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The Wellcome Trust produced this video in 2009, and its well worth watching for anyone wanting know the basics of sleep apnoea. The Trust’s aim with this video was to explain the condition and treatment, but also to put a spotlight onto the work of Dr Mary Morrell, who studies the condition. At the time of filming she was about to embark on a major new trial in the elderly, for whom this problem is very common.
According to a new report by iData Research, the leading global authority in medical device market research, the European anesthesia, respiratory and sleep-management device market was valued at over $1.4 billion in 2011. By 2017, this market is expected to reach almost $2 billion, fueled by the rapidly growing telehealth/homecare therapeutic sleep-apnea and ventilator segments. Philips Respironics, ResMed and CareFusion are leading these markets, despite growing competition.
“Sleep disorders are becoming much more widely diagnosed in Europe, which is driving the demand for more advanced devices that can diagnose, treat and monitor in the home,” says Dr. Kamran Zamanian, CEO of iData. “Philips, ResMed and CareFusion are leaders in this space, however many other companies have released products in a bid to gain share in this lucrative market.”
The report states that the market for automatic positive airway-pressure (APAP) devices, which automatically detect apneic events, are expected to be the fastest-growing segment. The U.K. and France are leading in sales growth, however there is expected to be a dramatic increase in demand in Germany, Spain and Austria.
Additionally, the ventilator segment is expected to see strong growth fueled by increased sub-acute and homecare usage as well as new remote-monitoring ventilators. Philips narrowly leads this market with their non-invasive homecare ventilators, but faces strong competition from ResMed.
I am pleased to announce I have been awarded the Middle East Hospital magazine award for excellence in respiratory care, and making an outstanding contribution to healthcare in the Middle East. The Snoring Disorders Centre took a stand at the Arab Health exhibition in Dubai this year to raise awareness of the negative impact that OSA is having in the UAE and wider Middle East, and I met with healthcare professionals interested in treating this issue in the Arab region. I also be attended Saudi Medicare in Riyadh in April to spread the message further around the region.
Levels of obesity, hypertension and heart disease are rocketing in the wealthy Middle East, mainly due to the life-style out there. People are working long hours, eating rich calorie-laden food, driving everywhere and not exercising enough. I believe that the success I have had in Lincolnshire can be replicated in the Middle East by raising awareness of the condition, and forming long-term partnerships with local hospitals, doctors, and government departments.
With the low level of awareness of sleep apnoea in the Middle East it’s no surprise that road accident rates out in Dubai and the UAE are dreadful. In fact road traffic accidents are the second major cause of deaths in the UAE. There are 3500 fatalities per year from RTAs in Saudi Arabia alone, and OSA could well be a factor in many of them.
The father of Toby Tweddell, who was killed in a road accident in 2006, has spoken out on radio 5 live calling for all lorry drivers to be screened for sleep apnoea. The driver responsible for the accident also joined the call for action.
This tragic case demonstrates the fatal consequences of the lack of awareness of the condition, both within the medical profession, and by drivers themselves. It also shows that commercial drivers have nothing to fear from a positive diagnosis as the driver in this case was absolved of resposibility for the accident having been misdiagnosed. He is still driving today having been treated successfully.
The coroner of the case, and Toby’s parents both called for screening at the time of the killing, and five years later nothing has been done and road deaths due to sleep apnoea have continued. However, with the Corporate Manslaughter Act now in full force a similar case could now result in the driver’s employers being sued for negligence. Hopefully companies will now take action before this happens again.
The BBC reported at the time, “Mr Tweddell, 25, from Sale, Greater Manchester, was killed when a lorry driver ploughed into a queue of traffic on the M62 in Merseyside in 2006. Lorry driver Colin Wrighton had been suffering obstructive sleep apnoea. The 54-year-old’s condition had yet to be diagnosed but he had complained to his doctor about feeling tired four months before the accident. Tests had been run for diabetes, which came back negative.
“Mr Wrighton was initially charged with causing death by dangerous driving, but the Crown Prosecution Service offered no evidence against him after his sleeping condition was revealed. In giving his narrative verdict, which was released as a statement, the coroner said: “It is my intention to prepare a Rule 43 Report to the Lord Chancellor concerning obstructive sleep apnoea in an endeavour to reduce the number of deaths that arise annually from this condition.”
The Lincolnshire-based Snoring Disorders Centre has opened a new clinic at Johnson Hospital in Spalding to enable sufferers of sleep apnoea from the surrounding communities easy access to a high quality treatment service.
The Snoring Disorders Centre (or Snore Centre) is based at Pilgrim Hospital in Boston, and a high demand for the service has led founder and sleep specialist Michael Oko to set up the Spalding clinic:
“The East Midlands and East of England is currently under-served in this therapy area, and people were having to travel long distances for diagnosis and treatment in Boston. Now the people of South Lincolnshire and North Cambridgeshire have an easily accessible sleep service, and the clinic is also easier to reach for patients from further afield”, said Mr Oko.
Up to 4% of the adult population are thought to suffer from sleep apnoea, which is often undiagnosed. This condition prevents sufferers from getting a good night’s sleep and is linked to serious medical conditions such as diabetes and hypertension. Sufferers are usually permanently tired, resulting in a reduced quality of life and an greatly increased risk of being involved in a road traffic accident. In a recent survey by road safety charity Brake one in seven drivers were found to have sleep apnoea.
Mr Oko added, “If you suspect that you or a relative may have sleep apnoea I strongly advise going to see your GP, who can refer you to a sleep clinic for diagnosis. You can also take this simple test
to find out if you have a high probability of being a sufferer. Treatment is straightforward and effective, and achieving a good night’s sleep can transform the lives of sufferers and their partners.”
At the Snore Centre there is a strong emphasis on patient satisfaction, which is monitored via interactive touch screen technology. Mr Oko saw 383 patients from April 2010 to April 2011 and on average 96% of patients were very satisfied with the service they received.
The Snoring Disorders Centre won an East Midlands Health and Social Care Award in the Service Transformation category in 2008, and also an MEH award for Excellence in Respiratory Care in 2009.
The results of a new study of 1000 drivers by the road safety charity Brake and Cambridge Weight Plan shows that one in eight drivers have nodded off at the wheel. They also found that one in seven (13%) of drivers suffer from sleep apnoea.
Julie Townsend, Brake’s campaigns director, said: “Tiredness at the wheel kills. Driving a vehicle is a huge responsibility that must be taken seriously. That means stopping when we feel drowsy and certainly never starting a journey tired. It’s a matter of life and death. We still have widespread misunderstanding of how to prevent driver tiredness, and ignorance about factors like sleep apnoea, a condition that can be treated. These messages still need to get through to the public, which is why we are calling for renewed efforts from the Government to tackle this issue urgently.”
Professor Tony Leeds, Medical Director, Cambridge Weight Plan, said: “Driver tiredness can have devastating results, but it is avoidable if drivers follow road safety and medical advice. I urge drivers to manage their sleep needs: make sure you get sufficient rest each night, and stop and rest if you feel sleepy at the wheel. If you often feel tired, there might be an underlying medical problem, so you should seek appropriate professional advice. A common cause of tiredness is obstructive sleep apnoea, which is more common among commercial drivers, and is linked to greater risk of crashing. Sleep apnoea is linked to body mass index, so overweight drivers should be particularly alert to the possibility of suffering from this disorder, but aware that it is treatable.”
I have long been calling for companies to test their drivers for sleep apnoea as a matter of routine. The test is simple and effective, and treatment is free on the NHS so will cost companies nothing to resolve, and will saving lives. With the Corporate Manslaughter Act now in force companies can and will be held legally responsible for failing to protect their employees, so there is every reason for employers of commercial drivers to act on this now.
Obstructive sleep apnoea may cause changes in blood vessel function that reduces blood supply to the heart in people who are otherwise healthy, according to a study published in Hypertension: Journal of the American Heart Association.
However, treatment with 26 weeks of continuous positive airway pressure (CPAP) improved study participants’ blood supply and function.
“The findings should change how doctors treat patients with obstructive sleep apnoea,” said lead author Gregory Y.H. Lip, MD, Cardiovascular Medicine, University of Birmingham, United Kingdom. “Even apparently healthy patients with sleep apnoea show abnormalities of small and large blood vessels, as well as impaired blood supply to the heart muscle, and these can improve with CPAP therapy.”
The study is the first to show blood vessel abnormalities in patients with sleep apnoea. Previous studies have linked blood vessel dysfunction to cardiovascular disorders.
Reversing blood vessel abnormalities could help patients with obstructive sleep apnoea who are otherwise healthy avoid developing and dying from cardiovascular disorders, researchers said.
For the study, Dr. Lip and colleagues looked for changes in blood vessel function in 108 participants who were otherwise healthy, with no differences in age, sex, body mass index, and smoking status.
Of the patients, 36 people had moderate or severe obstructive sleep apnoea without high blood pressure, 36 had high blood pressure without obstructive sleep apnoea, and 36 individuals without high blood pressure or obstructive sleep apnoea.
Two studies that link the quality of sleep to the occurrence of erectile dysfunction and other urologic conditions were presented to reporters during the 2011 Annual Meeting of the American Urological Association (AUA).
The studies suggest that men with erectile dysfunction (ED) should be screened for obstructive sleep apnoea (OSA). After adjusting for age and other health conditions, patients with ED were more than twice as likely to have sleep apnoea than their normal counterparts.
This was the largest study to date to demonstrate a relationship between obstructive sleep apnoea and erectile dysfunction. Researchers at Mount Sinai Medical Center in New York evaluated 870 consecutively enrolled men through a cardiac screening program. Patients were screened for obstructive sleep apnea and erectile dysfunction through clinical questionnaires and were asked about their history of cardiovascular disease, blood pressure, diabetes and smoking. The mean age in the study population was 47.3 years, with a mean BMI of 30.2.
Sixty-three percent of patients in the study screened positive for obstructive sleep apnea, 5.6 percent had a history of diabetes, and 29 percent had a smoking history. The likelihood for having OSA increased as the severity of ED increased.
The good news for patients with both OSA and ED is that treatment for sleep apnea through continuous positive airway pressure therapy (CPAP), together with drug therapy, has been shown to improve symptoms of ED.