overweight pilotsFAA has now revised its policy for pilots who now will be allowed to keep flying while being evaluated for the sleep apnea disorder.Facing a backlash from pilots and aviation lobbying groups, the FAA has reversed course on a controversial medical policy that would have grounded overweight pilots until they underwent screening for obstructive sleep apnea.
The FAA’s new medical screening guidance follows more than a year of lobbying efforts on behalf of several aviation organizations, including AOPA, the National Business Aviation Association and the Experimental Aircraft Association. As first revealed by the agency late in 2013, the FAA’s chief federal air surgeon sought to require that any pilot with a body mass index (BMI) of 40 or greater, and a neck size of 17 inches or greater, undergo obstructive sleep apnea screening prior to receiving a medical certificate.
The new policy, which takes effect March 2, will require overweight pilots who are diagnosed with OSA to receive treatment to continue flying.
AOPA President Mark Baker and NBAA President and CEO Ed Bolen both applauded the policy change, calling the revised guidelines a “common-sense approach” to medical certification.

gestational diabetesWomen who are diagnosed with gestational diabetes bear seven times probability of suffering with obstructive sleep apnea (OSA)  compared to the other pregnant women. A most recent research study concluded and due to be published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM) revealed

Pregnancy is associated with sleep disturbances. Sleep is more disturbed in GDM than in P-NGT women. There is a strong association between GDM and OSA.

Prime objective of the research study was to assess the relationship between pregnancy, obstructive sleep apnea (OSA) , and GDM.

“It is common for pregnant women to experience sleep disruptions, but the risk of developing obstructive sleep apnea increases substantially in women who have gestational diabetes,” said Sirimon Reutrakul, MD, who conducted the research at Rush University Medical Center in Chicago. “Nearly 75 percent of the participants in our study who had gestational diabetes also suffered from obstructive sleep apnea.”  Read the rest of this entry

Low Energy Diet Improves Sleep Apnea

low energy dietObese men with moderate to severe obstructive sleep apnea who followed a very low energy diet may maintain their initial improvements one year later.

Researchers at the Karolinska Institute in Stockholm, Sweden, assessed whether early improvements in obstructive sleep apnea after a very low energy diet were maintained one year later in 63 men, aged 30 to 65 years, with moderate to severe obstructive sleep apnea and body mass index of 30 to 40 kg/m². Participants were treated with continuous positive airway pressure and underwent a one-year weight loss program consisting of nine weeks of a very low energy diet followed by a weight loss maintenance program, which was completed by 44 men. The severity of sleep apnea was measured using the apnea hypopnea index. Read the rest of this entry

pregnant womenWomen with obstructive sleep apnea (OSA) and cardiac symptoms have a 31 percent incidence of cardiac dysfunction. Researchers have recommended use of echocardiograms should be considered in the clinical management of these women.

Obstructive sleep apnea (OSA) is characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. These pauses can last from at least ten seconds to minutes, and may occur five to 30 times or more an hour; this can lead to cardiovascular disease.

Researchers conducted an observational study with an objective to measure the incidence of OSA among pregnant and reproductive women.  Read the rest of this entry

People sleep significantly better and feel more alert during the day  if they get at least 150 minutes of exercise a week, a new study  concludes.

A nationally representative sample of more than 2,600 men and women,  ages 18-85, found that 150 minutes of moderate to vigorous activity a  week, which is the national guideline, provided a 65% improvement in  sleep quality. People also said they felt less sleepy during the day,  compared to those with less physical activity.

The study, out in the December issue of the journal Mental  Health and Physical Activity, lends more evidence to mounting  research showing the importance of exercise to a number of health  factors. Read the rest of this entry

University of Chicago scientists have dovered important new relationships between obesity, sleep-disordered breathing (SDB) and cognitive processing among elementary school children.

“The intricate interdependencies between BMI, SDB and cognition shown in our study are of particular importance in children, as their brains are still rapidly developing,” says study author Karen Spruyt, PhD, assistant professor in the Department of Pediatrics at the Pritzer School of Medicine. “Rising rates of obesity in children may amplify these relationships. Public health campaigns targeting obesity should emphasize not only the health benefits but the potential educational benefits of losing weight.”

The findings were published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. Read the rest of this entry

New Sleep Apnea Diagnosis Tool Developed

Two UB physicians have developed and patented a computerized screening tool that detects severe obstructive sleep apnea in cardiovascular patients.

The new neural network-based screening tool diagnoses sleep apnea based on a patient’s answers to questions about body mass index, neck size, the presence of hypertension and other clinical characteristics.

Between 30 and 50 percent of cardiovascular patients are believed to suffer from this potentially life-threatening condition, which prevents sufficient air from getting into the lungs. Many of them are undiagnosed.

In heart patients, obstructive sleep apnea can trigger,  heart attacks , atrial fibrillation and stroke. Read the rest of this entry

A new computer screening tool developed and patented by a UB physician is helping to detect severe obstructive sleep apnea in cardiovascular patients who have not yet been diagnosed with this common and potentially dangerous condition.

The study, funded by the U.S. Department of Veterans Affairs, is being conducted by a UB researcher at the Veterans Affairs Western New York Healthcare System.

The goal is to evaluate how well the computer screening tool developed at UB diagnoses sleep apnea in patients with heart disease, compared to an overnight sleep study, or polysomnography, considered the ‘gold standard’ for diagnosing sleep apnea.

“The importance of this grant is that it may give us a faster way to screen for sleep apnea in patients who are already at high risk but who are undiagnosed,” says principal investigator Ali A. El Solh, professor of medicine, School of Medicine and Biomedical Sciences, and professor of social and preventive medicine, School of Public Health and Health Professions. Read the rest of this entry

Obese, asthmatic, anxious or depressed children are more likely to experience excessive daytime sleepiness, or EDS, according to Penn State College of Medicine sleep researchers.

“Although excessive daytime sleepiness in children is commonly assumed by physicians and the public to be the result of sleep-disordered breathing or inadequate sleep, our data suggest that EDS in young children is more strongly associated with obesity and mood issues as it is in adults,” said Edward Bixler, professor of psychiatry and vice chair of research at the Sleep Research and Treatment Center.

Excessive daytime sleepiness is the inability to stay awake during the day, while sleep-disordered breathing is a group of disorders that includes sleep apnea, characterized by pauses in breathing. Read the rest of this entry

Just a month ago, the FDA approved the use of the Lap-Band® weight loss surgery procedure for patients with a Body Mass Index (BMI) of 30 or over that also suffered from obesity related diseases (comorbidities) such as type II diabetes, high cholesterol high blood pressure and sleep apnea. This loosening of the qualification guidelines for Lap-Band® surgery will have a profound effect on New Jersey residents who are seeking to undergo bariatric surgery in the future. Before this announcement, only patients with BMIs of 40 or more with no comorbidities or BMIs of 35 or more with one or more comorbidities could qualify.  A BMI of 30 or over qualifies a person as obese while 40 or over is considered severely obese.

The new regulations have opened up bariatric surgery as a weight loss option for thousands of New Jersey residents who would not have qualified for bariatric surgery under the old guidelines. According to the Centers for Disease Control 23.9% of New Jersey residents had a BMI greater than or equal to 30. As an example, while a typical 5’9” male with comorbidities needed to weight 237 lbs to qualify under the old criteria, they now only need to weigh 203 lbs. Read the rest of this entry

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