November 2011

 

Fall Bulletin Online Now

The latest edition of our quarterly Bulletin is up on the SECTION WEBSITE now, with great articles on commercial drivers and sleep disordered breathing, caffeine and sleep, and how community talks can help spread the word about the need for sleep testing and treatment.

Symptom Screening Identifies Bariatric Surgery Patients Needing Polysomnography

Screening obese patients scheduled for bariatric surgery for symptoms of sleep apnea syndrome (SAS) appears to be a good method of identifying those patients who should be evaluated by polysomnography, report researchers from the University of California, Davis. They studied 834 patients who had completed a preoperative evaluation, finding 25% had previously diagnosed SAS and an additional 21% exhibited symptoms of the condition. Those exhibiting symptoms then underwent polysomnography, and 73% were diagnosed with SAS requiring treatment. Six percent had mild sleep apnea and the remaining 21% tested negative for the condition. “To avoid the potential perils of undiagnosed SAS during the perioperative period, patients who undergo bariatric surgery should be screened, tested, and treated for this co-morbidity,” conclude the investigators. The study was published ahead of print in Surgery for Obesity and Related Diseases on July 24. READ ABSTRACT

Denture Wear May Up AHI

Should elderly obstructive sleep apnea (OSA) patients wear their dentures while sleeping? Probably not, conclude Canadian researchers who studied denture wear during sleep in 23 patients with a mean age of 69.6 years. Results showed a higher apnea/hypopnea index (AHI) when patients slept with their dentures, particularly among patients with mild OSA, who saw their AHI increase on average from 8.9 events per hour to 16.6. Among ten of 14 patients who reported preferring to sleep with their dentures, the AHI increased during denture wear. “Contrary to previous studies, we found that OSA patients may experience more apneic events if they sleep with their dentures in place,” write the authors. The study was published ahead of print in Sleep & Breathing on Sept. 21. READ ABSTRACT

Even Mild OSA Affects Heart Rate Variability

A new study out of Harvard Medical School finds patients with asymptomatic OSA suffer from reductions in cardiac vagal modulation. Investigators arrived at that conclusion after performing polysomnography followed by simultaneous electrocardiographic and impedance cardiographic recordings in 74 obese patients without cardiovascular disease, 59% of whom had OSA with a media AHI of 25.8 events per hour. Significantly decreased daytime time- and frequency-domain heart rate variability (HRV) indexes, but not significantly different preejection periods, were seen in the OSA patients compared to the controls. After controlling for age, gender, blood pressure, fasting cholesterol levels, and glycosylated hemoglobin, the AHI significantly predicted time-domain HRV measures in all awake conditions. The study was published ahead of print by the American Journal of Cardiology on Sept. 24. READ ABSTRACT

OSA Linked to Diabetes, Pre-Diabetes

Extremely obese people with pre-diabetes and type 2 diabetes are at high risk for OSA, find researchers publishing ahead of print in Cardiovascular Diabetology on Sept. 25. Their study was conducted among 137 patients who underwent somnography and a two hour oral glucose test. Eighty-one percent of the men in the study and 55% of the women were found to have OSA, and OSA was significantly more common among those diagnosed with either pre-diabetes (67%) and type 2 diabetes (78%) than in those with normal glucose tolerance (33%). The findings held true even after the results were adjusted to take age, gender, body mass index, and other factors into account. READ ABSTRACT