Snoring And Apnoea Blog

A Hidden Epidemic. And YOU Know Someone Who's Affected.

Posted on Wed, Nov 07, 2012

We are all living through what medical literature refers to as 'a hidden epidemic'.  This epidemic affects both genders, all ages, and all body shapes, from lean to obese.  One in every three adults suffer from a significant form of this condition -- yet most people blithely ignore the condition, thinking it's normal.

The condition in question is 'sleep disordered breathing' (SDB).  This term covers a wide range of ailments, from simple snoring through to severe obstructive sleep apnoea, where the sufferer literally stops breathing while asleep. 

All forms of the condition are harmful, to varying degrees.  Even simple snoring, which everyone tends to joke and tease about, is actually a loud, clear signal that the airflow is impaired.  This is NEVER a good thing. 

Countless studies have found clear links between sleep disordered breathing and a wide range of negative consequences and co-morbidities, including hypertension (high blood pressure), heart disease, stroke, type 2 diabetes, metabolic retardation and conseqenent weight gain / obesity, acid reflux, loss of libido, impotence, waking tiredness, daytime sleepiness, and reduced cognitive ability. 

Excellent treatments are available, and diagnostic sleep studies no longer need to be performed in hospital or sleep lab environments.  (These studies monitor the patient's breathing patterns and stoppages, brain activity, cardiac activity, sleeping position, blood oxygen levels, limb movements ... and much more, all while the patient sleeps.  Portable diagnostic equipment means the sleep study can now be performed in the comfort, privacy and convenience of the patient's own bedroom.

If you snore or suffer from the side effects listed above, or if you know someone who does, then take action.  Snoring might be common, but it is NOT normal and is probably a sign of a more serious underlying condition. 

Call us on 1300 246 637 for more information or to chat with a friendly sleep therapist.

Tags: snoring, sleep disordered breathing, hidden epidemic, apnoea

Belly Fat Linked To Sleep Disorders

Posted on Wed, Nov 07, 2012

Numerous studies have found poor quality sleep leads to overeating and physiological changes that lead to heart disease, obesity, depression and Type 2 diabetes.  The ‘tricky’ part is that inadequate sleep actually disrupts the body’s balance and stimulates the appetite ... which leads to greater weight gain and consequently greater risks.  The good news is that the latest studies suggest a two way relationship between sleep disorders and weight gain – meaning improved sleep can help you lose weight, and losing weight can help you sleep better.

Independent scientific studies have consistently founds that sleep disorders are clearly linked to obesity and heavier individuals tend to report more problems getting a good night’s sleep.

Now, in a new study just released by researchers at Johns Hopkins University School of Medicine. It has been reported that weight loss, either through diet or a combination of diet and exercise, can lead to better sleep.

The researchers followed 77 overweight or obese individuals with type 2 diabetes or pre-diabetes over a 6 month period. At the start and end of the study, the participants completed surveys detailing their sleep problems such as sleep apn0ea, fatigue, insomnia, restless sleep, excessive sleep and use of sedatives.   Each participant’s body mass index (BMI) was also recorded so weight changes could be tracked.

The participants were then separated into two groups. The first group went on a weight-loss diet with exercise training and the second group simply stuck to a diet program.

At the end of the six months, both groups experienced a weight loss of about 15 pounds on average and a 15% reduction in belly fat. The researchers also authors found both groups had improved their sleep quality by about 20%.

“The key ingredient for improved sleep quality from our study was a reduction in overall body fat, and, in particular belly fat, which was true no matter the age or gender of the participants or whether the weight loss came from diet alone or diet plus exercise,” said study author Kerry Stewart, a professor of medicine at John Hopkins in a statement.

According to Stewart, belly fat is particularly concerning since it can be metabolically detrimental to health. “Belly fat is almost like a living organ. It produces proteins that cause inflammation,” says Stewart. “When you lose a lot of belly fat in particular, the level of those substances go way down and the inflammatory response is much less than it was before.”

"That means that rates of heart disease may decline as belly fat dissolves. Inflammation aggravates blood vessels, which can increase heart disease risk, and also  interfere more generally with the body’s normal physiological processes. The end result is obesity, and obesity in turn puts added mechanical pressure on the heart and lungs. “If you have a lot of belly fat, the lungs can’t expand as well, so it becomes harder to breathe when you’re sleeping, which is why more people get sleep apnoea,” says Stewart. “When you have sleep apnoea, you wake up more in the middle of the night and that leads to daytime sleepiness and fatigue. So people are feeling miserable because they haven’t had a good nights sleep.”

Shedding extra weight and increasing physical activity triggers a drop in inflammation, lowers insulin resistance and improves metabolism. “This can foster weight loss or prevent further weight gain,” says Stewart.

Whether sleep disorders cause obesity, or obesity causes sleep disorders isn’t clear, although it’s likely  both processes are at work simultaneously. “We are not exactly sure where the problem starts, but we think it is a vicious cycle. Regardless of where it starts, they feed off each other,” says Stewart.

If you are struggling to lose weight, it may be that an underlying sleep disorder like sleep apnoea is part of the problem.  If you are overweight, snoring, waking tired, and feeling sleepy through the day it is almost certain that you have an underlying sleep disordered breathing (SDB) condition.  Treatment of the SDB can help re-start the metabolism and reduce the risks associated with obesity.

If you think you have some sort of sleep disorder, give us a call on 1300 246 637 to talk things over with a friendly sleep therapist ... or request a sleep study online by clicking the button below.

 

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Tags: apnoea, sleep disorders, weight gain, obesity, belly fat

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

Diabetes 'Epidemic' Is Grossly Over Rated. (Apnoea Gets Ignored!)

Posted on Fri, May 06, 2011

Diabetes Is NOT The Problem.  SLEEP APNOEA Is!! 

We are constantly being told about the ‘diabetes epidemic’ and how diabetes is the single most serious health problem for the developed world.  As a result, huge public and private investments are being made in prevention, treatment and hopefully cure.

But here’s a question:  How come the same investments aren’t being made in dealing with sleep apnoea?

After all, diabetes affects only around 2.8% of the population … whereas even the most conservative estimates find sleep apnoea is affecting almost 5% of the population.  (We believe the true prevalence of apnoea is actually much higher.) 

Given that sleep apnoea is a proven CAUSE of diabetes, you’d think apnoea would get serious attention as a possible part of the solution. 

By rights, it could be argued that the treatment of sleep apnoea should get more attention and funding than type 2 diabetes ... because of the clear links between it and other serious consequences and co-morbidities, including hypertension, gastro oesophageal reflux disease, cardiovascular disease, depression, loss of libido and erectile dysfunction.  Factor in the further issues of quality of life and safety and it becomes obvious that sleep apnoea truly is a major health issue.  

What do YOU think?  Sleep apnoea or diabetes?  Which should our medical institutions and researchers be focusing on?  Please leave a comment.

Tags: apnoea, diabetes

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

The Fatal Snore

Posted on Sat, Mar 19, 2011

An article titled ‘The Fatal Snore’ by Kate Robertson of Fairfax Media discusses the case history of Marshall Caliph, nicknamed ‘Foghorn’ by his friends. Apnoea is dangerous

Marshall suffered from sleep apnoea, to the extent that he had crashed his car several times after falling asleep at the wheel.  He had even been known to fall asleep mid sentence.

This appears to be a severe case of sleep apnoea, but as Professor Rob Pierce (the physician who treated Marshall and who was interviewed for the article) says, “One-third of the population snores at some time, at least intermittently, and conventionally it’s been thought snoring is a bit of a joke. But now we know it is a potentially serious medical condition…and we have to treat it seriously because with the epidemic of obesity, it’s becoming more common.”

The article cites the Austin Hospital’s Institute of Breathing & Sleep, which says snoring affects 3 in 5 Australians — a massive 60% of the population.  This is twice the estimated level of prevalence found in previous research.

Some patients with ‘sleep disordered breathing’ conditions such as apnoea stop breathing up to 100-plus times an hour, for at least 10 seconds at a time.  According to Professor Pierce, “These people have incredibly fragmented sleep, which impacts on many aspects of their daytime.  Impaired work performance, mental dysfunction, depression, relationship problems and a greatly enhanced risk of car accidents are just some of the results.  It’s probably a major cost factor in industrial and transport accidents.”

Unfortunately, this list of problems is not exhaustive.  Other conditions clearly linked to sleep disordered breathing include hypertension, ischaemic heart disease, metabolic retardation and consequent obesity, acid reflux, loss of libido, impotence, AD/HD, and even type II diabetes.  In many cases, people suffering from these conditions are actually suffering from an underlying (and often undiagnosed and untreated) sleep disorder.

Once again, the point to note is that snoring is not just an embarrassing or irritating noise.  It is ALWAYS an indication that something is wrong and that a more serious condition exists or is developing.  If you snore, or know someone who does … do something about it.

And take heart!  Treatment for snoring and sleep apnoea is NOT limited to only the surgical or Constant Positive Airway Pressure solutions mentioned in the article.  The Academy of Sleep Medicine now endorses ‘oral appliance therapy’ as first line treatment.  This form of treatment involves the custom fitting of specialised dental devices which sit comfortably inside the mouth and hold the patient’s jaw and connected tissue clear of the airway while they sleep. 

Tags: snoring, apnoea, Snore