People With Sleep Apnea At Increased Risk of Gout

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

Dr. Blagojevic-Bucknal

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.

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CPAP Improved Sexual Quality of Life for Women

MedicalResearch.com Interview with:

“The new CPAP machine” by Bryan Alexander is licensed under CC BY 2.0

One CPAP model
Image by Bryan Alexander

Sebastian M. Jara, MD
Resident Physician & Research Fellow
Department of Otolaryngology – Head & Neck Surgery
University of Washington Affiliated Hospitals 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Sleep apnea is a common disorder associated with numerous health consequences and reduced quality of life. There is growing evidence that sleep apnea also affects sexual quality of life and that treatment for sleep apnea, with CPAP (continuous positive airway pressure), may improve sexual quality of life. The goal of this study was to evaluate the impact of long-term CPAP therapy on sexual quality of life in a group of men and women with sleep apnea.

Our study included 182 men and women with newly diagnosed obstructive sleep apnea, each of whom were prescribed a CPAP. Subjects completed a quality of life survey, which included questions on sexual quality of life, at their initial clinic visits and again one year later. Changes in sexual quality of scores over time were then compared between CPAP users and non-users.

Among the subjects, 72 used a CPAP nightly and 110 did not. When looking at all subjects, an overall improvement in sexual quality of life was observed in subjects that used their CPAP compared to subjects that did not, after accounting for several factors that can also affect sexual quality of life. When subgroup analysis was performed, a large improvement in sexual quality of life was noticed for women in the study. In contrast, men in the study experienced little-to-no improvement in sexual quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: These findings add to a large body of evidence that CPAP improves overall health and quality of life, in both men and women with sleep apnea. Because sleep apnea is more common men, there are fewer studies, especially those assessing sexual dysfunction, in women. However, there’s growing recognition that women, too, are affected and can benefit from CPAP use. Our findings demonstrate that improved sexual quality of life is one of the many health benefits that comes with CPAP treatment for women.While this study showed no improvements in sexual quality of life for men, CPAP has been shown to have numerous other health benefits in men and use should still be encouraged. Our hope is that the findings of this study will help motivate patients of both sexes who sleep poorly to seek evaluation for sleep apnea as treatment can have a wide-range of health benefits, including improved sexual quality of life. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, it will be important to study more comprehensive measures of sexual quality of life in sleep apnea patients. This will include both a more extensive assessment of sexual quality of life in patients themselves and effects on their bed partners. Additionally, it will be important to test the effects of other sleep apnea treatments, such as surgery. Although CPAP is the first-line treatment for sleep apnea, it can be cumbersome to wear and might adversely affect intimacy and sexual quality of life compared to other treatments. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study was funded by the National Institutes of Health. The authors of this study otherwise have no other funding, financial relationships, or conflicts of interest to disclose. 

Citation:

Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485

 

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Sleep Apnea Increases Amyloid Load In Brain, A Hallmark of Alzheimer’s Disease

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

Dr. Osorio

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

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Study Finds CPAP Improved Quality of Life But Did Not Reduce Cardiovascular Risk

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.

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Study Raises Concerns About Sales of Secondhand CPAP Devices

MedicalResearch.com Interview with:

Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota

Dr. Kunisaki

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

Dr. Prichard

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.

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CPAP For Sleep Apnea May Decrease Atrial Fibrillation Recurrence

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.
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Sleep Apnea Predisposes To Impaired Brain Blood Flow With Physical Activity

Paul M. Macey, Ph.D. Assistant Professor in Residence Associate Dean for Information Technology and Innovations, Chief Innovation Officer UCLA School of Nursing and Brain Research InstituteMedicalResearch.com Interview with:
Paul M. Macey, Ph.D.
Assistant Professor in Residence
Associate Dean for Information Technology and Innovations,
Chief Innovation Officer UCLA School of Nursing and Brain Research Institute

Medical Research: What are the main findings of the study?

Dr. Macey: People with sleep apnea are less able to control the blood flowing to their brain, in particular when they grip tightly, or have their foot put in cold water. We measured changes in blood flowing through the brain using an MRI scanner while people gripped hard, had their foot placed in cold water, and breathed out hard into a tube with a very small hole in it. These activities all lead to more blood flowing to the brain in healthy people, which probably helps protect the cells from being starved of blood and oxygen. However, people with sleep apnea send less blood that the healthy participants during the gripped and cold foot activities.

A further important finding is that women with sleep apnea are worse off than men. The female patients showed much weaker blood flow than the males, even accounting for normal differences between men and women.
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CPAP Effective In Elderly Sleep Apnea Patients

MedicalResearch.com Interview with:
Prof. Mary J Morrell
Faculty of MedicineNational Heart & Lung Institute
Professor of Sleep & Respiratory Physiology
Imperial College, London


Medical Research: What are the main findings of the study?

Prof. Morrell: Our results showed that when older patients with obstructive sleep apnea were treated with continuous positive airway pressure (CPAP) they had significantly less daytime sleepiness than those not treated with CPAP. A comparison of the costs and benefits of treatment suggested that CPAP would meet the usual criteria for being funded by the NHS.
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Blood Pressure: Effect of CPAP in Patients with Obstructive Sleep Apnea

MedicalResearch.com Interview with:
Dr. Miguel-Ángel Martínez-García
Respiratory Department, Hospital Universitario y Politécnico La Fe
Valencia, Spain

MedicalResearch.com: What are the main findings of this study:

Answer: The main findings of the study are:

1. The treatment with CPAP
(continuous positive airway pressure) achieves a clinically and
statistically significant reduction of blood pressure in patients with
resistant hypertension (blood pressure that remains above goal in spite of
the use of at least three antihypertensive drugs) and obstructive sleep
apnea.
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Sleep Apnea: Effect of CPAP on Blood Pressure

MedicalResearch.com Interview with:
Cristiano Fava MD, PhD
University of Verona
Department of Medicine
Division of Internal Medicine C
Hospital “Policlinico G.B. Rossi”
37134 Verona Italy

University of Lund
Department of Clinical Sciences
Division of Endocrinology
CRC, Lund University
S-205 02 Malmö Sweden

MedicalResearch.com: What are the main findings of the study?

Dr. Fava: The main finding of the meta-analysis is that cPAP usage for at least 2 weeks, with respect to either placebo or usual care is associated with a significant reduction in both systolic and diastolic blood pressure. However the effect size of blood pressure reduction is modest.

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Sleep Apnea: CPAP Treatment and Golf Performance

MedicalResearch.com Interview with:

Marc L. Benton, MD, FCCP, FAASM
Morristown Medical Center and Atlantic Sleep & Pulmonary Associates,
300 Madison Ave. Third Floor
Madison, NJ 07940

MedicalResearch.com: What are the main findings of the study?

Dr. Benton:  When compared to a group of matched controls, 12 male golfers who had moderate-severe obstructive sleep apnea syndrome (OSAS) demonstrated statistically significant improvement in their ability to play golf (as measured by changes in the Handicap Index, the standardized indicator of golfing performance) after undergoing CPAP treatment for their condition.  Treatment adherence among the group placed on CPAP was unusually high.
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