New Guidelines for treating Obstructive Sleep Apnoea (OSA)

If you already suffer from sleep apnoea, or think that you or your partner may have this dangerous problem, and it remains undiagnosed for whatever reason, then the new rules that have been issued in the United States will have some real meaning for you.

The American College of Physicians (ACP) has published new clinical practice guidelines regarding the management and treatment of OSA in adults. It deals with the known detrimental effects of the problem, and discusses the limitations of the various available treatments. These findings endorse those of the AASM – the American Academy of Sleep Medicine but take recommendations further.

As ever, the USA is ahead of the UK in dealing with this huge problem, partly because it is so much more widespread in the community there. Much of this can be linked to obesity, a major problem in the USA, and which is rapidly becoming so here due to changes in our diet, lower exercise levels in youth, and sedentary occupations now being the largest group by far versus manual workers. Alcohol also often plays a significant role in the equation – mostly due to the high calorific intake and the effect that alcohol can have on sleep hygiene.

What is OSA?

OSA disrupts breathing during sleep, and this is usually as a result of the muscles and soft tissues in the throat relaxing and collapsing to block the airway. It can last for about 10 seconds or even more. It affects people of all ages, but particularly those of us in middle age, and particularly the elderly.

However, we believe that around 80% of cases remain undiagnosed. OSA is easy to treat but when left undiagnosed and untreated, is linked with a range of serious health concerns that include heart disease and stroke, diabetes and high blood pressure, called hypertension. Fatigue becomes a huge problem too.

Current approved treatments for OSA and sleep disordered breathing

OSA is a chronic medical disorder that requires immediate action, but also requires long term, and often lifelong. therapy. Obviously a healthier lifestyle will come high on the list from any GP but this will not stop the problem of your snoring immediately, and sometimes does not succeed at all.

As well as recommending weight loss in overweight and obese patients, it recommends and approves the following treatments as it is recognised that weight-loss intervention alone will not achieve the desired objectives.

Medical Treatments and Clinical Recommendations for OSA

CPAP Mask wearer

  • Continuous Positive Airway Pressure (CPAP) is recommended for more serious sufferers but it is readily identified that many patients reject this treatment for various reasons, particularly having to wear a mask for such long periods of time, claustrophobia, having a dry mouth, or the associated discomfort of the mask amongst others.
  • It is still however strongly recommended for chronic sufferers if acceptable.

Sweet dreams

  • Mandibular Advancement Devices (MAD’s or Splints) are fully recommended as a primary treatment route and a strong option in many cases versus CPAP. They are more readily accepted than masks and have many distinct advantages over them including, ease of wear, instant results, high rates of effectiveness and also being inexpensive by comparison – even bespoke mouthpieces or the now available self-fit versions which are highly adjustable compared to the standard oral appliance – although this may be the best starting point.
  • Strongly recommended by ACP for less severe versions of OSA.

Snoring Surgery

  • Surgery however is not listed in the ACP’s summarized recommendations, but the guideline does specifically discuss its role as a treatment for OSA. It highlights that surgical procedures, which are intended for sleep-disordered breathing, are not as effective as either CPAP or using MAD’s. Currently success rates vary greatly and can be as low as 20%, as well as it sometimes requiring several procedures.
  • Not currently recommended by ACP to American Physicians.

More and more clinics, doctors and hospitals in the USA now recommend using oral appliance technology in the form of a mouthpiece to be used when sleeping and this is now becoming more accepted as a route here in the UK, particularly now that higher quality MAD’s are NHS Approved.

By John Redfern

 

 

 

 

 

 

 

 

 

 

 


Massive increases recorded in the number of women who snore

Women in particular do not like to think they snore – there’s a stigma attached to it – yet they now account for 40 per cent of snorers,” says Dr Martin Allen, who is a consultant physician at the University Hospital of North Staffordshire, and a spokesperson for the British Lung Foundation.

Snoring damages health

Previously considered by many to be a predominantly male domain, it is now women who account for almost half of the snoring problem in the UK. There is no denying that it is predominantly their changed lifestyle that has caused the problem, and again there is massive proof to support this. Latest figures show that women are seeking to resolve it however, and are dealing with it in a number of ways, dependent upon the problem’s severity.

Clinics are now advising 10 times more women snorers than 2 years ago – and the problem is conclusively a result of drinking, smoking, and weight gain. As well as the health problems previously mentioned, fatigue and irritability are also often a major result of having that disturbed night’s rest.

As we are all aware, stopping smoking is difficult, even in Stoptober, drinking tends to be an important part of all our social lives, and losing those extra pounds is harder work still, which can often necessitate lots of time and expense at the Gym in the early morning or after a busy day – which is not always convenient.

The majority of women snorers can stop snoring immediately through the use of a simple oral appliance that has previously been targeted at men alone; it’s fast, unobtrusive, and inexpensive. It’s a simple mouthpiece that helps to keep the airway open at night when asleep. No prescription is required and some products in the UK already have NHS Approval Status having been tried and tested for many years. It’s both fast and effective and it can stop your snoring whilst you’re working hard correcting those other lifestyle issues.

SleepPro are the leading British company in this field and their oral appliances are recommended by Clinics, Doctors, and Dentists throughout the world. As well as having full NHS Approval they have a recorded 98% success rate for product effectiveness, which at the end of the day is what counts most.

To meet this new and rising demand from women they have now taken it further and are the first to produce a specially produced mouthpiece for women that has now become available land was launched just this week.

Look for new SleepPro Woman – it’s pink, not the traditional male blue, and in the early sales period, there’s a pound donation from every sale going to support the vital research carried out by the Breast Cancer Campaign – appropriately named #wearitpink.

By John Redfern


Heavy Texting and Social Media are linked to Sleep Problems and poor performance for University students

I recently highlighted the high incidence of sleep disorders in adults, particularly women, and also wrote about the worrying problems that lack of sleep and snoring can cause in children – but what about young adults – particularly students going away from home for the first time?

Sleep deprivation has always been regarded as a major problem for those leaving home to go to College and University – as part of their transition to campus life. Now, a new study in the USA has identified another problem when it comes to students and sleep problems. In a word, it’s Texting.

Sleep Problems and poor performance

In a recent article it was reported that texting was a direct predictor of sleep problems among first-year students in a study that examined links between inter-personal stress, text messaging behaviour, and three indicators of college students’ health: burnout, sleep problems and emotional well-being.

Although the results of this study showed that the impact of texting on a student’s psychological well-being very much depended on the level of interpersonal stress they were already facing, more texting was associated with poorer sleep regardless of their previous level of stress.

The students in the study were all in their first year away from home and answered questions that measured academic and social burnout, emotional well-being, and sleep problems. They were also asked to estimate how many text messages they sent and received on an average day.

The study’s findings on sleep were especially significant given the well-documented compromises in sleep that students experience throughout their time in higher education, but especially in the first year. Several recent studies have shown that 70 per cent of college students receive less than the eight recommended hours of sleep. A recent survey concluded that “Only 40 per cent of students feel rested on two days of the week”.

To assess the students’ sleep quality, a ‘Sleep Quality Index’ was used to fit the college sample. It measured multiple aspects of sleep quality such as sleep duration, the amount of time it takes to fall asleep, the amount of time actually spent sleeping while in bed, night-time disturbances, and any daytime sleepiness.

The key finding was that the higher the number of daily texts – the higher the index of the student’s sleep problems. It is worth noting that this finding reinforces previous evidence pointing to a direct association between the use of mobile phones and poor sleep in adolescents and emerging adults.

Among the possible causes for this connection are two tendencies: students’ feeling pressured to respond immediately to texts, no matter what time of day or night, and students’ sleeping with the phone nearby, thus being awakened by the alerts from incoming texts. Initial conclusions are that heavy text messaging could be problematic during times of stress. Although speculative, it could be argued that texting is a uniquely unsuitable mode of communication for coping with interpersonal stress in close relationships.”

For instance, it is suggested that the abbreviated language that is common in texting — so-called “textese” — lacks the ability to provide the kind of nuance that is important in discussing sensitive issues. In addition, texting fails to offer critical non-verbal indications and hints that would be part of a face-to-face conversation. The Report stated that:

“Text messaging may carry a high risk of producing misunderstandings and unproductive interactions during periods of stress. When interpersonal stress involves conflict, the conditions required for productive communication may be particularly difficult to achieve through texting.”

To put it simply, as well as distracting students from restful sleep, leaving them tired the next day, texts can very easily be misunderstood, and cause more problems than they solve in a conversation.

Texting, Social Networking and other Media use has also been linked to poor academic performance in a US Report which says the widespread use of media among college students — from texting, to chatting on cell phones, to posting status updates on Facebook — may be taking a very serious academic toll.

According to this new study, new women students spent nearly half their day — 12 hours — engaged in some form of media use, particularly texting, music, the Internet and social networking. Researchers found media use, in general, was associated with lower grades an other academic problems. However, there were two exceptions: newspaper reading and listening to music were actually linked to a positive academic performance.

These findings were reported online in the journal Emerging Adulthood, and they offer some new insight into media use in early adulthood, at a time when many young people are living independently for the first time and have significant freedom from parental monitoring.

By John Redfern


SleepPro supports the British Lung Foundation

SleepPro supports the British Lung Foundation

The British Lung Foundation has launched a new online action that enables people to email their local parliamentarian, urging them to take action in parliaments and governments across the UK to draw attention to the problems presented by heavy snoring and obstructive sleep apnoea.

Most people will snore at one time or another but the incidence of heavy snoring is increasing rapidly, mostly due to lifestyle factors, and snoring is now thought to regularly affect the lives of 40% of men in the UK, and 25% of women, which if correct, adds up to almost 20 million people.

In addition, up to 4 per cent of middle-aged men and 2 per cent of middle-aged women in the UK have obstructive sleep apnoea (OSA. With awareness of OSA low among the general public and even healthcare professionals, and up to 80 per cent of people with OSA remaining undiagnosed (and some studies suggest this could be even higher), there is a real need to take action on OSA – a known killer.

sleep cycle

Health boards are already under pressure to cut costs and improve standards by centralising services, but the British Lung Foundation says solutions can be found to provide better access for rural patients who are the ones to suffer most from lack of treatment or even diagnosis – and often with inevitable fatal results.

Earlier this year, the BLF launched a ten-point charter calling on governments and decision makers across the UK to take action to ensure that people affected by OSA are diagnosed earlier, and that they and their families get the treatment and support they need.

In a very short time this will save thousands of lives – and a great deal of money in the NHS budgets.

Dr Penny Woods, Chief Executive, British Lung Foundation said:

Obstructive sleep apnoea is a treatable condition, but unfortunately awareness of it is not always what it should be. As a consequence too many people remain undiagnosed and untreated. Getting parliamentarians across the UK to engage with OSA as an issue is a great way to ensure the UK’s various governments and decision makers give OSA the attention it deserves.”

Caroline Stevens, Interim Chief Operating Officer at the BLF, said:

“The BLF’s OSA charter reflects the need for earlier diagnosis, better access to treatment and increased awareness – both amongst the wider public and medical community. The impact of OSA on health and lifestyle means these recommendations not only have the potential to save lives, but to make considerable savings to the NHS at a time of great financial pressure”.

Please help everyone with this problem by taking action now.

To write to your MP, MSP, AM or MLA by visiting this page:

www.blf.org.uk/osa-action

By John Redfern


Snorers who lie-in are TWICE as likely to develop bowel cancer

Snorers who sleep more than nine hours a night are twice as likely to develop bowel cancer than snorers who get seven hours of sleep a night, according to new research conducted at Harvard in the USA.

According to the Harvard study, snoring isn’t just annoying it poses very serious risks to a person’s health.

The study showed a significant link between long periods of sleep and the development of colorectal cancer, especially among people who are overweight or who snore. As a result, it is believed that obstructive sleep apnoea, a form of snoring that causes interrupted breathing during sleep, could contribute to an increased risk of cancer. One of the effects of sleep apnoea is that you are likely to suffer from excess fatigue because of disrupted sleep and this makes sufferers prone to sleeping longer to try to catch up.

The researchers asked participants to estimate their total hours of sleep in a 24-hour period and asked them if they snore.

A statement from the Department of Medicine at Harvard Medical School gave the following information:

‘Our current study adds to the very limited literature regarding the relationship between sleep duration, sleep quality and colorectal cancer risk. The novel observation of increased risk among regular snorers who sleep for long periods raises the possibility that sleep apnoea and its intermittent oxygen deprivation may contribute to cancer risk.’

Of 76,368 women and 30,121 men the researchers documented a total of 1,973 cases of colorectal cancer – almost 2 per cent of the total.

They broke the participants into subgroups which showed that men and women who were overweight, or who were regular snorers, and who reported sleeping nine hours or more per day, had a 1.4 to 2-fold increased risk of developing colorectal cancer compared to overweight people, or snorers, who got seven hours sleep a day.

The general recommendation is that most adults should get about seven to eight hours of sleep a night.

The authors suggest that the association between long sleep duration and colorectal cancer may be explained by obstructive sleep apnoea, which involves repetitive episodes of complete or partial upper airway obstruction during sleep.

The most common cause of obstructive sleep apnoea is excess body weight, and loud snoring is a common symptom of the condition.

The researchers strongly believe that sleep disruption caused by heavy snoring may reduce sleep quality and increase sleepiness, resulting in longer reported sleep durations. In addition to this, intermittent oxygen deprivation, similar to that which occurs in people with sleep apnoea, has been shown in animal models to promote significant tumour growth.

Other recent research has shown that people who sleep for less than six hours a night are at a significantly increased risk of stroke.

Researchers at the University of Alabama found that those in middle age who skimped on sleep were more likely to suffer stroke symptoms than those who got at least nine hours of shut-eye – even if they were a healthy weight and with no family history of stroke. Yet again, the scientists found that heavy snoring made the problem worse as it reduced the quality of people’s sleep.

The American Academy of Sleep Medicine reports that individual sleep needs vary. However, the general recommendation is that most adults should get about seven to eight hours of nightly sleep.

Relate this information to your own problem of snoring and take some immediate steps to reduce it – it’s ‘sound advice’.
By John Redfern

 


STOP SNORING WEEK • Day 5

Ladies – Do you Snore – or are you actually very ill?

According to the very latest research, one woman for every two men are now diagnosed with sleep disorders. Basically their partner may snore – or it may even be themselves that is snoring. No longer ladies, can you tell your men that snoring is a man thing.

Men are also more likely to seek help for their snoring, outnumbering women eight to one, which could support the argument that men’s snoring is more disruptive than women’s snoring. But there has been a recent growth in women seeking help for their problem.

Mostly help is sought for social reasons – disruption – but if that problem is not just snoring, but obstructive sleep apnoea, then there are some very serious health implications too.

A study found that women who sleep with snorers might get decent sleep just 73 per cent of the time they are in bed; women who do not sleep with snorers get more than 90 per cent. So a woman who gets eight hours of beauty rest is awakened multiple times and might really get only five or six hours. More disturbing is the university’s finding that couples who are plagued by snoring are more likely to divorce, although we doubt that anyone has ever listed it on divorce papers as the reason for the split.

Men, or Women, who complain of persistent sleep disruption should encourage their partner to see their family doctors to rule out underlying problems such as anaemia, depression, fibromyalgia, thyroid disorder, etc. The doctor might also recommend a sleep study to rule out sleep apnoea, which is easily treated with positioning pillows, mouthpieces and CPAP devices. Sleep apnoea occurs when breathing stops because the airway becomes completely blocked.

‘Female First’ reports that over 40% of people say their partners snoring habit has a negative impact on how well they sleep and while a third of people have no idea why they snore, more than half have never done anything to stop themselves doing so.

This blind acceptance by snorers is contributing to some extreme reactions from long-suffering partners. Nearly a third of other halves resort to sleeping in another room while 2 in 5 engage in bedtime tussles, moving their partner from their back to their side to help ease the noise.

And this now applies to both men and women – not men alone – but women are not snoring more – there are just more of them seeking help. As obesity rates continue to rise and extra weight has an influence over snoring for lots of people, it is not unexpected that people are linking it with recent reports that more women are coming to clinics to stop their snoring. Drinking and smoking are additional contributory lifestyle factors.

If it is simply snoring, invest in an NHS recommended oral appliance, a dental mouthpiece, and you will quickly put it right.

If you suffer from obstructive sleep apnoea, you should consult your GP who may decide in consultation that you need a CPAP machine for night-time use. However, in the USA, where snoring problems and OSA have been accepted and treated for many years in advance of the UK, an alternative to a Continuous Positive Airway Pressure (CPAP) machine is becoming a more popular remedy for sleep apnoea.

Sleep Centre Directors in the US are recommending mouthpieces for the problem as they are likely not to deter patients from coming forward and they are also likely to be used much more. Rejection of CPAP has been a problem for many years and for many reasons including extreme dryness of the throat and even claustrophobia.

A relevant comment from a leading Sleep Centre Director, Dr Michael Coats, was made last Thursday on Sleep Apnoea Day:

“What we’re finding is the compliance rates for the oral appliances is higher,” he said. “The efficacy or the success rate of the oral appliance may be a little lower, although, if the patient is not wearing a CPAP at all, the next best thing can be an oral appliance to help them.”

By John Redfern


STOP SNORING WEEK • Day 1

The bedroom battleground: Four in ten snorers argue with their partner over the noise while a quarter don’t even share a bed.

The latest figures show that around a quarter of women and four in ten men are frequent snorers, although nearly half of all people snore occasionally.

A new survey of 1,134 snorers and their partners, conducted to mark National Stop Snoring Week, found that 27 per cent of people are regularly left feeling grouchy, 21 per cent constantly feel tired, and 16 per cent are less productive as a result of snoring.

More than a half of respondents said they had never tried anything to tackle the problem.

 Some 41% of snorers engage in regular night-time tussles with partners

 More than half of people have never tried anything to tackle the problem

 Around one quarter of women and four in ten men are frequent snorers

Bedtime should be a blissful part of any happy couple’s day and the bedroom a safe haven where partners snuggle up before drifting into a peaceful night’s sleep.However, for many couples, it has become a battleground and the site of a nightly war with a single cause: SNORING.

A new study has found that 41 per cent of snorers engage in regular nightly disagreements with their partners. They are usually woken up by an annoying whistle, wheeze or snort and the annoyed party will attempt to shift their partner from on their back onto their side to help ease the noise. Others find even a shove or dig in the ribs does not work and so 28 per cent regularly resort to sleeping in another room to get some sleep.

Snoring can be caused by a number of factors.

Dr Chris Idzikowski, Director of the Edinburgh Sleep Centre, said: ‘Snoring can greatly impact sleep quality which may eventually lead to more serious health problems.

‘To ensure couples maintain the intimacy of their relationship and prevent snoring from getting in the way of a good night’s sleep, it is important that both the snorer and the partner work together to find a solution.

‘If you or your partner snore then there’s a variety of simple things you can do to manage the condition such as sleeping on your front or side, maintaining a healthy weight and avoiding alcohol late at night.

‘While there is no cure for snoring, it can be controlled so it may also be worth discussing options such as mouth guards.’
By John Redfern


Sleep shapes a new Computer Game for Teenagers

Channel 4 Education and Chunk have co-operated to let teens turn their sleep patterns into a game with new app called ‘Zeds’.

Channel 4 Education and Chunk have co-operated to let teens turn their sleep patterns into a game with new app called ‘Zeds’.

Channel 4 Education and Games company Chunk have today launched a new app, which lets teenagers record their sleep patterns, which is then used to build a ‘track’ for a game.

Called Zeds, the tracks created by the apps reflect the pattern of the sleep, changing features as you move from light to deep, and aims to show teenagers the effects of poor quality of sleep.

When sleep has been really poor, the game will be much harder, while periods of deep sleep are calmer and populated with collectible ‘Z’s, giving temporary immunity and other bonuses – in the usual way of reward.

The owner and founder of Chunk, Donnie Kerrigan, said: “Channel 4’s brief was to present the facts about sleep to teenagers, an do it in a format that they’d engage with, to help them come to their own conclusions about their sleeping habits and how it affects them.

“Tracking their sleep, and then delivering the data as a game, is as direct, entertaining and memorable way of doing that as we can imagine. And, importantly, it’s a unique idea that will catch their interest in the first place.”

Chunk commissioned BAFTA award winning animation team, The Brothers McLeod, to bring the game characters and environments to life.

Faraz Osman, Editor of Dducation at Channel 4, said: “We wanted to encourage teenagers to both switch off from their gadgets, and help them understand the benefits of doing so. New research is revealing that sleep is a vital part of education and development and impacts on so many elements of life for teens, and yet is often overlooked, or felt to be unimportant. We wanted something that could alter that perception in an intelligent way.”

Available at the moment on iPhone and iPod Touch, the app is also supported by Professor Russell Foster, FRS; Professor of Circadian Neuroscience at Oxford University.

By John Redfern


Join our Partners Against Snoring group!

Are one of the many long suffering snoring partners looking to vent their frustrations?

SleepPro have set up a group for your convenience, let your feelings known if your partner is keeping you up at night (for the wrong reasons).

Let your feelings known, name and shame your partner or even post a video demonstrating just how horrible snoring can be.

We think that partners deserve a place to vent their frustration so we have set up a Google plus community for anyone looking to let their feelings known or looking to gain some of the best advice on how to stop snoring and how to improve your sleeping pattern.

PAS

All you have to do is sign up at http://bit.ly/16czGon share your information, share your thoughts and troubles, in turn we’ll share some of our most helpful tips to help cut out the snoring.
By Richard Owen


WINNING THE BATTLE OF BEDTIME – An important new TV Programme

Is your child sleep-deprived? Do they have problems getting to sleep? Does your toddler wake up often during the night? Is your teen addicted to the screen? Watch Channel 4 at 8 p.m. every Tuesday starting on 19th March for the next few weeks and find out the problems – and some of the solutions.

Professor Tanya Byron and the Bedtime Live team have the skills and experience to help get the nation’s kids and teens to bed.

Any you can contribute to the show if you are prepared to answer a few questions online. Here’s what Channel 4 say:

Are you the parent or carer of a child with sleeping problems?

We’d like to ask you some questions about the child who has the most trouble getting to sleep in your house.

The survey will take about 5 minutes to complete. We won’t ask you for personal details, but we may share overall findings from the survey anonymously on Bedtime Live.

Thanks very much for taking part and contributing to the TV show in this way.

Take the Sleep Survey

As any parents of a young child who is a problem sleeper will confirm, permanent tiredness and constant irritability can put a huge strain on your relationship. In fact, according to a survey, lack of sleep is a big factor in divorce and separation for a third of couples. Snoring causes the same problems as we all well know – either by you or your partner. Add sleepless children to the mix and it’s even more of a problem.

Ahead of a new series on the subject, a poll carried out for Channel 4 suggests the average parent surveyed got fewer than six hours of sleep a night. It also found that three in 10 couples that had split up said sleep deprivation since having their child was a factor in the breakup. Nearly 45% said they had dozed off in a place they shouldn’t have or was unsafe, with one in 20 admitting to falling asleep at the wheel of their car.

Children waking throughout the night, as well as the struggle to get children off to bed at a respectable hour, were equally important issues for parents. Nearly half of the 2,000 people questioned said getting their child to sleep at a consistent time was a nightly battle.

The key to establishing an age-appropriate bedtime was to look at what time children needed to get up and work backwards from that. If you refer to the NHS guidelines they state that youngsters aged between three and five need 11 hours of sleep, 10-year-olds need 10 hours, and 14-year-olds nine hours. Sleep needs remain just as vital for teenagers as for younger children, and scientists have been moving towards the view that they should start their day a little later than younger children to allow their brains to fully wake up. But social pressures and the lure of tablets, phones and Facebook keep many up way past their recommended bedtimes.

Tune in – it’s compulsive – and important. It may save your marriage in the same way as stopping snoring does. It’s all about a good night’s sleep.
By John Redfern