Sleep Apnea

  • Obstructive Sleep Apnea, Sleep Apnea

    7 Athletes and The Common Misconception About Obstructive Sleep Apnea

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    Original Post in CPAP.com | APRIL 12, 2019 7 MINS READ

    At Sleep Apnea Dentists of New England, we see many athletes of all skills and ages who are dealing with Obstructive Sleep Apnea. We stumbled upon this very useful article that directly addresses the current misconception of athletes and sleep apnea and found it shareworthy.

    Athletes and Sleep Apnea

    According to the American Sleep Apnea Association, as many as 22 million individuals1 in the U.S. struggle with obstructive sleep apnea (OSA) – men, women and children. And, 80 percent of moderate and severe OSA cases are undiagnosed. Researchers have also found you have a 46 percent higher risk of dying early when you have severe OSA, and this includes athletes with sleep apnea.

    Sleep Apnea Misconceptions

    Surrounding these statistics though are misconceptions about sleep apnea that keeps an individual from receiving a diagnosis ― and being treated.  A couple of common sleep apnea myths are:

    Sleep Apnea Only Affects People Who Are Overweight

    OSA is often viewed as being closely related to an above-average BMI. While many individuals with a diagnosis are overweight, there’s still many who are at an average weight. Anyone of any size or shape can get sleep apnea. Genetics can sometimes play a role.

    But, OSA does decrease how much restful sleep an individual gets each night and some studies do show a link between weight gain and insufficient sleep2.

    However, another study shows a link between CPAP therapy for sleep apnea and weight gain and that it can increase both weight and BMI (Body Mass Index). To experience CPAP and weight loss at the same time, you should combine your therapy with a healthy lifestyle that includes:

    • A healthy diet
    • Not smoking
    • Exercise
    • Quality sleep
    • Taking care of yourself

    Sleep Apnea Only Affects Men

    The common misconception is that sleep apnea only affects men. Sure, men do tend to receive more diagnoses of the condition than women, but women do get it too. Most women develop sleep apnea following menopause, with around six percent of them having it. And, female patients now make up 45 percent of sleep study referrals.

    Not only does sleep apnea affect both men and women, but celebrities with sleep apnea aren’t uncommon either. In fact, there are many famous athletes who have or had sleep apnea.

    7 Athletes With Sleep APnea

    1. Shaquille O’Neal, who goes by the nickname “Shaq” is a retired professional basketball player in the U.S. He raised sleep apnea awareness by featuring in the four-minute video, “Shaq attacks sleep apnea,” where it shows him interacting with sleep specialists from Harvard as they prep him for an overnight sleep study. He’s also the global ambassador of ZYPPAH — a solution to snoring3.

    Shaquille O’Neal tells Bill Littlefield about his academic struggles as a kid, his growth at LSU and his current work as a children’s book author. (Courtesy Turner Sports)

    2. Ryan Jensen, who is offensive lineman of the Baltimore Ravens told ABC news, “an obstructive sleep apnea diagnosis saved my career.” 4. He lost a lot of weight and strength and was cut from the team. After using a CPAP machine for several nights, it “changed everything.” His weight went up after one month of use, his strength returned, and he even returned to the team.

    3. Reggie White, a two-time NFL Defensive Player of the Year, died prematurely because of sleep apnea5. His widow, Sara, created the Reggie White Foundation, which helps to raise awareness of the condition.

    The new kid in town met some of the other kids in town for a Green Bay training camp tradition, July 1993. John Biever/Sports Illustrated

    4. Roy Green, a retired NFL wide receiver, has now started focusing on promoting awareness of sleep apnea6 all over the country to help improve both current and former professional athletes’ health. He’s teamed up with David Gergen, dental icon and the Pro Player Health Alliance to help hold free local community public awareness events all over the nation.

    5. Warren Sapp, Super Bowl champion, was prompted to seek treatment after the death of Reggie White, his friend and fellow football star. Through the Sleep Apnea Prevention Project7, he now helps raise sleep apnea awareness.

    Warren Sapp, a former defensive tackle for the Tampa Bay Buccaneers and the Oakland Raiders. Robert B. Stanton/NFLPhotoLibrary

    6. Percy Harvin, former NFL wide receiver, received a sleep apnea diagnosis in 2010 after collapsing at practice. He talked to reporters during an interview about how CPAP therapy made him immediately feel much better. In fact, he said “It’s a 100 percent difference.”8

    7. Josh James, a pitcher for the Houston Astros found his performance was lacking in between the 2016 and 2017 seasons. He sought help from a sleep specialist and was diagnosed with sleep apnea. After starting treatment, he saw his symptoms (and performance on the field) improve dramatically.

    Why Do Some Athletes Get Sleep Apnea?

    In recent years, Sleep-disordered breathing like OSA has gained notoriety within the athletic community. The prevalence of OSA in the NFL is around 14 to 19 percent and has a two to five percent estimated prevalence rate in the general U.S. population9.

    NFL players have a higher susceptibility of possibly developing OSA due to risk factors9 like having a large waist circumference and high prevalence of obesity.  NFL linemen could be especially susceptible because they usually have a higher BMI.

    Athletes, while often in great physical condition, have “thick” necks10 due to excessive weightlifting and having to carry around extra weight required for pushing others around the football field. This is another risk factor of sleep apnea.  The extra fat or muscle tissue on the neck can cause the wall of the windpipe to become thicker and make it more difficult to keep the airway open when the body’s in a relaxed state.

    Other muscular athletes, like football players, who carry extra weight11 have a risk for sleep apnea-related health concerns like stroke, high blood pressure, and other life-threatening problems.

    Today, we live in a culture that’s celebrity-obsessed. Because of this, professional athletes that have sleep apnea can help raise awareness of the condition, making a difference toward public education. When the public sees athletes with sleep apnea that are tackling it, it makes a great impression.

    David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

    References

    1. American Sleep Apnea Association. Sleep Apnea Information for Clinicians Published on their official website. Accessed April 12, 2019.

    2. Harvard University Medical Center. Sleep and Health Published on their official website. Accessed April 12, 2019.

    3. Press Release. ZYPPAH® Signs Shaquille O’Neal as its Global Brand Ambassador Accessed April 12, 2019

    4. Thorbecke, Catherine, et al. NFL star Ryan Jensen says Sleep Apnea Diagnosis ‘Saved my Career’ ABC News. Accessed on April 12, 2019.

    5. Reggie White Foundation About Us. Accessed on April 12, 2019.

    6. Press Release. Arizona Cardinals’ Alumni Roy Green Joins Pro Player Health Alliance To Spread Awareness Of Sleep Apnea At An Event Hosted By Dr. Bradley Eli At Scripps Memorial Hospital Accessed on April 12, 2019.

    7. Zyppah, Inc. Warren Sapp – Sleep Apnea Prevention Project Video Segment 1 Published on YouTube. Accessed on April 12, 2019.

    8. Associated Press. With Sleep Apnea Diagnosis Percy Harvin Believes His Migrane Problems are in the Past. Published by Fox News. Accessed on April 12, 2019.

    9. Rogers, April J et al. “Obstructive Sleep Apnea among Players in the National Football League: A Scoping Review.” Journal of sleep disorders & therapy vol. 6,5 (2017): 278. doi:10.4172/2167-0277.1000278 Accessed on April 12, 2019.

    10. National Center on Sleep Disorders Research. “Problem Sleepiness in Your Patient” Published on their official website. Accessed on April 12, 2019.

    11. National Institute of Diabetes, Digestive, and Kidney Diseases. Health Risks of Being Overweight. Published on their official website. Accessed on April 12, 2019.

  • Sleep Apnea

    Sleep Apnea Treatment Linked with Lower Health Care Costs

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    Original Post | SleepReviewMagazine, Published on October 15, 2019

    Piggy Bank showing cost savings from treatment of sleep apnea

    Treating patients with moderate or severe obstructive sleep apnea with positive airway pressure (PAP) therapy is associated with reduced acute care visits and health care expenditures, according to a recent study.

    Every one-hour increase in PAP usage per night was associated with an 8% decrease in inpatient visits (rate ratio 0.92) and a 4% decrease in overall acute care visits (RR 0.96). PAP adherence also was associated with a significantly lower number of emergency department visits and inpatient stays, and increasing PAP usage was associated with a lower likelihood of having positive costs from these visits. Among patients with emergency department costs, PAP adherence was associated with 27% lower costs.

    “While it’s not surprising that treatment of moderate or severe sleep apnea is good for overall health, the fact that PAP treatment in a relatively short time frame was associated with an impact of this significance was unexpected,” says lead author Douglas B. Kirsch, MD, American Academy of Sleep Medicine president, medical director of sleep medicine at Atrium Health in Charlotte, NC, and clinical professor in the Department of Medicine at UNC School of Medicine, in a release. “In addition, while many older research trials suggested patients were not often adherent to PAP therapy, this study of more than 1,000 patients suggests that with appropriate education and support, a significant majority of patients are likely to use PAP therapy in an effective manner.”

    The study was published in the Sept 15 issue of the Journal of Clinical Sleep Medicine.

    The authors conducted a retrospective cohort study of adult patients who initiated PAP therapy after a diagnosis of moderate or severe sleep apnea at a large integrated health system between 2014-2016. The study consisted of 1,098 patients (average age 55.7 years, 66.3% male) who had at least 18 months of available data after PAP therapy was initiated. Treatment adherence was defined as using PAP more than four hours per night for at least 70 percent of the studied nights.

    Results show that 60% of the study population was adherent to PAP therapy, and the overall average percentage of nights with PAP usage of more than four hours was nearly 70%. The average use on nights when PAP was used was 6.4 hours per night, and the average use on all nights was 5.3 hours.

    “Patients, clinicians and health systems should recognize that effective treatment of sleep apnea is valuable in both an individual’s health and as a mechanism to keep overall medical costs lower for the patient and the health system,” says Kirsch. “This study suggests that a significant majority of patients not only tolerate but are adherent to therapy over an 18-month time frame when given effective education and support.”

  • Sleep Apnea

    Sleep-Disordered Breathing Tied to Accelerated Aging

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    Original Article Medscape Medical News | Megan Brooks, June 13, 2019

    SAN ANTONIO — Sleep-disordered breathing (SDB), and the disruption in nightly sleep it causes, speeds up the aging process, according to preliminary research.

    SDB is a common disorder that results in oxidative stress and inflammation and is associated with several age-related health disorders. However, it hasn’t been well studied with respect to epigenetic aging.

    “To our knowledge, this study is the first empirical study that has linked sleep-disordered breathing with epigenetic age acceleration,” Xiaoyu Li, ScD, of Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, told Medscape Medical News.

    The study was presented here at SLEEP 2019: 33rd Annual Meeting of the Associated Professional Sleep Societies.

    Elderly Looking Woman

    Women are particularly vulnerable. 

    The study included 622 adults (mean age 69 years, 53% women) from the Multi-Ethnic Study of Atherosclerosis (MESA). All participants underwent polysomnography; DNA methylation, a marker for epigenetic age acceleration, was measured in blood samples.

    Age acceleration measures were calculated as residuals from the regression of each epigenetic age on chronologic age. The association of each SDB trait with age acceleration was estimated using linear regression, controlling for sociodemographics, health behaviors, body mass index, and study site.

    Increasing SDB severity and sleep disruption were associated with epigenetic age acceleration, independent of measured confounders, Li reported.

     

    Read The Full Article Here
  • Sleep Apnea

    Impulsive Behavior in Children Linked to Sleep and Screen Time, Study Says

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    Original Post | Sleep Review Magazine, Published on August 22, 2019

    Children and youth who do not sleep enough and use screens more than recommended are more likely to act impulsively, recent research published in Pediatrics suggests.

    Impulsive Sleep Deprived Child Jumping on Bed

    The findings come from the Healthy Active Living and Obesity Research Group (HALO) at the CHEO Research Institute in Ottawa.

    “Impulsive behavior is associated with numerous mental health and addiction problems, including eating disorders, behavioral addictions and substance abuse,” Michelle Guerrero, PhD, lead author and postdoctoral fellow at the CHEO Research Institute and the University of Ottawa, says in a release.

    “This study shows the importance of especially paying attention to sleep and recreational screen time, and reinforces the Canadian 24-Hour Movement Guidelines for Children and Youth. When kids follow these recommendations, they are more likely to make better decisions and act less rashly than those who do not meet the guidelines.”

    The Canadian 24-Hour Movement Guidelines for Children and Youth recommends 9-11 hours of sleep per night and no more than 2 hours of recreational screen time per day.

    The paper analyzed data for 4,524 children from the first set of data of a large longitudinal population study called the Adolescent Brain Cognitive Development (ABCD) Study, which will follow participants for 10 years. In addition to sleep and screen time, the ABCD study also captures data related to physical activity. Physical activity is a third pillar of the Canadian 24-Hour Movement Guidelines, which recommend at least 60 minutes of moderate to vigorous physical activity daily.

    The ABCD study allowed Guerrero and her team to look at the three pillars of the movement guidelines against eight measures of impulsivity, such as one’s tendency to seek out thrilling experiences, to set desired goals, to respond sensitively to rewarding or unpleasant stimuli, and to act rashly in negative and positive moods. The study results suggest that meeting all three pillars of the movement guidelines was associated with more favorable outcomes on five of the eight dimensions.

    Guerrero and her team say that studies using feedback devices to measure the movement behaviors in future research will help further our understanding of how physical activity, screen time, and sleep relate to children’s impulsivity.