Lack of sleep and regular snoring linked to poorer breast cancer survival

A new study from the USA reports that short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent breast cancer survival.

Lack of sleep and breast cancer

 

Results show that women who typically slept less than the recommended 7 hours of sleep per night and were frequent snorers in the years before their cancer diagnosis experienced a poorer cancer prognosis.

The findings were especially robust for women who were diagnosed with breast cancer. Breast cancer patients who reported sleeping 6 hours or less per night and snoring 5 or more nights per week before their diagnosis were 2 times more likely to die from breast cancer (hazard ratio = 2.14) than patients who reported sleeping 7 to 8 hours per night and rarely snored.

The study results are published in the April 15 issue of the Journal of Clinical Sleep Medicine.

In a week where scientists have revealed extensive data on the world’s sleeping patterns, leading researchers have told the BBC that society has become “supremely arrogant” in ignoring the importance of sleep. They say people and governments really need to take the problem seriously.

The body clock drives huge changes in the human body. Cancer, heart disease, type-2 diabetes, infections and obesity have all been linked to reduced sleep. It alters alertness, mood, physical strength and even the risk of a heart attack in a daily rhythm.

Sleep experts worldwide, including many who are based in the UK, endorse these statements. They include Dr Akhilesh Reddy, from the University of Cambridge, who said that the body clock influences every biological process in the human body and the health consequences of living against the clock were “pretty clear cut”, particularly in the case of breast cancer.

But the pressures of work and social lives mean many people cut their sleep during the week and catch up at the weekend. Researchers are investigating whether there is a health impact.

The study, by a team at the University of Bristol in the UK and Weill Cornell Medical College in Qatar, assessed “sleep debt” – a measure of the difference in the nightly hours asleep on weekdays and at the weekend.

“We found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance,” said Prof Shahrad Taheri from Weill Cornell. He added: “Sleep loss is widespread in modern society, but only in the last decade have we realised its metabolic consequences.

“Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success.”

The study was funded by the UK’s Department of Health, where 10% of healthcare budgets are already spent on treating diabetes. Perhaps they’ll act on it accordingly.

Information on global sleep habits has been equally informative and it was clearly evident that there was a conflict between our desire to stay up late and our bodies urging us to get up in the morning.

Prof Daniel Forger, one of the researchers, said “Society is pushing us to stay up late, our body clocks are trying to get us up earlier, and in the middle the amount of sleep that we have is being sacrificed; that’s what we think is going on in global sleep crisis.

The study found people in Japan and Singapore had an average of seven hours and 24 minutes sleep while the people in the Netherlands had eight hours and 12 minutes. People in the UK averaged just under eight hours – a little less than the French. The study also showed women had about 30 minutes more per night in bed than men, particularly between the ages of 30 and 60.

The message to everyone is very evident.
Sleep enough – Stop Snoring – and don’t ignore the opinions of the experts.

John Redfern


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

 

 

 

 

 

 

 

 

 

 

 


Snoring mothers-to-be are linked to low birth weight babies

The British Press have covered this subject extensively this week based on the results of a new research study that has just been completed in the United States. The research was published in the journal ‘Sleep’.

Snoring can be more than just an annoyance to others who are trying to sleep in the same room. For pregnant women, snoring could indicate certain higher risks. Experts say that snoring may be a sign of breathing problems that could deprive an unborn baby of oxygen.

Snoring is often a key sign of obstructive sleep apnoea, which results in the airway becoming partially blocked, said the researchers, whose findings appear in the journal Sleep. This can reduce blood oxygen levels during the night and is associated with serious health problems, including high blood pressure and heart attacks. The experts stress sleep apnoea can of course be easily treated.

The study found that chronic snorers, who snored both before and during pregnancy, were two thirds more likely to have a baby whose weight was in the bottom 10%.

Newborn baby girl sleeping

They were also more than twice as likely to need an elective Caesarean delivery, or C-section, compared with non-snorers.

Dr Louise O’Brien, from the University of Michigan’s Sleep Disorders Centre, said: “There has been great interest in the implications of snoring during pregnancy and how it affects maternal health but there is little data on how it may impact the health of the baby.

“We’ve found that chronic snoring is associated with both smaller babies and C-sections, even after we accounted for other risk factors. This suggests that we have a window of opportunity to screen pregnant women for breathing problems during sleep that may put them at risk of poor delivery outcomes.”

Previous research has already shown that women who start to snore during pregnancy are at risk from high blood pressure and the potentially dangerous pregnancy condition pre-eclampsia.

More than a third of the 1,673 pregnant women recruited for the new US study reported habitual snoring. They were also more than twice as likely to need an elective Caesarean delivery, or C-section, compared with non-snorers.

Scientists found that women who snored in their sleep three or more nights per week had a higher risk of poor delivery outcomes, including smaller babies and Caesarean births.

The very worst cases of sleep apnoea can be treated with CPAP (continuous positive airway pressure), which involves wearing a mask attached to a machine during sleep, which pumps oxygen to keep the airways open. Most other forms of sleep apnoea can be treated with the wearing of a simple snoring mouthpiece, similar to a gumshield that is worn for sports.

Dr O’Brien added: “If we can identify risks during pregnancy that can be treated, such as obstructive sleep apnoea, we can reduce the incidence of small babies, C-sections and possibly NICU (neo-natal intensive care unit) admission that not only improve long-term health benefits for the newly born but also help keep costs down.”

By John Redfern


Snoring can cause Women to put on weight

Lack of sleep affects food choices and if you don’t sleep well it can cause you to choose more high-calorie foods. So, not only does being overweight cause you to snore, it would appear that snoring causes you to gain weight too.

It’s obviously normal for a poor night’s sleep to affect you the next day and make you feel tired; if it’s a constant problem then it could have some wide-ranging effects on your health.

Several studies have suggested that a lack of sleep can increase the chance of weight gain and obesity. It may be that a lack of sleep affects hormones that help control our appetite, that people eat more calories to make up for the tiring effects of lost sleep, or that people who stay up late tend to sleep less overall and eat more calories during their extended waking hours.

Snoring and Weight gain

However, these are mostly theories, as few good-quality studies have explored the link between sleep, eating, and weight gain. To help fill this gap in what we know, researchers recruited 225 healthy, non-obese people (aged 22 to 50 years old) to live in a sleep laboratory for 12 to 18 days.

They randomly selected participants to have five nights of either:
Restricted sleep, with four hours in bed, from 4 a.m. to 8 a.m., or
Unrestricted sleep, with 10 hours in bed, from 10 p.m. to 8 a.m.

During the day, people had regular meals and could also eat at other times, as food was always available in the kitchen. What food they ate and their weight were closely monitored, so the researchers could compare the two groups to see whether restricted sleep increased the chance of weight gain.

What did we learn?
People who had restricted sleep consumed more calories than those who had unrestricted sleep.
All of the extra calories – around 550 per day on average – were from food consumed between 10 p.m. and 4 a.m.
When eating late at night, people also got more of their calories from higher fat foods than at other times of the day.
On average, people with restricted sleep gained nearly a kilo of weight, while those with unrestricted sleep gained only one-tenth of a kilogram.

How reliable is the research?
This was a good-quality study. However, it’s worth noting it only included people who were healthy, fairly young, and not obese. So it’s not clear whether these findings will definitely apply to other groups of people. Also, the participants weren’t able to exercise during the study and might not have had access to all the foods they usually ate. These things might have had an effect on the findings.

What does this mean for me?
It provides good evidence that restricted sleep can increase how many calories you eat and leads to weight gain, at least in the short term. If you tend to stay up late and/or get little sleep, it may be especially pertinent to you as after 10 p.m. was when people typically got their extra calories, rather than during the day.

By John Redfern


Snoring, sleep apnoea, and sleep loss in women

Snoring, and sleep apnoea in particular, were both generally considered to be conditions predominantly affecting men but we now know this not to be the case, with the ration of men to women estimated at approximately 2:1. Since sleep apnoea is mainly a problem that is self-reported , men were more likely to seek help for this and heavy snoring, even if prompted to do so by their partner.

Approximately 50% of women snorers are believed not to report their symptoms to their GP, mostly due to being embarrassed. Some studies show that as many as 90% of more severe cases go undiagnosed in women, and women have a tendency not to report apnoea events, choking or restless sleep, whereas most men did report these matters.

Treatment however can be both simple and inexpensive and it can prevent major health problems in later life. Sufferers are often put off by the thought that the treatment most used historically was CPAP, where air is forced via a mask into the lungs throughout the whole night. More recent thinking is to recommend the use of an oral appliance for mild and moderate cases of sleep apnoea.

Sleep apnea in womenComparison showing Continuous Positive Airway Pressure (CPAP and an Oral Appliance (MAD)

The contrast is shown in the photography above where one patient is using a mask

for CPAP and the other an oral appliance – just distinguishable in the inset, with the result that this method is now much more appealing to those who suffer – both men and women. This treatment, although not quite so effective, works very well.

Snoring often results in a disturbed night and it is very common to hear a comment such as – “I barely slept last night. I just couldn’t get comfortable” – or – “I tried to fall asleep, but my mind kept racing.”

Sleep, and the lack of it, is a common talking point, and disturbed sleep generally is much more common in women than men. A woman’s experience of sleep loss is different and sometimes feminine factors are involved that may cause and maintain sleep difficulties. However, focusing on quality sleep is important to help prevent many aspects of both physical and mental health.

Disruption of sleep leads not only to daytime sleepiness, but memory lapses, weight gain, headaches, irritability and poor work performance overall. It can also contribute to psychological disorders such as depression and for the more severe cases, there’s an increased risk of high blood pressure, premature heart disease and stroke.

It’s not an area to neglect.

The best solution is an approach on several fronts including exercise, reduced alcohol consumption, healthy eating and treatment for the sleep apnoea or heavy snoring which will stop the snoring immediately whilst other things take time.

There are several treatment solutions including surgery, CPAP (Continuous Positive Airways Pressure) a full-face mask which works by stopping the airways from collapsing, or a mandibular advancement device, like a sports mouth-guard, that holds the lower jaw slightly forward, making more space to breathe.

Many women now opt for the mouthpiece. It’s easy to wear, quite comfortable, non-claustrophobic unlike the mask, and doesn’t create dryness of the mouth, which CPAP has a tendency to do. Mouthpieces are easily acquired as they are non-prescription, but some are NHS Approved, which is preferable, and they will bring you immediate results.

SleepPro now have a special product in their range dedicated to women only – the only oral appliance technology company to do so.

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