December 31, 2012
• What other options are there when CPAP doesn’t work?
• Are dental devices effective?
• What are my surgical options?
• Do tongue exercises, acupuncture or didgideroo playing help to cure sleep apnea?
• What about Provent nasal plugs?
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December 27, 2012
Here’s another study showing that a significant percentage of children are found to have sleep-disordered breathing. Researchers in Finland found that 1 in 10 children suffered from either obstructive sleep apnea or snoring. What was different about this study compared to other studies is that obesity wasn’t the main reason that correlated with a sleep-breathing disorder. Rather, it was their dental occlusion, or how their upper and lower teeth fit together, as well their facial shapes.
This is exactly what I’m seeing in young children with sleep-related breathing disorders. They are not usually overweight, but have narrow faces with recessed jaws, and a high arched hard palate.
Considering that resistance to airflow increases exponentially as the diameter decreases (inversely to the 4th power, see Hagen-Poiseulle equation), even minor changes in our jaw structures can have huge consequences when it comes to breathing, especially when our upper airways are susceptible to collapse in multiple areas.
December 17, 2012
Fully 1/3 of people with arthritis were found to have symptoms of anxiety or depression in this study. Overall, 31% of participants with arthritis had anxiety, and 18% had depression. The authors explain that people living with arthritis may be worried about their livelihood or their ability to perform at their job might be stressful.
Here’s another possible explanation: Having obstructive sleep apnea is known to cause systemic inflammation, including inside the joints. A recent study published in Sleep Medicine showed that heavy snorers had double the risk of developing rheumatoid arthritis later in life. Furthermore, poor sleep in general can also worsen rheumatoid arthritis. I’ve even had a handful of patients that stated that their severe rheumatoid arthritis resolved completely after starting CPAP for obstructive sleep apnea.
Did your arthritis ever improve after starting treatment for obstructive sleep apnea?
November 28, 2012
In this Expert Interview, I have a fascinating discussion with Nancy Rothstein, The Sleep Ambassador® and author of My Daddy Snores. Nancy serves as an Adjunct Faculty member at NYU where she developed and teaches an online course on Sleep Wellness through the School of Continuing and Professional Studies. She is also consulting with NYU to create University enterprise initiatives and educational outreach on Sleep Wellness, as well as on general Wellness.
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November 2, 2012
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PDF of slides (free).
November 1, 2012
Despite all that we know about the importance of good quality and quantity of sleep in achieving effective weight loss, the mainstream press and media outlets mention sleep only occasionally, a luxury that few people are able to afford in our busy, stress-filled lives. Even when sleep is written about, it’s glossed over with one-liners or placed on a top 10 list along with various other good sleep hygiene tips.
However, I was happy to see that Scientific American wrote an in-depth article on this subject, which I strongly urge everyone to read. The article focuses on sleep deprivation in general, not mentioning underlying sleep-breathing problems such as obstructive sleep apnea or upper airway resistance syndrome, but it’s a good start. Remember, you can sleep 8 to 10 hours and still not get good quality sleep if you stop breathing 20 to 50 times every hour.
Whether or not you have a sleep-breathing disorder, start now by getting a solid 7-8 hours of sleep on a regular basis. Let me know how this goes…
October 18, 2012
It’s been taught that significant weight loss in morbidly obese people can cure sleep apnea. My experience with patients and this recent study from Australia shows that in many cases, you can lose a lot of weight, but your sleep apnea severity may not improve significantly. Just like any intervention for sleep apnea, you’ll see a wide range of responses. Some people are cured, some have no effect, but most are somewhere in the middle. I generally counsel my patients that you’ll likely go down one level in the severity of sleep apnea: If you start with mild sleep apnea, losing a lot of weight may get you down into the normal levels, and if you start at severe sleep apnea, that same weight loss may get you down to moderate levels.
Did you lose a lot of weight, and if so, how much did your sleep apnea improve?
October 15, 2012
Here’s an article about increasing rates of strokes in younger people. Rates of stroke in people ages 20 to 55 increased from 12.9 to 18.6% from 1994 to 2005. Researchers site the usual reasons for stroke, including bad diets, lack of exercise, and obesity. Nowhere does it mention anything about obstructive sleep apnea, which is always something to think about for anyone who suffers from a stroke. In a recent study from Sweden, 50% of women aged 20 to 70 were found to have obstructive sleep apnea. In the US, with increased rates of obesity, this figure is likely to be much higher. There are many different reasons for obstructive sleep apnea raising your risk of stroke, but one important thing to remember is that blood is much thicker in people with sleep apnea. This makes blood more susceptible to clot in various parts of your body, including your brain.
If you had a stroke at a young age, do you have sleep problems?
October 4, 2012
I’ve written about the many dangers of untreated obstructive sleep apnea for adults and children, but what happens if you’re pregnant and have obstructive sleep apnea? A recent study showed that it can be very dangerous:
- Babies born to mothers with obstructive sleep apnea are more likely to be admitted to the neonatal ICU (46 vs. 18%)
- Mothers with sleep apnea had double the rate of c-sections compared with those that didn’t have sleep apnea (65 vs. 33%)
- 42% of those with sleep apnea had pre-eclampsia, compared with 17% that didn’t have sleep apnea.
- About 15% of pregnant women had obstructive sleep apnea. They were more likely to be obese and had high blood pressure
Additionally, this study didn’t include women with upper airway resistance syndrome, where they may not formally meet the official definition of obstructive sleep apnea (5 to 15 apneas and hypopneas per hour). You can stop breathing 20 to 30 times per hour and still not officially have sleep apnea.
Based on all these statistics, wouldn’t it make sense to routinely screen for obstructive sleep apnea if you’re pregnant, especially if you’re overweight? This study didn’t show that treating obstructive sleep apnea will lower complication rates, but it’s highly likely that that may be possible.
September 20, 2012
Western diets and lifestyles are taking a toll on China. A recent population study revealed that as of 2010, an average of 38.5% of Chinese over age 15 have a body mass index (BMI) of 25 or greater (overweight or obese). Four percent are considered obese (BMI > 30). This is a 54% increase in overweight or obese categories compared with 2002, and a 208% increased rate of obesity. In the US, 78% and 46% meet these same criteria, respectively.
It’s been shown that Asians and African Americans are more susceptible to obstructive sleep apnea, due to smaller craniofacial structures. For every pound of weight gained, Asians develop higher levels of apneas and hypopneas.
It’s not surprising that children of immigrant Chinese in New York are found to have high rates of obesity and diabetes.
If you’re of Asian descent, are your children having problems with being overweight?