June 2012
Specialty Practitioner of the Year: Deadline Quickly Approaching!
There are only a few weeks left to nominate a fellow section member for our 2012 Specialty Practitioner of the Year Award, so take some time today to consider who among your colleagues you feel is deserving of this prestigious honor. The nomination deadline is July 31, and nominations may be made via our online NOMINATION FORM.
Sleep Problems Common in TBI
Australian researchers who studied sleep problems in a large cohort of patients with traumatic brain injury (TBI) find fatigue and sleep disturbances are common in these patients and are associated with anxiety, depression, and pain. Fatigue was also linked to slowed information processing and increased effort in performing tasks. Polysomnography revealed reduced sleep efficiency, increased sleep onset latency, and increased time awake after the onset of sleep. These patients also had an increase in slow-wave sleep. Lower levels of melatonin production were seen as well and were associated with less rapid-eye movement sleep. While depression and pain were found to exacerbate sleep problems in this group, they could not entirely account for the sleep problems. The authors conclude treatments such as cognitive behavior therapy supporting lifestyle modifications, pharmacologic treatments with modafinil and melatonin, and light therapy to enhance alertness, vigilance, and mood may help these patients. They call for more study to investigate their value in this patient population. The study was published in the May edition of the Journal of Head Trauma Rehabilitation. READ ABSTRACT
SDB Ups Mortality Rate for Cancer Patients
Cancer patients with severe sleep disordered breathing (SDB) had nearly a five times higher mortality rate than those without SDB in a recent study conducted by investigators from the University of Wisconsin-Madison. The researchers analyzed 22-year mortality data on 1522 subjects from the Wisconsin Sleep Cohort. The findings held true even after the investigators adjusted them to take factors such as age, sex, body mass index, and smoking into account. The higher death rate for people with severe SDB was most significant among non-obese subjects than obese subjects. “If the relationship between SDB and cancer mortality is validated in further studies, the diagnosis and treatment of SDB in patients with cancer might be indicated to prolong survival,” study author Dr. F. Javier Nieto was quoted as saying. The study was presented at the American Thoracic Society conference in May. READ PRESS RELEASE
More Evidence on OSA, CPAP, and Hypertension
A new study out of Spain adds to the evidence that CPAP can help reduce blood pressure in patients with OSA. Researchers followed 1889 patients who were without hypertension at baseline and were referred for nocturnal polysomnography between 1994 and 2000. Over the 12-year trial, 37.3% of the subjects developed hypertension. The crude incidence of hypertension per 100 person-years was 2.19 in those not diagnosed with OSA, 3.34 in those with OSA ineligible for CPAP therapy, 5.84 in those with OSA who declined CPAP therapy, 5.12 in those with OSA nonadherent to CPAP therapy, and 3.06 in those with OSA who were treated with CPAP therapy. “Compared with participants without OSA, the presence of OSA was associated with increased adjusted risk of incident hypertension; however, treatment with CPAP therapy was associated with a lower risk of hypertension,” write the authors. The study appeared in the May 23 edition of JAMA. READ ABSTRACT
Surgery for OSA Reduces Seizures in Kids with Epilepsy
Surgical treatment of OSA for young children with epilepsy may lead to a reduction in seizures, report Harvard researchers publishing in the June issue of Pediatric Neurology. They followed 27 patients with a median age of five who had surgery to correct their OSA. Three months after surgery, 37% were seizure free, 11% demonstrated greater than a 50% reduction in seizures, and 22% exhibited an amelioration of seizure frequency. Seizure frequency was unchanged in 7% of the patients, and it worsened in 22%. Median seizure frequency went from 8.5 prior to the surgery to three, for a reduction of 53%. The findings were strongest in children with elevated body mass index scores and those who had the surgery at a younger age. READ ABSTRACT
