Sleep Medicine Blog

The Importance of Screening for Sleep Apnea Prior to Surgery

Darius Zoroufy — Thu, 04 Nov 2010 03:54:39 +0000

For the full text of this article, click on the link below.

http://drzzzsleep.blogspot.com/2010/10/sleep-apnea-screening-is-necessary.html

Exercise relieves insomnia

Darius Zoroufy — Thu, 04 Nov 2010 03:21:53 +0000

Click on the link below to learn about the fascinating relationship between exercise and sleep.

http://drzzzsleep.blogspot.com/2010/10/aerobic-exercise-relieves-insomnia.html

Keeping Your Mask Clean

Darius Zoroufy — Sun, 24 Oct 2010 17:11:14 +0000

Go to the link below for this Blog entry.

http://drzzzsleep.blogspot.com/2010/10/clean-mask-every-day-makes-cpap-much.html

Untreated Sleep Apnea found to increase the risks for Heart Disease in large Midwest Study

Darius Zoroufy — Sat, 23 Oct 2010 20:21:58 +0000

When a study follows a particular demographic or statistical group that study can be considered a cohort study. One carefully followed group is the Wisconsin Sleep Cohort. The Department of Medicine, and the University of Wisconsin has been following this cohort for over 20 years. I was fortunate to attend my residency at the University of Wisconsin and to meet some of the researchers who are still actively involved in this project.
[“Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort”, Young, Terry PhD, et al., Department of Population Health Sciences and Department of Medicine, University of Wisconsin-Madison, Madison, WI. SLEEP, Vol 31, No. 8, 2008.]
When the researchers wrote their 18th year report and released it to SLEEP Journal it was released for expedited publication. The cohort sample includes 1522 adults assessed at baseline for sleep disordered breathing/sleep apnea and stratified as mild, moderate, and severe sleep apnea. All-cause mortality risk was adjusted for confounding factors such as age, gender, weight (body mass index), other disease states, etc that could have affected the results.
The researchers found startling results. People with severe untreated sleep apnea had a 3.8 times greater chance of dying than the baseline population without sleep apnea. They also had a 5.2 times greater chance of dying of cardiovascular disease. These people did not necessarily have current cardiovascular disease or other cardiovascular risk factors to account for these deaths.
Moderate sleep apnea conveyed an overall 1.7 times greater risk. Even mild sleep apnea conveyed a 1.4 times greater risk.
These findings were significant and were consistent with other important studies like the Sleep Heart Health Study.
Patients at the Swedish Sleep Medicine Associates Clinics get a thorough evaluation. If they are found to have sleep apnea they are advised to get treatment and to consistently adhere to their treatment plan in order to eliminate symptoms of sleep apnea such as daytime sleepiness, snoring, loss of mental acuity. They are also told that treating sleep apnea also has the critically important role of reducing cardiovascular risk.
For a full, comprehensive sleep medicine evaluation contact:

Swedish Sleep Medicine Associates
(206) 386-4744
www.gosleep.com
Darius Zoroufy, M.D.

Cardiovascular Changes in Pediatric Sleep Apnea

Darius Zoroufy — Sun, 17 Oct 2010 19:08:27 +0000

Many of you have already learned about increased cardiovascular disease risk markers in patients with uncontrolled sleep apnea. When I speak with patients at Swedish Sleep Medicine Associates, they often seem to take on an opinion that the cardiovascular risk issues are have more to do with older adults an people who already have significant heart disease. Patients in their 20’s, 30’s, 40’s and 50’s sometimes seem disinterested in the cardiac effects of sleep disordered breathing, as if they are too young to be affected by sleep related breathing affects on the heart.
In the article by Marilisa Montesano, M.D. and her colleagues at The Pediatric Department “La Sapienza” University, Il Faculty, Medicine, Rome, Italy in SLEEP (Vol 33, No. 10, Oct. 1, 2010, pp. 1349-1355.) In the study children ages 7 – 14 underwent overnight sleep studies. 18 had obstructive sleep apnea and 25 were in the control group.
The investigative group did many sophisticated analyses leading to many surprising results. One of the most significant was that children have markedly greater blood pressure if they have sleep apnea compared to those who do not.
Obstructive Sleep Apnea Group: (Apnea/hypopnea Index mean = 5.3/hour)
Blood Pressure: 112/65 mmHg
Heart Rate: 77/min

Control Group: (Apnea Hypopnea Index mean = 0.3/hour)
Blood Pressure: 101/58 mmHg
Heart Rate: 68/min

Statistical analysis showed a clear and direct relationship between the AHI (Apnea-Hypopnea Index: the number of apneas and hypopneas per hour) and cardiovascular parameters in these children.
It is evident that there are already cardiovascular changes in children who are suffering from obstructive sleep apnea. We must take the cardiovascular effects of sleep apnea very seriously in every sleep apnea patient and make sure we are fully managing sleep apnea in every single patient to the best of our ability.

Reduced Sleep and Reduced Learning

Darius Zoroufy — Sun, 17 Oct 2010 18:56:37 +0000

Many studies have demonstrated that sleep quality has a close relationship with memory and mental performance. In fact, many of us have recognized in our own lives that our memory and recall are not as sharp when we are sleep deprived compared to times when we are well rested. In this month’s journal SLEEP (Vol 33, No. 10, Oct. 1, 2010) another study and associated editorial were published on this very subject. (“A Time for Learning and a Time for Sleep: The Effect of Sleep Deprivation on Contextual Fear Conditioning at Different times of the Day” Roeline Hagewoud, et al, pp1315-1322)
This study showed that rats demonstrated reduced learning when allowed to sleep less following a learning stimulus when compared with rats which had the opportunity to sleep amounts consistent with the normal rat sleep cycle. The researchers concluded that not only was the amount of sleep deprivation a significant factor, but the timing of sleep deprivation (deprived during normal sleep hours) that affected learning and the consolidation of memories. It appears that each stage of sleep may have a layering effect in the production of long term, integrated memories.
A corollary of the study is that late night work is not nearly as productive as we tend to think it is. It is far better to put work away at bedtime, get adequate, restorative sleep and start fresh in the morning.
The age-old question “How much sleep do I need may be a much more complicated question that it initially seems but the answer definitely requires getting a full night of sleep on a consistent schedule. Adults should be getting to bed by 10-11 p.m. and sleeping 8 hours. Children have varying sleep schedule requirements depending on their ages. However, essentially all children should be in bed going to sleep at least by 9 p.m. and most school aged children should be getting 9-10 hours of sleep/night. If you or the children are too tired to wake up easily, you are probably not getting enough sleep.
Sleep well and have a good day.

Darius Zoroufy, M.D.

The Eyes Play Important Role in Sleep

Sophea — Wed, 13 Oct 2010 20:51:45 +0000

Light is the most powerful regulator of our biological clock. Morning light signals the biological clock to synchronize many of our body’s hormonal and other internal cycles. Our sleep patterns — feeling sleepy at night and awake during the day — are largely regulated by the daily cycle of light and darkness.

Existing drugs that modify sleep-wake cycles (sleeping pills, alerting drugs) target many chemical pathways and different parts of the brain at the same time, resulting in some undesirable side effects.

However, there are nerve cells in the eye that use the level of brightness in our environment to modulate sleep and arousal. Could we use this pathway to control our degree of sleepiness? Researchers suggest that the ability to use this system to mimic the effect of light pharmacologically might enable us to turn sleep on and off without a lot of side effects.

Daily Routines Reduced Insomnia in the Elderly

Sophea — Thu, 30 Sep 2010 17:14:53 +0000

A study of older adults living in a retirement community suggests that establishing and maintaining daily routines may help improve sleep and decrease insomnia.

Researchers know that normally sleep patterns and daytime routines are synchronized, so they predicted that they would find a relationship between routine activity patterns and sleep quality in the older people in their study group.

However, they found even stronger correlation between daytime patterns and sleep patterns than they expected.

Their results show that developing regular lifestyle activity patterns for basic activities such as bathing, dressing, and eating is a good way to maintain good sleep quality. A daily routine was associated with a shorter time to fall asleep, higher sleep efficiency and improved sleep quality.

Better sleep efficiency was associated with a long-term, stable pattern of basic and activities and with more stable lifestyle regularity. Poorer sleep quality was associated with less lifestyle regularity and more illness.

Sleep Well to Age Well

Sophea — Thu, 23 Sep 2010 16:34:32 +0000

Consumer Report’s guide to healthy aging considers good sleep to be one of ten important steps to aging well.

Some important steps include:

      o Keep your brain active.
     o Maintain social ties.
     o Take care of hearing loss and eye health.
     o Keep your heart healthy.
     o Follow an improved diet.
     o Do regular strength training and exercise.
     o Get good sleep.

Older People Do Not Need Less Sleep

Many people think that older people need or want less sleep. This is not true. Older people tend to have lighter sleep, and may awaken more often during the night. But they still need enough sleep and good quality sleep.

Older People Can Improve Their Sleep By…

      Using their bed and bedroom for sleep and sex only.
      Taking relaxation training, which reduces tension and promotes sleep.
      Reducing the amount of time in bed instead of spending too much of that time lying awake.

End Childhood Obesity: Good Sleep, Family Meals, Less TV

Sophea — Mon, 13 Sep 2010 19:08:10 +0000

Family behavior maybe the key to preventing childhood obesity, which affects 9 million children, ages 6 – 19.

When families eat dinner together, their children are more likely to get better sleep and watch less TV, and are 40% less likely to be obese, according to a recent study in the journal of the American Academy of Pediatrics.

Family dinner, a good night’s sleep and less TV may seem easy. But work schedules of parents and after-school activities make it difficult.

The lead researcher, Sarah Anderson, says parents should “make these behaviors a priority. Sit down and figure out how you can make it happen.”

Here are two tips that can help:

 Healthy meal choices: more fish, fruits and vegetables. Avoid fast foods and foods high in carbohydrates or fats.

 Consistent exercise, which will improve both weight loss and sleep. But avoid exercising less than 3 hours before bedtime, which can make it harder to fall asleep.