Adrian ZACHER

A third category of oral appliance for sleep?

noreply@blogger.com (Adrian Zacher MBA) — Mon, 14 Nov 2011 09:37:45 PST

A third category of oral appliance for sleep?

Custom made and universal 'One-Size-Fits-All' oral appliances comprise I believe two categories of oral appliance for snoring and sleep apnea. On my June 2011 trip to the American Academy of Dental Sleep Medicine (AADSM) meeting in Minneapolis, I enjoyed a glass with long-time associate Prof. John Remmers and saw his business partner SomnoMed, launch his company's (Zephyr Sleep Technologies) product, now branded the SomnoMed MATRx. Cadwell Therapeutics also entered this third category with the 'Silent Sleep' and finally Advanced Brain Monitoring displayed the 'ApneaGuard' in a perhaps more low-key manner.

On Saturday 12th November 2011, I attended the German Dental Sleep Medicine Society meeting in Mannheim where I observed Air Aid Sleep introduce their Predictor appliance that used the Respident mechanism.

This year, I have witnessed the competitive emergence of a third category of oral appliance for sleep. The 'Predictor'. A Predictor appliance is NOT intended to provide therapy. This new third category finally emerging commercially, interests me as in 2003, I patented an oral device with the design intention being to determine whether:

Can a patient wear an oral appliance

a challenge for some patients that I consider remains underestimated

Does it work?

subjectively = no more snoring with partner reporting (during this time they also have the opportunity to learn to tolerate wearing an oral appliance - or perhaps NOT!)
objectively = in a sleep lab setting enabling a Physician to feel comfortable 'signing off' that this patient will be effectively treated with an oral appliance in the position determined by the 'predictor' appliance

So, let's define what constitutes a valid predictor device as opposed to a universal 'treatment' device. In my view a Predictor appliance should include these design features, it should:

Be low cost or free else it defeats the point
Permit a short period of wear to determine the patient's ability to tolerate and persevere with oral appliance therapy
Be self-limiting and sacrifice discreet design for functionality, as it is intended to provide the ability to adjust mandibular protrusion in a monitored sleep setting, consequently, the mechanism needs to be extra-oral (outside the mouth)
Retentive (hold the teeth and therefore the mandible) in a protrusive position
Adjustable in protrusion incrementally (ideally, <1mm increments)
Not give rise to posterior interference on protrusion
Permit free lateral movement
Permit adjustment or present a limit to vertical opening
Exhibit the usual bio-compatibility requirements and ideally be autoclavable

I think it is important to repeat that a Predictor appliance is NOT intended to provide therapy.

So what?
If sleep apnea patients' are to be effectively treated the medical and dental profession must work together in a patient centric way. Predictor appliances are perhaps the means to build the 'bridge' between the two.

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Movember

noreply@blogger.com (Adrian Zacher MBA) — Tue, 01 Nov 2011 02:15:13 PDT

Movember

During November each year, Movember is responsible for the sprouting of moustaches on thousands of men’s faces in the UK and around the world. The aim of which is to raise vital funds and awareness for men’s health, specifically prostate cancer and other cancers that affect men.

So, I have donated my face and am intending to grow a proper Magnum PI 'tash'. You can follow my efforts (with regular photo updates!) and donate here: http://uk.movember.com/mospace/1464728/

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Chocolate is good for you - its true - well maybe...

noreply@blogger.com (Adrian Zacher MBA) — Sat, 02 Jul 2011 07:00:06 PDT

Chocolate is good for you - its true!

For a while now chocolate has been linked with making you feel loved when you eat it or it acting as an aphrodisiac. Some people think its better than a passionate kiss with their partner - chocolate gives a bigger buzz...

Recently, while in London I noticed a campaign by a chocolate company on the side of a bus extolling the virtues of a certain chocolate, that was promoted as having lots of anti-oxidants. I'd love to try it !

Does chocolate affect alertness, sleep or your health?

Chocolate contains, apart from calories and fat (not so great), tiny amounts of caffeine, theobromine and phenylethylamine. Caffeine you may recognise as a stimulant and it could therefore be thought to perk you up if consumed in the morning or disrupt your sleep if consumed in the evening.

The continental breakfast of a pain au chocolat would seem to fit as a perker upper. However, it may be that the chocolate is too processed. Also realistically the amount of caffeine in chocolate is tiny compared to a cup of coffee (about one tenth).

But what about the other substances mentioned and even perhaps an interaction between them - some recent research considers chocolate a 'super food'. Reputedly with lots of anti-oxidants and flavonols and this links up with my previous post on 'Chocolate as brain food' where blood flow in the brain was thought to be positively impacted.

Turn it around the other way - if a high cocoa solid, unprocessed chocolate was consumed in the evening it would seem reasonable to suggest it would interrupt sleep.

The lesson here is that eating around 150g of an unprocessed high cocoa solid (above 70%) dark chocolate, about 3 times a week before lunch is a good thing!

Chocolate better than kissing?

http://news.bbc.co.uk/1/hi/health/6558775.stm

Found these online that purport to have health benefits:

http://xocai.co.uk/

http://www.healthbychocolate.com/products.html

Chocolate the new 'super food'?
http://www.journal.chemistrycentral.com/content/5/1/5

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleepless in Minneapolis

noreply@blogger.com (Adrian Zacher MBA) — Sat, 18 Jun 2011 19:04:48 PDT

Sleepless in Minneapolis

Last week, I had the privilege of attending both the American Academy of Dental Sleep Medicine meeting and the Associated Professional Sleep Societies meeting in Minneapolis, Minnesota. It was very good to see old faces and new and follow the developments in technology and research.

Two interesting trends became apparent to me in response to both medical and business concerns over whether an individual patient will respond to treatment, if they do how much they will respond and given that they do - how do we know that they are using the therapy.

Three companies commercial drive to eliminate, in a sleep laboratory, the unknown response of an individual patient to mandibular protrusion - "Does it work" - prior to construction of a custom mandibular repositioning device - and ideally then what jaw relationship is effective can be transferred to the laboratory for custom device construction. Making the in sleep lab tool - 'diagnostic'.
What is known as 'objective compliance monitoring' has been recognised as necessary for research studies. This technology can address scepticism over how long a patient actually wears a device and for payment providers it means they will get paid for a 'compliant' patient. The first poster using a temperature monitoring technology derived from orthodontics, was unveiled by Olivier Vanderveken using the RespiDent device.

Finally, Professor Cistulli kindly gave a 'sneak peak' of his as yet unpublished paper comparing oral appliance therapy with positive air pressure therapy, in which the establishment upsetting outcome was that custom adjustable oral appliances for obstructive sleep apnoea 'were not inferior' to positive airway pressure therapy. Watch out for that paper later this year he says.

Overall, a fascinating week - if they could just provide a 'cure' for jet lag....

Temperature based technology to monitor oral appliance wear rates:
http://www.english.thera-mon.com/the-product/index.html

Respident:
http://www.respident.com

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleep in the News

noreply@blogger.com (Adrian Zacher MBA) — Tue, 26 Apr 2011 01:32:05 PDT

Ed Miliband diagnosed with obstructive sleep apnoea
Tempting as it is to conjure up a more dramatic headline about the Labour party and Sleep... I will confine myself to merely pointing out that Ed Milliband is in the news as apparently having obstructive sleep apnoea. I find it curious how ENT has become involved.

The second story in the news involves some interesting 'advice' about sleep as one of the 'Seven Daily Sins'. It would at first appear to sanction fragmented sleep. However, what I believe Prof Horne is attempting to do is convey a simple message in an attempt to break a common insomnia spiral. The real message I would suggest is "Not to worry about not sleeping" as this worrying in itself may be the reason the individual is not sleeping.

http://www.independent.co.uk/news/uk/politics/the-mps-surgery-ed-votes-for-a-nose-job-2273734.html

http://www.dailymail.co.uk/health/article-1380504/Seven-daily-sins-Shower-day-Rinse-brushing-teeth-These-healthy-habits-devilishly-bad-you.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Take life in your stride - sleep more

noreply@blogger.com (Adrian Zacher MBA) — Mon, 21 Mar 2011 03:57:52 PDT

Take life in your stride - sleep more

The effects of inadequate sleep, brought about through insomnia, sleep apnoea or your partner's snoring has recently been highlighted in the Daily Mail. The author focuses on insufficient sleep and its impact on his own mood but also other physiological effects. It makes interesting and accessible reading also highlighting caffeine consumption and appetite hormone release.

I also noticed another link on the same page about snoring. Sadly, while highlighting that snoring was disrupting the partner's sleep and perhaps their own (potential sleep apnoea) it didn't offer any solution other than leave! Interestingly, it did highlight that snoring was cited in 6% of divorce proceedings...

Interesting also to see that my theory regarding computer screens (TV makes you fat) disrupting melatonin production has been proposed again in a recent study. The sleep loss article makes reference to the fact that we sit much closer to a laptop screen than a TV.

http://www.dailymail.co.uk/health/article-1367811/Sleep-How-losing-just-hours-sleep-YEARS-life.html

http://www.dailymail.co.uk/femail/article-1366968/Snoring-OK-I-admit-I-snore-husband-sounds-like-wounded-warthog.html

http://dx.doi.org/10.1016/j.pedhc.2010.12.002

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Artificial lights that help you sleep?

noreply@blogger.com (Adrian Zacher MBA) — Tue, 08 Feb 2011 05:04:40 PST

Artificial lights that help you sleep?

Melatonin is thought to play an important role in regulating your circadian rhythm. Following on the previous theme of 'light temperature', melatonin, sleep and the impact of this on your health. It seems that artificial light sources that produce a warm yellowish light in the evening have a less detrimental effect on your melatonin production - meaning you may sleep better and for longer.

Artificial lighting is graded from warm yellow though bright blueish tone lights and onto daylight. A light source of 3000k is called 'warm white' (yellower),

Colour Temperature

2700K = Warmwhite
3000K = Warmwhite
4000K = Coolwhite
6500K = Daylight

Having had a look at the new lights available, I recommend the latest LED lights of 2700k or less would be good, that now have both the capability to be dimmed - reducing the lumen (how bright it is) - and are available in a range of 'k' or light temperatures. Could make sense from several perspectives to consider them - low power consumption (£$) and better sleep for you.

Here is what Philips produce as a guide and below that a link explaining more about colour temperature.

http://www.lighting.philips.co.uk/pwc_li/gb_en/subsites/oem/download/masterled/master_led_brochure.pdf

http://www.seesmartled.com/kb/colortemp.php

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Artificial light, melatonin and now cancer!

noreply@blogger.com (Adrian Zacher MBA) — Fri, 04 Feb 2011 03:13:35 PST

Artificial light, melatonin and now cancer!

Following on from my January blog post 'TV makes you Fat?' where I explored the link between artificial light, melatonin and obesity, another perspective - cancer - has been recently highlighted by the Daily Telegraph as a downside.

Bluer light waves from energy saving light bulbs are speculatively thought to result in higher breast and possibly prostate cancer rates if used late at night, claimed Professor Abraham Haim. The artificial light (from any source) even perhaps your TV, is thought to depress melatonin production.

A German paper from 1999 explored whether winter darkness for an Arctic population inhibited cancer from beginning in the first place. Personally, I elected over two years ago to place opaque blinds in the bedroom so that I slept past 5am in the summer and am now investigating reduced lighting in the evening.

Does winter darkness in the Artic protect against cancer? The melatonin hypothesis revisited.

http://www.ncbi.nlm.nih.gov/pubmed/10499816

Light as an alerting stimulus

http://www.ncbi.nlm.nih.gov/pubmed/17691225

Lighting for the human circadian clock:
http://www.ncbi.nlm.nih.gov/pubmed/15325001

Prof Haim's piece: Does the Modern Urbanized Sleeping Habitat Pose a Breast Cancer Risk?

http://www.international-light-association.org/pdf/CBI-Urban-Light.pdf

Daily Telegraph:

http://www.telegraph.co.uk/health/healthnews/8288982/Energy-saving-light-bulbs-could-trigger-breast-cancer.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Trying to get help to stop snoring - its not great

noreply@blogger.com (Adrian Zacher MBA) — Wed, 02 Feb 2011 03:37:30 PST

I was talking to a friend about this so it might appear a bit like a rant... but here goes....

I believe that snorers and their partners need valid information in a timely fashion and that most start off with a low-cost snoring device bought online or some nasal spray etc and then give up when they realise how ghastly it is. Only the really sleepy ones end up at their Doctor when the wife/partner thinks they are sufficiently depressed (!) or when the individual embarks on a new relationship and the new partner won’t put up with the snoring noise.

The problem then is that the family Doctor may not know very much about sleep medicine. Dependent on the knowledge of the Doctor and what services are in the local area they may then be referred to ENT and the poor snorer waits for 6 months to get ENT surgery or shells out a large amount of money to go private. ENT surgery (except in very carefully selected cases) all focuses on the soft palate, pharyngeal walls and residual tonsils and does NOTHING for the estimated 70% of patients who's problem is the tongue base... and ENT surgery may prejudice success with CPAP should the problem get worse and become sleep apnoea.

OR, if the snorer/sleepy individual is lucky they wait 6mths or more to get to see a sleep specialist who MAY do a basic assessment and say “Sorry you don’t merit CPAP therapy” or if they do merit therapy bolt on a low cost CPAP that is really arduous to live with. Or worse still through their passive complicity some sleep docs allow patients to buy OTC self-fit ‘anti-snoring’ devices or (even worse again) fit these themselves with no dental assessment.

It’s not great.

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Mail Online tells it like it is?

noreply@blogger.com (Adrian Zacher MBA) — Tue, 01 Feb 2011 09:24:20 PST

Mail Online tells it like it is?

Yes, I know its hard to believe but.... in an article published today a variety of High Street available supposed 'sleep aids' have been expert reviewed (Prof Jim Horne, Sleep Research Centre, Loughborough University, UK) and the respective manufacturers invited to feedback.

The market for the biggest sleep problem - insomnia - is huge, with around a third of us experiencing difficulty getting to - or maintaining sleep. Little wonder then that businesses promote gadgets to entice the insomniac to part with their money.

What I find interesting about insomnia is that it is sometimes a self fulfilling prophecy, in so much that the individual worries about being awake when they think they should be asleep, and it is this very worrying that prevents sleep in the first place.

Read the review here:

http://www.dailymail.co.uk/health/article-1352369/Dream-machines-Organic-tea-eye-masks-musical-pillows-light-projectors.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Getting fat from sitting still

noreply@blogger.com (Adrian Zacher MBA) — Wed, 26 Jan 2011 05:57:56 PST

Stand up, move more, more often

It seems that going to the gym each day is only one part of becoming generally more active if you want to keep the weight off and the heart risk down.

I picked up on this as it relates to the last post about how TV makes you fat, but from a sedentary angle.

The "So What" here is that going to the gym is not an antidote to long periods of sitting. Stand up, move more, more often!

http://www.businessweek.com/lifestyle/content/healthday/648761.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

TV makes you FAT?

noreply@blogger.com (Adrian Zacher MBA) — Mon, 24 Jan 2011 11:46:51 PST

TV makes you fat?

Across the Western world we have an obesity epidemic. Every night these same people stare at a TV or computer monitor. It could be that the light emitted by the TV disrupts sleep and hormone regulation making us more susceptible to weight gain. Read on to learn more...

We don't know yet the complete role of melatonin, however we do know it impacts upon the sleep/wake cycle and potentially glucose homeostasis (disruption of regulation of blood sugar levels which could affect type II diabetes onset). TV could be making us fat, not only because it is a sedentary past-time, but because the light that the TV or computer monitor emits is disrupting melatonin's release and duration.

Dr Gooley of Massachusetts said: “...room light exerts a profound suppressive effect on melatonin levels and shortens the body's internal representation of night duration. ....., chronically exposing oneself to electrical lighting in the late evening disrupts melatonin signaling and could therefore potentially impact sleep, thermoregulation, blood pressure, and glucose homeostasis"

he went on to say

"Given that chronic light suppression of melatonin has been hypothesized to increase relative risk for some types of cancer and that melatonin receptor genes have been linked to type 2 diabetes, our findings could have important health implications for shift workers.”

So, staring at a TV or computer monitor could be making us FAT! I suggest switching off main room lights and turning on low wattage side lights in the evening (not a dimmer switch as that consumes the same power! save some money!) and turning off the TV much earlier in the evening.

There is a neat little computer program for changing the light emitted from your laptop below. At the opposite end of the day, there are now products that may help you wake up and may be used to treat seasonally affected disorder.

I found this wiki article surprisingly good (scroll down to circadian rhythm disorders and also the SAD bit).

http://en.wikipedia.org/wiki/Light_therapy

Melatonin
http://en.wikipedia.org/wiki/Melatonin

Gooley, J et al, (2010), Exposure to room light before bedtime suppresses Melatonin Onset and Shortens Melatonin Duration in Humans, Journal of Clinical Endocrinology and Metabolism.
http://jcem.endojournals.org/cgi/content/abstract/jc.2010-2098v1

Blog article that triggered my thoughts about light, melatonin and TV:
http://www.drbriffa.com/2011/01/14/why-its-important-to-turn-the-lights-down-low-in-the-evening/

Computer monitor light adjusting software:
http://www.stereopsis.com/flux/

Klok et al (2007) The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review.Obesity reviews.

http://www.ncbi.nlm.nih.gov/pubmed/17212793

Philips light therapy:
http://www.philips.co.uk/c/light-therapy/38702/cat/

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Implant 'CURE' for obstructive sleep apnoea...

noreply@blogger.com (Adrian Zacher MBA) — Thu, 06 Jan 2011 08:23:33 PST

Implant 'CURE' for obstructive sleep apnoea

An interesting new option for sleep apnoea has been developed by a spin off from Medtronic. Inspire Medical Systems implant 'cure' is now undergoing large scale clinical trials in the US and Europe. The company hopes to receive commercial approval from the US FDA by 2013.

The new option is an experimental surgical implant that stimulates the hypoglossal nerve - the nerve responsible for tone in the upper airway and tongue. The theory being that electrical stimulation of the nerve will maintain muscle tone as it does during the day - and breathing will therefore be normal.

What appears challenging is providing sufficient pulse stimulus to maintain tone, while not disturbing the sleep of the individual AND providing that nerve pulse at the appropriate time in the breathing cycle.

Fascinating stuff! Explore the links below:

http://www.inspiresleep.com/pdf/11.30.10-StarTribune.pdf
http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=10696844
http://www.inspiresleep.com/
http://www.inspiresleep.com/video/flvplayer.swf?width=640&height=390&path=../video/animation-sound.mp4

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

A new therapy for sleep apnoea?

noreply@blogger.com (Adrian Zacher MBA) — Mon, 20 Dec 2010 00:38:33 PST

A new therapy for sleep apnoea?

Now if you believe the hype on the website, there has been an 'evolutionary jump' in sleep apnoea treatment. Quite what the new species looks like, how it differs from established therapies and what it adds, is not clear.

While progress and evolution is inevitable and hopefully positive, the problem any innovator has - (and particularly in a medical market) is the answer to the question "Does it work?" And then in medical speak "Where is the clinical data - objective evidence of efficacy" - and "For who (what severity of disease)?".

So unless it is very similar to something else (ie not new - meaning it is merely a cynical marketing campaign) it has to start with medical trials (time and money) before it is widely accepted. This needs deep pockets and patience.

We wait with interest for http://mytranscend.com/

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Happy Holiday drinks?

noreply@blogger.com (Adrian Zacher MBA) — Mon, 20 Dec 2010 00:08:38 PST

Happy Holidays!

Its that time of year again - the season of good will and over indulgence - and the hangover in the morning (never mind the mountain of washing up!).

So, why do we feel so bad after a few too many drinks? Well, according to Kate Hilpern writing in the Independent "The Science of your hangover", it is not just about dehydration. You can read more about her thoughts and what to do about it (apart from the obvious - drinking less...) in the link below.

We all know that an evening drink helps you 'nod off' but did you know that it actually interferes with your nights sleep and appetite regulation? Landolt, Hans-Peter et al (1996) put the science into how alcohol disrupts sleep stages and if factor in what we know about Leptin (suppressing food intake) and Ghrelin (stimulating food intake) it goes some way to explain the morning 'munchies'.

So what can you we do about it?
Realistically, confining alcohol to the middle of the day, minimising caffeinated drinks (further dehydrates) and then adopting the traditional cure of rehydration (non fizzy water) and an English breakfast: bacon (replaces some salts) and eggs (mops up any remaining alcohol), fruit juice (replaces some sugars) and an aspirin actually seem quite a reasonable idea!

Sleep well this festive season,

Independent article here:
http://www.independent.co.uk/life-style/food-and-drink/features/the-science-of-your-hangover-2159477.html

The role of leptin and ghrelin in the regulation of food intake and body weight:
http://www.ncbi.nlm.nih.gov/pubmed/17212793

Alcohol and Sleep here:
http://alcoholism.about.com/cs/alerts/l/blnaa41.htm

Sleep stages disturbance here:
http://journals.lww.com/psychopharmacology/Abstract/1996/12000/Late_Afternoon_Ethanol_Intake_Affects_Nocturnal.4.aspx

If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Owl or a Lark - it's all in the genes

noreply@blogger.com (Adrian Zacher MBA) — Wed, 27 Oct 2010 05:30:20 PDT

Owl or a Lark - it's all in the genes

It is old news that people may feel they function better at one end of the day or another. However, why people appear to require differing total amounts of time asleep and perhaps more importantly how to identify those individuals more susceptible to the negative effects of sleep deprivation has been unclear.

Until now perhaps. A sleep research team including Nami Goel at the University of Pennsylvania School of Medicine, Philadelphia, undertook some research with a previously identified gene known to play a role in sleep disturbance.

How this relates to sleep duration and whether someone may consider themselves an 'Owl' or a 'Lark' is not clear (to me!) - anyway you can read the Independent article here:

http://www.independent.co.uk/news/science/the-secret-to-staying-alert-good-genes-2116462.html

Sleep well.

If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleep and Obesity - Again

noreply@blogger.com (Adrian Zacher MBA) — Tue, 05 Oct 2010 06:44:45 PDT

Sleep and Obesity

The often repeated story of a caloried controlled diet, together with exercise to achieve weight loss, now has a new twist. Getting enough sleep has been proven to impact on the amount of actual fat reduction - as opposed to losing fat and muscle mass.

The 4th Oct. article in the Los Angles Times provides information about how the hormone Ghrelin impacts on appetite, but what it doesn't mention is how sufficient sleep improves daytime function in general. The inter-relationship of sufficient sleep, good diet and regular exercise is what Prof Dement of Stanford University describes as the "Triumvirate of Health".

You can read the LA Times article, Prof Dement's page and the source article for the story from the below links:

http://articles.latimes.com/2010/oct/04/news/la-heb-sleep-fat-20101004

http://www.stanford.edu/~dement/sleepless.html

http://www.annals.org/content/153/7/435.abstract?aimhp

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleeping pill users may die more early!

noreply@blogger.com (Adrian Zacher MBA) — Sun, 12 Sep 2010 13:01:04 PDT

Not a headline, that if you struggle getting off to sleep, you want to read!

So, what's the basis for it?

A recently published Canadian study of 12000 people, by Dr Belleville (published in the Canadian Journal of Psychiatry), took into account factors like depression, alcohol, tobacco and physical health. The findings make interesting reading from a respiratory perspective.

Alarmingly, the impact of some types of insomnia medications may suppress the respiratory system. This concerns me as I wonder how this impacts the massive undiagnosed sleep apnoeaic population - particularly WOMEN. Sleep apnoeaic women may report insomnia as a symptom and for them to be prescribed a sleeping pill that suppressed their respiration further....

Read it for yourself as reported in the Daily Mail

http://www.dailymail.co.uk/health/article-1310549/Sleeping-pills-increase-risk-dying-36-cent-study-finds.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Can you 'coach yourself' to sleep better?

noreply@blogger.com (Adrian Zacher MBA) — Tue, 03 Aug 2010 05:12:01 PDT

Can you 'coach yourself' to sleep better?

An interesting new product has been launched: The Zeo Personal Sleep Coach. This product, through a headband and a wireless link, somehow monitors your sleep stages and records them for later display and personal analysis via a spreadsheet. The idea being that you can then change something you do (eg late night alcohol or daytime caffeine consumption) and effect a change in your sleep - as detected by this product.

I think it's a great idea in principle, and I would like to try it, and see if the product delivers on what it promises.

Further, the product has an alarm clock that should - if it works wake you up in a lighter sleep stage. This particular idea has been around for a while and hasn't been widely available.

What would be good to add to this product would be some sort of alerting that the sleep is seriously fragmented and perhaps a symptom of a sleep disorder requiring further medical investigation. This functionality could then perhaps be clinically validated as a screener....

Zeo product here:
http://www.myzeo.com/product/13_zeo_personal_sleep_coach_basic.cfm#BVRRWidgetID

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

So you or your partner snore

noreply@blogger.com (Adrian Zacher MBA) — Thu, 29 Jul 2010 03:10:16 PDT

So, you or your partner snore.

If you are on the receiving end of jibes about your snoring, you probably feel a little persecuted. You cannot help snoring - you don't do it deliberately just to be annoying! However, if you are kept awake by a snorer you are most probably tired and not so willing to be tolerant.

Your next step (both of you) is probably to do a quick Google search on 'snoring' - perhaps inserting your Country name. Most likely you end up reading rubbish or at the least commercially biased 'advertorials' from some business or other that attempts to portray itself as something it is not. Beware!

What to do?

You most probably think your Doctor will laugh you off - and not to malign the informed and caring Doctors out there - this is a sad reality for some. But you must persist - particularly so if you are sleepy in the day. This is a result of not just annoying snoring but perhaps a symptom of obstructive sleep apnoea (I will save you the search - visit http://www.sleep-apnoea-trust.org ).

In short, if you or your partner snores then you don't have to put up with sleep disturbance and if you are sleepy in the day then go and see you Doctor - make a fuss about getting a referral to a sleep centre - or if you have the money get a proper overnight sleep test from a private company (you can do this at home). ResMed offer such a service - http://www.realsleep.co.uk/rsuk/ and there are others such as the London Sleep Centre http://www.londonsleepcentre.com/ or http://www.edinburghsleepcentre.com/

Sleep well.

If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleep and heart risk

noreply@blogger.com (Adrian Zacher MBA) — Wed, 21 Jul 2010 09:28:57 PDT

Sleep and heart risk

Like so many things that seem common knowledge yet have to be researched and proven to be the case for anything to be done about it, some recent research has proven that not breathing is bad for your heart!

So then, it is with no sense of a great discovery that I read about a study promoted on HealthDay that "Sleep Apnea Could Raise Heart Risks for Older Men". In this study approx 4500 people (both men and women) were assessed for sleep apnoea - about half - had some severity of sleep apnoea (yes you read that right - about half) and these individuals had no heart problems initially. Over the following 8 years the individuals who were drawn from a broad community population, were then contacted and and finally followed up in 2006. The results are shocking:

"During that time, 473 cardiac events occurred, including 185 heart attacks, 212 heart bypass operations, and 76 deaths. There were also 308 cases of heart failure; of these 144 people also had a heart attack."

The HealthDay article continues:

"The study found that men between 40 and 70 years of age who had severe sleep apnea were 68 percent more likely to develop heart disease, and 58 percent more likely to develop heart failure, than those without the condition. Increasing severity of sleep apnea was also associated with obesity, high blood pressure, hypertension and diabetes, all of which are known contributors to heart disease."

As I type this, I wonder what it takes to make a difference to the public awareness of sleep disordered breathing and it's consequences - and I realise I have become a cynic!

HealthDay article here:

http://consumer.healthday.com/Article.asp?AID=641041

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Tart cherry juice may reduce insomnia

noreply@blogger.com (Adrian Zacher MBA) — Wed, 14 Jul 2010 10:11:50 PDT

Tart cherry juice may reduce insomnia

For some time now we have known that melatonin plays an important role regulating the sleep-wake cycle. Some pharmaceutical companies have rushed to produce melatonin supplements and mixed results have been shown in medical research trials. Sales without prescription remain illegal.

However, 'tart cherry juice' is a natural product that may provide similar melatonin effects (minimal) AND provide you with some vitamin C - besides it probably tastes better!

The important thing to realise about insomnia is that the individual most likely does sleep but perhaps perceives that they require more sleep than they have think they have experienced. They then get slightly paranoid about the loss of sleep and its daytime effects which creates the tension and worry that inhibit sleep onset. A self-fulfilling prophecy!

So, unless you are a chronic insomniac - if you struggle to get off to sleep after 20 minutes of tossing and turning THEN GET OUT OF BED. Go and do something relaxing and try to switch off. Do not worry about it - that is the worst thing to do.

A recent pilot study, published in the July issue of The Journal of Medical Food is reported in somewhat more easily understood fashion here:

http://www.upi.com/Health_News/2010/07/14/Tart-cherry-juice-may-reduce-insomnia/UPI-65481279082595/

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Sleep and prospective memory

noreply@blogger.com (Adrian Zacher MBA) — Wed, 07 Jul 2010 08:35:13 PDT

Sleep and prospective memory

An interesting story ran recently in the Daily Telegraph (which is still free to read online...) in it the researcher, a psychologist named Dr Mark McDaniel details how 'prospective memory' is improved by sleep. Prospective memory according to the Daily Telegraph is "..being able to remember to do something in the future".

Professor Dement in his book "The Promise of Sleep" hypotheses that slow wave sleep is where we sort through the events of the day and 'program' our long-term memory - so I wonder how the protocol in this study relates to another two of Professor Dements theories - sleep hygiene (keeping to sleeping at a set time and minimising daytime naps) and the concept of sleep debt.

It is all interesting research and perhaps in time will lead to a better understanding of inadequate time asleep or fragmented sleep affects us - and raise awareness of the treatment options.

Telegraph story:
http://www.telegraph.co.uk/health/healthnews/7868104/Sleep-increases-your-crossword-powers.html

Sleep well. If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Obstructive Sleep Apnoea, Obesity and Diabetes

noreply@blogger.com (Adrian Zacher MBA) — Tue, 11 May 2010 07:46:35 PDT

More on the worrying trio of Obstructive Sleep Apnoea, Obesity and Diabetes

Sleeping badly or just not sleeping enough - even for just one night - reduces insulin sensitivity, according to recent research published in the Journal of Clinical Endocrinology and Metabolism. The research lead by Dr Esther Donga, Director of the Leiden University Medical Center in the Netherlands, found that in otherwise healthy individuals blood sugar levels rise and reduced insulin sensitivity by 19 to 25 percent, after sleep was reduced to just 4 hours. Dr Donga thought it tempting to suggest that perhaps "the negative effects of multiple nights of shortened sleep on glucose tolerance can be reproduced, at least in part, by just one sleepless night."

Turning then to weight loss - and more importantly keeping the weight off.

A recent article in the Telegraph found that contrary to popular belief, losing weight rapidly in the initial phases of a lifestyle change to eating less and taking more exercise "...lost more weight overall, maintained their weight loss for longer and were less likely to put weight back on than the more gradual weight losers".

So, what are we to conclude? It would seem reasonable to suggest, that sleep of sufficient duration and quality, may lessen your risk of developing diabetes. And we know that sleep apnoea is aggravated by weight gain, so losing weight fast helps keep it off AND lessens your risk of type II diabetes.

Syndrome Z looks more viable.

For more on syndrome Z: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1765908/
http://www.google.com/hostednews/ukpress/article/ALeqM5ixDhHNsLW0FPnirYYZtuHGcRgNug
http://www.telegraph.co.uk/health/healthnews/7692529/Losing-weight-quickly-is-key-to-staying-slim.html

Image via Healthline.com
Sleep well.

If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.

Political decision making and the siesta

noreply@blogger.com (Adrian Zacher MBA) — Thu, 06 May 2010 02:11:22 PDT

Political decision making and the siesta

According to Judith Woods in 5th May's Telegraph an afternoon siesta was good enough for Churchill - and George Bush had a regular 9pm bedtime. This would appear to be good anecdotal evidence that historically leaders valued their sleep and responded to what their body needed in preference to societal norms.

Regardless of what 'leaders' and celebs do their actions raise the profile of sleep per se and indirectly the topic of quality and quantity of sleep. Which has to be good news.

Professor Jim Horne who runs the Sleep Research Centre at Loughborough University is also quoted as saying "...if someone is in high office and they react to a crisis by not sleeping then that will impact on their decision -making..."

Perhaps this is the time for Nick Clegg to say that he observes strict sleep hygiene, gets 8 hours a night sleep and is even tempered and clear thinking as a result?

Sleep well.

http://www.telegraph.co.uk/news/election-2010/7682867/General-Election-2010-David-Cameron-super-charged-or-sleep-deprived.html

If you are unsure about your medical condition, please DO consult a Doctor with experience of sleep medicine. I strongly support providing current, accurate medical information so that individuals are better able to make informed decisions about their health care.