After studying the sleep characteristics of nearly 11,000 adults in an overnight sleep laboratory, Mayo Clinic researchers suggest that obstructive sleep apnea (OSA) – and, in particular, the low nighttime oxygen saturation of the blood it causes – may be a risk factor for sudden cardiac death (SCD).

OSA is a condition that disrupts breathing during sleep and is associated with obesity.

The study identified OSA as one of two traits that contribute to the highest risk of SCD. The other is age – patients who are 60 years old or older.

SCD can happen when the heart’s electrical system malfunctions; if treatment – cardiopulmonary resuscitation and defibrillation – is not administered quickly, a person dies.

If further studies validate these findings, OSA would join established risk factors such as smoking, obesity, high cholesterol and high blood pressure. Mayo Clinic cardiologist Apoor Gami, M.D., the lead researcher on the study, presents the findings today at the American Heart Association’s Scientific Sessions 2008 in New Orleans.

Significance
Physicians have suspected for years that OSA might be implicated in SCD because of evidence that low oxygen alters the blood vessels in a way that promotes heart disease. This is the first large study to rigorously test the hypothesis, Dr. Gami says.

“Nighttime low oxygen saturation in the blood is an important complication of obstructive sleep apnea,” says Virend Somers, M.D., Ph.D., the study’s principal investigator. “Our data showed that an average nighttime oxygen saturation of the blood of 93 percent and lowest nighttime saturation of 78 percent strongly predicted SCD, independent of other well-established risk factors, such as high cholesterol. These findings implicate OSA, a relatively common condition, as a novel risk factor for SCD.”

Dr. Somers says these early results are relevant to clinical care. He urges physicians to watch for OSA in their heart patients and consider treating severe cases. “It is possible that diagnosing and treating sleep apnea may prove to be an important opportunity to advance our efforts at preventing and treating heart disease,” he says.

Obstructive sleep apnea and public health
OSA is a common breathing disorder associated with frequent and repeated instances of upper airway obstruction during sleep. Restless sleep and extremely loud snoring are typical symptoms. Obstruction can be caused by excess tissue in the airway, a large tongue or large tonsils, or nasal passage irregularities that diminish airflow. Obesity is a major cause of the condition. Treatments are available, such as a customized appliance worn during sleep to stabilize tissues.

Given the rising incidence of obesity in children and adults, OSA is also becoming more common, Dr. Somers says. So concerned are major heart physicians’ groups about this emerging public health trend that last summer the American Heart Association and the American College of Cardiology issued a joint statement calling for studies probing the link between OSA and SCD, says Dr. Somers. He chaired the committee that wrote the statement.

About the study
The researchers reviewed data from 10,701 consecutive adults who underwent an initial diagnostic sleep laboratory analysis session between 1987 and 2003. During a follow-up period of up to 15 years, researchers assessed cases where patients had sudden cardiac arrest, and either died (SCD) or were resuscitated, in relationship to the presence of OSA and other data, including nighttime levels of oxygen saturation in the blood. Results showed that during an average follow-up of 5.3 years, 142 patients had suffered SCD and either died or were resuscitated.

Treatment

The research article did not talk about treatment at all, however this all points to how important it is to get early treatment and lower the risk of death associated with OSA.  Our patent pending oral appliance is a fantastic treatment option for anyone who is suffering from OSA because it deals with the cause of the obstruction… the tongue.  It’s also a great solution for patients that are CPAP intolerant.

Please do yourself or a loved one a huge favor… get treatment. It won’t get better with time.

Here’s a great report by Matt Lauer, the host on the Today Show, specific to the problems with Sleep Apnea and Snoring in America.

Once again, this report brings much needed attention to the fact that sleep apnea and snoring is an epidemic that needs to be addressed and treated in this country.

Unfortunately, the only treatment that is mentioned is CPAP, and many people are CPAP intolerant. For these apnea sufferers there are other alternatives that may include oral appliances such as the Full Breath Solution that I use in our clinics near Los Angeles and Irvine, California.

The most important point that is made is this.

Sleep apnea and snoring do not get better on their own. These conditions need to be treated. Please see a doctor, find out what your options are and don’t put it off… it may save your life or the one you love….

In the August 1 issue of the journal Sleep, one of the studies was specific to a group of 1,522 adults that were tested for sleep apnea in an overnight sleep study. They were then followed up over a period of 18 years.

The results were astounding.

19 percent of the adults with severe sleep apnea died over the course of the study. Compare that with only 4 percent of people who died that had no sleep apnea. Approximately 42 percent of the deaths of those with the severe sleep apnea were directly related to heart disease or stroke.

“People with untreated, severe sleep apnea had four times the risk of all-cause mortality, and five times the risk of cardiovascular death,” said lead author Terry Young, PhD.  Ms. Young is a professor at the University of Wisconsin-Madison.

My goal here at Apnea-Treatment.com is to alert my readers, and perhaps those who think that they may have just a loud annoying snoring problem that it could be something that can cost you your life. These new studies are conclusive.

Young points out in her research that the repeated pauses in breathing causes a “compound stress.”  Blood pressure rises drastically. Irregular heart rhythms occur. Oxygen levels drop. Restorative sleep (REM) sleep is disturbed and apnea patients never get the rest they need. These pauses in breathing can happen 30 times per hour (or more) all night long. This stress takes a severe toll on the body.

Young also estimates that “10 percent of the adult population has a significant problem with sleep apnea.” She also fears that the rising rate of obesity adds more patients at risk for sleep apnea since obesity is a key risk factor.

As pointed out in previous posts, when a person has sleep apnea and is obese, they wake up tired, have no energy and can barely stay awake all day. These patients have a hard time modifying their behavior to lose weight because they are too tired to exercise. It becomes a circuitous loop of frustration. The studies that show how not getting restorative sleep affects the metabolism and putting people into a “pre-diabetic” state is also documented.

Another study done by Nathaniel Marshall, PhD, at the Woolcock Institute of Medical Research in Sydney Australia found similar results.  His research with 380 adults over a 14 year period brings him to this conclusion: “Or findings along with those from the Wisconsin Cohort, remove any reasonable doubt that sleep apnea is a fatal disease.”

The adults in Marshall’s study were tested with a portable home-monitoring device for one night.  33 percent of the study subjects with moderate to severe sleep apnea died during the follow-up period.  Only 7.7 percent of those studied that did not have sleep apnea died. Those with sleep apnea had six times the risk for death.

Both researchers point out that treatment is imperative and that the risk of death does not go down with time.  Though they discuss the effectiveness of CPAP as a potential treatment option, they do not mention anything about the cause of sleep apnea and other effective treatments for those who may not be able to tolerate a CPAP machine.

As a Doctor that treats Sleep Apnea and Snoring disorders in my clinics throughout the Los Angeles and Orange County areas, I see patients every day that know that this treatment is saving their lives.  At the risk of sounding overly dramatic it is important to see that these research studies confirm the fact that if you have sleep apnea, and leave it untreated,  your risk of dying is 19-33 percent higher than those who don’t.  Please don’t put off making an appointment with someone that can help you. You can call me directly at 888-31-SNORE.

Dear Amy: My wife insists that we sleep in separate rooms. She says I snore — and maybe I do, a little — but sleeping alone makes me feel emotionally alone.

I’ve tried to compromise, asking her if we could stay together for a while first before splitting — but she will not yield, not even a little.

I was sad, but now I’m angry too.

After 20 years of marriage, I feel utterly rejected.

Help!

Sleeping Alone

Dear Alone: I read an article recently saying that “snoring rooms” are the latest thing in home design.  These little soundproof bedrooms give everybody a chance to get a decent night’s sleep if there is a snorer in the house. But the idea isn’t that the snoring room will become a separate bedroom– but more of an occasional refuge.

I agree with you that your wife’s actions are destructive, and your reaction is completely understandable. The charitable assumption is that your wife is so disabled by two decades of interrupted slumber that it has made her lash out.

But I don’t think this is really about the snoring.

Snoring is a relatively easy issue to grapple with, compared with what you two are facing — a lack of intimacy and exile to emotional Siberia.

Whenever a relationship changes so radically, it’s safe to assume there is something major going on.

You need to get to the bottom of this, and a marriage counselor could help.

The response that Amy gives “Sleeping Alone” assumes that the core problem is a lack of intimacy and that going to a marriage counselor would be the best solution. Though a lack of intimacy may have developed over the years of snoring, it is not intimacy that is the problem…

As a Doctor that treats snoring and sleep apnea disorders, to say that “Amy” missed the mark in an understatement.

I am sure that Amy is simply unaware, that there is a sleep disorder epidemic going on.

The general public that she serves in her column is, like Amy, simply unaware that snoring has been linked to a silent killer that has been creeping into peoples bedrooms and destroying marriages just like “Sleeping Alone.”  For over 18 million people that have this disorder, snoring can be the very sign that exposes this insidious disease and alerts someone to the possibility that they may have a very serious and life threatening disorder called “Obstructive Sleep Apnea.”

What Amy obviously doesn’t know is that her advice to see a marriage counselor won’t do much good if hubby dies in the meantime from a stroke or a heart attack, both of which have been associated with untreated obstructive sleep apnea, which main symptom is snoring.

What “Sleeping Alone” needs is a trip to a qualified doctor, not a counselor.

He needs to be evaluated,  prescribed a sleep study to determine if the snoring is caused by obstructive sleep apnea, and get it treated.  Building a “sleep room” in new houses is a feeble  attempt to deal with a problem that doesn’t need rejection, or to be ostracized and banished to emotional exile.

It’s obvious that this syndicated columnist cares about her readers.

The advice she gives is on the mark most of the time, however a person like “Sleeping Alone” who snores should be evaluated and treated. Amy, and her readers, should be made aware that those who are suffering from snoring and sleep apnea can, not only get treatment, but extend their quality of life and have the chance to develop the very intimacy that they deserve and should be between them.

Perhaps Amy would be willing to add to her answer that she gave Sleeping Alone… it could save his life…

Image by mlhradio via Flickr

Are you personally experiencing, or know someone, who’s living costs are outstripping their monthly income as housing costs are skyrocketing, health-care costs, food costs and just about everything just costs more? It’s truly getting expensive to live.

Everyone knows that businesses have a “cost of doing business,” with the expenses they incur as they run the day to day operations of their business such as taxes, wages, overhead, disability insurance, worker comp, advertising, and on and on… there is a cost to run a business.

The fact is that there is a cost associated with just about any activity, and yes, even a cost associated with inactivity.

Sometimes doing nothing will cost more than doing something.. think of your car maintenance.What happens if you don’t change your oil, or let don’t change your brake pads? Your engine can seize up, or you find yourself replacing not just pads, but rotors, calipers and everything else… or worse, getting into an accident over something that didn’t cost that much to replace compared to the pile up that just happened. Yes, letting things go can have a huge cost associated with it doesn’t it?

So… what does all of this have to do with sleep apnea you may ask?

A few weeks ago I conducted a survey where I asked my subscribers what issues where important to them, and what were their concerns.

Of those surveyed 46.7% had concerns about having sleep apnea and 66.7% had questions about alternative treatments other than CPAP like an oral appliance. There were over 45% of people that were not treated but concerned! What opened my eyes was the next statistic.

85.7% of those surveyed were worried about the cost (expense) of getting treatment!

Yes, there is a cost of treatment, but there is an even greater cost of non treatment. The question I have for you is this: Which is greater? The cost of treatment or the cost of non treatment? This question gives new meaning to the term “Cost of Living.”

Here are some facts about the cost of living with untreated sleep apnea. Let’s put these in terms of value

Personal Cost:

Cost to Your Family:

Cost to Society:

If you are someone you love has sleep apnea and are worried about the cost of treatment, ask yourself this important question:

Are the costs of not getting treated more than I’d ever want to pay?

Call now for a free consultation.

Dr. Jonathan Greenburg
888-31-SNORE

Sleep apnea is a serious sleep disorder in which an individual actually stops breathing during sleep. While the person is in a relaxed sleep state, the muscles in the back of their neck and throat relax, allowing tissue from the soft palate to block the airway. This blockage triggers the brain to send constant signals to the body, causing frequent waking.

The sleep apnea cycle can be repeated hundreds if not thousands of times per night.The basic connection between the two ailments boils down to obesity. Both conditions are common in patients who are extremely overweight. In addition, these patients are more likely to suffer from insulin resistance.

Research has shown that the upper airway obstruction caused by sleep apnea can lead to a condition known as oxygen desaturation. This desaturation increases certain hormone levels such as cortisol, which causes increased insulin resistance. Increased cortisol levels are also common in diabetic patients. When levels are elevated, the body does not function properly and can create serious metabolic issues.

Cortisol is responsible for, proper glucose metabolism, regulation of blood pressure, insulin release for blood sugar maintenance and a variety of other biological functions. Another cortisol connection is the fact that it is often released when the body is under stress. A time of stress for the apnea sufferer is likely when the brain senses it is not receiving enough oxygen. To reduce the serious complications that sleep apnea and diabetes present, it is important to be aware of the symptoms of the conditions.

While not every sleep apnea sufferer is diagnosed with Type II Diabetes, having the condition puts you at greater risk of developing this and other serious aliments. In the end frequent monitoring and communicating health changes to your doctor are crucial to receiving the correct treatments and best possible patient care.

Traditional treatments with CPAP, though effective, has a high rate (over 60%) of patients that are intolerant to wearing the masks for a variety of reasons. As Dr. Ulysses Magalang, a sleep expert with Ohio State University Medical Center points out in the video segment, new alternative treatments are needed. New treatments like oral appliance such as the FDA approved Full Breath Solution, have over an 85% success rate.

Please do not hesitate to leave a comment or contact me directly at 888-31-SNORE

We’ve known the purpose of our other biological drives for hundreds of years: we eat to give our bodies energy, we drink to keep hydrated, we procreate to perpetuate the species – among other things. But what is the biological purpose of sleep?

It turns out no one really knows for sure. As correspondent Lesley Stahl reports, why we sleep is one of the biggest unanswered questions in all of science, which is why researchers all over the country are doing studies and coming up with some new and intriguing discoveries.
“We don’t sleep just to rest our tired bodies?” Stahl asks Matthew Walker, the director of the Sleep and Neuroimaging Lab at the University of California, Berkeley.

“Well, that’s been one of the long-standing theories. But I think what we’re starting to understand is that sleep serves a whole constellation of functions, plural,” Walker explains.

One thing that’s clear, says Walker, is that sleep is critical. In a series of studies done back in the 1980s, rats were kept awake indefinitely. After just five days, they started dying.”

The 60 Minutes piece also points out that research showed that patients that were sleep deprived and did not enter into REM (deep restorative sleep) were “pre diabetic” after only 5 days and found themselves ravenously hungry because there is a lack of a chemical in the brain that tells the body that it doesn’t need any more food. It shows us that lack of sleep can be a crucial part of the diabetes and obesity problems we are facing.

There are several other fascinating points made related to drowsy driving and several well known accidents. A National Institute of Health study done at the University of Pennsylvania by David Dinges, the scientist in charge, shared that “Studies show that all of that stuff people tend to do – slapping themselves in the face, rolling the window down, radio up, singing – they’re convinced it helps. But it’s only a matter of seconds or minutes. And you can have a sudden sleep attack right in the midst of doing that,” Dinges says.

And it’s not just driving. Dinges has examined, sometimes as an expert witness, the role of inadequate sleep in some of the world’s most well-known accidents.

He thinks inadequate sleep may have contributed to the Exxon Valdez oil spill, Chernobyl, the Three Mile Island disaster and the 2003 Staten Island ferry crash.

60 Minutes checked. The Exxon Valdez spill happened after midnight with a man at the helm who’d slept only four hours the night before; Chernobyl and Three Mile Island also occurred late at night and involved human error. And the assistant captain who crashed the Staten Island ferry into a pier, killing 11, admitted that he felt exhausted before the accident.

As a doctor who treats sleep apnea and snoring, I see this many patients who are pre-diabetic, exhausted and at risk of heart attacks and strokes. Many of these symptoms and risk factors are reduced if treated.

Let’s face it. We all need our sleep. (and if you snore…so does your spouse…) Get treatment. Don’t put it off.

The enitre article is located at 60 Minutes-The Science of Sleep.

Think you’re getting enough sleep? Take the Great American Sleep Challenge and find out!

Are you tired of feeling tired? Do you want to make a commitment to getting the sleep you need but don’t know where to begin? Then it’s time to take the NSF Great American Sleep Challenge™!

The Sleep Challenge is designed to make it easy for you to determine whether you’re satisfied with your sleep, and if not, to make changes and put yourself on a path to getting the sleep you need. Remember – sleep affects all areas of life including your health, productivity, mood and safety!

The Sleep Challenge takes place from March 3 - March 31, 2008. To take the Sleep Challenge, simply check out one of the many activities below. Don’t forget that you can enter for a chance to win a prize when you take the Challenge!

As a doctor that treats Sleep Apnea and sees the toll that a lack of sleep plays on so many individuals, I thought it would be fun to pass this information on to you.

“At midnight Sunday night, the National Sleep Foundation (NSF) will launch the 11th annual National Sleep Awareness Week® (NSAW). This award-winning, public education and advocacy campaign will focus intense media and policy maker attention on the importance of good sleep as well as the signs and symptoms of chronic sleep disorders that affect millions of Americans.

NSF’s education and policy initiatives have quickly gained momentum and despite many challenges, we are making significant and measurable progress in increasing recognition in Congress and the media that sleep and sleep disorders MUST be part of public health and disease prevention programs.”

For my part in helping to bring awareness and help educate the public I am doing a live simulcast that will be available either via the web or live phone call. I’d like to invite any of my readers to this live event that will be held as follows:

EVENT:  Dr. Jonathan Greenburg – Sleep Apnea
DATE & TIME: Wednesday, March 5th at 7:30pm Pacific
FORMAT: Simulcast! (Attend via Phone or Webcast — it’s your choice)
TO ATTEND THIS EVENT, CLICK THIS LINK NOW…
Live Sleep Apnea Simulcast-Dr. Jonathan Greenburg
I look foward to seeing you on the call!