As if the fear of heart attacks, brain damage and increased risk of car crashes due to being over tired are not enough to make people want to see a sleep apnea specialist I have just been reading about silent strokes.

The report on CNN’s Blog, I link to it below, is based on a study that was the focus of a presentation at the American Stroke Association’s conference. Silent strokes are called that because there are not always obvious side effects. You may not even know you have had one, or a whole number of these small strokes. So what is so bad?

Well they dramatically increase the risk of a major stroke and that is definitely bad news! The idea seems to be if we can reduce silent strokes then we can reduce the full blown noisy and damaging ones. That makes sense to me, and anything that can increase the amount of study that is done (and hopefully fixes found for) obstructive sleep apnea (osa) is a good thing.

http://thechart.blogs.cnn.com/2012/02/01/sleep-apnea-linked-to-silent-strokes/

When should an oral surgeon get involved with patients suffering from sleep apnea?

I am not sure whether dentists coming into the sleep apnea market is a good or a bad thing. I do think that every person who can be treated should get treated, but the root cause of Sleep Apnea is , not always but very often, being overweight so would it be better if we had nutritionists and weight loss experts enter the arena?

If an health insurance company is willing to spend two thousand dollars on the mouth piece that dentists are offering (is it just me or isn’t that the exact price that is charged for sleep testing)  why will they not spend the money on a diet plan. I bet they could get a huge discount from Jenny craig or weight watchers.

Anyway here is the link to the podcast - http://www.reachmd.com/xmsegment.aspx?sid=6524

Sleep Apnea has serious repercussions, heart problems, strokes and long term health issues. That is bad enough when you are over forty years old , imagine the damage to a kids body? The health problems that a child has will generally only get worse as they get old. That is true unless something is done about it, If a child has prediabetes then helping them to lose weight and eat a more healthy diet may well help them push diabetes far off into their future.

The problem that I see is no one thinks of kids when they are talking about sleep apnea. Should we be discussing this with parents of obese children as a possible problem. If the chance that they will have diabetes is not scaring them into looking after themselves more maybe the realization that they may have to wear a cpap mask for the rest of their days will do it.

How much is this going to cost the medical system over the next thirty years? Think on it if we have a whole generation where a third of them have all these medical issues just because we eat to much (I understand that may seem a simplistic view to many people but it is true) it will eventually make health insurance so expensive no one will be able to afford it. I mean even more so than we are already seeing.

Do you think there should be more done to help obese kids deal with it?

With the side effects being so serious I really do welcome any coverage that will get the information out to people.CPAP machines are not pretty and they can be really annoying but they do save lives. The news report talks about how dentists can help with some type of mouth guard. I have got no personal experience with that but I do wonder if merely opening your jaw a bit is going to help as much as having oxygen forced into your throat.

Anyway watch the video or read the report at kwwl.com

http://www.kwwl.com/story/16602511/dubuque-health-professionals-see-rise-in-sleep-apnea-patients

The show has various contestants, sometimes it is husband and wife, sometimes they have families and sometimes a totally different combination altogether. I watched the 1st season of the biggest loser and it was pretty good but people in the second season seemed mean so we stopped watching.

Anyway in this season one of the guys was a commercial truck driver, and the Dr on the show told him he has severe sleep apnea. Apparently a driver who has sleep apnea is over 200% more likely to be involved in a crash than someone who sleeps normally. So your husband is keeping you awake with his snoring and then he is twice as likely to be in a crash than you are (assuming you don’t suffer with it as well).

If that stat does not scare people into at least getting checked out by their Dr nothing will.

If you are, or you know someone who is, a truck driver you should be looking into the new mobile testing opportunities that we discussed in this post 

Huge thanks to Brett Emison for sharing the info and scaring the life out of me – Read more - http://kansascity.injuryboard.com/tractor-trailer-accidents/did-you-know-the-biggest-loser-highlighted-sleep-apena-problem-in-semi-truck-drivers.aspx?googleid=297760

It says they use the “Buteyko Method”, you can find more info on the class on their site

http://www.cleveland.com/chagrin-valley/index.ssf/2012/01/stop_snoring_and_sleep_apnea_b.html

If you do not live in Cleveland it does not really help you of course, but it does make me wonder if this kind of class is taught anywhere else. If you could learn to breath differently for less than $200 it would save health insurance companies and medicaid an absolute fortune. You know what that means don’t you..Dr’s who specialize in surgery and cpap machines will kill the idea stone dead before it gets tested.

If you have ever tried the “Buteyko Method” and had success , or not, please do get us know as I think it is an interesting idea.

My advice is to speak to your dentist,I know that it may not seem normal to tell a dentist about your sleep problems but they can help. My understanding is that your sleep is affected by the way you breath in and out while asleep. You breath in and out through your mouth, if your jaw line is not quite right then you breath badly and you snore and are possibly going to have sleep apnea.

I appreciate this is probably a very simplistic way of explaining it but that is how I see it. Your dentist can fit you for a sleeping guard that can help keep your lower jaw in a position which will allow more air to go down your throat, this reducing your snoring and the oxygen starvation which is one of the worst side effects of Sleep apnea.

Not every dentist will be able to help you with this, but I think it is worth calling your local one and see if they can help.

They are talking about a study from Taiwan, where it was found that people who reported sudden deafness were more likely than the general population to have suffered with sleep apnea.

This is the kind of info that can only really be found out as companies have access to huge databases of health insurance information. On the surface of it, and I do suggest you read the full page and then let me know what you think, it seems like great information but it doesn’t really help us in any way that I can think of.

I suppose if someone has been diagnosed they should be warned to look out for any problems with deafness. Read the full story and see if there

http://www.chicagotribune.com/health/sns-rt-us-study-apneatre80j1u4-20120120,0,4159769.story

This is all changing now, today I read a press release which included

Precision Pulmonary Diagnostics (PPD(R)) recently added portable monitor testing to its diagnostic offerings of sleep apnea in commercial drivers. PPD is an industry leader, providing turn-key sleep apnea disease management program and lab network.

There is such a big market for sleep apnea tests among commercial carriers that they have designed testing equipment that is portable. They quoted the govt as saying that as many as 28% of all commercial carriers have sleep apnea. That is a scary statistic if it is true, does that mean 1 in 4 of the truck drivers in the country are hauling heavy loads (and some dangerous ones) while they are suffering with the effects of sleep apnea.

A guy who has had a terrible nights sleep and is now driving a semi at some crazy speed is not a great idea. So I think the new portable testing units are a great idea. If they can make the freeways a safer place that has to be good doesn’t it?

The other upside of this testing is that it will save the health insurance companies a fortune, they can also test the full fleet a lot quicker than if the traditional testing methods are used.

You can read more about the new product and all the services they offer on their company website http://www.precisionpulmonary.com/ They even have a couple of videos, one from the employers point of view and one from the drivers point of view. A very informative and impressive site.

The article quotes the Annals of Internal Medicine

Women with mild to moderate apnea had a mortality rate of 0.94 per 100 person-years (P=0.034 compared with the control group)

Very few studies are done on women, even though 2-3 out of every hundred middle age women suffer with Obstructive sleep apnea.

In a 116-patient, observational study, those with severe obstructive sleep apnea had a cardiovascular mortality rate of 3.71 per 100 person-years compared with the control group’s rate of 0.28 per 100 person years (P< 0.001), Francisco Campos-Rodriguez, MD, from Valme University Hospital in Seville, Spain, and colleagues found.

Now I am not a Dr (and I have never played one on TV) but those numbers seem to prove that women have a real problem with sleep apnea. I am sure that there are ways other than using continuous positive airway pressure that they can reduce to reduce the number of deaths. As I mentioned in my post about sleep apnea treatment being big business there is so much money involved in the treatment and promotion of treatments for sleep apnea that maybe no one wants to really cure people.

Treatment = ongoing income
Cure = no more sales

I just wonder how many people would benefit from having $1900 spent on lifestyle training, cooking and nutrition training and things to change their life rather than paying for a sleep study and the ongoing costs of cpap machines.

That is my thought, not one I picked up from the study, which you can read more about  here –  http://www.medpagetoday.com/Pulmonology/SleepDisorders/30736

According to an article on Boston’s WBUR site testing for sleep apnea has become big business. The increase in costs to medicare annually have grown over $150 million from 2001 to 2009. Yes in eight years the cost to medicare has climbed to $235 million a year. When anyone says medicare is spending $x they actually mean we are, because our taxes page for medicare.

With a overnight sleep apnea test costing as much as two thousand dollars it is easy to see how it is costing us millions of dollars each year. Well make that hundreds of millions of dollars.

Sleep Apnea Testing

WBUR Spoke to Dr. Fred Holt medical director of Blue Cross Blue Shield in North Carolina and I have to say I was not really surprised to see him say that expensive tests are being done to early in the medical study. Just because someone snores it does not mean they have sleep apnea, if they do have sleep apnea they do not instantly need a cpap machine.

Some people would benefit from being put on a weight loss regime, they would reduce the risk of heart disease, reduce their high blood pressure and usually save their insurance company a fortune in future payouts.  Sleep apnea can cause very serious problems, such as a mini stroke and anyone from the heart association will tell you just how dangerous it can be.

All in all I found the article enlightening but also a bit upsetting (thinking of all the fraud) and that is a good thing as to me it means it is not a powder puff piece. Read the full article here:- http://www.wbur.org/npr/145182935/the-sleep-apnea-business-is-booming-and-insurers-arent-happy

The general story in the news report linked to here is that in late 2009 a lady who lived in Santa Fe was given surgery to help stop her snoring and improve her fatigue (the two main complaints we hear about from anyone who has sleep apnea). The ops failed and she had more ops, none of which seem to have helped and they may well have made it worse.

You can read more about the surgeons and law companies involved here:- http://www.setexasrecord.com/news/241198-sleep-apnea-surgery-leads-to-malpractice-lawsuit

My heart goes out to the lady in question, but as to whether or not the surgeon is to blame, well best to let the jury decide that I think

I have sleep apnea but Im sure I do not want to use a c-pap or an a-pap machine. Just looking for the next best solution. See your doctor and get a sleep study first you can’t leave  sleep apnea untreated. When you stop breathing, your blood doesn’t get oxygen. The danger isn’t so much that you won’t start breathing again , the danger is what happens when your body isn’t getting enough oxygen + the danger of what happens when you DON’T SLEEP because when you wake up several times an hour due to not breathing (and aware of it or not, you do) you DON’T SLEEP.

Before we start looking at the best solution for sleep apnea let’s look at the possible problems some more.
Not enough oxygen = heart problems. Ever wake up with your heart beating wildly?
Not enough sleep = more problems. Loss of concentration, Fatigue,General irritability (which causes problems at work and in relationships)

Trust me, the c-pap machine is the best solution for sleep apnea and you do get used to using it and you won’t even want to nap without one once your body and mind are reminded what REAL SLEEP feels like. That’s what you get with a cpap. IF you don’t like the first mask they try you on, move on to the next. There are a few different styles of c-pap mask available and since you will be wearing it nightly you should get one that works.

Weight Loss
One of the most common causes of sleep apnea and the easiest one to control is obesity. You control what you eat and how much exercise you get, eat less and exercise more and you will lose weight and as you lose weight you will see an improvement in your sleep apnea.

Main cause of sleep apea is obesity, so the best solution for sleep apnea is to lose weight. Thin people do suffer with it too but nowhere near so much as obese people.

Next option: Learn to play the Didgeridoo. Seriously. It teaches you circular breathing.

But, while you are losing weight and learning to play the Didgeridoo, for goodness’ sake get a CPAP machine and a good night’s sleep. You have to take this seriously, your life is more important than keeping someone awake with your snoring or overcoming the mental road block involved with learning to use a CPAP.

I never thought I would be able to sleep with one. For about a year I told myself that it would not help me sleep, that it would make it more difficult for my wife to sleep, that it would be uncomfortable…

The very first night I used CPAP it felt a little akward, but by the end of the first week ALL of my symptoms had disappeared. It has been three years now and I have no more headaches, no more muscle cramps, no more waking up several times a night with horrible heartburn or horrible sweating. My blood pressure and cholesterol have returned to normal. In one week I went from a 25 year old in danger of having a heart attack to a well rested guy who can just enjoy life again. I cannot even begin to explain how much better you will feel.

Get the CPAP and try it for a week. Just 7 days. If you can’t do it, talk to your doctor. There is a surgical procedure that can reduce apnea, however less then 30% of the people who have it see any significant change and most people must have the surgury repeated throughout their lives to stay symptom free.

Most importantly, do not ignore this condition. If you do you will continue to gain weight, the headaches will get worse. Your blood pressure will continue to skyrocket. You will develop holes in your stomach and esophogus from the acid. You will have a potentially fatal heart attack. Left untreated and supervised by a doctor this condition will kill you.

When people ask about the best solution for sleep apnea I generally tell them to get the CPAP, then work on losing weight..