November 2008

Notes from the Section

• The fall issue of our Section Bulletin is online now, so click on the link and spend some quality time reading great articles on avoiding the appearance of impropriety and hybrid sleep centers.
• If you’re planning to attend the AARC Congress in Anaheim, this Dec. 13–16, be sure to come by the section meeting, scheduled for Tuesday, 11:35 a.m.–12:15 p.m.
• The meeting is also offering the very first administration of the NBRC’s new sleep specialty exam. Check it out here.
• Learn more about the AARC Congress and what it has to offer RTs specializing in sleep in the Advance Program.
• And for an inside look into other aspects of the meeting—including some great videos of last year’s event and a link to things to see and do in Orange County that was constructed especially for the AARC—go here.

CPAP Improves Blood Pressure, Metabolic Syndrome
CPAP treatment appears to lower blood pressure and reduce other aspects of the metabolic syndrome in people with obstructive sleep apnea (OSA) who adhere to the treatment. Researchers publishing in the October issue of CHEST studied 32 severe OSA patients, 16 of whom were adherent to CPAP for at least 4 hours per night over an 8 week period and 16 of whom did not meet this standard. By the end of the study, adherent patients had significant reductions in morning systolic and diastolic blood pressure, total serum cholesterol, and insulin resistance. They also improved on measures of oxidative stress and systemic inflammation. No changes were noted in the nonadherent group. The most common reason for nonadherence in the study was mask leak, and this was more frequent among extremely obese patients. READ ARTICLE

The Latest on Home Sleep Testing, CPAP Therapy
Sleep testing continues to be the focus of government agencies. Over the past month:

• Palmetto GBA, which covers California, Nevada, and Hawaii, released its draft Local Coverage Determination for home sleep testing, specifically calling for the apnea-hypopnea index (AHI) to be based on a minimum of two hours of sleep. Comments are being accepted until December 15. READ ARTICLE
• The Centers for Medicare and Medicaid Services has added language to its National Coverage Determination (NDC) for home CPAP therapy stating that an initial 12-week period of CPAP is covered in adult patients with OSA if: 1. The AHI or respiratory distress index (RDI) is greater than or equal to 15 events per hour, or 2. The AHI or RDI is greater than or equal to 5 events and less than or equal to 14 events per hour with documented symptoms of excessive daytime sleepiness, impaired cognition, mood disorders or insomnia, or documented hypertension, ischemic heart disease, or history of stroke. The AHI or RDI is calculated on the average number of events per hour; if based on less than 2 hours of continuous recorded sleep, the total number of recorded events must be at a minimum the number of events that would have been required in a 2-hour period. READ NCD

Sleep Problems Linked to Cognitive Functioning in the Elderly
A new study out of North Carolina State University suggests a link between trouble falling asleep and cognitive functioning in older African Americans. The research was conducted among 174 people ages 65 to 90. Those who reported difficulty falling asleep scored worse on tests to measure working memory—skills necessary to multitask. The authors believe this finding may suggest a role for the treatment of sleep disorders in preventing or minimizing cognitive problems in older people. The research was published in this month’s Research on Aging. READ PRESS RELEASE

Asleep or Awake, the Brain is the Same
Johns Hopkins researchers who timed rapid eye movements (REM) in 11 healthy male and female volunteers while also taking MRI images to visualize brain activity have found that the brain functions much the same during sleep as it does when people are awake. The finding could significantly improve the diagnosis and monitoring of conditions involving the brain, including psychiatric disorders, Parkinson’s disease, and Alzheimer’s disease, because MRIs are easier to conduct on sleeping patients, who are more likely to remain still throughout the procedure. Obtaining reliable results in awake patients often requires the study of multiple subjects, whereas the REM study produced robust findings in a single participant after just six minutes of REM sleep. The study appeared in the October issue of Human Brain Mapping. READ PRESS RELEASE