Medication Improves Sleep Apnea Events in Trial Study

Treatment options for the dangerous condition known as obstructive sleep apnea (OSA) has evolved from continuous positive airway pressure (CPAP) devices to oral appliances and may soon include prescription medication.

In January, an advisory panel of the Food and Drug Administration (FDA) recommended approval of Qnexa, a medication being developed by Vivus Inc. for treatment of conditions including obesity, type 2 diabetes and OSA. Although the FDA is not bound by the advisory panel, it will consider the committee’s recommendation when it reviews the Qnexa application for regulatory approval later this year.

Specific to Qnexa’s potential for OSA treatment, a mid-stage trial of the drug indicated that Qnexa reduced the incidence of sleep apnea events in obese patients with OSA by nearly 70 percent.

In a 28-week study of 45 patients, Vivus reported that Qnexa resulted in a mean drop of apnea events from 46 per hour to 14 per hour. Patients also saw improvements in blood pressure and nighttime blood-oxygen levels, according to the California-based pharmaceutical company.

The most frequently reported side-effects were dry mouth, an altered sense of taste and sinus infections. However, Vivus has indicated that it would seek approval of Qnexa only for obese women who are not of childbearing potential and men; Qnexa is contraindicated for pregnant women and women who are planning to become pregnant, which means the drug should not be used because the potential risk outweighs the possible benefits for these patients.

If Qnexa is approved, it would be the first pharmaceutical to receive FDA approval for OSA treatment.

If you think you might suffer from OSA or another sleep disorder, a qualified dentist may be able to help. Please contact us to locate a dentist in your area with experience in diagnosing and treating sleep apnea and other sleep disorders.

Childhood Sleep Apnea Treatment can Improve Daytime Attention, Behavior

In addition to being exposed to potential health problems such as heart disease later in life, children with obstructive sleep apnea (OSA) often have trouble staying awake during the day, face difficulty paying attention in school and may have behavioral problems.

All of these issues are caused by the lack of sleep associated with OSA, in which a person’s breathing is interrupted numerous times during sleep because of an airway obstruction. However, new research published in The American Journal of Respiratory and Critical Care Medicine suggests that childhood treatment of OSA that results in even three hours of uninterrupted sleep can make a significant difference in the attention, behavior and quality of life of children who suffer from OSA.

The study focused on 52 children with an average age of 12 who were diagnosed with OSA. Ten of the participants had developmental problems. Children in the study used a continuous positive airway pressure (CPAP) device during sleep for a three-month period.

Although children only used the device for an average of three hours per night, all of the children in the study—including those with developmental delays—showed improvement in daytime responsiveness, cognition and drowsiness.

While CPAP has proven to be effective in treating sleep apnea, children are perhaps even less likely to use the device long-term than adults. CPAP masks can be uncomfortable and cumbersome, and many patients halt CPAP use soon after they start.

Fortunately, there are oral appliances that have demonstrated success in treating OSA. Consulting with a dentist who specializes in sleep disorder diagnosis and treatment can help determine the best sleep apnea treatment option for you or your child.

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

Children with Sleeping Problems may be Prone to Sleep Disorders Later, Study Suggests

A recent study indicates that one in 10 children under 3 years old has trouble sleeping at night and may be at increased risk for developing a sleep disorder such as obstructive sleep apnea (OSA) with age.

The research focused on 359 children between 6 months and 3 years old over a three-year period and found that sleep problems were common, but that parents did not always recognize warning signs such as loud, chronic snoring. Regular snoring is one of the symptoms of OSA, a dangerous sleep disorder that can contribute to an increased risk for health problems including heart attack and stroke.

The study, which was published in January in the journal Pediatrics, suggested that children who had sleep problems at this early stage in life were three to five times more likely to have sleep problems later, which challenges the common belief that most children outgrow sleep disorders.

“The data indicate that sleep problems in children are not an isolated phenomenon,” said Dr. Kelly Byars, a co-author of the study and an associate professor at the Cincinnati Children’s Hospital Medical Center. “If you have it early and it’s not remedied, then it’s likely to continue over time.”

Over the course of the study, parents of the children were interviewed when the infants were 6 months old, and then again at 1, 2 and 3 years old. Research showed that about 35 percent of the children who had problems sleeping at the beginning of the study continued having problems more than two years later.

In addition to snoring, other indicators of potential sleep disorders included frequent waking interruptions of sleep in the middle of the night, regular nightmares and regularly taking longer than 20 minutes to fall asleep.

If you believe your child suffers from the symptoms of sleep apnea or another sleep disorder, a dentist who specializes in sleep disorder diagnosis and treatment may be able to help. Please contact us to locate a qualified dentist near you.

Sleep Apnea, Memory Loss and Dementia

Marsha from Little Rock;

Question: Could untreated mild to moderate sleep apnea cause concentration loss? I am a 58-year old female.

Dr Shapira Response: Absolutely! Short term memory loss is strongly asociated with untreated sleep apnea. It is also associated with Alzheimers and Dementia if it runs in your family.

Untreated Sleep Apnea can cause numerous cognitive problems in both young and old. Short term memory loss is very common and it may be irreversible if you wait too long to treat it.

Cognitive loss also deals with concentration and ability to organise and complete activities.

Study Links Sleep Apnea to Silent Strokes

Sleep apnea—a condition in which a person’s breathing stops periodically during sleep—has long been associated with an increased risk for strokes. But a new study links sleep apnea with silent strokes, a symptomless type of stroke that can cause brain damage and lead to a heightened chance for a major stroke.

The study was conducted by researchers at Dresden University, and the findings will be formally presented at the upcoming American Stroke Association’s international conference.

Research focused on overnight testing of 56 men and women with an average age of 67 who had suffered a stroke or the neurological dysfunction called transient ischemic attack (also known as a mini-stroke). Ninety-one percent of the patients who experienced a stroke also had sleep apnea.

Brain imaging was used to monitor the patients during sleep, and researchers found that having more than five episodes of sleep apnea during a sleep cycle was associated with silent stroke. According to the study, the more times a person stopped breathing during the night, the greater the risk of a silent stroke.

The research led to a number of questions, including whether pre-existing sleep apnea plays a role in silent strokes or whether patients who suffer silent strokes are more vulnerable to developing sleep apnea. According to WebMD, 20 to 25 percent of people 60 and older have had a silent stroke.

Most people who suffer a silent stroke are unaware they’ve had a stroke, as silent strokes typically do not have noticeable symptoms. They do, however, cause minor damage to the brain and put those who suffer silent strokes at an increased risk for major strokes in the future.

If you suffer from the symptoms of sleep apnea, a dentist who specializes in sleep disorders may be able to diagnose the source of your condition and recommend effective treatment options.

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

Research Suggests Link between Sleep Disorders and Schizophrenia

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

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.