July 2011
Adopt-a-Company is Your Chance to Connect with Your Community
The AARC is partnering with DRIVE4COPD in a new campaign aimed at delivering COPD education and screening to the people who need it most: working Americans who may be at risk for this chronic lung condition but don’t even know it. Find out how you can help by adopting a company in your community. READ MORE
Paid Malpractice Claims are Common in Outpatient Settings
Sleep clinics may believe they are at a significantly lower risk for malpractice claims than hospitals, but such is not the case. According to a new study in the June 15 edition of JAMA, paid malpractice claims are similar for the inpatient and outpatient settings. The Weill Cornell Medical College investigators based their results on data from 2009 that showed 47.6% of all paid claims occurred in inpatient settings and 43.1% occurred in outpatient settings. The remaining 9.4% involved both settings. The most common reason for a paid claim in the outpatient setting was diagnostic in nature, while inpatient claims were paid most often for surgical cases. READ ABSTRACT
Glycemic Control Worsens with Increasing Severity of OSA
British researchers publishing ahead of print in Diabetes Technology & Therapeutics on June 29 find increasing severity of obstructive sleep apnea (OSA) is linked to worsening glycemic control. The investigators arrived at that conclusion after studying 52 consecutive patients attending a diabetes obesity clinic who had risk factors for sleep apnea. All underwent a polysomnography study, and OSA prevalence came in at 58%. After adjusting for co-founders, researchers found increased severity of OSA was associated with increased HbA1c levels, although a plateau effect between the two was noted from the moderate to severe OSA levels. The authors speculate that identifying and treating OSA in type 2 diabetes patients could “confer benefits in improving glycemic control.” READ ABSTRACT
SDB Linked to Rise in BP in Kids
Any degree of sleep-disordered breathing (SDB) puts children at risk for an increase in blood pressure (BP), report Australian researchers who looked at SDB and BP in 105 children referred for assessment of SDB and 36 non-snoring controls. BP data were categorized into four groups: quiet awake (recorded before sleep onset), non-rapid eye movement sleep 1 and 2 combined, slow-wave sleep, and rapid eye movement sleep. The children were assigned to groups based on their apnea/hypopnea index. Results showed:
- BP recorded before sleep onset and during overnight sleep was elevated by 10 to 15 mm Hg in the three SDB groups compared with the control group; this finding was independent of SDB severity.
- BP during stable sleep (with respiratory events and movements excluded) was also elevated in the children with OSA compared with the control group.
- BP was elevated in rapid eye movement sleep compared with the non-rapid eye movement sleep, and heart rate was higher during wake state than in all sleep states.
The authors believe these findings call for clinicians to consider the cardiovascular effects of SDB of any severity on children with the condition. The research was published ahead of print in Pediatrics on June 27. READ ABSTRACT
Nasal, Oronasal Masks Deliver Similar Mean Pressures, But Differences Remain
A study published in this month’s Sleep noted no significant differences in mean pressures delivered with an oronasal mask or face mask during CPAP titration studies, but nasal-to-oronasal mask-pressure differences were noted in 43% of subjects. The investigators also found that residual respiratory events, arousals, and measured leak were greater with the oronasal mask, while the nasal mask was preferred by 79% of the patients. The research involved 24 treatment-naïve patients and was conducted in a prospective, randomized, cross-over design on two consecutive nights of CPAP titration. “Patients with obstructive sleep apnea syndrome can generally switch between nasal and oronasal masks without changing machine pressure, although there are individual differences that may be clinically significant,” conclude the authors. READ ABSTRACT |
