May 2013
Spring Bulletin Online Now
Section Chair Russ Rozensky offers a preview of a new survey in the works for the section in his Notes column and also authors an informative article about a new law set to go into effect in New York next year to regulate health professionals working in sleep. A piece on drowsy driving in the teen years rounds out the Spring issue. READ ISSUE
Explaining the Health Effects of Sleep Deprivation
British researchers who conducted studies in eight healthy volunteers between the ages of 20 and 35 believe they are helping to shed some light on how sleep deprivation impacts cardiovascular disease and sleep apnea. The volunteers slept a normal eight hours on the first two nights of the study, then slept four hours during each of three consecutive nights. A significant reduction in vascular function was noted after two nights of short sleep, but it returned to baseline after the third night, suggesting an adaptive response to acute sleep loss. In other tests, the researchers exposed the subjects to moderately high levels of carbon dioxide, which normally increases the depth and rate of breathing. However, breathing control was substantially reduced after the volunteers lost sleep. The researchers later had these volunteers sleep ten hours a night for five nights. After completing the same tests, results showed that vascular function and breathing control had improved. The authors believe these findings could suggest a mechanism behind the connection between sleep loss and cardiovascular disease. The loss of breathing control could play a role in the development of sleep apnea as well. The researchers presented their findings at Experimental Biology 2013, held in April. READ PRESS RELEASE
SW/ST Dreams Differ from RBD Dreams
A new study out of France found significant differences in dreams experienced by people suffering from sleepwalking or sleep terrors (SW/ST) and those with rapid eye movement behavior disorder (RBD). The investigators collected mentations associated with SW/ST and RBD behaviors over the patients’ lifetimes and following video polysomnography. Enacted dreams were recalled by 91% of 32 subjects with SW/ST and 87.5% of 24 subjects with RBD. RBD dreams were more complex and less bizarre than those reported by SW/ST patients, but they also had a higher level of aggression. Up to 70% of the SW/ST dreams included a threatening situation vs. 60% of the RBD dreams. Misfortunes and disasters were more common in SW/ST dreams while human and animal aggressions took place more often in RBD dreams. Sleepwalkers were more likely to flee from a disaster, with only 25% reporting fighting back when attacked. Conversely, 75% of RBD patients counterattacked when assaulted. “Different threat simulations and modes of defense seem to play a role during dream-enacted behaviors…paralleling and exacerbating the differences observed between normal dreaming in nonrapid eye movement (NREM) vs. rapid eye movement (REM) sleep,” conclude the investigators. The study was published ahead of print by Sleep Medicine on April 16. READ ABSTRACT
CPAP Reduces the Risk of AF Recurrence Following PVI
CPAP therapy can play a key role in helping OSA patients with atrial fibrillation (AF) avoid an AF recurrence after undergoing pulmonary vein isolation (PVI), report researchers from Beth Israel Deaconess Medical Center and Harvard Medical School. They looked at outcomes for 426 patients who underwent PVI; 62 had OSA. Among the OSA patients, 32 were defined as CPAP users. Over a 12 month follow up, AF-free survival was 71.9% in CPAP users vs. 36.7% in CPAP non-users; 65.6% vs. 33.3%, respectively, experienced AF-free survival off anti-arrhythmic drugs or repeat ablation. AF recurrence in the CPAP users was similar to that seen in AF patients without OSA. Recurrence in CPAP non-users was similar to that seen in OSA patients with AF who were managed medically without ablation. The authors conclude, “CPAP is an important therapy in OSA patients undergoing PVI that improves arrhythmia free survival. PVI offers limited value to OSA patients not treated with CPAP.” The study was published ahead of print by the Journal of the American College of Cardiology on April 23. READ ABSTRACT
OSA Website Improves CPAP Compliance
Could a website devoted to CPAP encourage OSA patients to be more adherent to the therapy? San Diego researchers believe the answer may be yes. They compared outcomes among patients who viewed an interactive website called MyCPAP with those of patients receiving usual care. Patients in the MyCPAP group filled out questionnaires aimed at gauging their perspective on using the site as well. The randomized, controlled trial found higher CPAP compliance among the MyCPAP users at a two month follow up. MyCPAP users also reported little concern about sharing their CPAP data on the Internet, and while they did increase their use of the Internet to find information on OSA, they did not use the Internet more often to find other health-related information. The study was published ahead of print by the International Journal of Telemedicine and Applications on Mar. 14. READ ABSTRACT
