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A growing body of research has also found that sleep apnoea can be a drain on intimacy, causing erectile dysfunction in men and loss of libido in women.
Scientists suspect this may have to do with sex hormones like testosterone, which rise with sleep and fall when there is a lack of it. Because it causes intermittent waking and chronic sleep deprivation, apnea may directly drive down levels of these hormones, causing sexual dysfunction.
In the most recent study, published last month in The Journal of Sexual Medicine, scientists compared 80 women with obstructive sleep apnoea between the ages of 28 and 64 with 240 women without the condition. They found that the apnea patients had significantly higher rates of sexual dysfunction. Their findings echoed those of earlier studies on women and apnea.
In a study in 2009, researchers looked for signs of sexual problems in 401 men who showed up at a clinic for suspected sleep apnea. Of those who received the diagnosis, about 70 percent also had erectile dysfunction, compared with 34 percent in those without sleep apnea.
But on the bright side, treatment can make a difference. Patients who undergo surgery to correct facial abnormalities that contribute to apnea see improvements in intimacy, and those who start using masks at night that administer continuous positive airway pressure also report benefits in their sexual relationships.
A new study published in the European Respiratory Journal has found that a Mediterranean diet coupled with increased exercise and continuous positive airway pressure (CPAP) therapy may help to treat sleep apnoea.
The researchers, from the University of Crete in Greece examined 40 obese patients suffering from OSAS. Twenty patients were given a prudent diet to follow, while the other 20 followed a Mediterranean diet. Both groups were also encouraged to increase their physical activity, mainly involving walking for at least 30 minutes each day. In both groups, the patients also received CPAP therapy, which involves wearing a mask that generates an air stream, keeping the upper airway open during sleep.
The results showed that people following the Mediterranean diet had a reduced number of disturbances, known as apnoeas, during the rapid eye movement (REM) stage of sleep, which usually accounts for approximately 25percent of total sleep during the night. The findings also revealed that people following the Mediterranean diet also showed a greater adherence to the calorie restricted diet, an increase in physical activity and a greater decrease in abdominal fat.
The researchers suggested that further studies in a larger sample are required to fully understand the benefits of this diet.
The BBC reported last week that the NHS is struggling with a “tidal wave” of sleep disorders related to obesity, according to specialists. They report that the number of people being referred for sleep problems in Scotland has risen 25% over the past three years, with about 80% of patients being overweight. Figures for the rest of the UK are not available but doctors at sleep clinics in Scotland say their experience is probably mirrored elsewhere. The DVLA estimates 20% of serious incidents on major roads are caused by sleepy drivers.
Dr Tom Mackay, an expert in sleep disorders, at the Royal Infirmary of Edinburgh says he is facing a “tidal wave” of cases. There are now more new cases of sleep apnoea being diagnosed than lung cancer and emphysema combined. Dr Mackay said: “Over the past five to 10 years we have noticed quite a rise in the number of people being referred to us. That rise seems to be accelerating. We are now seeing 2,500 new patients each year. We are reaching capacity in terms of what we can cope with, and there is an undoubted link with people’s weight. For a man, if you’ve got a collar size of more than about 17.5in (44cm) then that is a marker for too much flesh around your neck. That roughly equates to a waist size of about 36in.”
Dr Mackay urged anyone who thinks they may be suffering from sleep apnoea to get properly diagnosed. The DVLA does not usually remove the driving licence of patients who are undergoing treatment.
Meanwhile the British Lung Foundation is so concerned about the steep rise in cases that it has made sleep disorders a priority for action.
The BBC has made this video report on one patient’s success in beating sleep apnoea through losing weight.
In the Daily Mail yesterday Jenny Hope reports on a new study published in the Journal of the American Medical Association that indicates a link between sleep apnoea and dementia. The study that found women who have breathing problems during sleep were up to 50 per cent more likely to develop cognitive impairment or dementia than women who sleep normally. The research involved only older women, but the mechanism is likely to be important in triggering similar problems in men.
Dr Kristine Yaffe and a team from the University of California, San Francisco, carried out a study involving almost 300 women with an average age of 82 years who did not have dementia. The women were given medical tests for breathing disorders during sleep, which measured the number of times their breathing was interrupted or briefly ceased while they were asleep, and levels of oxygen deprivation, or hypoxia, in the brain. One-third met the criteria for sleep-disordered breathing. After more than four years of follow-up, 36 per cent of the women developed mild cognitive impairment or dementia. Forty-seven women (45 per cent) with prevalent sleep-disordered breathing developed mild cognitive impairment or dementia compared with 31 per cent of those without sleep-disordered breathing – an increase of 50 per cent in the numbers affected.
Dr Yaffe said, “Given the high prevalence and significant morbidity associated with both sleep-disordered breathing and cognitive impairment in older populations, establishing whether a prospective association exists between sleep-disordered breathing and cognition is important. This is especially important because effective treatments for sleep-disordered breathing exist.
“Furthermore, the finding that hypoxia and not sleep fragmentation or duration seems to be associated with risk of mild cognitive impairment or dementia provides clues to the mechanisms through which sleep-disordered breathing might promote cognitive impairment. The increased risk for cognitive impairment associated with sleep-disordered breathing opens a new avenue for additional research on the risk for development of mild cognitive impairment or dementia and exploration of preventive strategies that target sleep quality including sleep-disordered breathing.”
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.
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.
Hi, my name is Stuart I live a pretty normal life for a 27 year old, other than the fact that during a night’s sleep my wife was complaining of my very loud snoring. This argument rumbled on for ages, until she said “if you don’t go to the doctors to see if they can sort this we might have to break up”: this is how serious things got for us.
So as I thought I was fine I went to the doctors and apologised for wasting his time. He asked some questions so I told him about my wife’s threats then he asked how I felt, so I opened up and told him I feel just as tired when I get up as when I went to bed. I also had a very short temper and this was not me; as anyone who knows me will tell you I am very laid back. The doctor said straight away it is one of two things; either diabetes or sleep apnoea. So he decided to rule out diabetes first -which he did with a blood test- then referred me to a sleep apnoea clinic.
I was very apprehensive and not sure what to expect. I turned up thirty minutes early with my wife (it’s a standing joke that I do not like being late) to book in and be shown to the waiting room. I knew I was in the right room as there were four men in there fast asleep, and one lady reading a book. As my wife was chatting with the lady she found out she was a wife of one of the men. I sat down and waited, trying to make sure I did not fall asleep, but sleep apnoea took its toll. I awoke with my wife tapping me on the arm saying the nurse wants to do some checks on my blood pressure, weight, height and measurements, than back to the waiting room and more sleep.
I was shown through to Mr Oko and I was asked to fill in a very small questionnaire on sleep and how I felt. While doing this Mr Oko was asking my wife questions like “does he stop breathing”, and my wife said no he goes quiet, but I know he is alive as his chest goes up and down. (YOU MUST TAKE YOUR BED PARTNER TO YOUR FIRST APPOINTMENT AS I DID NOT KNOW HALF OF THE ANSWERS THAT MY WIFE GAVE MR OKO)
I think I scored 18 on the questionnaire, which I was then told was high, and there was a good chance I had sleep apnoea. Mr Oko asked if I would be prepared to come in and collect a sleep analysis machine to find out what was going on.
I turned up to my second appointment to collect the sleep analyser; needless to say while waiting for my appointment I had a little sleep, as when I have a comfy chair and nothing to do I fall asleep at the drop of a hat. Mr Oko explained how to put on the machine and then took it off telling me to put it on before I go to bed and take it off the next morning (TIP NO1. MAKE SURE YOU TURN OFF THE SLEEP ANALYSER AS SOON AS YOU WAKE UP)
Two weeks later I returned to Mr Oko. When I was called in I was shown on a computer the results. Mr Oko showed me where I was snoring and was concerned at how low my oxygen levels were dropping, and explained that was enough evidence to prescribe me a C Pap machine. Mr Oko then measured my nose and gave me a mask ( TIP NO2. THESE MASK ARE DAUNTING WHEN YOU FIRST SEE THEM SO START OFF WHILE SITTING WATCHING THE TELEVISION, JUST PUTTING ON FOR A FEW MINUETS AT FIRST YOUR PARTNER WILL POSSIBLY JUST LAUGH, BUT YOU WILL BOTH GET USED TO IT).
For the next stage I was called by a Respironics sleep support team, letting me know they would be delivering my C Pap machine and pipes. I got home and plugged it in. Again, I was very apprehensive about going to sleep. When I went to bed I put the mask on and started the machine the first time felt very strange with air blowing up my nose, but soon felt ok (I remembered the words of mr Oko: if you manage a couple of hours then when you wake up you will feel FULL OF BEANS). I think I managed about four hours before taking it off, but a lot of people I know say the normal is about two hours building up to a full night’s sleep. I am not sure if tip 2 helped, but on night two I managed a full night and when I woke up the next morning sure enough I felt FULL OF BEANS.
I was amazed at how quickly I felt the benefit; this is when the thought of that dreadful mask goes away and it becomes the best thing since sliced bread.
My Wife is happy as the snoring has stopped and we both sleep much better. My short temper has gone and I am back to my normal self. My thanks goes to my wife for the constant nagging and to the doctor for getting me diagnosed very quickly, and to Mr Oko for all the help and support I could have ever wanted.
If you feel you or your partner could be suffering from sleep apnoea then please go and get yourself checked. Remember, sleep deprivation is a form of torture; don’t torture yourself or your sleep partner. I will guarantee you will feel the benefit straight away. You will feel full of beans again: don’t delay get checked ASAP.
Last week the Division of Sleep Medicine at Harvard Medical School released the 3rd module of its online Sleep and Health Education Program. “Apnea: Understanding and treating obstructive sleep apnea” features a four-minute video starring celebrity and NBA giant Shaquille O’Neal, who announced the video’s debut on Wednesday in a tweet to the 3.8 million followers of @THE_REAL_SHAQ on Twitter.
The video, “Shaq attacks sleep apnea,” shows O’Neal interacting with Harvard sleep specialists as they prepare him for an overnight sleep study. Then they discuss his treatment options and select a CPAP mask after the study shows that he has moderate OSA. O’Neal reports that treatment is helping him get seven to nine hours of sleep each night, which is giving him more energy and allowing him to manage his weight.
At the 8th Otolaryngology Exhibition and Conference, Philips is demonstrating, for the second year in a row, its most recent innovative range of Sleep Diagnostics and Therapy Solutions. The event will take place in Dubai from the 8th – 10th of May.
Otolaryngology is a branch of medicine that deals with diagnosis and treatment of diseases related to the ear, larynx, and upper respiratory tract. Philips’ participation comes in line with its goal to increase awareness around sleep disorders caused by breathing difficulties.
“There are a number of potential causes for a disturbed night’s sleep. These include sleep disorders such as Obstructive Sleep Apnea (OSA), which affects approximately 4 percent of the adult population”, says Diederik Zeven, General Manager of Philips Healthcare Middle East. “It’s a disorder characterized by airway collapse behind the tongue during sleep, which obstructs breathing. If untreated, it can contribute to the development of high blood pressure, diabetes, heart attacks, and strokes”, he adds.
As a global leader in the management of sleep disorders, Philips Healthcare has developed a wide range of products and solutions, from diagnostic tools through patient-centered sleep therapy devices, to help enhance the quality of sleep and thereby improve the health and well-being of people around the world.
Philips will be hosting a workshop, during the event, on Sleep Therapy Solutions, taking place on the 10th of May, demonstrating sleep apnea therapy devices and masks to the clinicians and offering them a practical hands-on training.
The Philips Healthcare solutions on display at the 8th Otolaryngology Exhibition and Conference are:
- Alice 5™ Polysomnography System: a sleep laboratory system that is suitable for hospital or institutional applications. This system represents the state-of-art technology in sleep diagnostics and combines a total of 55 channels to diagnose sleep disorders in the lab setting.
- Alice PDx™ Portable Sleep Diagnostic System: a portable sleep recording device for Obstructive Sleep Apnea screening, follow up and diagnostic assessment of Cardio-Pulmonary Sleep Disorders. The Alice PDx™ enables clinicians to test their patients outside the lab, at home or clinic, without compromising the study’s results.
- RU Sleeping™: a basic screening device that provides real-time apnea score
- System One Sleep Therapy Platform of CPAP & BiPAP: is the latest generation from Philips Respironics Sleep Therapy Devices for the treatment of Obstructive Sleep Apnea. The new CPAP and BiPAP devices comes with intelligent technology that simplifies patient management by monitoring patients and recognizing when therapy needs are changing, while offering sophisticated comfort enhancements.
- Comfort Gel Nasal & Face Masks: Philips Respironics provides a wide range of patient masks for the treatment of Obstructive Sleep Apnea. Besides it’s unique and comfortable Gel Nasal and Face Masks, it offers minimal contact masks that aims to provide more patient comfort during therapy.