sleepImageAcross the globe more than a million exhausted people with sleep apnea—a sleep and breathing disorder caused when throat muscles relax and block the airway during sleep—get into car accidents, causing over a thousand deaths every year.

 Apnea is linked to obesity, heart disease, diabetes, an additional $3.4 billion in medical costs, and $16 billion in auto collision costs. Even though apnea has telltale signs (loud snoring, daytime fatigue), it remains totally undiagnosed in almost 75 percent of the people.

Polysomnography, the only diagnostic sleep study for sleep apnea is not cheap generally. the standard medical sleep study, requires a medical technician to attach 22 wires to a person’s body and monitor them all night long. The average cost is nearly $3,000. This is quite an out of the pocket expense for anyone. Follow-up tests are even more cost bearing and burdensome. The idea of doing clinical sleep studies once a month to monitor progress is a diagnostic crack-pipe fantasy. Read the rest of this entry

sleep disorder in military personnelA recently concluded research study attempted describing the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders.

This retrospective cross-sectional study was conducted with the military medical treatment facility involving active duty military personnel with diagnostic polysomnogram in 2010.

Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Read the rest of this entry

Home Sleep Apnea Testing At Kendallville

home sleep apnea testingSleep apnea is a deadly disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times.

The home sleep apnea testing started in the month of January. Till the availability of home based sleep apnea testing only the sleep centers at Cameron Hospital in Angola, DeKalb Health in Auburn, Parkview Noble Hospital in Kendallville and Parkview LaGrange Hospital in LaGrange used to offer such tests. Sleep testing at a sleep center involved spending the night in the hospital and wearing wires connected to monitors.

Weldon Cline, the Parkview Noble polysomonographer technologist says that some people may be eligible to have these tests done in the comfort of their own homes.  Read the rest of this entry

Economic Impact of Obstructive Sleep Apnea

NovaSom, Inc., the leader in home sleep testing for Obstructive Sleep Apnea (OSA) management, announces it has collaborated with Jefferson School of Population Health to convene the first expert advisory board exploring the impact of undiagnosed OSA on healthcare costs and productivity in the workplace. The unique event brought together top industry thought leaders to discuss new avenues for employers to administer OSA screening, diagnosis and treatment for employees in an effort to manage the growing OSA epidemic within their organization. It took place in Washington, DC on March 9, 2012. Read the rest of this entry

New Home Sleep Testing Classification System

A new classification system detailing the type of signals measured by home sleep testing devices for diagnosing obstructive sleep apnea (OSA) appears in the latest issue of the Journal of Clinical Sleep Medicine.

The proposed system categorizes home sleep testing devices, called out-of-center (OOC) testing devices in the paper, based on measurements of Sleep, Cardiovascular, Oximetry, Position, Effort, and Respiratory (SCOPER) parameters. Criteria for evaluating the devices are also presented, based on pre-test and post-test probabilities.

The first widely used classification system for describing sleep testing devices was published by the American Academy of Sleep Medicine (AASM) in 1994. Read the rest of this entry

A newly concluded research study findings published online in the European Respiratory Journal, evaluated the impact a Mediterranean diet can have on obese people with sleep apnea, compared to those on a prudent diet.The study revealed that Mediterranean diet combined with physical activity can help to improve some of the symptoms of sleep apnea.

Obstructive sleep apnea syndrome (OSAS) causes frequent pauses of breathing to occur during sleep, which disrupts a person’s normal sleeping pattern. It is one of the most prevalent sleep-related breathing disorders with approximately 2-4% of the adult population experiencing the condition. This percentage increases up to 20-40% with obesity, and weight loss is often an essential part of the recommended treatment plan.

The researchers, from the University of Crete in Greece, examined 40 obese patients suffering from OSAS. Twenty patients were given a prudent diet to follow, while the other 20 followed a Mediterranean diet. Both groups were also encouraged to increase their physical activity, mainly involving walking for at least 30 minutes each day.

In both groups, the patients also received continuous positive airway pressure (CPAP) therapy which involves wearing a mask that generates an air stream, keeping the upper airway open during sleep. Read the rest of this entry

SleepApneaDisorder/[ Press Release ]/ GLEN BURNIE, Md. /Oct 11, 2011/ NovaSom, Inc., the market leader in technology-driven, payer-aligned cost-saving solutions for obstructive sleep apnea (OSA) management, today announced it has entered a preferred relationship to aid HealthAmerica with managing its sleep disorder diagnostic expenses. Under the agreement, HealthAmerica will direct physicians and patients to the NovaSom(R) Home Sleep Test (HST) instead of in-facility testing for diagnosing OSA, when clinically appropriate. In addition to managing costs, patients overwhelmingly prefer the privacy, convenience and cost savings associated with home testing.HealthAmerica is driving the adoption of home sleep tests as the preferred solution for addressing the OSA epidemic,” said John Wallendjack, MD, Medical Director, HealthAmerica. “NovaSom has invested in clinical content, work flow process and technology solutions to enable us to rationalize OSA diagnosis and redirect testing to the home, when clinically appropriate.” Read the rest of this entry

The benefits of continuous positive airway pressure machines (CPAP) for patients with obstructive sleep apnea (OSA) are quickly reversed when the therapy is withdrawn, according to Swiss research. The findings appear online in the articles-in-press section of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

“In patients with obstructive sleep apnea who are established on CPAP treatment, withdrawal of the therapy is associated with a rapid recurrence of OSA and sleepiness within a few days” said Malcolm Kohler, MD, senior consultant at the Sleep Disorders Centre and Pulmonary Division of the University Hospital in Zurich. “After 14 days of CPAP withdrawal, OSA patients experienced considerable increases in heart rate and blood pressure as well as a deterioration in vascular function.” Read the rest of this entry

A multidisciplinary clinical practice guideline, “Polysomnography for  Sleep-Disordered Breathing Prior to Tonsillectomy in Children“, was  published as a supplement to the July issue of Otolaryngology—Head  and Neck Surgery. This guideline provides otolaryngologists with  evidence-based recommendations for using polysomnography in assessing  children, aged 2 to 18 years, with sleep-disordered breathing (SDB) and  who are candidates for tonsillectomy, with or without adenoidectomy.

Polysomnography (PSG) is presently the gold standard for diagnosing  and quantifying sleep-disordered breathing in children. SDB affects  approximately 12% of children with manifestations ranging from simple  snoring to potentially serious conditions, including sleep apnea. SDB is  also the most common indication for tonsillectomy with or without  adenoidectomy in the United States. Since more than 530,000  tonsillectomies are performed annually on children younger than the age  of 15, primarily for SDB, clear and actionable guidance on optimal use  of PSG is strongly needed. Read the rest of this entry

Impaired brachial flow-mediated dilation (FMD) is associated with risk for subsequent cardiovascular events in patients after myocardial infarction (MI). These patients often have obstructive sleep apnea (OSA). We tested the hypothesis that patients with OSA post MI will exhibit more severe impairment in FMD.

The researchers studied 64 patients with MI admitted to our hospital. Obstructive sleep apnea was determined using polysomnography. FMD was measured using high-resolution ultrasonography, with researchers blind to the obstructive sleep apnea (OSA) diagnosis.

The mean age was 60 ± 11 years, and the mean BMI was 29 (26, 32 kg/m2), 84% of patients were men, 39% had moderate to severe OSA (apnea-hypopnea index [AHI] > 15), and 31% of the patients had  mild OSA (5 ? AHI < 15). FMD was severely impaired in patients with moderate to severe OSA (0.8% ± 0.7%) as compared with patients without OSA (4.7% ± 0.8%, P = .001) and with mild OSA (3.9% ± 0.8%, P = .015). Linear regression showed that FMD was associated with log nocturnal nadir oxygen saturation (minSao2) (? = 31.17, P = .0001), age (? = ?0.11, P = .006). MinSao2 was an independent predictor of FMD after adjustment for possible confounders (? = 26.15, P = .001).

FMD is severely impaired in patients with moderate to severe OSA post MI, which may be partially related to nocturnal hypoxemia. Patients with  obstructive sleep apnea may, therefore, be at higher risk for subsequent cardiovascular events after an MI. Identifying and treating   obstructive sleep apnea may have important implications in the long-term prognosis of patients post MI. Further studies are necessary to determine if the presence of OSA would affect the long-term occurrence of cardiovascular events after an MI.

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