Sleep apnoea sufferers face a 17% higher risk of pneumonia

People with sleep apnoea may be at much greater risk for developing pneumonia, according to a new study. And the more severe the sleep apnoea, the greater the risk, the research suggests.

SleepPro and apnoea

The sleep disorder causes the upper airway to become blocked, cutting off the supply of oxygen during sleep. The researchers said this increases the risk for aspiration, or inhaling contents or fluid from the throat into the lungs. This can put people at much greater risk of developing pneumonia.

The researchers found that patients with untreated sleep apnoea have a 17% greater risk of developing pneumonia than those without the sleep disorder. Untreated sleep apnoea doesn’t just raise the risk of pneumonia – it’s also unfriendly to the heart.

The 11-year study involved over 34,000 patients and almost 7,000 of these participants had sleep apnoea, and about 27,000 did not. The researchers found that more than 9%of the sleep apnoea group at some stage developed pneumonia, compared to just over 7% of those without the sleep disorder. In addition the risk was significantly higher among patients who were using continuous positive airway pressure (CPAP) therapy, always previously considered as the gold standard for treating sleep apnoea.

Pneumonia can affect anyone, and it often occurs during the autumn and winter months. If you catch it, pneumonia can be serious and highly life threatening.  It is caused by infection from bacteria, viruses or fungi, which irritate the lungs. This irritation causes the tiny air sacs in your lungs to become inflamed and swell up with fluid. Pneumonia could have dramatic longer-term effects on your life; stopping you from carrying out simple daily activities that are often taken for granted.

  • Up to 1 in every 100 UK adults develop pneumonia each year and over 172,000 adult hospital admissions are due to pneumonia – 1 in 5 of them occurring in people aged under 65.
  • If you have a heart condition and have pneumonia, you are over four times more likely to have a heart attack or stroke.
  • More than 50,000 UK adults die of pneumonia each year and it is one of the most common causes of death due to infection in both men and women.

Sleep apnea is a chronic sleep disorder that affects approximately 20 million North Americans, many still undiagnosed because there isn’t a simple test that can diagnose the condition. With cases of sleep apnoea, breathing repeatedly starts and stops throughout the sleep cycle. The interruption in breathing can last seconds to minutes, and normal breathing usually resumes with a loud snort or choking sound.

According to the American Heart Association (AHA), treating sleep apnoea may protect your heart from harmful changes that contribute to heart disease. An AHA study found six months of treatment reversed abnormal heart changes related to sleep apnoea in study participants.

Sleep apnoea is most commonly treated with continuous positive airway pressure (CPAP), or a custom-fitted oral appliance that eliminates snoring while keeping the airways open to promote healthy breathing. According to a study published in the Canadian Medical Association Journal, it can help promote a healthy respiratory system too.

People with sleep apnea often snore loudly, and are tired, even after a full night’s sleep because their sleep cycle is so frequently interrupted. Unfortunately they are rarely aware of this and it is best if their partner observes to see who snores heavily and note if these interruptions happen.

OSA is the more common type and happens when the muscles in the throat relax during sleep, resulting in the collapse or blockage of the airway. It can affect anyone, but is more common in obese individuals.

Treatment is both vital and simple, and most people who have mild to moderate sleep apnoea can control the effects by using a tailor-made oral appliance – a mouthpiece that simply adjusts the position of the lower jaw and in doing so keeps the airway open. No more snoring – and no health danger of the types described earlier.

Don’t ignore it – make 2016 a great year for good sleep and good health.

 

John Redfern


Bruxism and Teeth Grinding is a major problem – and growing fast

A recent medical report has indicated that about one in four people with obstructive sleep apnoea (OSA) suffer from teeth grinding, particularly nocturnal bruxism, and it is more common in men. Evidence shows that stress and anxiety play significant roles in this growing problem.

Bruxism SleepPro has the answer

Figures produced by British dentists say teeth clenching and grinding is on the rise. In fact, they report a 30% increase in bruxism over the last 5 years. Many dentists blame stress and the inability to cope with it. They say that whist we sleep, a lot of our worries – even if they are only in our subconscious mind – can lead to clenching and teeth grinding.

Bruxism however is not confined solely to OSA sufferers and some studies have suggested that as many as 10% of the total population may be affected. This figure may be significantly higher as many cases of bruxism, just like sleep apnoea, are not reported.

Colgate, a leader in the toothpaste industry, recently posted on their blog the top three ways to treat Bruxism, also known as teeth grinding. The three highlighted solutions were to talk to your dentist about jaw alignment, get a mouth guard and to let go of negative stress.

The article goes on to state that “stress, anxiety, smoking, heavy alcohol, caffeine, depression and sleep disorders are all possible causes of teeth grinding according to the Bruxism Association”.

The Bruxism Association also explains that the most common symptom of teeth grinding is a headache. Other symptoms may include muscle aches, enlargement of facial muscles, discomfort of the jaw and stiffness in one’s neck or shoulders.

Sufferers of bruxism may experience eroded enamel, making teeth vulnerable to tooth sensitivity. Although Colgate offers special toothpaste for sensitive teeth, they hope to educate readers so that their teeth do not become eroded.

One of the easiest solutions recommended by the Colgate article to eliminate Bruxism is the use of a mouth guard, also known as a night guard that is specifically used to prevent teeth grinding. When purchasing a night guard for teeth grinding, their recommendation is that it is important to get one that can be moulded for your specific teeth.

Although a relationship has been established between bruxism, sleep apnoea, and stress, many dentists are also noticing that teeth grinding is a problem among people who have narrow arch width, especially in the upper jaw. Dentists say correcting the arch has been known to help with both grinding and the recurrent risk of sleep apnoea. Studies out of the University of Montreal indicate that a narrow arch is a “primary risk factor” for bruxism in children and adults.

Grinding teeth can lead to enamel erosion, which in turn can lead to cavities, so it is something that dentists are always looking for when people come in for regular check-ups. Grinding and clenching teeth can happen unconsciously and cause a range of problems.

The signs and symptoms of bruxism can be subtle and may include:

  • Audible grinding or clenching at night, usually noticed by a partner
  • Flattened, worn or chipped teeth* Sensitive teeth – especially to hot or cold food
  • Facial pain or headaches in the temple region
  • Increased yellowing of teeth as the enamel is worn away
  • Sore or tight jaw muscles
  • Earache – even though the ear is not affected, jaw problems can present with ear symptoms.

Doctors and dentists don’t fully understand why some people are “bruxers” and others aren’t, but if you suffer this way then take you should take the right steps immediately with a customised night guard before the problem gets worse  – and also gets much more expensive.

John Redfern


Do you think you have sleep apnea? It varies in form and there are four main types of treatment.

Good sleep is critical to good health. But what if someone stops breathing for short pauses in the middle of the night, breathes shallowly, snorts, snores, gasps for air, or breathes infrequently?  This is known as sleep apnoea and it could be contributing to a great number of health issues. Those disruptions through the night may last from 30 seconds to several minutes and may occur hundreds of times. This results in a lack of oxygen to all tissues, but this particularly includes the brain.

Apnea and snoring

It can be tricky to diagnose, as there is no blood test for it. What’s needed is for someone to be sleeping in the same room to notice the snoring, gasping, snorting, and pauses through the night, in order to raise concern.

It occurs in two types, which differ in how serious they are, although both have major implications for health if untreated. Obstructive sleep apnoea is the most common form, with central sleep apnoea being less common.

Someone with obstructive sleep apnoea has an airway that becomes partially or fully blocked during sleep due to either excess weight, large tonsils compressing the area, or simply to anatomical defects.  Central sleep apnoea on the other hand occurs when the part of the brain that handles breathing does not correctly communicate with the muscle required for breathing, resulting in pauses or infrequent breaths while sleeping. A combination of the two can occur but is not common,

In all cases the body receives less oxygen than it needs, and it responds by releasing the hormones involved with stress such as cortisol and adrenaline.

The increase in these hormones coupled with a lack of oxygen can put a person with sleep apnoea at higher risk for high blood pressure, heart attack, stroke, irregular heartbeats, and heart failure. These people often also wake up with a headache, are very tired, and experience brain fog through the day, due to this lack of oxygen and quality sleep.

Some people have sleep apnoea in a mild or even moderate form that might be quite subtle, in that their snoring or pauses doesn’t wake up others, yet they themselves wake feeling tired and unrested without knowing why. Others with more severe sleep apnoea are often told that their snoring sounds like a freight train, or their own gasping for air wakes them up, such that they feel like they were choking.

Doctors and researchers have described the recent continuous growth of sleep apnoea as an epidemic. It is well established in men, but is showing rapid increases amongst women and it is estimated to affect somewhere between 25% and 30% of adults, but often undiagnosed and untreated.

The key telltale sign is snoring. Sufferers may also gasp for air and choke briefly whilst sleeping, but have no recall of it when waking up. They will usually feel sleepy during the day, be tired, and as a result often irritable too.

CPAP

Historically the main treatment for moderate to severe sleep apnoea has always been to keep the airway open via a mask. The CPAP mask and machine (continuous positive airway pressure) has been around since the early 1980’s and this is highly effective – but there are problems.

Patients often reject it for various reasons that include discomfort, dry mouth, noise disturbance, claustrophobia, and of course it doesn’t travel well.

Surgery

This may involve removal of the adenoids or excess flesh, or be one of the recent pacemaker type of implants that place a generator in the upper chest which has an electrical stimulation lead to the neck to keep the airways open. This is usually only for those severe cases that reject CPAP.

Positional Therapy

Most sleep apnoea patients suffer worst when they lie on their back causing the tongue to fall back and obstructing the airway. The old method was a tennis ball sewn into the back of the pyjama jacket but special pillows are now available, both for users of oral appliances and CPAP users too.

Dental Appliance Therapy

Often called an Oral Appliance or mouthpiece, this treatment makes use of something called an M.A.D. (mandibular adjustment device) – a simple well fitting gum shield that is comfortable to wear and highly effective. They work by moving the jaw forward slightly, which then opens the airway; breathing is smooth and continuous, and snoring stops immediately.

This is by far the most popular and the easiest to use. It’s comfortable to wear, shapes itself to your dental profile and has proved effective in 98% of cases. It has the added advantage of being easy to take wherever you go – either away on business, or on the family holiday.

Quality mouthpieces are now highly recommended by the NHS for all who snore, and also for cases of mild to moderate sleep apnoea and they are now even proposed as a replacement for CPAP intolerance.

 

John Redfern


Stop snoring appliances proved to lower blood pressure and save lives

High blood pressure, also known as hypertension, affects millions of people, even children and teenagers and is often called a ’silent disease’ because you usually don’t know you have it; there may be no outward symptoms or signs, so monitoring your blood pressure is critical.

Snoring and high blood pressure

 

Nearly one-third of people who have high blood pressure are totally unaware.  It rarely has noticeable symptoms, but if untreated it increases your risk of heart attack, heart failure, kidney disease, stroke, eye disease, erectile dysfunction or even dementia.

 It has now been proved that Mandibular advancement devices (MADs) and continuous airway pressure (CPAP) are equally effective therapies for reducing blood pressure in patients with obstructive sleep apnoea (OSA), and this was confirmed by a recent new analysis.

Daniel J. Bratton, PhD, of the Department of Pulmonology, University Hospital in Zurich, Switzerland, and colleagues found that there was a distinct parallel in how these two devices affected blood pressure and the results of their work appeared in the Journal of the American Medical Association on December 1, 2015.

For those suffering from heavy snoring, or OSA, the disrupted sleep and the reduction of oxygen getting to the brain can contribute significantly to high blood pressure, but using either of the two common treatments for the condition can lower blood pressure effectively. A comparison of the two treatments — continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) — showed that each produces a modest but valuable reduction in both systolic and diastolic blood pressure rates.

CPAP and MADs not only reduce the symptoms of obstructive sleep apnea such as sleepiness, but also lower blood pressure,” said Dr. Malcolm Kohler, chair of respiratory medicine at the University Hospital of Zurich.

OSA is the leading cause of excessive daytime sleepiness, and can cause high blood pressure, which raises heart disease risk, the agency says.

Mandibular advancement devices work by pushing the jaw and tongue forward to keep the airway open during sleep. In continuous positive airway pressure, patients wear a facemask hooked up to a device that produces mild air pressure to keep the airway open.

Some patients find it difficult to adapt to CPAP, Kohler said. Some have problems wearing the facemask, others can’t get used to the noise of the compressor and some can’t abide either. “MADs are now considered as an alternative treatment to the more widely used CPAP, especially in patients who fail to adapt to CPAP treatment,” Kohler added. “MADs work better in mild to moderate sleep apnea.”

In the UK, over 6 million people are unaware they have high blood pressure, yet it affects more than 1 in 4 adults. Left unmanaged, it can lead to emotional, psychological, and even physical problems, including coronary artery disease and high blood pressure. Some 2 million patients are known to have OSA, with millions of others going undiagnosed.

In the USA the figures are even higher with 75 million American adults having high blood pressure; that’s one in every three adults, but only 52% of them have it under control. The prevalence of high blood pressure is higher among non-Hispanic black adults compared with non-Hispanic white and Mexican-American adults and increases greatly with age.

High blood pressure was a primary or contributing cause of death for more than 360,000 Americans in 2014. That’s nearly 1,000 deaths each day and costs the nation $46 billion each year including the cost of health care services, medications, and missed days of work.

In Australia,10% of adults are estimated to have high blood pressure, but this may be an underestimate as this is based on self-reported data. An earlier study that measured the blood pressure of participants found that almost one in three men and one in four women over the age of 25 had high blood pressure or were on medication for hypertension.

The only way of knowing there is a problem is to have your blood pressure checked and all adults should have their blood pressure checked regularly and having this done is easy and could save your life and safeguard your health. Using an MAD, or mouthpiece, will do just the same so act now.

John Redfern