Category Archives: Health

Health

Treating sleep apnea in cardiac patients reduces hospital readmission

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A study of hospitalized cardiac patients is the first to show that effective treatment with positive airway pressure therapy reduces 30-day hospital readmission rates and emergency department visits in patients with both heart disease and sleep apnea. The results underscore the importance of the “Stop the Snore” campaign of the National Healthy Sleep Awareness Project, a collaboration between the Centers for Disease Control and Prevention, American Academy of Sleep Medicine, Sleep Research Society and other partners.

Results show that none of the cardiac patients with sleep apnea who had adequate adherence to PAP therapy were readmitted to the hospital or visited the emergency department for a heart problem within 30 days from discharge. In contrast, hospital readmission or emergency department visits occurred in 30 percent of cardiac patients with sleep apnea who had partial PAP use and 29 percent who did not use PAP therapy.

Journal Reference:
  1. Shilpa R. Kauta, Brendan T. Keenan, Lee Goldberg, Richard J. Schwab. Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates. Journal of Clinical Sleep Medicine, 2014; DOI: 10.5664/jcsm.4096
Health

Sleep Apnea Tests and Diagnosis

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Sleep Apnea Test which is Right for You?
08
Oct
If you have symptoms of sleep apnea, your doctor may ask you to have a sleep apnea test, called a polysomnogram. This may be done in a sleep disorder center or even at home. A polysomnogram — or sleep study — is a multiple-component test that electronically transmits and records specific physical activities while you sleep. The recordings are analyzed by a qualified sleep specialist to determine whether or not you have sleep apnea or another type of sleep disorder. If sleep apnea is determined, you may be asked to do further sleep testing in order to determine the best treatment option.
What to Expect During a Sleep Study On the night of your sleep study if you are in a sleep center lab, you will be assigned to a private bedroom in the sleep center or hospital. Near the bedroom will be a central monitoring area, where the technicians monitor sleeping patients. You will be hooked up to equipment that may look uncomfortable. However, most people fall asleep with little difficulty. Similar, more portable equipment is now available for home testing, especially for less complicated cases or situations.
Equipment Used for a Sleep Study During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are then recorded digitally. Belts will be placed around your chest and abdomen to measure your breathing. A bandage-like oximeter probe will be put on your finger to measure the amount of oxygen in your blood.
Other Tests and Equipment Used for Sleep Apnea. EEG (electroencephalogram) to measure and record brain wave activity. EMG (electromyogram) to record muscle activity such as face twitches, teeth grinding, and leg movements, and to determine the presence of REM stage sleep. During REM sleep, intense dreams often occur as the brain undergoes heightened activity. EOG (electro-oculogram) to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep. ECG (electrocardiogram) to record heart rate and rhythm. Nasal airflow sensor to record airflow. Snore microphone to record snoring activity.    

Health

Tongue size and fat

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08
Oct

A new study of obese adults is the first to show that those who have obstructive sleep apnea have a significantly larger tongue with a higher percentage of fat than obese controls. This may provide a mechanistic explanation for the relationship between obesity and sleep apnea.

Results show that obese participants with sleep apnea had significantly greater tongue volumes, tongue fat and percentage of tongue fat than obese controls without sleep apnea, after adjusting for potential confounders such as age, body mass index (BMI), gender and race. Further analysis found that tongue fat percentage in participants with sleep apnea was site specific, with increased fat toward the base of the tongue in the retroglossal region. “This is the first study to show that fat deposits are increased in the tongue of obese patients with obstructive sleep apnea,” said principal investigator and senior author Dr. Richard J. Schwab, Professor in the Department of Medicine and co-director of the Penn Sleep Center at the University of Pennsylvania Medical Center in Philadelphia. “This work provides evidence of a novel pathogenic mechanism explaining the relationship between obstructive sleep apnea and obesity.” Study results are published in the Oct. 1 issue of the journal Sleep. “Tongue size is one of the physical features that should be evaluated by a physician when screening obese patients to determine their risk for obstructive sleep apnea,” said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler. “Effective identification and treatment of sleep apnea is essential to optimally manage other conditions associated with this chronic disease, including high blood pressure, heart disease, Type 2 diabetes, stroke and depression.” The study involved 90 obese adults with sleep apnea and 31 obese controls without sleep apnea. All subjects underwent high resolution upper airway magnetic resonance imaging (MRI). Sophisticated volumetric reconstruction algorithms were used to study the size and distribution of upper airway fat deposits in the tongue. The authors proposed that in addition to enlarging the size of the tongue, increased tongue fat may impair the functioning of the muscles that attach the tongue to bone, preventing these muscles from positioning the tongue away from the airway. According to the authors, future studies should examine the effectiveness of removing tongue fat through weight loss, upper airway exercises or surgery as a potential treatment for sleep apnea. The American Academy of Sleep Medicine reports that excess body weight is the major predisposing factor for obstructive sleep apnea (OSA). Common warning signs for sleep apnea include snoring and choking, gasping, or silent breathing pauses during sleep. The AASM and other partners in the National Healthy Sleep Awareness Project urge anyone with signs or symptoms of sleep apnea to visit http://www.stopsnoringpledge.org to pledge to “Stop the Snore” and talk to a doctor about sleep apnea. Adults who have a BMI of 30 or higher are considered to be obese. According to the Centers for Disease Control and Prevention, 34.9 percent of U.S. adults — 78.6 million people — are obese, based on nationally representative survey data from 2011 — 2012 Journal Reference:
  1. Andrew M. Kim, Brendan T. Keenan, Nicholas Jackson, Eugenia L. Chan, Bethany Staley, Harish Poptani, Drew A. Torigian, Allan I. Pack, Richard J. Schwab. Tongue Fat and its Relationship to Obstructive Sleep Apnea. SLEEP, 2014; DOI:10.5665/sleep.4072
Health

The Epworth Sleepiness Scale

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The Epworth Sleepiness Scale
04
Oct

 How likely is it to fall asleep in the following situations, in contrast to feeling just tired?

This test is referring to your everyday lifestyle over the past few years.

  Use the following scale to choose the most appropriate number for each situation:

0 = would never doze 1 = slight chance of dozing 2 = moderate chance of dozing 3 = high chance of dozing

 
Situations
  1. Sitting and reading
  2. Watching TV
  3. Sitting inactive in a public place (ex a theater or meeting)
  4. As a passenger in a car for an hour without a break
  5. Lying in the afternoon when circumstances permit
  6. Sitting and talking to someone
  7. Sitting quietly after a lunch without alcohol
  8. Sitting in a car, while stopped for a few minutes in traffic
Change of dozing
  1. 0 1 2 3
  2. 0 1 2 3
  3. 0 1 2 3
  4. 0 1 2 3
  5. 0 1 2 3
  6. 0 1 2 3
  7. 0 1 2 3
  8. 0 1 2 3
  For every situation, write down the chance of dozing (0-3), according to the scale above. Then, sum all the numbers you entered and check in which category you belong from Score Results below.  

SCORE RESULTS: 1-6: Congratulations, you are within normal limits! 7-8: Moderate sleepiness 9 and above: Very sleepy – you should seek medical advice.

 
Health

Become more aware

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Become more aware
04
Oct

Research on sleep apnea has come a long time ago from diagnosis in the mid-1960s. Today’s technology is allowing people to gain better knowledge about sleep apnea and symptoms.

Although from statistics have done have shown that both men and women can have sleep apnea, men are evident in 24%, compared with only 9% of women. Sleep apnea has been found to affect even children. However, it is more common in adults.

Research shows that person with mild to moderate cases of sleep apnea can stop breath, average from 1 to 10 times a night. During these episodes, the person may stop breathing from10sec or above of 30sec seconds per episode. Furthermore, for someone with a severe case of sleep apnea can have 30 or more episodes in one night with pausing breathing at rate of 30 seconds per episode.

Having so many pauses during sleep is the reason why sleep apnea puts a strain on your body, causing serious health issues. Good, deep, restful sleep is imperative for your body to regenerate and function properly.

Health

Sleep Apnea Risk

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Sleep apnea risk
04
Oct

Assess Your Likelihood of Sleep Apnea: This evaluation aims to determine your potential risk of experiencing apnea episodes during sleep. Kindly record your responses to accurately gauge your risk level.

A. How frequently are you made aware that you’re snoring significantly disrupts the sleep of others?

  • Never
  • Rarely (less than once a week)
  • Occasionally (1 – 3 times per week)
  • Often (more than 3 times a week)

B. How frequently have you been informed or observed pauses or cessation of breathing during your sleep?

  • Never
  • Rarely (less than once a week)
  • Occasionally (1 – 3 times per week)
  • Often (more than 3 times a week)

C. What is your current Body Mass Index (BMI) or how would you classify your weight in relation to a healthy range?

  • Not at all
  • Slightly (10 – 20 kg)
  • Moderate (20 – 40 kg)
  • Seriously (over 40 kg)

D. The Epworth Sleepiness Scale (ESS) is commonly used to assess daytime sleepiness. The total score can range from 0 to 24, with higher scores indicating increased daytime sleepiness.

  • Less than 8
  • 9-13
  • 14-18
  • 19 or more

E. Could you specify if your medical history comprises any particular conditions or ailments?

  • High blood pressure
  • Stroke
  • Heart disease
  • More than 3 awakenings per night (on average)
  • Excessive fatigue
  • Difficulty concentrating or staying awake during the day

Should your responses indicate a score of 3 or 4 in questions A through D, particularly if accompanied by the presence of any conditions outlined in category E, it suggests a heightened risk of sleep apnea. It is highly advisable to engage in a discussion regarding these findings with your healthcare provider for further evaluation and guidance.