October 2009

AARC Congress Coming Up Soon; Program Online Now
The AARC will be heading to San Antonio this Dec. 5–8, and if the Advance Program is any indication, it should be a great meeting for RTs specializing in sleep. With talks on everything obstructive sleep apnea and cardiovascular disease to the obesity-hypoventilation syndrome, the meeting will bring us up-to-date on the latest thinking in our field. So check out the program, and then register by Oct. 31 for earlybird savings. 

PAP Adherence Document Available to Members
Adherence is a major problem for patients undergoing PAP therapy. 50% quit using their devices after one year. This booklet trains clinicians how to communicate with sleep patients, identify reasons why adherence is poor, and intercede with interventions that may improve compliance. It's a free booklet for members and carries CRCE credit too. LEARN MORE

Kudos To…
Harry Timothy Slomers for passing the NBRC’s new Sleep Disorders Specialty exam in May and earning the SDS credential. Harry earned his CRT in 1999, and his RPSGT in 2004. He works in the Sturgis Hospital Sleep Lab in Sturgis, MI. “With all the changes in sleep, licensing, and accreditation, I would encourage all RTs with a passion for sleep to take the SDS exam,” says the section member. “Although I am a registered sleep technologist, I’ll always be a respiratory therapist first! I consider it a privilege to now be a CRT-SDS.”

Sleep Quality May Affect NIV Success in the ICU
Does sleep quality play a role in noninvasive ventilation (NIV) failure in acute hypercapnic respiratory failure patients? French researchers set out to answer that question in a study involving 27 patients in an ICU who were on NIV for more than 48 hours. All underwent a 17-hour polysomnography study 2–4 days following NIV initiation. Late NIV failure was defined as death, endotracheal intubation, or persistent need for NIV on day 6. Seven of the 14 patients with late NIV failure had an abnormal electroencephalographic pattern verses just one of the 13 patients treated successfully with NIV. Patients failing NIV also had poorer sleep quality with greater circadian sleep-cycle disruption and less nocturnal rapid eye movement sleep, and they were more likely to suffer from delirium during the ICU stay. The study was published in the Sept. 28 Epub edition of Critical Care Medicine. READ ABSTRACT

New Link Found Between Sleep and Alzheimer’s Disease
Researchers who monitored levels of amyloid beta in the brains of mice genetically engineered as a model of Alzheimer's disease found chronic sleep deprivation led to earlier and more frequent development of the brain plaques. They also linked the protein orexin, which helps to regulate the sleep cycle, to the increase. “Orexin or compounds it interacts with may become new drug targets for treatment of Alzheimer's disease,” senior author David M. Holtzman, MD, from Barnes-Jewish Hospital, was quoted as saying. “The results also suggest that we may need to prioritize treating sleep disorders not only for their many acute effects but also for potential long-term impacts on brain health.” The findings were reported in a recent issue of Science Express. READ PRESS RELEASE

Obesity, not OSA, May be to Blame for Impaired Functional Capacity
Most obstructive sleep apnea (OSA) patients are overweight or obese. But the condition occurs in lean people too. A new study out of Brazil looked at the differences between lean patients with OSA and their healthy counterparts, focusing specifically on exercise capacity to determine whether there was a link between OSA and the ability to exercise. All the subjects underwent polysomnography, along with other tests, including spirometry. The research found a higher cervical circumference in the lean OSA patients, along with statistically significant differences in the AHI, minimal oxygen saturation, and mean oxygen saturation. Higher glycemia was seen as well. Peak oxygen consumption, anaerobic threshold, respiratory exchange ratio, blood pressure, and heart rate were similar between the two groups. “These results suggest that OSA does not impair functional capacity in lean subjects and that obesity probably participates in the diminished cardiopulmonary capacity observed in OSA patients,” write the authors. The study appeared in the Oct. 3 Epub edition of CHEST. READ ABSTRACT

Three Most Important Words in CPAP Adherence: Education, Education, Education
When it comes to promoting CPAP adherence, reinforcement is key. That’s the take home message from German researchers who developed a standardized information program for OSA patients who had been treated with CPAP for a period of time. The program was delivered to more than 6,000 people during patient support group meetings held around the country. Questionnaires were mailed to a random sample of 526 support group members, with a return rate of 475. Among that group, 243 had attended one of the sessions and received a booklet reiterating the information provided during the lecture, and 232 had not. People who had attended the informational program were significantly more likely to report longer daily use of their CPAP device (6.9 hours per day versus 5.7) and they also had significantly lower Epworth Sleepiness Scale scores, a median of 6 versus a median of 11. The researchers published their findings in the Sept. 26 Epub edition of Respiration. READ ABSTRACT