New Screening Tool for Epileptic Sleep Apnea Patients

Having to deal with sleep apnea is already difficult, but if you combine it with another disorder, such as epilepsy, it can be much more dangerous because the seizures can be triggered by a lack of oxygen that happens when someone’s sleep is obstructed. To compound the problem, the Epilepsy Foundation has estimated that approximately 40% of people diagnosed with epilepsy have a higher disposition towards obstructive sleep apnea (OSA) than other people.

According to a study that was published in the journal Neurology Clinical Practice, epileptic patients have not been typically evaluated in previous years even though they run a higher risk of developing OSA. Fortunately, there is a new electronic screening tool that is being developed for neurologists so that they can help diagnose apnea in epileptic patients. The reason this is revolutionary is that it’s the first time a patient’s electronic health record will be a contributing factor in helping neurologists make this assessment. This early detection is vital because it means precautions can be taken to help those people who are suffering from both of these conditions simultaneously. Some of the benefits will include better seizure control, a decrease in the need for antiepileptic medications and a reduction of the onset of sudden, unforeseen death.

The researchers cultivated their findings based on data that examined 12 risk factors, and all of these considerations were attainable from the patient’s electronic health record. An alert was set to go off based on factors, and some of the risk factors that they looked at were: a person’s body mass index (greater than 30 was a flag); snoring, choking or gasping for air while asleep; repeatedly waking up during the night, and having morning headaches. Other morning data included whether the patients woke up with a dry mouth, sore throat or a tightening of the chest. In addition to all these factors, they also looked at the frequency of nighttime urination, whether the person’s neck circumference was larger than 17 inches, and whether the patient exhibited a reduction in memory and concentration, to name just a few. If the alerts showed that a patient showed at least two potential risk factors, they were referred to a clinic to have a sleep study. The idea behind this research was to hopefully diagnose epileptic patients who otherwise would have gone unnoticed as potential candidates for sleep apnea therapy.

The findings were very dramatic. For patients without an electronic alert, only 7% were referred for sleep studies and 56% of them were diagnosed with sleep apnea. Out of the 405 cases with an alert attached to their record, 33% were referred for sleep studies, and 87% of those who completed the study were diagnosed with sleep apnea.

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Future Sleep Apnea Treatments

Roughly 20 million Americans suffer from one of three types of sleep apnea. The most common form is called obstructive sleep apnea (OSA) and it is characterized by a closing of the airways during sleep. Contributing factors to OSA are smoking, obesity, alcohol consumption, and sleeping on one’s back. Fortunately, there is lots of buzz lately about advancements in technology regarding this disorder.

The typical person gets diagnosed with sleep apnea after hearing from loved ones or even noticing themselves that they are showing the following symptoms: being awakened by loud snoring or gasping for air during the night, morning headaches, dry mouth, irritability, and excessive daytime sleepiness. Your doctor should immediately be consulted if you experience any of these symptoms, just to rule out the possibility of sleep apnea.

The next step towards getting diagnosed is to take part in a sleep study. During an overnight sleep study, electrodes are attached to a person’s face and body and the person is monitored by a technician all night long. The resulting diagnosis ranges from a  low to high severity, which translates to a numerical pressure setting on a continuous positive airway pressure (CPAP) device. This is a machine that the person takes home and uses thereafter every night. The CPAP is not designed to cure OSA, it’s merely a way to prevent further harm caused by a lack of oxygen to the brain whenever breathing stops. While it may seem awkward to use and hard to adapt, it is very important to not let OSA go untreated because it can lead to other health risks such as a stroke or heart failure, high blood pressure, irregular heartbeat, or even a heart attack. It has also been linked to an increase in diabetes, depression, and frequent headaches.

Until recently, people with OSA have had to get by with current CPAP technology. This includes the painstaking time and effort needed daily to clean out all hoses and the bulky humidifier, as well as purchasing copious amounts of distilled water for the device. Because of this, many people abandon their CPAP machines out of frustration. Future technology will make the humidifiers and tubing easier to disassemble and clean and make the entire unit more compact, which will appeal to travelers. In addition, the software that is built-in to the unit will be getting smarter so people will be able to download and analyze their own data. Another feature that is being discussed is the advent of infrared or UV-light technology to purify the air as the person inhales all night long. There is also talk of custom-molded CPAP masks designed to perfectly fit a person’s face. Doctors are optimistic this will go a long way towards user compliance when it comes to actually using these machines.

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What’s the Connection Between Sleep Apnea and Strokes?

Obstructive sleep apnea is dangerous for many reasons. Most people just think about the fact that this condition means you will stop breathing in your sleep. This is scary enough. However, obstructive sleep apnea can increase the chances of other conditions as well, including having a stroke.


When you have sleep apnea, you stop breathing. This leads to a decrease of oxygen to the brain and an increase in blood pressure. High blood pressure is a risk factor for stroke. Furthermore, these factors harm the brain’s ability to prevent it from being damaged. Because you are having these episodes multiple times throughout the nights, it reduces the brain’s ability to meet its own metabolic needs.


Sleep apnea affects your entire body because your body is trying to force you to take a breath. While all its resources are being devoted to this one task, many other functions are negatively affected. Sleep apnea’s effect on the vascular parts of the brain can cause a stroke.


It is important to get treated for sleep apnea because it can result in a catastrophe. Treating the sleep apnea can reduce to chance of stroke, high blood pressure, and other conditions. Sleep apnea doubles the chance of stroke in men. Worldwide, stroke is a significant cause of death, ranking second. There have been many studies, confirming the link between sleep apnea and stroke.


It is an important condition to get under control because if you have a stroke during sleep, it may not become apparent until the morning. This delay is important because if more than three hours have passed before getting treatment, the doctors will not be able to administer drugs that will reverse the effect of the stroke.


Since there is a significant link between stroke and sleep apnea, people diagnosed with sleep apnea need to take steps to reduce the occurrences of both conditions. If you have not been diagnosed with sleep apnea, but you exhibit some of the signs, you should be tested. For instance, if you are always tired, even after a full nights sleep, or you have loud snoring, you might have sleep apnea.


Taking charge of your health and contacting the right doctors to educate you on your conditions is key. Without intervention for your sleep apnea, you may suffer a stroke and be left with its devastating effects.


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Sleep Apnea and Driver Fatigue

Sleep is top safety concern in the transportation industry. The public demands that drivers be well-rested before taking commercial vehicles on the road, and trucking companies understand it’s imperative to prevent accidents, but regulations that enforce required sleep minimums aren’t always the answer.

There is increasing industry recognition that among the many conditions for which anyone behind the wheel should be treated is sleep apnea — a disorder that can cause breathing to pause hundreds of time per night, triggering momentary wakefulness that leaves the sufferer feeling sleep deprived the following day. For drivers, this can result in fatigue, impaired judgment and slowed reaction times despite having had the required hours of sleep.

According to The Federal Motor Vehicle Carrier Safety Administration, up to 13 percent of accidents involving commercial trucks may be the direct result of drivers who are too tired to be working safely. What’s worse, the organization believes that truckers have a rate of sleep apnea up to four times higher than the general population, in part due to the lifestyle challenges of being on the road.

While a physician may declare a driver medically ineligible to drive due to an unsafe condition, the rules governing sleep apnea are vague. Since both the cost of testing for the disorder and the equipment necessary to treat it are cost-prohibitive for many, it’s likely that not all recommendations receive follow-up.

Unlike conditions such as diabetes, there are no simple tests that can show how a driver with sleep apnea is affected and if they’re compliant with prescribed treatment.

Industry experts suggest that changing how transportation companies see the threat of sleep apnea can help mitigate the risk. In addition to fears that apnea-associated symptoms may result in accidents, employers are also acknowledging the cost of fatigue in terms of productivity. Several major companies have realized significant health cost savings as well as performance improvements by implementing fatigue reduction programs that specifically include the treatment of sleep apnea.

Until there is a clear and fair regulatory solution to address the problem of sleep apnea among commercial drivers, preventing it’s potentially deadly consequences remains a partnership between drivers and their employers. With a collaborative effort, it can be a win for both the transportation industry and the public.


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New Study Uses Blood Tests to Screen for Sleep Apnea

Patients are commonly diagnosed with sleep apnea following when a sleep disorder specialist obtains a medical history and perform a physical exam. Affected patients commonly complain of habitual snoring and an inability to get quality sleep. They also have larger neck sizes and a smaller upper respiratory airway. Individuals suspected to have the disorder typically undergo a sleep study. However, recent research reveals that specific blood tests may hasten diagnosis and treatment.


Biomarker Study


The research involved 264 male adults from various locations. Blood samples were taken from each of the men and tested for various levels that included C-reactive protein, hemoglobin A1c and erythropoietin. Elevations in C-reactive protein, erythropoietin and hemoglobin A1c correlated with the presence and severity of obstructive sleep apnea. The lack of oxygen caused by apnea naturally increases erythropoietin levels.


The findings reveal that blood testing proved superior to traditional methods used for sleep apnea screening. The biomarkers also revealed that patients suffering from the disorder may or may not have symptoms. The blood tests were more accurate than body mass index determination, as half of all people suffering from sleep apnea are not overweight. By making blood tests part of the diagnostic regimen, sleep specialists may be better able to diagnose and treat patients based on the severity of the disorder.


Obstructive Sleep Apnea Treatment


Treatment methods are designed to ensure that the airway remains open when an affected individual sleeps. The proper mode of treatment eliminates symptoms and reduces the possibility of developing any of the medical conditions that may occur. Sleep specialists may prescribe a variety of therapies based on the severity of the disorder.


Continuous positive airway pressure or CPAP remains one of the more effective treatment options. The therapy involves wearing a CPAP mask, which is connected to tubing and a device that continually blows air into the passages.


Some apnea sufferers may be advised to change their sleep position. Sleeping on one side or the other helps keep the airway open during sleep. However, the tactic is not always effective.


An obese patient diagnosed with sleep apnea is often told to lose weight through changes in diet combined with an increase in physical activity. However, not all patients are able to maintain the weight loss.


Avoiding alcohol or medications designed to induce sleep are commonly discouraged. The substances may cause an excess of muscular relaxation, which leads to the obstruction.


Originally posted on on September 25, 2018

Sleep Apnea Frequently Missed in Black Americans

Statistics indicate that nearly 42 million adults living in the United States live with sleep apnea. If not diagnosed and treated, the disorder often leads to an increased risk of developing cardiovascular diseases, diabetes and other health issues. A study performed by researchers found that a large number of African-American adults live with sleep apnea that has not been diagnosed or treated.


Jackson Heart Sleep Study


The study involved 852 men and women of African-American descent for the project. The average age of the adults was 63. During the course of the sleep study, the researchers found 24 percent of the participants suffered from moderate to severe sleep apnea. The scientists also found that up to 15 percent of the sleep apnea sufferers were female. However, only five percent of the volunteers had been diagnosed by a health care provider. The data suggests that 95 percent of the people had the problem but were never diagnosed or treated.


The study revealed that the sleep apnea sufferers had chronic snoring problems. They also had an abnormally high body mass indexes and larger neck circumferences.


The director of the National Center on Sleep Disorders Research from the National Institutes of Health believes that the study’s findings were revealing. Although the data indicates that more research is necessary to further develop the programs needed to ensure that more African-Americans receive diagnosis and treatment for the disorder, this is a significant starting point. More research on the topic will make that possible in time, and the hope is that more research will allow doctors to diagnose more people who suffer from sleep apnea with more accuracy.


About Sleep Apnea


Sleep apnea is classified as either central or obstructive. Central apnea occurs secondary to abnormal breathing patterns. Obstructive apnea involves a narrowing of the airway, which closes off air intake through the throat. Obstructive sleep apnea is the most common form of the disorder.


While asleep, the blockage causes an increase in carbon dioxide and a decrease of oxygen in the body. An individual may temporarily awaken to open the airway by engaging the upper respiratory muscles. They then typically take a number of deep breaths and fall back to sleep. Most do not remember the incident.


In either form of the disorder, affected individuals do not experience a restful sleep. They commonly feel unusually tired during the day without knowing the reason. The general fatigue can lead to an increased risk of becoming involved in an automotive accident. A loss of the ability to focus and concentrate also commonly affects work performance.


Alternative Sleep Apnea Treatments

Sleep apnea is a common sleep disorder that thousands of people suffer from every year. One of the most frequently prescribed treatments is a CPAP machine, which pumps continuous positive air pressure and where the machine gets its name.

There are other methods, of course, that patients can use if a CPAP machine is not a viable option for any reason. Talk with your sleep doctor about some of these alternatives if you have sleep apnea but would prefer an alternative treatment plan:

Medical Weight Loss

In general, the greater a patient’s weight, the harder it is for their airway to remain stable and open. This is why so many sleep apnea patients also happen to have above-average weight, because the added weight further collapses the airway. Losing weight helps reduce this obstruction, and therefore opens the airway. For some sleep apnea patients, their treatment might just be as simple as returning to a healthy BMI range, and there are programs and even some medication that doctors can prescribe to guide the process.

It is the hope that with the reduced weight comes a more open airway, thereby alleviating the symptoms of Obstructive Sleep Apnea, if not outright eliminating them.

Oral Appliances

Another popular appliance for patients with obstructive sleep apnea is a mandibular advancement device. These devices physically stabilize the jaw to maintain an open airway while sleeping.

Night Shift

Night Shift is a monitor from Advanced Brain Monitoring that vibrates when its user begins sleeping on their back. It’s worn at the back of the neck, and increases intensity in vibration until the user shifts their sleeping position. Snoring occurs most frequently when people sleep on their backs, so this product gently encourages the user to move into a different sleeping position and therefore stop snoring. It is worth noting, however, that people with neck, shoulder, or back pain, or a pacemaker, should opt for a different solution, as the Night Shift could interfere or negatively affect those conditions.


Winx is a machine that anyone who suffers from Obstructive Sleep Apnea should be able to try. Instead of a CPAP machine, which produces oxygen for the user, the Winx keeps the tongue and soft palate from falling back, subsequently blocking the airway. It uses a light vacuum and mouthpiece to accomplish this. Since it’s a newer therapy, not all insurance policies will cover it, but depending on your coverage, it could be an option.


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