Author Interviews, JAMA, Obstructive Sleep Apnea, Sleep Disorders, USPSTF / 23.11.2022

MedicalResearch.com Interview with: Martha Kubik, Ph.D., R.N. Professor, School of Nursing College of Health and Human Services George Mason University Member, U.S. Preventive Services Task Force MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a health condition in which part or all of a person’s airway gets blocked during sleep, causing their breathing to stop and restart many times. Untreated sleep apnea is associated with heart disease, stroke, and diabetes. However, there is currently very limited evidence on screening people who don’t have signs or symptoms like snoring and excessive daytime sleepiness. (more…)
AHA Journals, Author Interviews, Obstructive Sleep Apnea, UCSF / 21.06.2021

MedicalResearch.com Interview with: Yerem Yeghiazarians, MD Professor of Medicine Leone-Perkins Family Endowed Chair in Cardiology San Francisco Board Past-President, American Heart Association Co-Director, Adult Cardiac Catheterization Laboratory Director, Peripheral Interventional Cardiology Program Director, Translational Cardiac Stem Cell Program Cardiovascular Research Institute Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research Associate Member in Experimental Therapeutics, UCSF Helen Diller Cancer Center University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is very common, undiagnosed and undertreated. The AHA Scientific Statement was prepared to increase awareness amongst physicians and patients about this condition and to encourage more screening and therapy as appropriate. Obesity is certainly one of the significant risk factors for sleep apnea and we highlight this in the Scientific Statement: “The risk of OSA correlates with body mass index, and obesity remains the one major modifiable risk factor for OSA. In a population-based cohort study of 690 subjects, a 10% weight gain was associated with nearly 32% increase in the apnea-hypopnea index (AHI), and even modest weight control was effective in reducing the new occurrence of sleep-disordered breathing. An even stronger correlation exists between OSA and increased waist circumference and neck size. Neck sizes predisposing to OSA are usually >17 and 16 in for men and women, respectively.” (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Obstructive Sleep Apnea, Pulmonary Disease, University of Michigan / 16.04.2021

MedicalResearch.com Interview with: Galit Levi Dunietz  MPH, PhD Assistant Professor

Tiffany Braley, MD, MS Associate Professor

University of Michigan, Medical School Department of Neurology Department of Nutritional Sciences Ann Arbor, MI 48109-5845 MedicalResearch.com: What is the background for this study? Response: Dementia is a public health crisis that affects more than 6 million Americans.  As no treatments to effectively reverse dementia are currently available, interest has shifted toward modifiable risk factors for dementia, which may offer a critical window for prevention or intervention. Recent research suggests that obstructive sleep apnea (OSA) is a common, yet undiagnosed, risk factor for cognition impairment in older adults. However, few studies have examined whether treatment of OSA with positive airway pressure (PAP) therapy could protect those with OSA against developing dementia, says principal investigator, Dr. Tiffany Braley, MD, MS, Associate Professor of Neurology from the University of Michigan. To address this gap, Dr. Braley and Dr. Galit Levi Dunietz, PhD, MPH, Assistant Professor and sleep epidemiologist, examined associations between PAP therapy use and 3-year incidence of Alzheimer’s disease, mild cognitive impairment (MCI), or other forms of dementia (DNOS, “dementia not otherwise specified”). (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Insomnia, Obstructive Sleep Apnea, Sleep Disorders / 29.10.2020

MedicalResearch.com Interview with: Salma Batool-Anwar, MBBS, MPH Instructor, Harvard Medical School Pulmonary and Critical Care, Sleep Medicine Brigham and Women's Faulkner Hospital MedicalResearch.com: What is the background for this study? Response: A well functioning sleep-wake cycle is vital to our health and prevention of chronic diseases. During previous disaters sleep disturbances have been reported. When Massachusetts governor declared a state of emergency in March’20, we hypothesized that sleep duration would be adversely affected by covid-19 related lockdown and stress. The study was approved by the institutional review board and information was collected retrospectively using the electronic medical records.  (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, Surgical Research / 09.09.2020

MedicalResearch.com Interview with:   Prof Stuart MacKay BSc (Med) MB BS (Hons) FRACS Honorary Clinical Professor Otolaryngology Head and Neck Surgery Clinical Professor at University of Wollongong Graduate School of Medicine Adjunct Professor Faculty of Health Sciences   MedicalResearch.com: What is the background for this study?
  1. Sleep Apnea is common and impairs daytime function and carries health risk.
  2. Many patients have difficulty with CPAP, the main treatment.
  3. Surgery offers an alternative, and we tested this at a very high level in this clinical study.
MedicalResearch.com: What are the main findings? 
  1. Surgery creates marked improvement in stoppages (apnea) and droppages (hypopnea) in airflow.
  2. Surgery significantly improves patient reports of daytime sleepiness.
  3. Many other outcomes related to quality of life, snoring and general well being improve with surgery.
(more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Pediatrics / 03.02.2020

MedicalResearch.com Interview with: Dr. Jonathan R. Skirko, MD , MHPA, MPH Assistant professor Division of Pediatric Otolaryngology University of Utah Health  MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a common problem that that impacts the lives of many people. Understanding treatment effectiveness is important and Health-State Utility is a standardized way of assessing quality of life.  Before this study, we didn't have a way of measuring quality of life in this population in this important way. You have to accurately measure something before you can improve it. (more…)
Author Interviews, Blood Pressure - Hypertension, Obstructive Sleep Apnea / 13.09.2019

MedicalResearch.com Interview with: Mireia Dalmases Cleries, MD Hospital Universitari Arnau de Vilanova and Santa Maria Group of Translational Research in Respiratory Medicine Lleida, Cataluña, Spain MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea has been associated with poor blood pressure control and resistant hypertension. Moreover, it has been described that its treatment with continuous positive pressure (CPAP) could be an effective means of controlling blood pressure in this population. Nevertheless, studies assessing OSA prevalence, characteristics and association with blood pressure control in resistant hypertensive patients are limited and that’s the reason why we decided to perform this study. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Emory, Obstructive Sleep Apnea, Race/Ethnic Diversity, Sleep Disorders / 26.12.2018

MedicalResearch.com Interview with: Dayna A. Johnson PhD Department of Epidemiology Emory University Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups. We were interested in studying whether sleep apnea contributed to hypertension control among African Americans. We found that participants with sleep apnea were more likely to have resistant hypertension than those without sleep apnea. In particular, individuals with severe sleep apnea had the highest risk of resistant hypertension. Most of the participants with measured sleep apnea were undiagnosed (96%).  (more…)
Author Interviews, BMJ, Obstructive Sleep Apnea, Pediatrics, Sleep Disorders, Surgical Research / 09.11.2018

MedicalResearch.com Interview with: Tom Marshall, MSc, PhD, MRCGP, FFPH Professor of public health and primary care Institute of Applied Health Research University of Birmingham, Birmingham, UK MedicalResearch.com: What is the background for this study?   Response: Tonsillectomy is one of the most common childhood surgical procedures. There are two main indications: recurrent sore throat and sleep-related breathing problems (including obstructive sleep apnoea). Jack Paradise’s 1984 study made clear tonsillectomy is modestly effective in children with frequent, severe sore throats: seven in one year, or five yearly in two successive years, or three yearly in three successive years. Sore throats must have symptoms: fever, pus seen on tonsils, lymphadenopathy or confirmed Streptococcal infection. With surgery, children average two sore throats in the next year, without surgery, three. Two years later there is no difference. Further research shows the benefits are too tiny to justify surgery in children with less frequent, less severe or undocumented sore throats. Subsequent randomised controlled trials have not changed the evidence. There isn’t enough good evidence to support surgery in children with obstructive sleep apnoea or sleep related breathing problems. Tonsillectomy is not a trivial procedure, about 2% are readmitted with haemorrhage and about 1 in 40,000 dies. Childhood tonsillectomy is linked to risk of adult autoimmune diseases. It is important to be sure tonsillectomy is only undertaken in children where there are evidence-based indications. (more…)
Author Interviews, Obstructive Sleep Apnea / 22.10.2018

MedicalResearch.com Interview with: "Snoring away" by Doug Ford is licensed under CC BY 2.0Matthew P Butler, PhD Assistant Professor, Oregon Institute of Occupational Health Sciences Assistant Professor, Department of Behavioral Neuroscience Oregon Health & Science University Portland, OR 97239 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive sleep apnea (OSA) is associated with heart disease and mortality, but how OSA does this is not well understood. We are therefore looking for sub-phenotypes within OSA that will help us predict who is at greatest risk. Current diagnosis of OSA is made on the basis of the apnea-hypopnea index (AHI – the number of respiratory events per hour of sleep). But the AHI is not a very good predictor of future mortality. We tested the hypothesis that the duration of events (how long the breathing interruptions are) would predict risk. We found that those with the shortest breathing interruptions had the highest risk of dying, after accounting for other conditions like age, gender, race, and smoking status.  (more…)
Author Interviews, Gout, Obstructive Sleep Apnea, Rheumatology / 30.08.2018

MedicalResearch.com Interview with: Dr M Blagojevic-Bucknal Senior Lecturer in Statistics Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences Keele University Staffordshire UK  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that elevated serum uric acid levels, the cause of gout, are also frequently identified in patients with sleep apnoea However, despite prevalent hyperuricaemia in patients with sleep apnoea, shared risk factors with gout of obesity and alcohol consumption, and research identifying the associations between gout and other co-morbidities, few studies have considered the possibility of an association between sleep apnoea and gout in short and long term. (more…)
Alzheimer's - Dementia, Author Interviews, Obstructive Sleep Apnea, Sleep Disorders / 07.07.2018

MedicalResearch.com Interview with: “Woman sleeping” by Timothy Krause is licensed under CC BY 2.0Nathan E. Cross PhD, first author School of Psychology. Sharon L. Naismith, PhD, senior author Leonard P Ullman Chair in Psychology Brain and Mind Centre Neurosleep, NHMRC Centre of Research Excellence The University of Sydney, Australia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Between 30 to 50% of the risk for dementia is due to modifiable risk factors such depression, hypertension, physical inactivity, obesity, diabetes and smoking. In recent years, multiple longitudinal cohort studies have observed a link between sleep apnoea and a greater risk (1.85 to 2.6 times more likely) of developing cognitive decline and dementia.  Furthermore, one study in over 8000 people also indicated that the presence of obstructive sleep apnoea (OSA) in older adults was associated with an earlier age of cognitive decline, and that treatment of OSA may delay the onset of cognitive impairment. This study reveals important insights into how sleep disorders such as OSA may impact the brain in older adults, as it is associated with widespread structural alterations in diverse brain regions. We found that reduced blood oxygen levels during sleep are related to reduced thickness of the brain's cortex in both the left and right temporal areas - regions that are important in memory and are early sites of injury in Alzheimer's disease. Indeed, reduced thickness in these regions was associated with poorer ability to learn new information, thereby being the first to link this structural change to memory decline. (more…)
Alzheimer's - Dementia, Author Interviews, NYU, Obstructive Sleep Apnea / 15.11.2017

MedicalResearch.com Interview with: Ricardo S Osorio MD Center for Brain Health Department of Psychiatry Center of Excellence on Brain Aging NYU Langone Medical Center New York, NY 10016, USA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study that was performed in a group of healthy normal elderly from the community that volunteered for studies on memory and aging. The main findings were that sleep apnea was very common, in almost all cases undiagnosed, and that it was associated with a longitudinal increase in amyloid burden which is considered one of the hallmark lesions of Alzheimer's disease (more…)
Author Interviews, Menopause, Obstructive Sleep Apnea / 09.11.2017

MedicalResearch.com Interview with: Stephanie S. Faubion, MD, FACP, NCMP, IF Director, Executive and International Medicine Director, Office of Women’s Health Associate Professor of Medicine Division of General Internal Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) was used for this study investigating the association between vasomotor symptoms (hot flashes and night sweats) and risk for obstructive sleep apnea, a common and underdiagnosed sleep disorder in women which is associated with increased cardiovascular risk. We found that Women who had severe or very severe hot flashes or night sweats were more likely to be at increased risk for obstructive sleep apnea.  This association held even after adjusting for age, body mass index, smoking and hypertension, such that the odds of women having intermediate /high risk for obstructive sleep apnea were 1.87 times higher for those with severe/very severe hot flashes/night sweats compared to those with less severe symptoms.  We decided to analyze the group of women with normal body mass index, and indeed, this finding was still significant in the lean group of women. (more…)
Alzheimer's - Dementia, Author Interviews, Obstructive Sleep Apnea / 26.07.2017

MedicalResearch.com Interview with: O. Michael Bubu, M.D., M.P.H., C.P.H Wheaton College MedicalResearch.com: What is the background for this study?
  • Obstructive Sleep Apnea (OSA) and Alzheimer’s disease (AD) are both chronic disease conditions that are highly prevalent, cause significant morbidity and mortality to those afflicted, and have an enormous socio-economic impact. Recent human and animal studies describe associations between Sleep Disordered Breathing (SDB) and Alzheimer's Disease (AD). However, whether OSA accelerates longitudinal increases in amyloid (Aβ) burden in MCI patients is presently unclear.
  • In this study, we examined the effect of Obstructive Sleep Apnea (OSA) on longitudinal changes in brain amyloid deposition, and Alzheimer’s disease (AD) Cerebrospinal fluid (CSF) biomarkers including CSF beta-amyloid 42 peptide (Aβ-42), CSF TAU protein, CSF phosphorylated TAU protein (PTAU) in Cognitive Normal (CN), Mild Cognitive Impairment (MCI) and AD elderly. Brain amyloid (Aβ) burden, CSF Abeta42 and tau proteins are biomarkers (measurable substances whose presence are indicative) of AD-associated pathologic changes in the brain.
  • Data from 1639 subjects (516 CN, 798 MCI and 325 AD, mean ages = 74.4 ± 5.8; 73.4 ± 7.4 and 75.1 ± 7.8 respectively), in the Alzheimer’s disease Neuroimaging Initiative (ADNI) database was used. OSA was self-reported and participants were labeled OSA positive, or OSA negative (mean ages = 72.3 ± 7.1; and 73.9 ± 7.3 respectively). Statistical analyses were conductedto examine whether OSA positive compared to OSA negative participants experienced significant differences in the rate of change of AD biomarkers over time (mean = 2.52 ± 0.51 years) in each group (CN, MCI and AD). Both OSA positives and negatives were similar in age, APOE e4 status, and history of cardiovascular disease. The final models controlled for sex, body mass index (BMI), and Continuous Pulmonary Airway Pressure (CPAP) use.
(more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Sleep Disorders / 04.03.2017

MedicalResearch.com Interview with: Dr. Simone Baiardi MD Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna MedicalResearch.com: What is the background for this study? Response: Drug-induced sleep endoscopy (DISE) is an useful tool for studying the upper airway dynamic in patients with obstructive sleep apnea syndrome (OSAS), and it’s crucial for the therapeutic choice (especially for non ventilatory treatment, such as surgery). The main limits of DISE are the lack of standardization of procedure and the low inter-observer reliability among non-experienced ENT surgeons. (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern / 02.03.2017

MedicalResearch.com Interview with: Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy. (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Sleep Disorders / 27.01.2017

MedicalResearch.com Interview with: Dr. Alex Krist, MD MPH Task Force member Associate Professor Fairfax Family Medicine Residency Co-director, Ambulatory Care Outcomes Research Network Virginia Commonwealth University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive sleep apnea (OSA) has been found to be associated with serious health conditions, including heart disease and diabetes. Additionally, OSA can cause excessive daytime sleepiness, which can significantly impact a person’s quality of life, increase involvement in motor vehicle crashes, and lead to an increased risk of death. Estimates show that OSA affected between 10 and 15% of the U.S. population in the 1990s, and rates may have increased over the past 20 years, so the Task Force wanted to examine the evidence on screening adults without symptoms or symptoms for obstructive sleep apnea. (more…)
Author Interviews, Heart Disease, NEJM, Obstructive Sleep Apnea, Sleep Disorders / 30.08.2016

MedicalResearch.com Interview with: Prof. Craig Anderson, PhD Professor of Stroke Medicine and Clinical Neuroscience Medicine, The George Institute for Global Health University of Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wished to prove whether treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP ) can modify the risk of cardiovascular disease. The is a lot of association data from epidemiological and clinical studies but no large scale international clinical trials assessing the effects of CPAP on the prevention of serious cardiovascular events like heart attack and stroke. Our study in nearly 3000 adults with prior heart attack or stroke and moderate to severe obstructive sleep apnea showed that CPAP treatment did not prevent recurrent cardiovascular events or major cardiovascular risk factors. However CPAP did improve wearers' sense of wellbeing, mood and work productivity. (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Pulmonary Disease, Sleep Disorders / 11.08.2016

MedicalResearch.com Interview with: Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota and Roxanne Prichard, PhD Associate Professor of Psychology and Neuroscience University of St. Thomas MedicalResearch.com: What is the background for this study? What are the main findings? Response: CPAP devices, or continuous positive airway pressure devices, are used to treat obstructive sleep apnea, a common condition that causes people to intermittently stop breathing during their sleep. This leads to poor sleep quality and often results in symptoms like excessive sleepiness in the daytime. In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription. We were aware of online advertisements for secondhand, used CPAP machines, but we have not seen publications that have analyzed this practice. Once a week, our research team monitored online advertisements for secondhand CPAP devices on Craigslist.org in 18 U.S. cities and areas over a one-month period. During that time, we found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only 5 of the advertisements mentioned anything about the legal requirements of a prescription and 61 percent of the devices included a used mask without information about its age or how it was cleaned. CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory. Our study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners. The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Obstructive Sleep Apnea / 21.03.2016

MedicalResearch.com Interview with: Stefanos N. Kales, MD, MPH, FACP, FACOEM  Associate Professor, Harvard Medical School & Harvard TH Chan School of Public Health Director, Occupational Medicine Residency Division Chief OEM, Cambridge Health Alliance MedicalResearch: What is the background for this study? Dr. Kales: Up to 20% of all large truck crashes are due to drowsy or fatigued driving, which would account for almost 9,000 fatalities and up to 220,000 serious injuries. OSA is the most common medical cause of excessive daytime sleepiness or fatigue, and has been linked with negative impacts on attention, working memory, vigilance, and executive functioning. Past studies primarily of passenger car drivers have linked untreated OSA with a several-fold increased risk of motor vehicle accidents. They have also shown that effective treatment with CPAP reduces this risk close to that of unaffected drivers. Although commercial truck drivers undergo a biennial examination to determine their medical fitness to safely operate a vehicle, there are currently no mandatory standards for OSA screening or diagnosis, in part because there have been no large-scale studies evaluating the crash risk of commercial drivers diagnosed with OSA. Our study examined the results of the first large-scale employer program to screen, diagnose, and monitor OSA treatment adherence in the U.S. trucking industry  (more…)
Author Interviews, Obstructive Sleep Apnea, Vitamin D / 24.12.2015

MedicalResearch.com Interview with: Ken M. Kunisaki , MD Associate Professor of Medicine Pulmonary, Allergy, Critical Care and Sleep Medicine University of Minnesota  Medical Research: What is the background for this study? What are the main findings? Dr. Kunisaki : Obstructive sleep apnea (OSA) is a very common condition that is the result of recurrent complete or partial closure of the upper airway during sleep.  OSA leads to poor sleep quality and excessive daytime sleepiness. A previous study suggested that OSA is more common in the winter, but there were no vitamin D measurements in that study, which seemed potentially relevant since many people have lower vitamin D levels in the winter, due to less sunlight exposure in the winter.  Several studies have also shown that people with low vitamin D levels have worse muscle function.  Since muscles are partially responsible for keeping the upper airway open during sleep, we wondered whether people with low vitamin D levels might have weaker upper airway muscles and therefore be more prone to having OSA. In our study, we found that indeed, persons with OSA had lower vitamin D levels than those without OSA, but this was explained by obesity.  In other words, the low vitamin D levels seen in OSA patients is likely just a marker of obesity and not likely related to the presence or absence of OSA. (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Surgical Research, UCLA / 29.11.2015

MedicalResearch.com Interview with: Soroush Zaghi, MD Department of Head and Neck Surgery David Geffen School of Medicine at UCLA University of California, Los Angeles MedicalResearch: What is the central message for clinicians and surgeons from your results? Dr. Zaghi: Multiple studies from different practitioners and institutions agree that Maxillomandibular Advancement (MMA) is a highly effective surgical option for patients with obstructive sleep apnea who cannot tolerate positive pressure therapy and have not found success with other surgical procedures. (more…)
Author Interviews, Obstructive Sleep Apnea / 17.07.2015

Sunil Sharma, M.D Associate professor of pulmonary medicine Sidney Kimmel Medical College at Thomas Jefferson UniversityMedicalResearch.com Interview with: Sunil Sharma, M.D Associate professor of pulmonary medicine Sidney Kimmel Medical College at Thomas Jefferson University Medical Research: What is the background for this study? What are the main findings? Dr. Sharma: Obstructive sleep apnea (OSA) is a highly prevalent disorder with significant cardiovascular implications. In this condition the patient may repeatedly quit breathing during sleep, sometimes hundreds of times, leading to loss of oxygen and frequent arousals throughout the night. OSA has been associated with high blood pressure, congestive heart failure, coronary artery disease, arrhythmias and stroke, among other conditions. While overall awareness is improving, the condition is under-recognized in hospitalized patients. Due to multiple co-morbid conditions these patients may be at higher risk for complications. Recent studies have also shown that early recognition of OSA in hospitalized patients may reduce readmission rates. In our study, we used a simple and cost-effective clinical pathway to determine high-risk patients. Of the 149 patient's determined to be high risk by our protocol, 128 (87%) were confirmed with the diagnosis by a polysomnography (gold standard test). Furthermore, data derived from a simple and cost-effective oxygen measuring device (pulse-oximeter) was found to co-relate well with the polysomnography.  (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea / 06.06.2015

Marie Marklund, DDS senior lecturer Department of Odontology, Faculty of Medicine Umeå University SwedenMedicalResearch.com Interview with: Marie Marklund, DDS senior lecturer Department of Odontology, Faculty of Medicine Umeå University Sweden MedicalResearch: What is the background for this study? What are the main findings? Response: Snoring and obstructive sleep apnea are common in the population and these disorders continuously increase because of the ongoing obesity epidemic in many countries. Today, 34% of men and 17% of women in the US suffer from obstructive sleep apnea of all severities. Symptoms include daytime sleepiness, poor sleep quality, headache, insomnia and restless legs. In the longer term, a more severe sleep apnea is associated with serious consequences, such as hypertension, stroke, cancer, traffic accidents and early death. Continuous positive airway pressure is a highly effective treatment for sleep apnea patients. Adherence problems, for instance from nasal stuffiness and claustrophobia reduces its effectiveness. An oral appliance holds the lower jaw forwards during sleep in order to reduce snoring and sleep apneas. This therapy has primarily been suggested for snorers and patients with mild and moderate sleep apnea. No previous placebo-controlled study has, however, evaluated this specific group of patients. Results from more severe sleep apnea patients have shown a good effect on sleep apneas. The effect of oral appliances on daytime symptoms is unclear. Symptomatic improvement is an important outcome for milder sleep apnea patients. The primary aims of the present study were to study the effects on daytime sleepiness and quality of life of a custom-made, adjustable oral appliance in patients with daytime sleepiness and snoring or mild to moderate sleep apnea, i.e. the primary target group for this type of therapy. Secondary aims included the effects on sleep apnea, snoring and various other symptoms of sleep disordered breathing such as headaches and restless legs. We found that oral appliance therapy was effective in reducing sleep apneas, snoring and symptoms of restless legs. The apnea-hypopnea index was normal (<5) in 49% of patients using the active appliance and in 11% using placebo, with a numbers needed to treat of three. Daytime sleepiness and quality of life did not differ during active treatment and the placebo intervention. The patients experienced reduced headaches with active treatment, but the results did not differ from placebo. It was concluded, that a custom-made, adjustable oral appliance reduces obstructive sleep apneas, snoring and possibly restless legs. The efficacy on daytime sleepiness and quality of life was weak and did not differ from placebo in this group of patients. (more…)
Author Interviews, Heart Disease, JACC, NYU, Obstructive Sleep Apnea, Sleep Disorders / 22.04.2015

Dr. Larry Chinitz MD Professor of Medicine and Director, Cardiac Electrophysiology NYU Langone Medical CenterMedicalResearch.com Interview with: Dr. Larry Chinitz MD Professor of Medicine and Director, Cardiac Electrophysiology NYU Langone Medical Center MedicalResearch: What is the background for this study? What are the main findings? Dr. Chinitz: The treatment algorithms proposed currently for maintenance of sinus rhythm in patients with atrial fibrillation focus on use of anti-arrhythmic drugs and catheter ablation. Data available to evaluate the effect of modification of known adverse clinical factors on atrial fibrillation recurrence is scant. Obstructive sleep apnea in a known factor associated with both new onset atrial fibrillation as well as its recurrence after catheter ablation. Through a meta-analysis of available data we found that use of continuous positive airway pressure in patients with sleep apnea was associated with a 42% relative risk reduction in recurrence of atrial fibrillation. This effect was similar across patient groups irrespective of whether they were medically managed or with catheter ablation. (more…)
Author Interviews, CHEST, Lifestyle & Health, Obstructive Sleep Apnea / 24.02.2015

Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State UniversityMedicalResearch.com Interview with: Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State University   Medical Research: What is the background for this study? What are the main findings? Dr. Buman: A lack of physical activity is a known risk factor for insomnia, poor sleep, and obstructive sleep apnea. In addition to physical activity, sedentary behavior has emerged as an important behavior. Sedentary behavior is not just the lack of physical activity, but actually refers to the time someone spend sitting. This behavior has been shown to, independent of physical activity, be related to many poor health outcomes including cardiovascular disease, diabetes, and even premature death. This is the first study to examine whether there is a relationship between excess sitting and insomnia, poor sleep, and risk for obstructive sleep apnea. We found, after adjusting for physical activity and body weight (among other confounding factors), that total daily sitting was associated with poor sleep quality but not other sleep metrics or OSA risk. However, we also examined sitting while watching television and found a significant relationship between this type of sitting and a host of sleep quality metrics as well as risk for OSA. In a subsequent analysis we found that despite the independent relationship between sitting while watching television with OSA risk, those that were physically active were protected from this negative impact. (more…)
Author Interviews, Heart Disease, JACC, Obstructive Sleep Apnea, Stroke / 01.02.2015

Dmitry Yaranov, MD Danbury Hospital Western Connecticut Health NetworkMedicalResearch.com Interview with: Dmitry Yaranov, MD Danbury Hospital Western Connecticut Health Network Medical Research: What is the background for this study? What are the main findings? Dr. Yaranov: Obstructive sleep apnea (OSA) is an independent risk factor for ischemic stroke (CVA) that is not included in the usual cardioembolic risk assessments for patients with atrial fibrillation. The aim of this study was to investigate the impact of OSA on CVA rate in patients with atrial fibrillation. We found that Obstructive sleep apnea in patients with atrial fibrillation is an independent predictor of CVA and this association may have important clinical implications in CVA risk stratification. (more…)