February 2012

Notes from the Section

• The Winter edition of our Section Bulletin is ONLINE now, so click over to read great articles on the PAP-NAP and surgical options for sleep apnea. We also have a “Notes” column from Chair Mike Runge and a profile of our 2011 Specialty Practitioner of the Year.
• Accessing our section discussion list on AARConnect has just gotten a lot easier. Go HERE for instructions on downloading our mobile app on your Blackberries, Androids, and iPhones.
• AARC Executive Director Sam Giordano, MBA, RRT, FAARC, will retire in June and the search is on for his replacement. If you are interested in applying for the position, CHECK OUT the application requirements.

Sleep Disturbances Carry High Risk

A new study out of the Perelman School of Medicine at the University of Pennsylvania suggests poor sleep quality puts people at risk for health conditions ranging from obesity to heart disease. Researchers analyzed data on 138,201 people in the 2009 Behavioral Risk Factor Surveillance System, focusing on difficulty falling asleep or staying asleep, or getting too much sleep. After adjusting for cofounders, they found a 35% higher risk for obesity, 54% higher risk for diabetes, 98% higher risk for coronary heart disease, 80% higher risk for heart attack, and 102% higher risk for stroke in people who reported sleep disturbances at least three nights per week. “This study is one of the largest ever to link sleep problems with important cardiovascular and metabolic diseases. It joins other studies that show that sleep is an important part of health, just like diet and physical activity,” study author Philip R. Gehrman, PhD, CBSM, was quoted as saying. The study was published in the online edition of the Journal of Sleep Medicine in January. READ PRESS RELEASE

ASV Outperforms CPAP in Heart Failure Patients with OSA and CSA/CRS

German researchers who compared the use of auto servo-ventilation (ASV) with CPAP in 70 patients with obstructive sleep apnea (OSA) and central sleep apnea/Cheyne-Stokes respiration (CSA/CRS), along with arterial hypertension, coronary heart disease or cardiomyopathy, and clinical signs of heart failure, found both modes of ventilation significantly improved respiratory disturbances, oxygen desaturation, and arousals. However, ASV was more effective in reducing the central apnea-hyopnea index and brain natriuretic peptide levels. Exercise performance and echocardiographic parameters were similar between the two groups. The authors conclude, “ASV improved CSA/CSR and brain natriuretic peptide over a 12 month period more effectively than CPAP.” The study was published ahead of print by CHEST on Jan. 26. READ ABSTRACT

Telephone Counseling Ups CPAP Compliance

Could regular telephone counseling improve CPAP compliance among your OSA patients? Yes, report French researchers who provided telephone counseling to 66 patients on days 3, 10, 30, 60, and 90 following the initiation of CPAP therapy. At a six month follow up, 94% of the patients who received the counseling were compliant with their CPAP vs. 81% in a control group. Patients in the intervention group were also using their CPAP for more hours per night at the three month follow up, but the result was not statically significant. “An educational intervention dispensed by phone is applicable and would have an impact on CPAP compliance,” write the authors. They call for a larger study using a randomized design to confirm their findings. The study appeared in the January edition of Revue Des Maladies Respiratorires. READ ABSTRACT

OSA in the Nation’s Vets

A study conducted among 596 veterans undergoing polysomnography at the Cincinnati Veterans Affairs Medical Center from 2005-2007 is helping to describe the OSA problem among the nation’s vets. Researchers found OSA in 76% of the patients, with 47% diagnosed with severe disease. Increasing OSA severity was linked to increasing body mass index, neck circumference, Epworth Sleepiness Scale score, hypertension, congestive heart failure, and type 2 diabetes. Eight-one percent of the vets were given positive airway pressure treatment, but good adherence was seen in only 59%. Among patients who were compliant, those with severe OSA were more likely to report an excellent response to the treatment. The study was published ahead of print in Preventing Chronic Disease on Jan. 26. READ ABSTRACT