Snoring And Apnoea Blog

Truck Drivers Not Reporting Sleep Disorder Symptoms

Posted on Wed, Sep 19, 2012

Truck drivers may be downplaying the severity of their sleep disoreders, according to a recent study delivered at the Annual Congress of the European Respiratory Society in Vienna.  

Dr. Werner Strobel, University Hospital, Switzerland is the lead author of the study.   He said, “Our study suggests that commercial drivers are playing down their levels of sleepiness for fear of losing their jobs.”

Dr Strobel acknowledged this is very difficult to prove, but the data recovered from a study of commercial drivers versus a control group of patients gave a strong indication commercial drivers downplayed their sleepiness compared to other patients.

A total of 37 commercial vehicle drivers with sleep apnoea were compared with a control group of 74 patients. Both groups shared similar characteristics such as age, body mass index (BMI) and similar numbers of disturbances experienced during the night.

“You would therefore expect their reports of sleepiness to be similar to begin with, however the (commercial) drivers estimated their levels of sleepiness as lower than the non-drivers,” Dr Strobel said. “This pattern continued throughout the course of the study, with drivers reporting lower symptoms, yet receiving less treatment and making more unscheduled visits to the clinic.”

Both groups also underwent treatment using Continuous Positive Airway Pressure (CPAP) — the 'gold standard' treatment for sleep apneoa.  Even after treatment, the drivers reported lower levels of sleepiness than their counterparts -- with the commercial drivers reporting an average sleepiness score of 4.8 and non-drivers reporting an average of 7.7 after 6 months of treatment.The authors speculate that the lower scores reported by the commercial drivers could be due to drivers under-scoring their sleepiness levels for fear of losing their license. 

“We can assume from these results that commercial drivers with sleep apnea symptoms could be under-reporting their sleepiness in order to protect their job,” Strobel added. “These results should be taken into account by healthcare professionals who are treating this group of people.”

In Australia, sleep disorders are a 'notifiable condition' for people seeking a driving licence of virtually any kind.  In many work places, the existence of an untreated sleep disorder is also grounds for denying work with many types of heavy equipment.

The good news is, patients with sleep apnoea who have successfully undergone treatment can continue to perform their duties ... and do so in the knowledge that they are still protected by the law and their insurance, in the case of an accident.  Untreated apnoea sufferers involved in an incident may be legally liable for the consequences of any accident, and may find that their insurance does not cover them.

The other good news is, diagnosis and tretment is now easier to arrange than ever before.  Dignostic sleep studies (polysomnograms) no longer need to be done in a foreigh and expensive hospital-based or sleep lab environment.  Instead, the sleep study can be done in the privacy, convenience and comfort of the patient's own bed.  This also delivers study results which are more representative of a 'typical' night's sleep.

If the diagnostic study identifies the need for treatment, this can often also be provided in the comfort and privacy of your own home. A Sleep Therapist will visit your home at a convenient time to explain and demonstrate how to use the CPAP equipment to best effect.  Weekly data downloads will be done to check progress, and your nurse will visit or check regularly to see what can be done to improve results.  Taking this approach, it often means weeks of trialling different masks, straps, humidification and other settings before the optimum solution is found -- but compliance and positive results are maximised after this point.  By comparison, merchants who simply sell CPAP machines do not have the ability to provide the follow up service and care and so the CPAP machine is often not used consistently or correctly.

If you are a driver and think you might have a sleep disorder, contact us immediately to arrange a diagnostic sleep study.  We have successfully treated many commercial drivers and understand the importance of privacy at every stage.  Our nurses are also experts at getting the best possible resutls for patients -- including the documentation necessary to show that the condition has been effectively treated and so the driver is fit to continue his or her duties.

Call today on 1300 246 637 for a free, no obligation chat with one of our friendly sleep therapists.  Alternatively, click on the button below to make an online enquiry.  Either way, get in touch soon and let us help.  That's what we're here for!

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Tags: driving, truck drivers, apnoea, apnea, truck driving

Apnea Linked to Nerve Damage In Diabetics

Posted on Fri, Jul 13, 2012

Obstructive sleep apnea has been linked to nerve damage in people with type 2 diabetes, according to a new study.

Researchers found the nerve damage, known as diabetic peripheral neuropathy, is linked to the severity of sleep apnea and the resulting blood oxygen desaturation which occurs while patients sleep.

People with obstructive sleep apnea stop breathing hundreds of times per night because the soft tissue of the upper airway collapses and blocks airflow.  Most of these breathing stoppages end with a brief 'micro arousal', where the sufferer wakes very briefly, often with a choking or gasping for breath.  Because these awakenings are so brief, the sufferer has no conscious memory of waking.  OSA sufferers with diabetic peripheral neuropathy may experience numbness or tingling in their extremities, or damage to their major organs.

The study of 234 adults with type 2 diabetes found that sleep apnea was independently associated with diabetic peripheral neuropathy even after the researchers accounted for a number of other possible factors, including obesity, ethnicity, gender, age at diabetes diagnosis, and the length of time a person had diabetes.

The findings were published online ahead of print in the American Journal of Respiratory and Critical Care Medicine.

"Obstructive sleep apnea is known to be associated with inflammation and oxidative stress, so we hypothesized that it would be associated with peripheral neuropathy in patients with type 2 diabetes," lead author Dr. Abd Tahrani, a clinical lecturer in endocrinology and diabetes at the University of Birmingham in England, said in a news release from the American Thoracic Society.

However, while the study uncovered an association between obstructive sleep apnea and peripheral neuropathy in diabetic patients, it did not prove a cause-and-effect relationship.

Further research is needed to determine the role of sleep apnea and low blood oxygen levels in the development and progression of nerve damage in patients with type 2 diabetes, and to assess the potential impact of continuous positive airway pressure treatment on diabetic peripheral neuropathy, the study authors said.

Continuous positive airway pressure treatment, or CPAP, keeps obstructive sleep apnea patients' airways open while they sleep.

Tags: apnoea, diabetic peripheral neuropathy, apnea

Apnea Linked to Nerve Damage In Diabetics

Posted on Wed, Jun 20, 2012

Obstructive sleep apnea (OSA) has been linked to nerve damage in people with type 2 diabetes, according to a new study.

Researchers found the degree of nerve damage, known as diabetic peripheral neuropathy, depends on the severity of the sleep apnea and the resulting blood oxygen desaturation which occurs while the sufferers are asleep. 

The study of 234 adults with type 2 diabetes found that sleep apnea was independently associated with diabetic peripheral neuropathy even after allowance was made for other factors such as obesity, ethnicity, gender, age at diabetes diagnosis, and the length of time a person had diabetes.

The findings were published in the American Journal of Respiratory and Critical Care Medicine.

"Obstructive sleep apnea is known to be associated with inflammation and oxidative stress, so we hypothesized that it would be associated with peripheral neuropathy in patients with type 2 diabetes," said lead author Dr. Abd Tahrani, a clinical lecturer in endocrinology and diabetes at the University of Birmingham in England.

The study authors also said further research is needed to determine the role of sleep apnea and low blood oxygen levels in the development and progression of nerve damage in patients with type 2 diabetes, and to assess the potential impact of continuous positive airway pressure (CPAP) treatment on diabetic peripheral neuropathy.

If you suspect you suffer from sleep apnea, a diagnostic sleep study is needed to determine the nature and severity of your condition.  An appropriate form of treatment can then be prescribed by a specialist sleep physician. 

Sleep studies can now be performed in the comfort, convenience and privacy of your own home.  To find out more, call 1300 246 637 or click the button below to make an online enquiry.

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Tags: apnoea, diabetic peripheral neuropathy, apnea

Truck Driving And Sleep Apnea

Posted on Thu, May 31, 2012

In a major step forward for the trucking industry, Trucking Canada has partnered with a sleep studies and CPAP provider to do testing and treatment of drivers who may have sleep apnea.

This decision is a direct result of a decision made by the US Federal Motor Carrier Safety Administration's Motor Carrier Safety Advisory Committee earlier in 2012.  The industry's Medical Review Board adopted 11 recommendations related to sleep apnea in the trucking industry.  One of the most significant of these was the decision to require all drivers with a body mass index (BMI) of 35 or higher to be tested for the condition.

High BMI has long been considered one of the most reliable predictors for the existence of obstructive sleep apnea (OSA).  This decision to routinely test drivers who are likely to have an undiagnosed case of OSA will ensure better treatment for those people who are suffering from the condition ... and better safety on the roads for the drivers as well as other motorists.

In Australia, sleep disorders such as OSA are "notifiable conditions" which must be treated in order for a driver to continue to operate a heavy vehicle or equipment.  Unfortunately, there has been no routine protocol of testing to ensure all OSA sufferers are being treated.  Most studies have found that the vast majority of sleep apnea sufferers are unaware of the condition and so remain undiagnosed and untreated. 

The Canadian decision to begin routine testing is a major step forward.  For more information, visit the TruckingInfo website.

Tags: driving, apnoea, apnea

Snoring & Apnoea - Scary Facts

Posted on Thu, Oct 27, 2011

According to a recent scientific paper published by BUPA:

Snoring arising from the base of the tongue can cause partial or complete airway obstruction due to a collapse of the throat, which is essentially a muscular tunnel. If the muscles relax too much, the walls of the tunnel fall in and this inhibits inspiration (breathing in). There may only be a partial collapse, but the effect nevertheless is that the muscles of breathing have to work harder to drag air into the lungs past this obstruction.

Where complete cessation of breathing occurs the condition is called Obstructive Sleep Apnoea (OSA). {Note: apnoea is spelt ‘apnea’ in the United States and Canada). Cessation of breathing may last anywhere from ten seconds to two minutes. Apnoea patients may experience 30 to 300 such events per night. These episodes often lead to significantly reduced blood oxygen levels.

Obstructive sleep apnoea is graded as mild, moderate or severe. Typically, sleep apneoa is considered mild when the patient has from five to fifteen arousals from sleep (“events”) per hour, moderate when the patient has fifteen to thirty events per hour, and severe when the patient has more than 30 events per hour. Some patients only exhibit apnoea, or the apnoea becomes more severe, during rapid eye movement (“REM”) sleep.

REM sleep occurs when the patient is dreaming and the body suspends itself into a flaccid paralysis, reducing muscle tone to its lowest level. The airway is most susceptible to collapse during REM sleep. Arousal during REM sleep is especially harmful to the patient because it is during REM sleep that the body gains the most significant restorative and regenerative benefits from sleep. Without REM sleep the person will not feel refreshed from the sleep period and is subject to the many medical consequences of sleep deprivation.

OSA can lead to severe fatigue at best and sudden death at worst. If you think you have this disorder, you must seek treatment from a medical professional.

According to various scientific studies:

  • An individual with untreated ‘obstructive sleep apnoea’ (OSA) is up to 4 times more likely to have a stroke and 3 times more likely to have heart disease. (National Sleep Foundation).

  • Patients with untreated apnoea run a 3% risk of stroke and heart attack. Treatment with CPAP was found to lower blood pressure and reduce the risk of stroke by 20% (The Lancet 2002; 359: 204-210)

  • About one half of patients who have essential hypertension (high blood pressure) have obstructive sleep apnoea, and about one half of patients who have obstructive sleep apnoea have essential hypertension. (Am Fam Physician 2002;65:229-36)

  • People suffering from sleep apnoea are six times more likely to be involved in a car crash (as a result of drowsiness) than those without sleep disorders. (New England Journal of Medicine, March 18, 1999)

The good news is snoring and apnoea can be treated.  Inexpensively.  And effectively.  Call us today for a free, no-obligation discussion about your situation (this consultation would normally be charged at $35, so call before we are fully booked.  Phone 1300 246 637 today.

Tags: snoring, health facts, apnoea, apnea

Apnoea = Silent Killer.

Posted on Wed, Mar 23, 2011

Apnoea (or 'apnea' depending on which part of the world you come from) is derived from the Greek:  a- without, and pnoea- breathing.

In the context of sleep disorders, apnoea is a condition where the sufferer repeatedly stops breathing while asleep.  A person suffering from 'mild' sleep apnoea will stop breathing between 5 and 15 times per hour while asleep.  A 'moderate' apnoea sufferer will stop breathing between 15 and 30 times per hour;  and a 'severe' apnoea sufferer will stop breathing 30+ times per hour.

To be considered an apnoeic 'event', each apnoea experience must last for at least 10 seconds -- although in many of the sleep studies we've done for patients, we've seen apnoea events lasting up to 2 minutes.  More typically, apnoea events last for around 20 to 40 seconds at a time.

Even a mild apnoea sufferer will therefore stop breathing Apnoea - the silent killersomewhere between (at least) 50 seconds per hour (being 5 events at just 10 seconds each) through to as much as 10 minutes per hour (being 15 events at 40 seconds each).  Obviously, in moderate and severe cases of apnoea, the breathing stoppages are for much greater periods of time.  We have regularly seen patients who are not breathing for more than half the time they are asleep.

The negative impacts of apnoea are many and uniformly negative. 

At the milder end of the scale, the patient suffers from waking tiredness, daytime sleepiness, fatigue, lethargy and loss of cognitive ability.  In more severe cases, apnoea is clearly linked to acid reflux, hyptertension, metabolic retardation and consequent weight gain/obesity, ischemic heart disease and stroke.

Apnoea is a 'silent killer' because it happens when people are asleep -- and the apnoea event is often characterised by the cessation of snoring.  The noise of snoring might be irritating to the snorer's partner, but the silence periods between snoring could be deadly.

If you snore, or know someone who does, arrange a sleep study immediately.  For more information, visit our Sleep Studies page.

Tags: sleep study, apnoea, apnea

Neck Size Is Key Indicator For Sleep Apnoea

Posted on Sat, Dec 04, 2010

A study of the ‘Predictors and Prevalence of Obstructive Sleep Apnoea and Snoring in 1001 Middle Aged Men’ has found that neck circumference and alcohol consumption were most closely correlated with the existence of obstructive sleep apnoea (OSA).   There was a clear correlation with age and obesity, but this was not as well defined. 

An abstract of the full article can be found at:

http://thorax.bmj.com/cgi/content/abstract/46/2/85

Tags: apnoea, OSA, apnea, neck circumference, neck size

Why Is Snoring Linked To Weight Gain?

Posted on Tue, Nov 30, 2010

It’s long been known that overweight people are more likely to suffer from a sleep disordered breathing condition.  This is hardly surprising, as the soft tissue of the tongue, soft palate and pharyngeal walls ‘bulk up’ with fat deposits, thus constricting the upper airway.

But many people are unaware of the fact that it is NOT simply a case of ‘fat people snore’.  In recent medicial research published by Dr Pascualy from the Swedish Medical Institute, a reverse connection was identified.  That is, the researchers pointed out that ‘snoring people get fat’. 

The basis of this finding was the discovery that the lipid metabolism is retarded as soon as sleep disordered breathing commences.  This is a particularly significant finding because it shows why snoring and apnoea are ‘slippery slope’ conditions which can often lead to a negative spiral. 

Specifically, the patient begins to snore or suffer from apnoeic events.  The body’s metabolism is retarded as a result, making it harder to lose weight and easier to gain weight.  The increased weight leads to ‘bulking up’ of the airway tissues, which leads in turn to increased snoring and apnoea.  The cycle is then repeated, with the patient becoming more and more tired and consequently less likely to exercise and do the things which are needed to re-boot the metabolism.

Such is the importance of this issue, leading nutritionists and dieticians are now telling patients their sleep disordered breathing condition must first be resolved before anything can be done to permanently reduce weight.  It makes sense, obviously.  Dieting with a slow metabolism will always be slow and frustrating, whereas a properly functioning metabolism will ensure rapid and sustainable results are enjoyed.

For more information on this and other health / wellbeing issues related to snoring and sleep apnoea, visit our website at www.SleepTherapyClinic.com

 

Tags: snoring, apnoea, apnea, weight gain

Snoring / Apnoea Linked To Brain Damage

Posted on Mon, Oct 25, 2010

Brain damage is linked to snoring and sleep apnoea, according to a recent article in The Courier Mail:

--begins--

YOUR snoring and troubled nights could be a red flag for brain damage occurring while you sleep, latest Australian research indicates.

Brain scans of 60 people, aged in their mid-40s and recently diagnosed with a common sleep disorder, show a "decreased amount of grey matter" when compared to healthy sleepers.
The damage was seen in the brains of Australians suffering from obstructive sleep apnoea, a condition affecting many overweight Australians that is also commonly overlooked.

"In Australia currently ... the evidence suggests about 90 per cent of cases are undiagnosed," said sleep physician Dr Fergal O'Donoghue from the Institute for Breathing and Sleep at Melbourne's Austin Health.
At least four per cent of Australian men, and two per cent of women, in middle age were thought to have the condition.

"Usually it's a consistent snorer who seems to stop breathing in sleep, or complains of waking up with a feeling of choking, or being tired during the day," Dr O'Donoghue said today.   "Those would be the red flags that this could be a problem with sleep apnoea."

People with this sleep disorder suffer from a collapse of their airways during the night, causing a pause in breathing that forces them to rouse from deep sleep.
Dr O'Donoghue said this could occur "many hundreds of times across the night" resulting in times when the brain was deprived of oxygen as well as "surges in blood pressure".

"What specific part of sleep apnoea might cause these changes we can't say, but we can see the changes that have occurred," Dr O'Donoghue said.  "There was a decreased amount of grey matter, so (less) brain cells in those areas."

The damage was seen in two pockets of the brain, one near a part that handles memory and the other in a region known to process smooth movement as well as changes in attention during complex tasks.
Damage to this area could explain why people with sleep apnoea were also know to have a higher rate of car accidents, Dr O'Donoghue said, adding their fatigue from routine lack of sleep would also play a role.

"The take home message is if you complain of these sort of symptoms it is not a good idea to ignore it, you should seek help," he said.

"Snoring in itself, there are some suggestions that it may cause problems but by no means has that been shown to be definitely so.  So it's snoring plus stopping breathing during sleep, or snoring plus waking up with a feeling of 'Gee, I've been choking'.

"Snoring and being sleepy during the day ... that's sleep apnoea."

Dr O'Donoghue's research was presented at the 22nd Annual Scientific Meeting of the Australasian Sleep Association and Australasian Sleep Technologists Association conference, in Christchurch, New Zealand.

Another study taking in 31 older Australians who sought treatment for insomnia found more than half (51.6 per cent) had sleep apnoea.

For more information, visit:  www.SleepTherapyClinic.com

YOUR snoring and troubled nights could be a red flag for brain damage occurring while you sleep, latest Australian research indicates.

Brain scans of 60 people, aged in their mid-40s and recently diagnosed with a common sleep disorder, show a "decreased amount of grey matter" when compared to healthy sleepers.

The damage were seen in the brains of Australians suffering from obstructive sleep apnoea, a condition affecting many overweight Australians that is also commonly overlooked.

"In Australia currently ... the evidence suggests about 90 per cent of cases are undiagnosed," said sleep physician Dr Fergal O'Donoghue from the Institute for Breathing and Sleep at Melbourne's Austin Health.

At least four per cent of Australian men, and two per cent of women, in middle age were thought to have the condition.


"Usually it's a consistent snorer who seems to stop breathing in sleep, or complains of waking up with a feeling of choking, or being tired during the day," Dr O'Donoghue said today.

"Those would be the red flags that this could be a problem with sleep apnoea."

People with this sleep disorder suffer from a collapse of their airways during the night, causing a pause in breathing that forces them to rouse from deep sleep.

Dr O'Donoghue said this could occur "many hundreds of times across the night" resulting in times when the brain was deprived of oxygen as well as "surges in blood pressure".

"What specific part of sleep apnoea might cause these changes we can't say, but we can see the changes that have occurred," Dr O'Donoghue said.

"There was a decreased amount of grey matter, so (less) brain cells in those areas."

The damage was seen in two pockets of the brain, one near a part that handles memory and the other in a region known to process smooth movement as well as changes in attention during complex tasks.

Damage to this area could explain why people with sleep apnoea were also know to have a higher rate of car accidents, Dr O'Donoghue said, adding their fatigue from routine lack of sleep would also play a role.

"The take home message is if you complain of these sort of symptoms it is not a good idea to ignore it, you should seek help," he said.

"Snoring in itself, there are some suggestions that it may cause problems but by no means has that been shown to be definitely so.

"So it's snoring plus stopping breathing during sleep, or snoring plus waking up with a feeling of 'Gee, I've been choking'.

"Snoring and being sleepy during the day ... that's sleep apnoea."

Dr O'Donoghue's research was presented at the 22nd Annual Scientific Meeting of the Australasian Sleep Association and Australasian Sleep Technologists Association conference, in Christchurch, New Zealand.

Another study taking in 31 older Australians who sought treatment for insomnia found more than half (51.6 per cent) had sleep apnoea.

Tags: apnoea, brain damage, research, apnea