The most common form of treatment for sleep apnea is a continuous positive airway pressure (CPAP) device. This is a machine with a mask that is worn over the nose and mouth during sleep that forces air into the airway to keep it open. There may be another alternative, though, for people with mild to moderate sleep apnea.

Many people with sleep apnea have what is referred to as “positional” sleep apnea. This refers to apnea episodes that occur when the patient is sleeping on their back, but not when sleeping on their side. It is estimated that 20% of people with moderate sleep apnea (15 to 30 events an hour) and nearly 50% of people with mild (less than 15 events per hour) have positional sleep apnea.

People often don’t make the connection between their loud snoring at night and their complaints of tiredness during the day. According to Samuel Krachman, D. O., professor of medicine and director of the Sleep Disorders Center at Temple University School of Medicine and Hospital, “They think that they’re just tired, not getting enough sleep or just working too hard. But in reality, it’s related to the sleep apnea.”

The new alternative is called Zzoma. The Zzoma, created by former Temple Fellow Joseph G. Crocetti, is a device which is worn around the chest like a belt, with a firm foam pad wrapped in canvas to keep the patient from rolling onto their backs.

Dr. Krachman says that they have been studying the use of the Zzoma in treating patients with mild to moderate sleep apnea and have found that the Zzoma is less obtrusive and easier to use than a CPAP.

“Although CPAP is very effective, the best studies have shown it’s only used correctly 50 percent of the time,” says Dr. Krachman. “That leaves many diagnosed with sleep apnea but not treated.”

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Researchers have discovered a simple procedure that can reduce snoring caused by fluttering of the soft palate.

The research, conducted by a team from Mansoura University in Egypt, evaluated a nonsurgical procedure that involves injecting a sclerosing, or hardening agent into the upper palate. The procedure is called snoreplasty.

34 participants with simple snoring were included in the study. Of the 34 study participants, 32 reported significant improvements in their snoring. On average they received 1.8 injections. In addition, the patients reported no significant side effects.

Snoring can result from many conditions including alcohol consumption, age, being overweight, having a cold, the flu or allergies. There are certain medications that can increase the likelihood of snoring.

More serious snoring issues can be related to sleep apnea, a condition where the breathing stops repeatedly during sleep.

The Egyptian study only dealt with those patients that had simple snoring involving issues with the soft palate and not with snoring due to tongue or nasal problems.

The researchers concluded that injection snoreplasty is a simple, safe, low cost and effective office treatment for simple snoring.

The teams findings were presented at the American College of Chest Physicians conference being held in Philadelphia, PA.

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Studies have shown that people with obstructive sleep apnea (OSA) that affects their daytime alertness have an increased risk of cardiovascular disease. But according to a recent study, even those with mild sleep apnea, may be at a higher risk for cardiovascular disease.

Statistics show that only 1 out of 5 people with diagnosed obstructive sleep apnea experiences daytime sleepiness. This means that a large number of people are unaware on their condition and the negative effects on their health.

Dr. Malcolm Kohler, of the Oxford Centre for Respiratory Medicine, and a team of researchers conducted a controlled, cross-sectional study to determine the differences in arterial stiffness, endothelial function and blood pressure in 64 people with minimally symptomatic OSA and compared these to 64 people without sleep apnea.

The endothelium is the thin layer of cells that line the interior surface of blood vessels. One of its functions is to regulate blood pressure.

“In our study, the augmentation index, a measure of central arterial stiffness that independently predicts cardiovascular events in high-risk populations, was significantly higher in patients with minimally symptomatic OSA compared to matched controls,” said Dr. Kohler. “We also found impaired endothelial function as indicated by decreased vascular reactivity of their arteries compared to control subjects without OSA.”

According to Dr. Kohler patients with even mild sleep apnea may benefit from use of a continuous positive airway pressure (CPAP) device.

This study will be published in the November issue of the American Journal of Respiratory and Critical Care Medicine.

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Obstructive sleep apnea (OSA) has been increasingly recognized as a common and serious health condition. OSA can result in cardiovascular, as well as psychological and learning, impacts. These are attributed to intermittent hypoxia, the term for the intermittent deprivation of oxygen experienced by people with OSA.

According to the lead author of a new study, the drop in oxygen levels and inflammation associated with obstructive sleep apnea, over time, can lead to the death of brain cells. This “oxidative stress” causes architectural changes in the brain tissue related to learning and memory. The results of the study indicate that drinking 6 to 10 cups of green team can help offset that decline.

Dr. David Gozal, of the University of Louisville, and team of researchers studied the effects of green tea polyphenols (GTP), added to drinking water, on rats who were intermittently deprived of oxygen similar to the intermittent hypoxia (IH) effects of OSA on humans.

This study included 106 male rats that underwent intermittent oxygen depletion during a 12 hour night cycle for 14 days. Half of these were given the water treated with GTP, the other half were given plain drinking water.

The rats were then tested for markers of oxidative stress and inflammation, in addition to performance in learning and memory tasks.

The rats that were given the GTP water performed significantly better in the tests that those that received plain water. Also, the GTP supplemented rats showed 40% lower levels of markers of oxidative stress.

The antioxidants in green tea have been documented have been shown to improve many conditions, ranging from heart disease and high cholesterol to Alzheimer’s.

The study was published in the Journal of Respiratory and Critical Care Medicine.

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The results of a Swedish study indicate the obstructive sleep apnea (OSA) is related to decreased insulin sensitivity. Impaired sensitivity for insulin is a known risk factor for diabetes.
Jenny Theorell-Haglöw of the Uppsala University Dept of Medical Sciences, Respiratory Medicine and Allergology, and her team performed the study of 400 healthy women to determine the presence of sleep apnea and its relationship with impaired insulin sensitivity.

Theorell-Haglöw’s team found that, after drinking a standardized glucose solution, levels of both insulin and glucose increased more in the women with sleep apnea compared with women without sleep apnea.

In addition, the insulin and glucose levels remained elevated for a longer time in the women with sleep apnea compared with women without. Moreover, as the severity of the women’s sleep apnea increased the insulin sensitivity decreased. Both sleep apnea and diabetes are prevalent in the general population, and both are closely related to obesity. However, according to the research team, patients with sleep apnea had higher glucose and insulin levels even when obesity was taken into account.

They also found that different variables associated with sleep apnea are related to the impairment of insulin sensitivity, particularly nocturnal hypoxemia.

In their conclusion, the authors state that that sleep apnea affects both insulin and glucose levels and is linked with a decrease in insulin sensitivity in women.

They add: “Decreased insulin sensitivity should be considered when treating patients with OSA.” Their findings were published in the European Respiratory Journal

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Awareness is increasing about the dangers of sleep apnea. Risk of stroke and cardiovascular events are a couple of the serious impacts of this condition. But what about the impacts of apnea on a patient undergoing surgery for an unrelated condition?

A recent article in US News & World Report highlights the surgery-related risks of sleep apnea. The article is based on an interview with Dr. Frances Chung, professor at the University of Toronto’s University Health Network.

According to Dr. Chung, surgical patients with obstructive sleep apnea are more difficult to manage in terms of anesthesia. Those with apnea have a greater chance of problems such as postoperative complications, difficult intubation, admission to the intensive care unit, and a longer hospital stay. During the surgery the anesthesiologist is present to monitor breathing but afterwards the patient is alone with medical staff occasionally checking on them. It is during this time where the highest level of danger exists.

Most hospitals do not routinely screen for sleep apnea prior to surgery so it is important to consult with your surgeon if you know you have apnea. If you have a CPAP machine, the anesthesiologist will usually put you back on the CPAP after surgery.

Dr. Chung has developed the STOP tool which consists of a series of yes or no questions to screen for sleep apnea. The questions are:

S: Do you snore loudly?

T: Do you often feel tired, fatigued or sleepy during the daytime?

O: Has anyone observed you stop breathing during sleep?

P: Do you have or are you being treated for high blood pressure?

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