We need to wake up to the problems of obstructive sleep apnoea

General Practitioners need to be much more alert to the signs of obstructive sleep apnoea (OSA) in their patients, after a UK survey highlighted the high prevalence of symptoms in the population.

British GP talking to senior man in surgery

The survey in question was conducted by by OSA UK, and involved almost 2,000 UK adults aged 25 and over. The survey found that OSA affects one person in five in the UK. However, many of those who suffer from OSA go undiagnosed, as only 12 per cent of men and 6 per cent of women with OSA have ever contacted their GP about it.

The condition is related to obesity, and this proportion is expected to rise in forthcoming years. However, awareness of the condition is currently very low and rates of diagnosis and treatment are lower in the UK than almost all other developed countries.

Leading OSA researcher, Professor John Stradling, from the Sleep Unit at Oxford’s Churchill Hospital, said: ‘The major problem is that patients are often reluctant to talk to a doctor about snoring, or abnormal sleepiness or fatigue, in case they are not taken seriously.’

Berkshire GP, Dr Robert Koefman an ENT specialist, added that more public awareness about OSA was needed and he added that the condition could lead to heart and lung disease amongst other things. ‘At the moment any form of treatment is very much a postcode lottery,’ he said. ‘We need more specialist sleep centres where people can receive appropriate treatment.’

Snoring and OSA are quite deadly and have serious effects. From heart disease to diabetes to impotence, it appears that there is no end to what can be caused.

OSA becomes more likely as people become older, mainly because BMI tends to increase with age. Typically, patients start to present symptoms from 40 onwards and may show a history of gradual progression of these symptoms over the previous five to 10 years.

Common symptoms include unrefreshing sleep, daytime tiredness, the need to sleep, snoring, witnessed breath-holding events and a dry mouth or headache on waking.

As a result of the growing concern for the problem, it was even reviewed this month by Saga in their monthly Newsletter, which highlighted that OSA may be regarded as a nuisance, but it leads to high blood pressure, heart attacks and stroke. It is also linked with a greatly increased risk of accidents at work and on the road caused by tiredness. The main contributory factors to the development of OSA are obesity, a large neck circumference (greater than 16 inches) and a lower mandibular retraction.

However many of us still do nothing to treat it – yet the treatment can be simple and highly effective if caught in good time.

Saga recommend wearing a mandibular advancement device (MAD) which they describe as a special gumshield to hold the lower jaw and tongue forward, creating more space to breathe normally by opening the previously blocked airway.

The most successful of these according to current research by the specialist research team at the leading NHS Hospital for this problem, Papworth, is the SleepPro Custom, a bespoke fitted mouthpiece which they recommend as the first line of treatment for snoring and mild to moderate sleep apnoea.

For those who have been identified with the problem, and referred for treatment, the hospital itself supplies other SleepPro stop snoring mouthpieces direct to patients, along with many other hospitals in the NHS system, which itself recognises SleepPro as an Approved product.

John Redfern


If you have high blood pressure you need to read this.

All data demonstrates that hypertension is almost unavoidable as we age, and once we reach the age of 55, we have a 90 per cent chance of becoming hypertensive. However that inevitability doesn’t mean we can’t do something about it. Step one is to modify your lifestyle: lose weight, exercise, and eat a wholesome diet – but there are other factors.Medical exam

What causes high blood pressure? The first culprits that pop into your mind are likely to be: eating too much salt, being stressed out all the time, and alcohol abuse. And you would be right. But there are also less obvious causes of high blood pressure, a condition that affects about one in three, or 78 million, adults in the U.S, and 15 million adults in the UK.

Sleep apnoea is one of these, and a common disorder that often goes undiagnosed, and leads to snoring, restless nights and possibly, elevated blood pressure. That’s because when your breathing is interrupted, the oxygen level in your body falls. Your brain then sends signals through your nervous system to increase the flow of oxygen to the heart and brain, thereby tightening up your blood vessels. Frequent drops in your blood oxygen level, along with reduced quality of sleep, can also trigger the release of stress hormones, which raise your heart rate and increase your risk for high blood pressure.

More than 45 per cent of Americans snore, and over 40 per cent of British adults do the same according to recent studies. Doctors, however say the common problem can be more than just a nuisance.

Recent research recently set out to find how reduced sleep quantity and quality could affect a person’s blood pressure. After monitoring their adult participants for 16 days, they found that when their subjects experienced prolonged periods of shorter sleep, they also registered substantially higher blood pressure numbers at night. While the size of the study was small, they presented their findings at the American College of Cardiology’s Annual Scientific Session in San Diego, California, on March 15th this year.

The healthy, normal-weight participants with ages ranging from 19 to 36 experienced a 4-day adjustment period before being split into two groups: one set who slept only four hours each night for nine days, and the other who slept for nine hours each night for those same nine days. They all also completed three days of recovery. Throughout the 16 days, the researchers monitored each subjects’ blood pressure 24 times throughout a daily cycle

Blood pressure levels naturally rise and fall in a circular pattern throughout the day. They tend to peak in the middle of the afternoon, and reach their lowest points in the middle of the night during one’s deep sleep. Now in this study, the sleep-restricted participants registered an average of 115/64 mm Hg during the night while their well-rested counterparts registered an average of 105/57 mm Hg. In addition to confirming that inadequate sleep limited the anticipated decrease in blood pressure with these figures, the experiment revealed a higher night-time heart rate in sleep-deprived subjects than those who experienced normal sleep.

We know that high blood pressure, particularly during the night, is one of the major risk factors for heart disease, and British and American adults typically do not get enough sleep.

This new study could also further demonstrate why sleep apnea is always considered a common contributor to high blood pressure. According to the National Sleep Foundation, this often-undiagnosed sleeping disorder creates pauses in a person’s breathing that lead to snoring and restless nights. That resulting decrease in sleep quantity and quality can lead to hypertension and heart disease, as well as possible mood and memory problems.

In the mild to moderate cases, patients are recommended to use quality bespoke oral appliances that are medically approved. These improve breathing and in doing so prevent the occurrence of apneas, and even reverse some issues already caused.

John Redfern


New research shows the impact of mouth breathing as a cause of snoring

If you sleep on your back, then you are more likely to snore than if you sleep on your side because of the effects of gravity on the upper airway. Basically, the tongue and soft palate fall back into the throat, narrowing the airway.

Alternatively if you usually sleep through the night with your mouth open, you probably snore just as much – but for different reasons.

Overweight Man Asleep In Bed Snoring

If this is the case a stop snoring oral appliance is the most beneficial way to prevent the problem. These are mouthpieces that are worn at night to hold the lower jaw and tongue forward, making more space to breathe.

However if you’ve been a heavy snorer for some time, there may have been damage to the nerves and muscles of the upper airway meaning that they’re more prone to collapse. This restricts the airway and vibrates the tissue of the tongue, causing it to block the airway and preventing you from breathing. This is called obstructive sleep apnoea, a condition that leads to interrupted breathing during sleep, and ­literally means “without breath”.

It affects around 4% of middle-aged men and 2% of middle-aged women, and studies indicate that 60% of those over 65 have OSA. Those affected stop breathing for periods of 10 seconds or more before waking with a loud snore or snort as the brain registers a lack of oxygen. Special oral appliances can be used to prevent this, or even to reverse it, and can be used by the majority of sufferers who have it in mild or moderate form. Chronic sufferers need special medical help. However, if it is left untreated, it can increase the risk of high blood pressure, diabetes, and even heart attack or stroke.

When we breathe in through the nose, air passes over the curved part of the soft palate in a gentle flow into the throat without creating unnecessary turbulence. When we breathe in through the mouth however, air hits the back of the throat ‘full on’ creating ­enormous vibrations in the soft tissue.

The most effective and reliable solution is a Chin Support Strap which, when worn at night, will help you to breathe through your nose.

A new online survey of American adults in February 2015 showed that a massive 61% of respondents identify themselves as mouth breathers, and when partners are taken into account it shows that 71% of beds are host to at least one mouth breather.

The most common signs of mouth breathing reported were being awoken by nasal congestion (75%) waking up dry-mouthed (61%) and snoring (37%).

The survey found that mouth breathing impacts the quality of sleep (64%) nearly as much as stress (69%). Mouth breathing impacts sleep more than a partner’s snoring (53%), noise (52%), and an irregular sleep schedule (51%).

Poor sleep can have a dramatic impact on energy, concentration and mood the next day and often can affect the sleep of a bed partner. The majority of respondents believe their (76%) or their partner’s (63%) mouth breathing has had a significant negative impact on how well they slept and according to the survey, more than 6 in 10 discussed the mouth-breathing problem with their partner.

Additional survey findings include:

  • Of mouth breathers surveyed, 54% reported they did not get a good night’s sleep the night before.
  • 56% reported they wake up at least two times each night due to mouth breathing.
  • Nearly three-quarters of participants who share a bed with a mouth breather said they are woken up at least once per night by their partner’s mouth breathing.
  • 59% of respondents sleep next to a mouth breather and 47% believe it impacts their ability to get a good night’s sleep.

If it’s you, or your sleep partner, try out a comfortable and problem-solving Chin Support Strap and wake up as fresh as a daisy after undisturbed sleep.

John Redfern


Will you give her what she really wants for Mother’s Day?

Not only is it International Woman’s Day this week, but Mothering Sunday also looms large on the horizon and the usual question comes to mind for all sons, daughters, partners and husbands.

Q. What does she want for Mother’s Day to make her feel appreciated and happy?

However, we shouldn’t really have to ask, as doing so would take away the magic, the surprise and the pleasure – and we ought to know in any case.

Should it be a lovely card, a bouquet of flowers, a potted plant, a delicious box of chocolates, her favourite wine, or a meal out to mark the occasion? Actually it should be none of these and lots of research has been done very extensively to prove it – and to find out what she wants most of all.

Young Woman Sleeping On Clouds

A.   She says she wants a really good night’s sleep.

2,000 adults were asked the question and they almost all commented on how much they slept – and whether it was undisturbed quality sleep.

Many mothers are simply hoping for the rare opportunity to stay in bed this Sunday, which seems like a fairly simple idea, but given the daily stresses and strains of normal work and home-life, many mothers simply don’t get the required amount of sleep each night.

Women only average just over 6 hours restful sleep per night and ideally they would love, and say they need around seven and a half hours, which is a level that research also suggests as it is the optimum amount for good health.

The University scientists who conducted this exercise found that just one week of poor sleep can seriously disrupt hundreds of genes that are closely linked to stress, immunity, and inflammation. We know the immediate sign of a lack of sleep all too well; and that is irritability, but it can be much worse.

Experts believe that insufficient sleep has become a worldwide epidemic, with chronic sleep deprivation linked to such serious medical problems as obesity, diabetes, cancer and immune deficiency. Obesity and weight gain of course can be a key cause of disturbed sleep through snoring and that is something that will accelerate these serious illnesses through oxygen deprivation to the brain, and lead on to obstructive sleep apnoea. Previous US research even found lack of could double the signs of skin ageing.

Other interesting key facts emerged which highlight the size of this problem for women, because although we always regard the man as the villain, particularly for snoring, that doesn’t seem to be the case any more.

·         More men than women are woken up by their partners – 11.5 per cent versus nine per cent

·         Snoring by a female partner kept one in ten awake while a further seven per cent suffered because of their own snoring

As a further sign that things have changed, more and more women are now bringing sleep-related concerns to their doctors, but the statistics aren’t pointing to the real problems that exist.  Men with the condition are likely to report snoring, snorting, or even waking up and gasping for breath – something that can be a sign of obstructive sleep apnea, and a dangerous condition. Women, on the other hand, are more likely to report fatigue, depression and un-refreshing sleep  – and overlook the fact that snoring plays a major part in this problem.

Many couples think they can solve the problem by sleeping apart but this only covers it up and doesn’t really change things. Simple mouthpieces, available for both men and women, are now widely used at night to stop snoring. Thousands of these SleepPro NHS Approved oral appliances are used throughout the UK and even issued and recommended by our leading hospitals and clinics – and they will safeguard your future health, and bring the refreshed feeling and a smile back to the morning awakening, simply by preventing dangerous snoring.

John Redfern


Is too much sleep bad for you? It depends on your age.

Getting enough sleep is vital for the health, particularly when you are younger. According to the National Sleep Foundation (NSF) teenagers function best obtaining 8-10 hours of sleep every night but that’s not the same if you’re older.

concept of aging and skin care

However, despite the popular stereotypical image that teenagers spend a ridiculous amount of time in bed, a new study reports that teenagers are increasingly sleep deprived. Researchers at Columbia University’s Mailman School of Public Health have found that the number of hours slept per night has decreased among teenagers in the US over the past 20 years.

Among their findings, published in Pediatrics, the researchers observed that female students, racial and ethnic minorities and students who are of lower socio-economic status were least likely to report regularly getting 7 or more hours sleep each night.

Without adequate levels of sleep, adolescents can find their abilities to think and reason impaired and become more prone to mood swings. Lack of sleep is also associated with mental health issues, weight gain, academic problems and substance abuse.

The NSF states that many teenagers also suffer treatable sleep disorders that can reduce the amount of sleep they get, including narcolepsy, insomnia and sleep apnea.

It used to be the case that people would brag about how little sleep they could get by on. Domestic diva Martha Stewart said she could run her empire on fewer than four hours a night, and Thomas Edison, the inventor of the light bulb, said he slept for no more than five.

But a growing recognition of the importance of sleep and the technological ability to monitor one’s sleep from the comfort of home have friends and work colleagues competing to see who can get the most quality sleep.

Cathy Barrick, Chief Executive Officer of the Alzheimer Society of Toronto, says she and her office colleagues routinely compare sleep reports from their personal sleep monitors. They wear Fitbits, Jawbones or other devices that slip around one’s wrist or under a pillow, monitoring things such as movement, heart rate and even body temperature. It’s pretty obvious to people when they’ve had a good or bad night’s sleep: They’re either rested or sleepy – but analysing the data helps put problems right.

Also By tracking changes in sleep habits, older adults or their carers may be tipped off to an impending stroke. Researchers have found that older adults who sleep for longer than eight hours each night are at a 46 per cent greater risk of stroke, according to a new study published in Neurology.

The researchers from the University of Cambridge and the University of Warwick followed nearly 10,000 people between 42 and 81 years old for almost a decade, having study participants record how much they slept a day and their quality of sleep. Most reported sleeping between six and eight hours (70 per cent), but 10 per cent slept more than eight hours.

Older adults who suddenly start sleeping longer hours are at an even greater risk than those who have always slept a lot, according to the study. “People who shifted over time from sleeping less than six hours a night to sleeping more than eight hours a night were nearly four times more likely to have a stroke than people who consistently slept an average amount,” said the co-author from the University of Cambridge.

Quality sleep matters – removing the problems that can be caused by snoring is a positive step to better health. Don’t neglect it by thinking it’s either harmless or merely amusing.

John Redfern