by Aldon Hilton DDS on April 23, 2009
As you may have read in my previous comments dated April 19th, I mentioned a study that was conducted with commercial truck drivers that showed how a vast majority them meet criteria for having sleep apnea.
On May 21st 2009, the National Transportation Safety Board held a hearing where they released the findings of a January 08, 2008 bus crash that occurred on a remote rural highway in Utah. The crash killed 9 passengers and injured 43 others who were coming home from a ski trip.
The investigation discovered that the driver was suffering from sleep apnea and was especially fatigued because he could NOT tolerate the CPAP machine that was prescribed to him. The accident occurred when the driver made a wrong turn while being sleepy, and lost control due tohis reaction time being affected by the lack of sleep. This sad story concluded with the comments from the NTSB and other federal authorities suggesting that perhaps in the future drivers should be screened for sleep apnea. It appears that as more incidents like this are being reported the public is demanding rules and regulations be put into place to prevent this accidents from occurring in the future.
CPAP machine intolerance is a major reason why most people do not use their CPAP machine. Just like this case, there are a lot of folks who are prescribed a CPAP machine and either do not use it or only use it sometimes. There are several reasons why people do not use their CPAP machine. For some people it can be the noise of the machine, the hassle with the masks and hoses, or the simple fact that it is uncomfortable. Many studies now show that compliance with using a CPAP machine is below 50% and as you have read here, this can pose dangers not only to the patient but those they come in contact with.
If you know of anyone who is having trouble with managing their sleep apnea please help them learn about this site and the alternatives to the CPAP machine that our office offers.
http://www.boston.com/news/
by Aldon Hilton DDS on April 20, 2009
By Aldon Hilton
As summer is fast approaching many folks begin to think about losing weight in order to look better on the beach . Well, losing weight can not only help suffers of obstructive sleep apnea look better it may even help them improve their condition.
Henri P.I. Tupmilehto , M.D., PhD., of the department of Otorhinolaryngology (this is a branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders) at the Kuopio University Hospital in Finland, recently studied the effects of losing weight and subsequent improvement in sleep apnea symptoms.
In this study patients were subjected to a combination of a very low calorie diet combined with active lifestyles counseling. For those that loss the weight and kept it off for a year saw markedly lower symptoms of obstructive sleep apnea. Dr. Tuomilehto noticed that the greater the change in body weight or waist circumference the greater was the improvement in a patient’s sleep apnea. The biggest improvements were found in patients who were able to lose more than 33 pounds.
Aside from the positive benefits of treating sleep apnea there were also marked improvements in hypertension, high cholesterol and diabetes not to mention improvement in cardiovascular health.
It is important to note that although this study shows a relationship between weight loss and the resulting improvements of sleep apnea symptoms, it is not recommended that this be the first treatment approach to be considered in treating sleep apnea. Furthermore, such a calorie restrictive program as discussed in this study should only be conducted with the supervision of physician
by Aldon Hilton DDS on April 2, 2009
Today I would like to review with you a book on sleep written by Steven Y. Park, MD entitled, ” Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired”. Dr. Park, is a Clinical Assistant Professor of Otolaryngology at the New York Medical College and shares his many years of experience working with individuals who have various sleep disorders.
This book is full of good tips to help you sleep better and snore less. For example, Dr. Park recommends that you don’t watch the clock if you can’t sleep. Doing so will only make you feel aggravated and frustrated with does not lead to better sleep.
One thing that Dr. Park and I agree on is that If you snore, skip all the throat sprays, pillows, nose strips and vitamins. Sleep aids only work sometimes, in some people. Dr. Park shows that published studies have found them all not helpful. To sleep better and snore less, don’t rely on sleep aids.
How about Singing to help improve your snoring and sleep apnea? Yes, it is true there are various singing and tongue exercises that may help you sleep better and snore less. Singing may improve your throat muscle control while exercising your tongue muscles as well.
So you don’t think you have a good voice, how about taking up a musical instrument. Studies have reported that using the Aboriginee musical instrument called the didgeridoo, can actually improve snoring and sleep apnea.
The book shows that you are better off staying away from prescription sleeping pills. Non-drug company funded studies have shown that these pills only increase sleep duration by about 10 minutes on average. Even if it works, the effect wears off if used long-term. For many sleeping pills – even the newer ones – the side effects can outweigh any potential benefit. Cognitive behavior therapy (CBT) for insomnia has been proven to help you sleep better.
What about Breathe-Rite strips also known as nasal dilator strips do they work? Unfortunately, they are not always strong enough to keep your nostrils open. Sometimes you need something stronger. There are various internal nasal clips that widen your nostrils while you sleep. Opening up your nose is found to help sleep apnea only in about 10% of people. But when it works, you’ll know – because you’ll sleep better and snore less.
The book has these and many other tips and solid information for anyone who is interested in improving their sleep hygiene. I am sure that you will find it a good read like I did.
by Aldon Hilton DDS on April 2, 2009
The American Journal of Respiratory and Critical Care Medicine published the results of a study that proved that individuals who experience moderate to severe sleep disorder breathing are four times more likely to have a stroke during the next four years.
Sleep-disorder breathing is one of a group of serious sleep disorders in which a sleeping person repeatedly stops breathing long enough to reduce the amount of oxygen in the blood and to increase the amount of carbon dioxide. Researchers categorized the level of the disorder by counting the number of times per hour that a person stops breathing for 10 seconds or more. In moderate to severe sleep disorders breathing is defined as a person stopping to breath 20 or more times per hour.
This study analyzed the results from 1, 475 participants with follow visits conducted over the next 4, 8, and 12 years. Among the group, 21 individuals suffered a first ever stroke at an average age of 53.
by Aldon Hilton DDS on April 2, 2009
New research on the effects of headaches on children ‘s sleep patterns are showing that children with migraines are twice as likely as the other children in the study to have sleep apnea. Sleep disorder breathing was found in 56 % of children with migraine versus 30% of children with non-migraine headache.
The research findings were presented at the American Academy of Neurology 60th Anniversary Annual Meeting in Chicago on April 17, 2008. Severe migraine was associated with shorter total sleep time, longer total time to fall asleep, and shorter REM sleep, which is the stage of sleep in which most dreams can be recalled.
The author of the study, Dr. Martina Vendrame, MD, PhD, of Temple University, stated that, “Sleeping problems can exacerbate the problems migraine causes on a child’s health and may hinder a child’s performance at school.”
The study also found 50% of children with tension headaches grind their teeth at night compared to 2.4% of children with non-tension headaches. Also, a child’s weight appears to be a contributing factor in the development of sleep disorder breathing.
by Aldon Hilton DDS on April 2, 2009
According to a study published in the September 18th issue of Archives of Internal Medicine discovered that individuals who have a sleep related breathing disorder appear to significantly be more likely to develop depression.
Previous studies had demonstrated that depression improves when sleep related breathing disorders are treated. This study found patients with mild levels of sleep related breathing disorders were 1.6 times as likely to be depressed; those with mild cases, twice as likely; and those with moderate to worse, 2.6 times as likely. It was further proven that Individuals whose breathing problems worsened over time increased their risk for depression. The authors wrote, “For example, persons initially without sleep related disorder but in whom minimal sleep related breathing disorder developed during a four year period are estimated to be at 80% greater odds for development of depression than those who remain without sleep related breathing disorders.”
This study concluded that medical professionals should have a heighten clinical suspicion of depression in those with sleep related breathing disorder.
by Aldon Hilton DDS on April 2, 2009
The University of Texas Health Science Center at San Antonio Dental School has been testing the application of oral appliances in an 18 month study involving sleep apnea patients at the South Texas Veterans Health Care System. According to Dr. McLornan author of the study, “What we found was that many of our patients with moderate to severe sleep apnea were not adhering to standard treatment with a Continuous Positive Airway Pressure (CPAP) machine. Dr. McLornan went on to explain, “some said it was uncomfortable or that it bothered their spouses, or that they were just too embarrassed to use the machine”. As a result of these complains it is known that less than 50% of those who are prescribed a CPAP machine are compliant in the use of the machine.
Not treating sleep apnea can lead to serious health concerns including high blood pressure, heart attacks, strokes, obesity and diabetes. This study showed that patients in the study improved significantly when using the oral appliance. As Dr. McLonan summarized, “We saw patients who began the study with severe sleep apnea end the study with very mild or no sleep apnea. They reported sleeping better, feeling more rested in the morning and altogether healthier”.
by Aldon Hilton DDS on March 17, 2009
In the March 2009 edition of the Journal of Occupational and Environmental Medicine a study was presented by Phillip Parks, MD, MPH regarding the dangers present in truck drivers who suffer from sleep apnea..
The study looked at 456 commercial drivers from 50 different employers, over a 15 month period. The study found that 78% of those drivers met the screening criteria for suspect of obstructive sleep apnea. The vast majority of these drivers were older and more obese, and had a higher average blood pressure.
Dr. Parks noted, “Although it is not surprising, it is concerning that we found that drivers with sleep apnea frequently minimize or underreport symptoms such as snoring and daytime sleepiness. In our study, the majority of truck drivers did not follow through on physician recommendation for sleep studies and sleep apnea treatment”. He concluded, as a result it is possible that many of the 14 million truck drivers on American roads have undiagnosed or untreated sleep apnea.
Dr. Stefanos N. Kales, MD, MPH, Medical director of Employee and Industrial Medicine at Cambridge Health Alliance stated, “it is very likely that most of the drivers who did not comply with sleep studies or sleep apnea treatment sought medical certification from examiners who do not screen for sleep apnea and are driving with untreated or inadequately treated sleep apnea.
Currently the Federal Motor Carrier Safety Administration is considering requiring sleep apnea screening for all obese drivers based on body mass index or “BMI”. However, at this time there is no requirement that sleep apnea screening be performed as part of the medical certification.
