Getting spouses involved may improve CPAP compliance

Having a CPAP user’s spouse involved may improve adherence. A study in the April issue of the Journal of Clinical Sleep Medicine followed 23 married men who were treated with continuous positive airway pressure. CPAP is the first-line treatment for sleep apnea. The men reported that when their spouse’s assisted them with CPAP, they were more likely to use the treatment.

Researchers looked at whether the spouses were encouraging or negative about their husband’s using CPAP, and whether they collaborated or were demanding. When spouses worked with their husbands, there was a moderate influence improving CPAP adherence. When spouses were negative or demanding, or even encouraging, there was no effect on CPAP compliance. The study suggested that physicians could improve CPAP compliance by teaching spouses how to become involved.

Visit the Your Sleep website to find out if you are at risk for sleep apnea and learn more about CPAP. For help with treating sleep apnea, locate an AASM-accredited sleep center near you.

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Sleep-disordered breathing linked with depression

Snorting, gasping or stopping breathing while asleep has been associated with nearly all depression symptoms. The Centers for Disease Control and Prevention (CDC) surveyed 9,714 Americans for a new study appearing in the April issue of SLEEP. The CDC determined that the likelihood of depression increased with the frequency of sleep-disordered breathing.

Symptoms reported included feelings of hopelessness and feeling like a failure. The association was made regardless of factors like weight, age, sex or race. The CDC study is the first nationally representative sampling to look at obstructive sleep apnea (OSA) and depression. Similar links have been made in previous studies, but in samples that were much smaller and more specific.

The study’s authors suggested that physicians screen for depression in the presence of sleep-disordered breathing, or vice versa. The said such screenings could help reduce the high incidence and under-diagnosis of both of these disorders.

Read more blog posts about sleep and depression. Or learn more about insomnia, or take a short quiz to test how well you sleep.

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Brain changes observed in sleep apnea sufferers

Researchers have observed changes to the brains of severe sleep apnea sufferers. A team in Australia used magnetic resonance (MR) spectroscopy to compare the brain tissue of sleep apnea patients to people without sleep disorders. They identified significant changes in the frontal lobe white matter and in the hippocampus. The changes to the frontal lobe were comparable to traumatic brain injury.

Patients were examined again after six months of continuous positive airway pressure therapy (CPAP). Changes to the hippocampus were no longer significant. CPAP also improved performance on a range of brain function tests. The study appears in the January issue of the journal SLEEP. It is the largest study to-date for looking at brain tissue changes in sleep apnea sufferers.

Sleep apnea occurs when the muscles relax during sleep, causing the soft tissue in the back of the throat to collapse and block the upper airway. The sleep disorder should never go untreated. If you think you may have sleep apnea, get checked out. Countless sleep centers across the U.S. offer overnight sleep studies for the diagnosis of sleep apnea.

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Snoring in infancy linked to impaired cognitive development

Two studies from Australia associate snoring in the first year of life to impaired cognitive development. Researchers suggest that lower cognitive development could become worse in these infants with age.

In the first study, 16 infants who started snoring shortly after birth were compared with 88 babies who did not snore. Infants were determined to be snorers if their snoring occurred three or more nights a week. Snoring because of a cold did not count. The results found that cognitive development was reduced in frequent snorers from the first month of life to six months.

The second study looked at 13 infants who snored frequently from the first month of birth to 12 months. These babies had significantly lower cognitive scores when compared with 78 infants who did not snore frequently.

Both studies were conducted through the University of Adelaide and University of Australia in South Australia. The research was published in the December edition of the journal Sleep Medicine.

Learn the facts about young children and sleep and about snoring. Additional stories about children and snoring are available on the Sleep Education blog.

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Exercise improves sleep apnea in overweight, sedentary adults

Exercise training may be beneficial for the management of sleep apnea in overweight patients who lead a sedentary lifestyle, according to a study in the December issue of the journal SLEEP. Forty-three overweight or obese adults, with at least moderately severe sleep apnea, were selected for the study.

These adults were used to exercising less than two times a week. For the study, they underwent a 12-week session of moderately intense exercise training. The purpose was to see if the exercise would have an effect on previously untreated sleep apnea.

Sleep apnea was improved despite no changes in body weight. However, only about a quarter of study participants saw a 50 percent or more reduction in sleep apnea. But a 20 percent reduction in sleep apnea was experienced by 63 percent of participants. Together, these results led researchers to conclude that exercise training is moderately effective in treating sleep apnea in sedentary, overweight patients.

Continuous positive airway pressure therapy (CPAP) is the first-line treatment for sleep apnea. Visit the Your Sleep website to find out if you are at risk for sleep apnea. Get help for sleep apnea at an AASM-accredited sleep center.

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Implant shows promise treating sleep apnea

An intriguing new method for treating sleep apnea is showing promise in the lab. The November issue of SLEEP contains a new study about stimulating the muscles in the throat to keep the airway from closing. The muscle stimulator resembles a pacemaker and is implanted in the skin beneath the chest.

In Australia, the muscle stimulator was tested on 21 patients with sleep apnea. After six months, 19 of the patients showed significant improvements. They slept better and felt less tired in the morning. Unfortunately, the 20th patient needed the device removed due to an infection.

Another muscle stimulator device was tested last summer at the Medical University of South Carolina (MUSC). As reported in July by the Sleep Education blog, the MUSC implantation was monitored as part of a trial by the Food and Drug Administration.

Continuous positive airway pressure therapy (CPAP) is the first-line treatment for sleep apnea. Visit the Your Sleep website to find out if you are at risk for sleep apnea. Get help for sleep apnea at an AASM-accredited sleep center.

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Sleep-disordered breathing & intimacy

Obstructive sleep apnea affects more than 12 million people nationwide. Daytime sleepiness and weight gain are usually the first symptoms that come to mind. Intimacy problems are an oft-overlooked aspect of untreated sleep-disordered breathing. Sleep apnea can cause erectile dysfunction in men and a loss of libido in women.

A recent study published in The Journal of Sexual Medicine looked at the prevalence of sexual dysfunction in women with sleep apnea. A sample of 80 women diagnosed with sleep apnea and 240 women without the disorder completed questionnaires about sexuality. Findings show female patients with sleep apnea had much higher rates of sexual problems.

A similar study conducted in 2009 used questionnaires to examine the prevalence of erectile dysfunction and sexual problems in men with sleep apnea. Almost 70 percent of men diagnosed with sleep apnea had erectile dysfunction, compared to 34 percent without the sleep disorder.

Sexual dysfunction may be linked to sex hormones such as testosterone. These hormones rise with sleep and drop when sleep duration or quality is insufficient. Brief wakings from sleep apnea secretly wreak havoc on your sleep quality, which can lower hormone levels.

Before you turn to that ubiquitous little blue triangle for help, find out if sleep apnea is causing your sex problems. The easiest way to know for sure is by getting an overnight sleep study at an AASM-Accredited Member Sleep Center. Common treatments for sleep apnea such as CPAP or oral appliance therapy can improve your sleep quality and intimacy so you won’t need to take a pill every time you want to be intimate.

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Nose spray reduces childhood apnea-linked inflammation

Early research shows certain steroid nasal sprays may help to reduce the inflammatory cell proteins in children that are linked to sleep apnea. A study included in the June of Archives of Otolaryngology – Head & Neck Surgery looked at how children who were due to have their adenoids and tonsils removed reacted to the drug fluticasone furoate.

The study involved 24 children from the ages of 2 to 12 years old, with sleep apnea. The children were divided into two groups. About half of the children received doses of the nasal spray once a day for two weeks prior to surgery. The control group did not use the nasal spray.

After children in both groups had their adenoids and tonsils surgically removed, the researchers examined the adenoids. While all of the adenoids weighed about the same, the treatment group had lower levels of the inflammatory cell protein IL-6. The cell protein has been linked to the development of sleep apnea.

In the study’s conclusion, the authors stated that steroid nasal spray could potentially be part of future pediatric sleep apnea treatments. The findings support previous research that found nasal fluticasone reduced the frequency of breathing pauses in children with obstructive sleep apnea in children.

The research is still in its early phases and parents should be aware that steroid nasal sprays are not a recognized obstructive sleep apnea treatment for children. The standard treatments include surgery, CPAP and weight loss. Some children with sleep apnea may benefit from wearing an oral appliance during sleep.

The American Academy of Sleep Medicine reports that about two percent of healthy young children have sleep apnea. The sleep disorder occurs when soft tissue in the back of throat collapses and blocks the airway during sleep.

Most children with sleep apnea have a history of loud snoring. This may include obvious pauses in breathing and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep.

Read more about obstructive sleep apnea in children. Get help at an AASM-accredited sleep center near you.

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Sleep Apnea and Sleepiness Raises Older Adults’ Death Risk

A study in the latest issue of the journal SLEEP provides further evidence that sleep apnea should never be left untreated. Older adults have twice the death risk when excessive daytime sleepiness is paired with obstructive sleep apnea.

The study involved 289 participants at least 65 years old and with no clear signs of dementia or depression. The average age at the start of the study was about 78 years old. About three-quarters of the patients were female.

An overnight sleep study at the beginning of the study was used to diagnose participants with obstructive sleep apnea. Subjects who indicated that they felt sleepy or struggled to stay awake during the daytime at least three to four times a week had excessive daytime sleepiness.

Social security death index records indicate after 14 years nearly 55 percent of the participants died. Results show that participants with excessive daytime sleepiness combined with sleep apnea were more than twice as likely to have died. Being sleepy in and of itself did not lead to an increased mortality risk.

The lead author of the study says it’s still unclear exactly why sleep apnea and excessive daytime sleepiness increase the risk of death in older adults, but he suspects it may be related to inflammation. Cases of inflammation may increase the risk of other medical problems such as hypertension.

Obstructive sleep apnea affects nearly 20 percent of older adults. It occurs when the soft tissue in the back of the throat collapses and blocks the upper airway during sleep, causing pauses in breathing.

The study was unable to demonstrate whether treatment for sleep apnea reduced the risk of death. The Sleep Education Blog strongly recommends that anyone with moderate to severe sleep apnea seek treatment immediately.

CPAP therapy is the first-line treatment for obstructive sleep apnea, especially in more severe cases. Surgery and oral appliance therapy are also effective options for lesser cases.

If you think you may have sleep apnea, get checked out at one of the more than 2,200 AASM-accredited sleep disorders centers in the United States. Go to http://www.sleepcenters.org/ to find a sleep center near you.

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Shift Work May Cause Swell in Sleep Apnea Symptoms

A new study provides further health concerns for the estimated 20 million Americans who sleep during the daytime because of their work schedule. The symptoms of untreated obstructive sleep apnea may be worse for shift workers, a new study reports.

The study compared a group of 31 shift workers to ten daytime workers. Members in both groups were previously diagnosed with sleep apnea and had similar ages, weights and sleep lengths.

Daytime and nighttime polysomnograph results show that the shift workers had more frequent breathing pauses in breathing and higher oxygen desaturation levels. Both measures show that shift workers had more severe symptoms of sleep apnea.

The authors of the study caution that patients with untreated sleep apnea should avoid nighttime work. The Sleep Education Blog urges workers with sleep apnea to take that warning one step further and never let sleep apnea go untreated. Sleep apnea has been linked to heart disease, diabetes, dementia and other serious health problems.

Shift work also can also harm your health. Some workers may struggle with shift work disorder, which causes your internal body clock to go awry. Workers with shift work disorder may be severely tired but unable to sleep. Loss of sleep length and quality may affect job performance and put workers at risk for injury.

Read more about obstructive sleep apnea and shift work disorder.

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Say Farewell to Daytime Fatigue with Surgery for Sleep Apnea

Treatment for obstructive sleep apnea can greatly improve your quality of life, the Sleep Education Blog often reports. A new study from researchers at Henry Ford Hospital shows surgery, like CPAP, can make you feel less sleepy during the daytime.

The study examined the effectiveness of three surgical interventions for sleep disordered breathing – removing excess tissue in the back of the throat, removing the tonsils and using radiofrequency waves to destroy tissue at the base of the tongue.

A group of 40 patients with mild to severe obstructive sleep apnea participated in the study. Before surgery, the patients completed the Epworth Sleepiness Test, a questionnaire that measures daytime sleepiness during various activities. All of the patients had an Epworth Sleepiness Score (ESS) of 10 or higher, meaning they were very sleepy during the day.

After surgery was completed, the patients’ average ESS dropped to 5.5. Nearly all of the patients posted dramatic improvements. Only one patient had no change in score, while two had an increase. Researchers also noted the patients had half as many pauses in breathing while they slept.

Never leave obstructive sleep apnea untreated. It can ruin your quality of life and make you feel constantly tired. Untreated OSA can also lead to other serious health problems, like heart disease or stroke.

Surgery is only one of the effective treatment options for OSA. CPAP, or continuous positive airway pressure, is the mainline treatment for the disorder, however severe. People with less severe OSA cases can also use an oral appliance to prevent the symptoms of OSA.

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First-Time CPAP Users Feel Refreshed Instead of Fatigued

One small lifestyle change can give sleep apnea patients a whole new lease on life. After only a few weeks sleeping with a CPAP machine, the constant fatigue from the sleep disorder fades, making way for improved energy and mood.

A study published in the January issue of the journal SLEEP provides proof that CPAP can drastically improve your everyday life.

A group of 59 middle-aged adults diagnosed with sleep apnea were randomly assigned to CPAP therapy or a placebo. The participants were instructed to use the equipment each night for three weeks. The group answered a questionnaire about fatigue and other sleep apnea symptoms before and after the treatment period.

Results show the subjects who used CPAP no longer suffered from clinically significant levels of fatigue after treatment. Self-reported energy levels also increased for CPAP users, and daytime sleepiness dropped.

The group that received a sham treatment did not see any benefit.

CPAP has other long-term benefits. It can save your life by reducing heart attack and stroke risk associated with sleep apnea.

Sleep apnea occurs when the muscles relax during sleep, causing the soft tissue in the back of the throat to collapse and block the upper airway. The sleep disorder should never go untreated. If you think you may have sleep apnea, get checked out. Countless sleep centers across the U.S. offer overnight sleep studies for the diagnosis of sleep apnea.

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Mike & Molly Mixed on CPAP, Sleep Apnea

Mike & Molly, a traditional CBS sitcom with three cameras and a laugh track, is the most controversial new show on television this fall. The show is about an obese Chicago couple in the early stages of their relationship.

Health pundits rail on Mike & Molly for promoting obesity and unhealthy life choices. Entertainment critics have a different but equally critical take on the show – some say the show uses endless fat jokes to mock obese people.

At this point in the show’s run it’s hard to say if either group is right, but there is one healthy choice Mike & Molly is promoting – the recognition and treatment of obstructive sleep apnea.

The latest episode, titled “Mike has Sleep Apnea,” introduced millions of prime-time viewers to CPAP, the front-line treatment for the sleep disorder. The episode is a step forward for sleep apnea awareness, but it doesn’t get everything right.

The episode is about the new couple’s difficulties sharing a bed for reasons including an obvious (and unfunny in this blogger’s opinion) fat joke and Mike’s treatment for sleep apnea.



The couple gets in bed and Mike matter-of-factly tells Molly he sleeps with a CPAP to stop from snoring. Then he tells her he doesn’t have to wear it that night. Both statements raise concerns.

After a few jokes about the appearance of Mike’s CPAP mask, Mike is fast asleep. Meantime, Molly can’t sleep because of the sound of air blowing from CPAP. She tries to move Mike, who starts snoring.

This is where the show gets things wrong. Loud snoring should not happen with CPAP unless the machine has a titration problem. An appointment with a sleep specialist can fix that easily.

For that matter, technically Mike’s treatment isn’t just to prevent snoring, but the breathing pauses from sleep apnea. A person with the disorder may sound like they are choking or not breathing at all.

Additionally, Mike’s offer to skip CPAP for a night sets a bad example. For moderate to severe cases of sleep apnea, treatment is not optional. Sleep apnea can wreck your sleep in the short-term and devastate your health in the long-term when untreated.

Make no mistake about it, Mike & Molly’s take on sleep apnea is flawed, but it may inspire people to seek treatment. And for that reason, the show may not be as bad as its reputation suggests.

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Dedication to CPAP Takes a Positive Personality

Do you view CPAP as the machine that can save your health or is it a consequence of your lifestyle choices? How you answer may predict whether you’ll stick with CPAP or become the 25-50 percent of obstructive sleep apnea patients who leave their condition untreated.

A study in the journal Sleep and Breathing examined what types of personalities adhere to CPAP, the front-line treatment for obstructive sleep apnea.

A positive outlook plays the biggest role, researchers discovered. The ideal patient is optimistic and responsive to the rewards from treatment, such as increased energy and improved mood.Pessimists and people with strong feelings of fear and anxiety will likely have a much more difficult time in the initial stages of CPAP therapy.

The study involved 31 men and 32 women previously diagnosed with sleep apnea. Their personalities were classified using a series of personality inventories completed at the beginning of the study.

Researchers referred to each of the patient’s medical records to look at CPAP adherence. The study defined adherence as using CPAP for at least 4 hours a night for about 5 nights per week.

By comparing personality types to medical records, researchers discovered positive or negative outlook predicted CPAP adherence 3 out of 4 times.

The findings are great news for the type of people who look at the bright side of things. There’s still hope even if you see the glass as half empty. It just might take some extra work.

Doctors are increasingly referring CPAP patients to behavioral sleep specialists who can help you improve your outlook and tackle the challenges of changing your lifestyle.

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My Child Snores, is it Sleep Apnea?

Snoring is especially prevalent in adults and a surprising number of their children also “saw logs.” Sleepeducation.com reports between 10 and 20 percent of American children snore. Children in China have similar snoring rates, a study included in the September issue of the journal Chest reports.

A survey of more than 6,000 school-aged kids found approximately 1 in 10 Chinese children snore habitually. Results show kids who snore have a parent who snores. Male gender and obesity also promote snoring. Kids with allergies or a history of upper respiratory infections tend to snore loudly.

A history of loud snoring can be a red flag for childhood OSA. Obstructive sleep apnea is also a problem for about 2 percent of healthy young children. One way to tell if your child has OSA is to if the child also appears to be working hard to breathe while asleep.

One of the main indicators of sleep apnea in teenagers or adults – daytime fatigue – is not always present for kids. Unlike older patients, children with OSA often do not wake up during breathing pauses leading to more normal sleeping patterns.

The primary treatment for children who snore or have OSA is different compared to adults. Children often have their tonsils and adenoids removed to increase the size of the airway. Most often children are able to breathe normally after this procedure.

When an adenotonsillectomy doesn’t solve sleep apnea many children choose child-sized CPAP masks to keep the airway open. Oral appliances and weight loss are two other options for children with sleep apnea.

If your child snores, find out if its sleep apnea by scheduling an appointment for an overnight sleep study at an AASM accredited sleep center.

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Vikings Receiver Harvin’s Health Woes Stem from Sleep Apnea

At 5’11’’, 184 lbs of solid muscle and the ability to complete the 40 yard dash in less than 4.4 seconds Percy Harvin, the explosive wide receiver for the Minnesota Vikings, doesn’t have the obvious warning signs of obstructive sleep apnea that NFL coaches and trainers can easily identify. Most players in the league who’ve been diagnosed with the sleep disorder have massive bodies with excess weight, like Mario Williams or Antwan Odom.

Entering his second season in the NFL, Percy Harvin’s was considered a talented player who may never reach his potential because of chronic health concerns caused by undiagnosed obstructive sleep apnea. Debilitating migraines have plagued him for his entire life. This year the painful condition kept him from practicing with the team in the preseason, prompting concerns of an early end to his NFL career.

When he finally stepped on the practice field he collapsed in a matter of minutes. His heart stopped beating for ten seconds. Harvin told NBC’s Andrea Kremer that his migraine medication led to the collapse. Strangely, this scary episode may have been the luckiest thing that ever happened to him.

Doctors at the hospital that day suspected he wasn’t getting enough oxygen when he slept. Four days later an overnight sleep study confirmed he had obstructive sleep apnea, which doctors believe triggered the migraines.

Harvin is now the proud user of CPAP, a machine that can save his career and his life. He even brings it on the road for away games.

After a long stretch of missed practices and preseason games Harvin saw regular action Thursday night in the NFL season opener against the New Orleans Saints. He only caught one pass for 12 yards in the 9-14 loss.

Despite a disappointing opening game, Harvin is past his migraines and back on track to become one of the league’s marquee receivers all thanks to one little machine he keeps at his bedside.

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CPAP Can Reverse Sleep Apnea-Related Male Infertility

A clinical sleep specialist may have the answer for would-be fathers with fertility woes. Infertility is one of the many health problems associated with obstructive sleep apnea. A new study shows it is reversible with the right treatment.

Continuous positive airway pressure (CPAP), the front-line treatment for obstructive sleep apnea, can solve the symptoms of sleep apnea, including infertility.

The study involved 10 men with an average of 57 years of age. All of the men were either obese or overweight with symptoms of sleep apnea. Each subject stopped breathing between five and 28 times per hour of sleep.

Following an overnight sleep study, researchers measured the participants’ secretion of the serum prolactin, a substance that affects male fertility. After 11 to 39 months of CPAP therapy the subjects’ prolactin levels decreased and in some cases normalized.

The findings are encouraging, but further research on the subject is needed due to the relatively small size of the study. Several past studies have investigated the topic but have had mixed results.

More research is needed to determine if alternative approaches including oral appliance therapy and surgery may also possibly help reverse infertility.

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Sleep Apnea in Europe

The cosmopolitan youth of Western Europe share the same sleep-related breathing risks as their Yankee counterparts, medical data suggests.

Whether they live in Europe or North America, overweight male smokers who have a large neck sizes most frequently experience breathing pauses caused by obstructive sleep apnea. People of African descent appeared to have a heightened risk, report the authors of a recent study in the journal Sleep and Breathing.

The study involved 121 patients, age 40 or younger, in Brussels, Belgium. Most of the participants were men. 42 percent were of African origin.

Each of the participants was referred by a physician for an overnight sleep study between 2007 and 2009.

The average male participant experienced 39 breathing pauses per hour, an indication of severe sleep apnea. Africans had nine more pauses on average.

Many of the Belgian OSA patients were diagnosed with additional medical ailments. More than a quarter had high blood cholesterol. 1 in 5 had hypertension. And 13 percent had diabetes, depression or acid reflux.

If left unchecked obstructive sleep apnea lead to serious heart problems or even death. It can also lower your quality of life by preventing you from getting restful sleep.

Luckily there are several treatment options available. CPAP therapy is the front-line treatment for severe cases. Many patients elect to have surgery for OSA. A mouthguard-like device called an oral appliance is effective for light to moderate sleep-disordered breathing.

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Is Sleep Apnea Risk Higher for Asians?

As obesity rates climb to epidemic levels in nearly every U.S. state, one population may need to be especially weary of a serious sleep disorder linked to weight gain. People of Asian descent tend to have more severe obstructive sleep apnea than Caucasians of similar age and BMI.

The findings are especially alarming because the Caucasians in the sample tended to be much more overweight than their Asian counterparts. Differences in facial bone structure appear to be the reason why Asians have a higher risk for OSA.

The findings were the result of a joint study between University researchers in Australia and China published in the August issue of the journal SLEEP. A sample of 74 Caucasian patients from an Australian clinic and 76 Chinese patients from a clinic in Hong Kong underwent a sleep study and a series of physical and x-ray measures.

OSA prevalence was similar for both populations, but Caucasians with OSA tended to be more overweight with a larger neck circumference. Chinese patients had smaller, more restrictive facial structures. When BMI measurements were similar the Chinese participants suffered from more frequent and severe breathing pauses during sleep.

The study may have some limitations due to the nature of the sample. The patients came from two very different environments and socioeconomic and culture backgrounds. Researchers caution that those factors influence the health and lifestyle habits that lead to OSA.

OSA isn’t the only sleep disorder influenced by race. An abstract presented at SLEEP 2010 showed black, white and Hispanic people all responded differently to sleep deprivation and insomnia.

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Learn About Sleep Apnea Treatments in 2 Minutes

Last week, Stanford University Hospitals and Clinics posted this educational video explaining sleep apnea. In the online video, AASM Past President Clete Kushida explains the top three treatment options:

The three main treatments options are Continuous Positive Airway Pressure (CPAP) , surgery and oral appliance therapy.

If you think you may have sleep apnea book an appointment at your nearest AASM-accredited sleep center.

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