May 2011

Spring Bulletin Online Now
The Spring edition of our Section Bulletin is ONLINE now, with three informative articles: two that address the need for inpatient testing for OSA and a third that delves into the opportunities that exist in portable home testing for patients who cannot or will not have an in-lab sleep study.

CPAP Treatment May Improve Cholesterol Levels
A new study out of Australia suggests treatment with CPAP can help lower total cholesterol and triglycerides in patients with severe OSA. The randomized, placebo-controlled crossover trial assessed the effect of two months of therapeutic and placebo CPAP on postprandial lipidemia (PPL) in 29 patients. Results showed CPAP reduced PPL when compared with placebo, with a mean TAG-AUC24 difference of -357 mmol.L-1.day. TAG levels peaked during both wakefulness (2 p.m.) and sleep (3 a.m.) in both arms of the study, but both peaks were lower during CPAP than placebo. Mean 24-hour total cholesterol was -0.19 mmol.L-1 lower on CPAP as well. The authors conclude, “The results imply that the association between OSA and cardiovascular disease may, in part, be caused by direct effects on dyslipidemia.” The study was published ahead of print by the American Journal of Respiratory and Critical Care Medicine on April 28. READ ABSTRACT

Anxiety Disorder, ADHD May Put Kids at Risk for Sleep Problems
Children with anxiety disorder and attention deficit/hyperactivity disorder (ADHD) are at higher risk for sleep problems, report researchers from Norway who conducted a cross-sectional, case-control study involving 141 children between the ages of 7 and 13. The children were divided into four groups: anxiety disorder; ADHD; a combination of anxiety disorder and ADHD; and healthy controls. Sleep problems were assessed via a standardized sleep questionnaire completed by the mother. All of the children in the clinical groups had more sleep problems than the healthy controls, with those in the anxiety disorder and combined anxiety disorder/ADHD groups faring the worst. “Clinical management of children with ADHD and anxiety disorders needs to include assessment of sleep problems,” conclude the investigators. The study was published ahead of print by European Child & Adolescent Psychiatry on May 1. READ ABSTRACT

iRBD Can Affect Cognitive Functioning
Patients with idiopathic REM sleep behavior disorder (iRBD) may also be suffering from an underlying evolving degenerative process, find researchers publishing in the May issue of SLEEP. They followed 24 cognitively asymptomatic iRBD patients with a mean age of 69.5 for two years, comparing their results on standard cognitive tests with those of 12 sex-, age-, and education-matched healthy controls. Executive functions, attention, and language were all normal, although the iRBD patients scored worse than controls on tests to measure delayed verbal memory and visuo-constructional abilities. At the two year follow up these patients continued to score lower on those two tests and they also showed a significant worsening in visuo-spatial learning when compared with controls. READ ABSTRACT

OSA Predicts AF Recurrence in Catheter Ablation Patients
Patients who undergo catheter ablation to treat atrial fibrillation (AF) are more likely to see the condition return if they also suffer from OSA. That’s the take home message from Los Angeles researchers who conducted a meta-analysis of studies that looked at the problem. Six trials involving 3995 patients met their inclusion criteria. In total, OSA conferred a 25% greater risk of an AF recurrence. On further analysis, polysomnography-confirmed OSA was found to be a strong predictor, while OSA diagnosed via the Berlin questionnaire was not. “In addition to other factors, a diagnosis of OSA merits special consideration when evaluating patients for catheter-based AF ablation,” write the authors. The study was published ahead of print by the American Journal of Cardiology on April 28. READ ABSTRACT