, 43% males, systolic and diastolic blood pressure: 176±31 and 107±19 mm Hg, respectively), obstructive sleep apnea (apnea-hypopnea index: >15 events per hour) was the most common condition associated with resistant hypertension (64.0%), followed by primary aldosteronism (5.6%), renal artery stenosis (2.4%), renal parenchymal disease (1.6%), oral contraceptives (1.6%), and thyroid disorders (0.8%). In 34.4%, no secondary cause of hypertension was identified (primary hypertension). Two concomitant secondary causes of hypertension were found in 6.4% of patients. Age >50 years (odds ratio: 5.2 [95% CI: 1.9-14.2]; P<0.01), neck circumference ≥41 cm for women and ≥43 cm for men (odds ratio: 4.7 [95% CI: 1.3-16.9]; P=0.02), and presence of snoring (odds ratio: 3.7 [95% CI: 1.3-11]; P=0.02) were predictors of obstructive sleep apnea. In conclusion, obstructive sleep apnea appears to be the most common condition associated with resistant hypertension. Age >50 years, large neck circumference measurement, and snoring are good predictors of obstructive sleep apnea in this populati
Can J Cardiol. 2011 May-Jun;27(3):319-38.

Former NFL Players Score Touchdown for Sleep Apnea Awareness

2011-10-19T13:37:00.000-07:00

Sleep apnea awareness has been on something of a winning streak lately, thanks in part to a number of former National Football League (NFL) players discussing their battles with the dangerous affliction.

Former Oakland Raiders quarterback JaMarcus Russell recently disclosed how the symptoms of sleep apnea caused him to nod off in team meetings and lose focus on the football field. Meanwhile, two former San Diego Chargers players—offensive lineman Aaron Taylor and kicker Rolf Benirschke—are collaborating on a sleep apnea patient support program.

Sleep apnea, of course, is not limited to football players and other athletes. Tens of millions of Americans suffer from this sleep disorder, which can lead to potentially fatal health complications.

In fact, NFL Hall of Fame defensive lineman Reggie White suffered from sleep apnea and died in 2004 from cardiac arrhythmia, one of the most common risks of untreated sleep apnea. After White’s death, his wife cofounded the Reggie White Sleep Disorders & Education Foundation to raise awareness about sleep apnea and other sleep disorders.

To learn more about sleep apnea and sleep apnea treatment options, please contact a doctor near you who specializes in sleep disorder treatment.

Alternative Sleep Apnea Treatments to CPAP

2011-10-10T07:56:00.000-07:00

Continuous positive airflow pressure (CPAP) devices are effective in treating sleep apnea in both children and adults. If the patients actually wear the masks.

CPAP entails the use of a small machine that circulates a continuous stream of air through a tube connected to a mask you wear while you sleep. The airflow prevents the tissues in your throat from collapsing and allows uninterrupted breathing.

Unfortunately, studies have revealed that patients’ long-term compliance with CPAP treatment is low. Most research regarding CPAP use indicates that about one-quarter to one-third of sleep apnea patients who try CPAP stop using the device.

Because the dangers of sleep apnea are potentially fatal and include increased risk for heart attack, stroke and high blood pressure, it’s important for those who are unable to adjust to the CPAP device to seek alternative treatment.

Oral appliances, which are similar to mouthguards, are often successful in treating sleep apnea patients who find they can’t wear the CPAP mask. There are a number of sleep apnea oral appliances available, and finding the right treatment option for your individual condition can be determined during a consultation with a dentist experienced in sleep apnea treatment.

To learn more about sleep apnea diagnosis and treatment, please contact a dentist who specializes in sleep disorders near you.

SomnoDent Medicare Approved

2011-10-05T15:49:00.000-07:00

This year, Medicare began funding the use of oral appliance therapy for treatment of obstructive sleep apnea, dependent on approval. Now, the country's most popular oral appliance has been approved for coverage.

In order to be covered, an oral appliance must meet certain characteristics, including:

Be used for reducing upper airway collapsibility.
Having a hinged or jointed mechanism
Be customized
Be capable of adjustment in increments of one millimeter
Must retain adjustment

After review, the Pricing, Data Analysis, and Coding (PDAC) Medicare Contractor and each of the four Durable Medicare Equipment Medicare Administrative Contractors have determined that the appropriate billing code for the device is E0486, a covered treatment code. This includes the SomnoDent Classic, the SomnoDent Flex, and the SomnoDent Edentulous.

We are happy that oral appliance therapy has finally been recognized for its successful and comfortable treatment of obstructive sleep apnea.

If you would like to learn more about the coverage and billing of oral appliance therapy, please contact a local sleep dentist today.

New Wireless Network for Monitoring Sleep Apnea

2011-09-28T15:21:00.000-07:00

Researchers at the University of Utah have announced that they have developed a wireless network that can monitor sleep apnea and other sleep breathing disorders without placing sensors on the patient. The technology, named BreathTaking, uses a network of 20 wireless transceivers that are placed around a hospital bed. This system reliably detected the breathing of the subject and accurately estimated the breathing rate to within 0.4 breathes per minute based on only 30 seconds of data.

The network detects the sound of a patient's breathing and collates data on the strength of the sound from all the different sensors, allowing the breathing of a patient to be tracked no matter where the patient is in the bed. On the positive side, the system allows for the tracking of patient breathing without attaching sensors to the patient, which itself can be disruptive of sleep or even dangerous. One potential use of the system proposed by inventors is for SIDS monitoring--it could identify immediately when a baby stopped breathing without the need for placing sensors on the baby.

Researchers say that it will likely take at least five years before the product is market-ready, but once available it can be used to noninvasively track apneic events in patients and evaluate the success of various sleep apnea treatments, such as oral sleep appliances.

To learn more about the most recent advancements in sleep apnea treatment that allows you to have comfortable relief from this life-threatening condition, please contact a local sleep dentist.

Woman Wages War against Truckers' Sleep Apnea

2011-09-26T08:53:00.000-07:00

A New Braunfels, Texas woman, Wanda Lindsay, has begun a crusade against sleep apnea in truckers. She lost her husband John when a semi truck slammed into the back of their stopped car in a construction zone. The truck was traveling over 65 miles an hour and had its cruise control on. It did not apply its brakes prior to the accident. The truck driver claims he had glanced away from the road and looked back to see the stopped car, but without enough time to stop. The widow thinks the truth is different from his official story.

The truck driver had been diagnosed with severe sleep apnea weeks before the accident, but had not received any treatment. Sleep apnea puts drivers at an increased risk of falling asleep behind the wheel and being involved in just the type of accident that killed John Lindsay.

The trucking company, Celadon, claims it had never seen those test results, or else the driver would not have been on the road that day. The question is, why hadn't it seen those results?

Nearly a third of truckers and other commercial drivers suffer from sleep apnea, and when these vehicles are involved in a deadly accident, it is someone other than the trucker that dies, nearly nine times out of ten. Truck drivers need to be tested for sleep apnea and those results need to be made known to their companies. The National Transportation Safety Board (NTSB) has urged mandatory testing of truck drivers and other commercial drivers and pilots since 2009, but the Federal Motor Carrier Safety Administration (FMCSA) has spent years considering the issue but has not yet issued any rules.

If you want to help get truckers with sleep apnea off the road, you can visit the website of the John Lindsay Foundation to contribute to the cause.

If you fear you may be suffering from sleep apnea, if you have the symptoms of sleep apnea, you should be tested. And if you are looking to learn more about all your sleep apnea treatment options, please contact a local sleep dentist today.

Lack of Sleep Impacts Sex Life

2011-09-21T14:51:00.000-07:00

A new study has compiled previous research to emphasize again that poor or fragmented sleep can negatively impact testosterone levels in both men and women. Testosterone is an important hormone for regulating sexual desire in both sexes. Typically, testosterone levels rise overnight, then decrease during the day. Research has shown that the periods of accumulation of the hormone correspond with REM sleep, the very sleep you miss out on if you are suffering from sleep disorders, such as obstructive sleep apnea.

A 2010 study focusing on surgical treatment of chronic sinus infections showed that the number of people reporting sexual dysfunction decreased significantly and the level of sexual activity increased significantly when people had surgical treatment of their sinusitis. This increase also went along with improved sleep patterns.

Sexual function and sexual activity are important parts of maintaining a high quality of life. If you are suffering from sleep apnea, they may be negatively impacted. Treatment can significantly improve them.

To learn more about how obstructive sleep apnea treatment can improve your quality of life, please contact a local sleep dentist today.

EncoreTM System for Sleep Apnea Treatment Approved

2011-09-14T14:44:00.000-07:00

Siesta Medical, Inc. announced September 12 that it had achieved 510(k) clearance for its Encore^TM System. The Encore System is a tongue suspension treatment designed to improve obstructive sleep apnea. According to Siesta Medical, the tongue is implicated in up to 80 percent of obstructive sleep apnea cases, but most sleep apnea surgical treatments do not address the tongue, which is one of the reasons why sleep apnea surgery is not very popular.

The Encore System received 510(k) approval because it was considered to be substantially equivalent to the manufacturer's previous device the Prelude III, which was approved because it was substantially equivalent to the Prelude II, which was approved because it was substantially equivalent to the Prelude. It seems like the first tongue suspension system approved was the Sleep-In^TM or Repose bone screw system, approved for treatment of sleep apnea or snoring in 1997. This device also received 510(k) approval because it was deemed to be substantially equivalent to oral appliances used for jaw and tongue advancement.

If you are curious about how the system works, the manufacturer has provided the following informative video:

http://www.siestamedical.com/animations/encore_animation_final.wmv

If you are interested in learning more about your treatment options for sleep apnea, please contact a local sleep dentist today.

Sleep Disorders Common, Untreated in Canada

2011-09-12T08:30:00.000-07:00

According to a recent survey by researchers at Laval University in Quebec City, Quebec, up to 40% of Canadians may suffer from sleep disorders, like insomnia or sleep apnea. According to the survey of 2000 people from across Canada, 40% suffered from symptoms of sleep apnea or insomnia. However, only 20% of those surveyed were unsatisfied with the quality of their sleep, and an even smaller number, 13%, had actually seen a doctor about sleep problems.

Another problem is that when people do attempt to improve their sleep, they go about it in ways that may actually hurt their sleep. The survey found that 21% of respondents had used natural products, over-the-counter drugs, or even alcohol in an attempt to treat their sleep problems. Unfortunately, when used without guidance, these products may actually do more harm than good. Natural products and many over-the-counter drugs have not been tested and may have serious side effects. Alcohol has been shown to increase the incidence of obstructive sleep apnea, and over-the-counter sleep medications may do so as well.

Whether you live in the US or Canada, if you are suffering from the symptoms of sleep apnea, you need to get treatment to ensure you avoid the serious dangers of the condition. To learn more about proven, successful sleep apnea treatment, please contact a local sleep dentist today.

Sleep Tips for Back to School

2011-09-07T15:19:00.000-07:00

Summer is over, and for your kids, this means they have to stop staying up all night and have to get to sleep so they can wake up for school in the morning. Unfortunately, this can be a hard thing for kids to do. If your kids are having trouble getting to bed or to sleep on time, you have to step in. Here are a few tips:

Turn off cell phones, computers, and the TV about an hour before bedtime. This is for you as well as your kids. Laptop use in bed has been implicated as a major recent factor in sleep disorders.
Create a bedtime routine, and go through it with your children.
No caffeine at least 12 hours before bedtime. This includes chocolate, whose caffeine content can have a big impact on kids' ability to get to sleep. Substitute oatmeal cookies instead of chocolate chip.
A regular bedtime is a big help for kids getting to sleep. Set a bedtime and stick to it. If your kids are having trouble transitioning between weekdays and weekends, you need to set the same bedtime for every day.
Stand up for sleep. Kids often want to stay up for chatting with friends or another story, but you need to set firm limits.
Keep your kids' rooms cool at night. This emphasizes to the circadian rhythm system that it it's night and time to sleep.

If you are noticing that you are doing all this, but your child is still showing signs of daytime sleepiness, bad mood, or inability to concentrate, they may actually be suffering from childhood sleep apnea, which is a major health risk and should be treated.

To learn more about treatment solutions for childhood sleep apnea, please contact a local sleep dentist today.

Mouth Sores, sensitive tongue and irritation to spicy foods from CPAP use

2011-08-24T18:24:00.001-07:00

Lou saks: "ARE THERE MOUTH PROBLEMS ASSOCIATED WITH THE BIPAP USE? My tongue and mouth have become sensitive. irritated.causing spicy foods to be difficult to eat. Do I need to see a doctor, and how do I end this problem?"

Dr Shapira response: LOU,

THE PROBLEM COULD BE ONE OF SEVERAL INCLUDING A YEAST INFECTION IN YOUR MOUTH. I HAVE HAD MANY PATIENTS COMPLAIN OF THIS TYPE OF PROBLEM WITH CPAP USE AND ON OCCASION WITH ORAL APPLIANCE USE.

SEE YOUR DOCTOR AND/OR DENTIST WITH YOUR CONCERNS FIRST.

IF NOTHING IS FOUND THERE IS AN EXCELLENT PERSCRIPTION PRODUCT CALLED GELCLAIR THAT CAN USUALLY ELIMINATE THAT TYPE OF PROBLEM.

IT IS DESIGNED TO BE DILUTED FOR SORES (MUCOSITIS) IN THE MOUTH FROM CHEMOTHERAPY BUT CAN BE USED FULL STRENGTH IN SMALL AMOUNTS (OFF LABEL) TO PROTECT THE ORAL TISSUES.

THE BIGGEST COMPLAINT I HAVE HEARD IS IT TASTES LIKE BLACK LICORICE, SOME PATIENTS CALL IT A "MIRACLE CURE"

THESE SYMPTOMS CAN ALSO BE RELATED TO VITAMIN DEFICIENCIES AND/OR ALLERGIES.

Stopping CPAP Treatment Leads to Rapid Recurrence of Sleep Apnea Symptoms

2011-08-23T23:24:00.000-07:00

According to an article in press at the American Thoracic Society, removing CPAP treatment quickly leads to a return of the symptoms of obstructive sleep apnea. The study recruited known sufferers of obstructive sleep apnea who were currently undergoing treatment using CPAP. These patients were randomly assigned to one of two groups: either they would continue treatment or they would have it reduced to a non-therapeutic level. Patients underwent polysomnograms at both the beginning of the study and after two weeks, along with a battery of tests designed to detect other dangerous effects of sleep apnea.

Patients saw an increase in apneic events and oxygen desaturations during the study period. They also saw a significant recurrence of markers for other dangers of sleep apnea, most notably a negative impact on the cardiovascular system. According to the lead researcher on the study, “We have shown that CPAP withdrawal leads to a return of OSA within the first night off CPAP.”

This means that periodic compliance or even compliance with CPAP treatment on most nights is insufficient for treatment of the condition and makes it even more imperative that patients be prescribed an appropriate sleep apnea treatment they can comply with when diagnosed with sleep apnea, whether this is CPAP, dental appliances, surgery, or a combination of treatments.

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

New Study Confirms Sleep Apnea-Dementia Connection

2011-08-22T23:46:00.000-07:00

On this blog, we have long been warning about the link between sleep apnea and dementia, including the fact that 70-80% of dementia sufferers have sleep apnea as well, and that treating sleep apnea often helps improve the symptoms of Alzheimer’s disease. Now a new study published in the Journal of the American Medical Association confirms that connection. Using a larger (but also significantly older) study population than previous studies, this new report shows that sleep apnea may double your risk of dementia.

This study looked at nearly 300 women with a mean age of 82, and looked at the presence of dementia in the two sub-populations of women with sleep-disordered breathing and women without sleep disordered breathing. Overall, any form of sleep-disordered breathing increased the risk of dementia or other cognitive impairment by about 85%. Further, more than 15 apneic or hypopneic events per hour were associated with a 70% increase in the risk of cognitive impairment or dementia, and people who spent more than 7% of their sleep time in apnea or hypopnea had more than double the risk of suffering from dementia.

Sleep apnea treatment that is comfortable and effective is essential for patients of all ages, from children to the elderly. If you or a relative is suffering from sleep apnea, it is crucial that you learn about your treatment options today.

To learn about all your sleep apnea treatment options, please contact a sleep dentist today.

Headaches and Sleep Disorders: New article in Cephalgia. Learn how Neuromuscular Dentistry and Sleep Dentistry can help relieve these problems.

2011-08-22T14:47:00.000-07:00

A new article in Cephalgia discusses the comorbidities of sleep and headache. It is well established that the two most commmon causes of "Morning Headache" are TMJ disorders and Sleep Apnea. There is an excellent paper fron the National Heart Lung and Blood Institute on the relation of these two disorders. The paper "CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS" can be found at www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf

The article in Cephalgia stated
Adults with severe headache are at significantly higher risk of also suffering from sleep problems, when compared with the general population, regardless of specific headache type. Optimal treatment of headache must include investigation for sleep disorders and vice versa."

The two primary sleep disorders associated with headache in my experience are sleep apnea and maintenance insomnia. Maintenance insomnia is usually the result of sleep apnea/ UARS (upper airway resistance syndrome) or restless legs (periodic leg movements in sleep PLMS)

Patients pesenting with severe stree frequently have sleep onset insomnia. Chronic pain frequently leads to stress(cortisol) disorders.

Treatment of Sleep Apnea is considered the Gold Standard for Sleep Apnea but most patients do not tolerate treat and abandon it completely (up to 60%) or more commonly use it only a few hours a night which is leaves significant residual disease and risks of cardiovascular disease, excessive daytime sleepiness, tiredness, headaches and migraines.

An excellent alternative treatment for sleep apnea is an oral appliance (http://www.ihatecpap.com) It is extremely effective for Upper Airway Resistances Syndrome, Snoring Arousals, and mild to moderate sleep apnea. It has been shown to be effective in severe sleep apnea but is usually not effectively in the morbidly obese. Morbidily obese patients with headaches and migraines are probably CPAP candidates but oral appliance therapy can be used if they do not tolerate CPAP.

Treatment of Sleep Disordered Breathing can be remrkably effective in treating many types of headaches, especially morning headaches. Oral Appliances are preferred by the majority patients over CPAP when they are offered a choice. A side effect of oral appliance therapy is bite changes. Exercises taught to patients can prevent most changes but many patients chose not to do the exercises. The reason is that when the jaw is advanced for 8 hours it "heals" in this new position frequently eliminating headaches and migraines. While dentists treating sleep apnea with oral appliances usually try to prevent bite changes dentists treating patients for TMJ disorders (TMD) chronic tension headaches and migraines actually welcome bite changes.

Daytime headaches are very effectively treated with a different type of oral appliance called a neuromuscular orthotic. If the headaches are eliminated a second phase of treatment can make these changes permanent. Understanding that TMD and Sleep Apnea are different faces of the same structural/developmental disorder.

Another pertinent and timely study J Headache Pain. 2011 Aug 17. "Clinical features of headache patients with fibromyalgia comorbidity." looks at chronic heqdaches and fibromyalgia comorbidities with tension headache, chronic daily headacahe and migraine. These are comorbidities to TMJ disorders (TMD) and problems of the Trigeminal Nervous system that is over one half of the total input to the brain.

Sleep disorders as well as tension-type headaches, chronic daily headaches and fibromyalgia can all be substantially improved in most patients with various types of oral orthopedic appliances that not only alter posture and airway but can change the autonomic overload from noxious stimuli into the trigeminal system. One appliance is specifically approved for migraine prevention.

Cephalalgia. 2011 Apr;31(6):648-53. Epub 2011 Jan 10.
Headaches and sleep problems among adults in the United States: findings from the National Comorbidity Survey-Replication study.
Lateef T, Swanson S, Cui L, Nelson K, Nakamura E, Merikangas K.
Source

National Institute of Mental Health, USA. TLateef@cnmc.org
Abstract
BACKGROUND:

Several studies have demonstrated an association between headache and disturbed sleep. None have examined this association across the headache spectrum. Our goal was to determine whether migraine and migraine with aura differ from nonmigraine headache in terms of associated insomnia complaints or severity of sleep problems.
METHODS:

A probability sample of US adults was used. A structured interview administered by trained interviewers was used. Diagnostic criteria for migraine and migraine with aura were based on the International Headache Society classification. The presence or absence of four forms of sleep disturbance associated with an insomnia diagnosis was ascertained.
RESULTS:

There was a significant association between frequent severe headache, including migraine with and without aura, and disordered sleep. Adults with headache reported more frequently difficulty initiating sleep (odds ratio [confidence interval] = 2.0 [1.6-2.5]), difficulty staying asleep (2.5 [2.1-3]), early morning awakening (2.0 [1.7-2.5]) and daytime fatigue (2.6 [2.2-3.2]) and also were more than twice as likely to report three or more of these symptoms(2.5 [2-3.1]) compared to the individuals without headache.
DISCUSSION:

Adults with severe headache are at significantly higher risk of also suffering from sleep problems, when compared with the general population, regardless of specific headache type. Optimal treatment of headache must include investigation for sleep disorders and vice versa.

PubMed abstracts below:

Comment in * Cephalalgia. 2011 Apr;31(6):643-4.

J Headache Pain. 2011 Aug 17. [Epub ahead of print]
Clinical features of headache patients with fibromyalgia comorbidity.
de Tommaso M, Federici A, Serpino C, Vecchio E, Franco G, Sardaro M, Delussi M, Livrea P.
Source

Neurophysiopathology of Pain Unit, Neurological and Psychiatric Sciences Department, Medical Faculty, Policlinico General Hospital, Aldo Moro University, Neurological Building, Piazza Giulio Cesare 11, 70124, Bari, Italy, m.detommaso@neurol.uniba.it.
Abstract

Our previous study assessed the prevalence of fibromyalgia (FM) syndrome in migraine and tension-type headache. We aimed to update our previous results, considering a larger cohort of primary headache patients who came for the first time at our tertiary headache ambulatory. A consecutive sample of 1,123 patients was screened. Frequency of FM in the main groups and types of primary headaches; discriminating factor for FM comorbidity derived from headache frequency and duration, age, anxiety, depression, headache disability, allodynia, pericranial tenderness, fatigue, quality of life and sleep, and probability of FM membership in groups; and types of primary headaches were assessed. FM was present in 174 among a total of 889 included patients. It prevailed in the tension-type headache main group (35%, p < 0.0001) and chronic tension-type headache subtype (44.3%, p < 0.0001). Headache frequency, anxiety, pericranial tenderness, poor sleep quality, and physical disability were the best discriminating variables for FM comorbidity, with 81.2% sensitivity. Patients presenting with chronic migraine and chronic tension-type headache had a higher probability of sharing the FM profile (Bonferroni test, p < 0.01). A phenotypic profile where headache frequency concurs with anxiety, sleep disturbance, and pericranial tenderness should be individuated to detect the development of diffuse pain in headache patients.

PMID:
21847547
[PubMed - as supplied by publisher]

Labels: chronic daily headaches, dental sleep medicine, fibromyalgia tension type headaches, headaches migraines, insomnia migraines, migraines sleep, sleep apnea migraines

posted by Dr Shapira at 2:42 PM

Pain Medications May Cause Sleep Apnea

2011-07-28T15:44:00.000-07:00

According to at least one study, sleep disordered breathing, including sleep apnea, was common among users of opioid pain medications for chronic pain. The study, published in the journal Pain Medicine, showed that up to three-quarters of users of opioid pain medications suffered from sleep apnea, nearly 10 times the rate in the general population.

Although many of the sufferers had obstructive sleep apnea, up to a third of them suffered from central sleep apnea. In addition, the researchers found that there was a dose-dependent effect of certain opioid pain medications on the severity of central sleep apnea. Methadone and benzodiazepines had dose-dependent relationships with the severity of central sleep apnea.

Unfortunately, pain medication and sleep apnea have a vicious cyclical relationship. Sleep apnea sufferers often see less effect from pain relievers, which may trigger them to move on to stronger opioid medication for chronic pain, which then will increase the severity of their sleep apnea. As sleep apnea worsens, people suffer an increased risk of heart attack, stroke, and other potentially deadly health consequences.

If you are taking chronic pain medication or if you have chronic pain that you are considering medication for, you should be evaluated for sleep apnea so that you can receive appropriate treatment to reduce the risks associated with this vicious cycle.

To learn more about sleep apnea and sleep apnea treatments, please contact a local sleep dentist today.

Study Confirms Long-Term Effectiveness of Behavioral Treatment for Sleep Apnea

2011-07-25T13:01:00.000-07:00

We have long known that behavioral treatment is an effective complement to other types of obstructive sleep apnea treatment. Now a recent study has confirmed its long-term effectiveness is so great that for some patients it may completely replace other forms of treatment.

The study, published in the BMJ, builds on initial results for a short-term trial in which patients were put on a very-low calorie diet for nine weeks in order to lose weight. The patients were then given counseling and advice about nutrition and exercise for one year. Over the year, patients who had lost weight maintained the weight lost, and many saw significant improvement in their sleep apnea. 48% of patients on the diet program no longer required CPAP for their sleep apnea, and 10% saw complete remission of their sleep apnea.

Behavioral treatment is not always the best option, but it is almost always an effective complement for people looking to get the best treatment possible for their obstructive sleep apnea. If you are being prescribed CPAP treatment and you feel your doctor has not adequately considered other treatment alternatives, perhaps you need a second opinion.

To learn more about treatment alternatives, please contact a local sleep dentist today.

Hotel Launches "Anti-Snoring Room"

2011-07-13T10:10:00.000-07:00

Crowne Plaza is the first hotel chain to offer what it describes as "snore absorption rooms." These rooms are ostensibly the result of research that has been done on the impact of snoring on UK couples' snoring habits. According to the research, snorers' cosleepers lose between one and five hours of sleep a night due to their partners' sleep disordered breathing. A similar proportion also reports that their vacations are ruined by snoring, so anti-snoring rooms make sense for the satisfaction of a hotel's clients.

Supposedly, the snore absorption rooms use "proven" technology to reduce the noise of a snorer's breathing. This technology includes:

· Sound proofing on walls to absorb and deflect the sound of snoring
· Sound-absorbing headboards that supplement the sound absorption of the walls
· An anti-snoring bed wedge that encourages side-sleeping or upright sleeping, which can stop the sound created by positional snorers
· An anti-snoring pillow which uses "rare" neodymium magnets that open the airways and stiffens the upper palate to reduce sound
· A white sound machine that drowns out snoring

There is no doubt that this is a problem that needs a solution, but the one offered by Crowne Plaza is dubious. At best, their solution simply masks the problem, and some of the technologies they propose are effective only for a limited number of people, if at all.

Instead, people who want to ensure that snoring will never ruin another vacation should seek out an effective, comfortable, portable snoring solution. The solution that best meets these criteria is an oral appliance. An oral appliance is not only a convenient solution to snoring that travelers can easily be transported when on vacation, it can also be used to treat the serious condition that snoring may signal: obstructive sleep apnea.

If you want to learn how you can reduce or eliminate your snoring for every vacation, please contact a local sleep dentist today to be evaluated for an oral appliance.

Medicare Now Covers Oral Appliance Therapy

2011-07-05T12:37:00.000-07:00

Beginning in January of this year, Medicare began funding the use of oral appliance therapy for the treatment of sleep apnea. This will allow seniors to get the sleep apnea treatment that is best suited for them, treatment that is comfortable, flexible, and effective. What's more, unlike many private insurance companies, Medicare does not require that you first attempt to use CPAP before seeking oral appliance therapy.

In order to get coverage for your oral appliance therapy, you must meet these criteria:

Have an evaluation by a treating physician prior to determine that you should be screened for obstructive sleep apnea

Your sleep test must find one of the following:
AHI or RDI of 15 events per hour with at least 30 events total
AHI or RDI of at least 5 with ten events total AND documentation of certain sleep apnea signs or symptoms
AHI or RDI >30, but you cannot tolerate CPAP or are otherwise not a good CPAP candidate
Your doctor orders the device
The device is provided and billed by a licensed dentist

In addition, not all oral appliances are covered. To meet the coding guidelines for coverage, oral appliances must:

Have a hinged or jointed mechanism
Be able to advance the mandible
Able to achieve mandible advancement beyond the front teeth
Be adjustable by you in increments of one millimeter
Be capable of retaining adjustment when removed

As a result, tongue positioning appliances are not covered.

We can help you understand which oral appliances meet the coding guidelines for coverage. To learn more, please schedule an appointment with a local sleep dentist today.

Snoring In Children Is Dangerous According To New Study in Sleep Medicine.

2011-07-03T22:03:00.000-07:00

A new study (PubMed abstract below) showed that even snoring (Primary Snoring = PS) is dangerous in children and like sleep apnea can lead to "behavioral, attention, and executive function difficulties are present in children with PS as well as OSAS. These results have implications for the treatment of milder forms of SDB, particularly PS, which is commonly viewed as benign."

Snoring in children can no longer be considered benign and should be carefully evaluated as it can affect a childs ability to learn and succeed.

Sleep Med. 2011 Mar;12(3):222-9. Epub 2011 Feb 15.
Neurobehavioral function is impaired in children with all severities of sleep disordered breathing.
Bourke RS, Anderson V, Yang JS, Jackman AR, Killedar A, Nixon GM, Davey MJ, Walker AM, Trinder J, Horne RS.
Source

Critical Care and Neuroscience Research, Murdoch Children's Research Institute, Melbourne, Australia.
Abstract
OBJECTIVE:

Sleep disordered breathing (SDB) is common in children and ranges in severity from primary snoring (PS), to obstructive sleep apnea syndrome (OSAS). This study investigated everyday function (behavior, attention, executive skills) in children with varying degrees of SDB and control children with no history of SDB recruited from the community.
METHODS:

One hundred thirty-six children aged 7-12 were studied. Routine overnight polysomnography (PSG) classified children into 4 groups: PS (n=59), mild OSAS (n=24), moderate/severe OSAS (n=18), and controls (n=35). Behavioral function and behavioral aspects of attention and executive function were assessed using the Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function (BRIEF).
RESULTS:

Children with all severities of SDB had significantly higher rates of total, internalizing and externalizing behavioral problems compared to control children. Increased rates of behavioral executive dysfunction were also found across the SDB spectrum.
CONCLUSION:

Our findings suggest that behavioral, attention, and executive function difficulties are present in children with PS as well as OSAS. These results have implications for the treatment of milder forms of SDB, particularly PS, which is commonly viewed as benign.

Pillars Do Not Reduce CPAP Pressure or Increase CPAP compliance.

2011-07-03T21:48:00.000-07:00

Patients with sleep apnea are frequently looking for an easy surgical procedure to treat their sleep apnea. Pillar surgery was intially considered to be a treatment for sleep apnea but has been relegated to a treatment for simple snoring coming from the soft palate.

PLACEMENT OF SOFT PALATE PILLARS SHOULD NOT BE CONSIDERED A PRIMARY TREATMENT FOR SLEEP APNEA!

A new study (PubMed abstract below)looked at Pillar Surgery to see if it increased compliance in CPAP users or decreased CPAP pressures. Sadly, this was not the case. The study published in Otolaryngology Head and Neck Surgery concluded that "Pillar implants do not significantly reduce CPAP pressure or increase CPAP compliance compared to sham controls but may subjectively improve CPAP satisfaction. These findings do not presently support the use of Pillar implants as an adjunctive treatment to improve CPAP compliance."

I advise patients who are looking for a surgical "cure" for sleep apnea avoid pillar surgery. Surgical interventions that can "cure sleep apnea" are available. The most successful is bimaxillary advancement. Base of tongue reduction is also successful but I strongly recommend doing it with the somnoplasty method to avoid adverse surgical consequences.

For the severely obese CPAP and tracheotomy are the most successful treatments. Mild to moderate sleep apnea is best treated with CPAP or Oral Appliances.

Otolaryngol Head Neck Surg. 2011 Feb;144(2):230-6. Epub 2010 Dec 29.
Effect of palatal implants on continuous positive airway pressure and compliance.
Gillespie MB, Wylie PE, Lee-Chiong T, Rapoport DM.
Source

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425-5500, USA. gillesmb@musc.edu
Abstract
OBJECTIVE:

Determine if the Pillar palatal implant system reduces continuous positive airway pressure (CPAP) pressure and improves patient compliance with CPAP therapy.
STUDY DESIGN:

Randomized, double-blind, placebo-controlled study.
SETTING:

Four geographically dispersed tertiary sleep disorder referral centers.
METHODS:

Subjects with mild to moderate sleep apnea dissatisfied with CPAP because of pressure-related complaints were randomized to receive Pillar implants or a sham procedure performed in double-blind fashion. Active and sham groups were compared for changes in therapeutic CPAP pressures (primary outcome) with a 90-day follow-up sleep study and CPAP compliance (secondary outcome) with a 90-day smart card report.
RESULTS:

Twenty-six subjects were randomized to Pillar implants and 25 to a sham implant procedure. There were no differences between groups with regard to demographics and baseline parameters. Both sham and active groups had reduced mean CPAP pressure (-1.1 vs -0.5 cm H(2)O) with no difference between groups (P = .32) at 90-day follow-up. In addition, there was no difference in average daily CPAP use between groups (P = .80). Both groups experienced improvements in Epworth sleepiness scores and Functional Outcome of Sleep Questionnaire scores at 90 days with no differences between groups. The active group reported significantly higher CPAP satisfaction scores than the sham group (P = .04).
CONCLUSION:

Pillar implants do not significantly reduce CPAP pressure or increase CPAP compliance compared to sham controls but may subjectively improve CPAP satisfaction. These findings do not presently support the use of Pillar implants as an adjunctive treatment to improve CPAP compliance.

PMID:
21493422
[PubMed - indexed for MEDLINE]

Exercise Alone Can Reduce Sleep Apnea

2011-06-30T13:45:00.000-07:00

According to a recent study, exercise alone can make a significant positive impact on sleep apnea. Currently, behavioral therapy for sleep apnea approaches stress exercise along with diet and other behavioral changes as part of a combination therapy for treating obstructive sleep apnea.

The study showed that when patients began an exercise program that combined brisk walking with weight training, they cut their sleep apnea by 25%. They were assessed using a polysomnography. Study participants went from 32 apneic events per hour to 25 apneic events.

The population used for the study were 43 sedentary adults. Researchers noted that the increase in exercise and decline in sleep apnea events occurred without any corresponding weight loss, and that, typically, a 10% weight loss (e.g. 20 pounds in a 200-pound individual) would be necessary to achieve the same results.

The study showed that people who are suffering from sleep apnea can see positive benefit simply from starting an exercise program, independent of weight loss. However, researchers noted that people should not see a moderate exercise program as an alternative to other forms of sleep apnea treatment, such as CPAP or oral appliance therapy. Instead, people should talk to their doctors about an appropriate level of exercise at the same time they discuss their sleep apnea.

If you are suffering from sleep apnea and would like to learn more about your treatment alternatives, please contact a local sleep dentist today.

Sleep Apnea May Increase Risk of Adverse Pregnancy Outcomes

2011-06-30T13:12:00.000-07:00

Research presented at the American Academy of Sleep Medicine's 2011 conference earlier this week suggest that women with sleep apnea are at the highest risk of having an adverse outcome to a pregnancy. However, researchers noted that their data was not able to distinguish whether obstructive sleep apnea or obesity was the primary risk factor contributing to adverse outcomes, which were led by gestational diabetes and preterm birth.

Gestational diabetes has been independently associated with maternal obesity. Preterm birth has also been independently associated with preterm birth, neonatal delivery, and low birth weight. In the population considered for this study, 87% of the women who had obstructive sleep apnea during pregnancy were also obese, making it a significant confounding factor.

Many women who do not normally suffer from obstructive sleep apnea may acquire it during pregnancy as a result of weight gain. It can become especially pronounced during the third trimester, when women's weight gain is at its greatest. Women who suspect they may suffer from sleep apnea prior to pregnancy are encouraged to be evaluated and receive sleep apnea treatment to lessen the potential impact of sleep apnea on their pregnancy.

If you would like to learn more about sleep apnea treatment options, please contact a local sleep dentist today.

Get Tested for Sleep Apnea When Awake

2011-06-30T11:31:00.000-07:00

New Research suggests that you may not have to get a sleep test to determine whether you suffer from obstructive sleep apnea. Instead, an analysis of your waking breathing may be able to determine your risk, and whether you are likely to suffer from mild, moderate, or severe sleep apnea.

The preliminary research was reported at the 2011 SLEEP conference, but suggests that several audible features of daytime breathing were significantly different between OSA and non-OSA subjects. Using just two of the most significant sound features, researchers stated they were able to predict the presence or absence of OSA with an 84% accuracy.

Researchers explained that the reason these breathing features were so significant was that OSA sufferers tend to have a narrower and more collapsible pharynx with more negative pharyngeal pressure. This gives greater resistance when a person breathes through his or her nose, creating distinctive sound features.

Subjects were asked to breathe through their nose normally for five breaths, then breathe through their nose at maximum volume for five breaths. They repeated the normal and maximum breathing through their mouth with a nose clip in place. This was done in upright and supine positions. Sounds were recorded using a microphone attached to the patients' neck, then analyzed using digital techniques. Finally, subjects were given a full night polysomnogram to determine whether they actually suffered from obstructive sleep apnea and their degree of apnea.

If this actually does prove to be a successful test for obstructive sleep apnea, it can save millions of dollars, not to mention the inconvenience associated with polysomnography.

However, if you suspect you might be suffering from obstructive sleep apnea, it is crucial that you not wait for new testing methods, but instead get tested and begin treatment today to protect your health and your life from this potentially deadly condition. To learn more, please contact a local sleep dentist today.

How Corticosteroids Treat Childhood OSA

2011-06-24T14:43:00.000-07:00

Although the largest portion of obstructive sleep apnea sufferers are adult males age 50 or over, childhood obstructive sleep apnea (OSA) is a serious problem. Childhood sleep apnea can result in behavior problems, school difficulties, and serious health consequences for its victims. Unfortunately, treatment of the condition can be difficult, and the preferred first line of treatment, surgery, is not as effective as doctors would like. Some studies estimate the effectiveness of surgical treatment to be as low as 50%. When you add in the risk of surgical complications, it seems that a nonsurgical treatment option may be a better front-line treatment.

Fortunately, one alternative sleep apnea treatment is the use of nasal corticosteroids. The most commonly studied steroid is fluticasone, which has shown reasonable success. In one study, children receiving nasal steroids saw a reduction of arousals due to apneic events of 3.5/hr. In addition, less than half of children treated with nasal steroids went on to have surgery, compared to three-quarters of children treated with placebo.

In the most recent study, researchers looked at the mechanism that allows the corticosteroid to treat sleep apnea. They found that corticosteroids significantly decreased the amount of cytokine IL-6, which has been associated with cardiovascular risk and death. Although the study is brief and involved only a small number of children, it does point to an important treatment option for childhood OSA sufferers.

If your child is having trouble in school or suffers from behavior problems, you should consider the possibility of childhood obesity among other potential causes. To learn more about how to get the best treatment for childhood sleep apnea, please contact a local sleep dentist today.