A new classification system detailing the type of signals measured by home sleep testing devices for diagnosing obstructive sleep apnea (OSA) appears in the latest issue of the Journal of Clinical Sleep Medicine.

The proposed system categorizes home sleep testing devices, called out-of-center (OOC) testing devices in the paper, based on measurements of Sleep, Cardiovascular, Oximetry, Position, Effort, and Respiratory (SCOPER) parameters. Criteria for evaluating the devices are also presented, based on pre-test and post-test probabilities.

The first widely used classification system for describing sleep testing devices was published by the American Academy of Sleep Medicine (AASM) in 1994. Read the rest of this entry

A newly concluded research study findings published online in the European Respiratory Journal, evaluated the impact a Mediterranean diet can have on obese people with sleep apnea, compared to those on a prudent diet.The study revealed that Mediterranean diet combined with physical activity can help to improve some of the symptoms of sleep apnea.

Obstructive sleep apnea syndrome (OSAS) causes frequent pauses of breathing to occur during sleep, which disrupts a person’s normal sleeping pattern. It is one of the most prevalent sleep-related breathing disorders with approximately 2-4% of the adult population experiencing the condition. This percentage increases up to 20-40% with obesity, and weight loss is often an essential part of the recommended treatment plan.

The researchers, from the University of Crete in Greece, examined 40 obese patients suffering from OSAS. Twenty patients were given a prudent diet to follow, while the other 20 followed a Mediterranean diet. Both groups were also encouraged to increase their physical activity, mainly involving walking for at least 30 minutes each day.

In both groups, the patients also received continuous positive airway pressure (CPAP) therapy which involves wearing a mask that generates an air stream, keeping the upper airway open during sleep. Read the rest of this entry

SleepApneaDisorder/[ Press Release ]/ GLEN BURNIE, Md. /Oct 11, 2011/ NovaSom, Inc., the market leader in technology-driven, payer-aligned cost-saving solutions for obstructive sleep apnea (OSA) management, today announced it has entered a preferred relationship to aid HealthAmerica with managing its sleep disorder diagnostic expenses. Under the agreement, HealthAmerica will direct physicians and patients to the NovaSom(R) Home Sleep Test (HST) instead of in-facility testing for diagnosing OSA, when clinically appropriate. In addition to managing costs, patients overwhelmingly prefer the privacy, convenience and cost savings associated with home testing.“HealthAmerica is driving the adoption of home sleep tests as the preferred solution for addressing the OSA epidemic,” said John Wallendjack, MD, Medical Director, HealthAmerica. “NovaSom has invested in clinical content, work flow process and technology solutions to enable us to rationalize OSA diagnosis and redirect testing to the home, when clinically appropriate.” Read the rest of this entry

The benefits of continuous positive airway pressure machines (CPAP) for patients with obstructive sleep apnea (OSA) are quickly reversed when the therapy is withdrawn, according to Swiss research. The findings appear online in the articles-in-press section of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

“In patients with obstructive sleep apnea who are established on CPAP treatment, withdrawal of the therapy is associated with a rapid recurrence of OSA and sleepiness within a few days” said Malcolm Kohler, MD, senior consultant at the Sleep Disorders Centre and Pulmonary Division of the University Hospital in Zurich. “After 14 days of CPAP withdrawal, OSA patients experienced considerable increases in heart rate and blood pressure as well as a deterioration in vascular function.” Read the rest of this entry

A multidisciplinary clinical practice guideline, “Polysomnography for  Sleep-Disordered Breathing Prior to Tonsillectomy in Children“, was  published as a supplement to the July issue of Otolaryngology—Head  and Neck Surgery. This guideline provides otolaryngologists with  evidence-based recommendations for using polysomnography in assessing  children, aged 2 to 18 years, with sleep-disordered breathing (SDB) and  who are candidates for tonsillectomy, with or without adenoidectomy.

Polysomnography (PSG) is presently the gold standard for diagnosing  and quantifying sleep-disordered breathing in children. SDB affects  approximately 12% of children with manifestations ranging from simple  snoring to potentially serious conditions, including sleep apnea. SDB is  also the most common indication for tonsillectomy with or without  adenoidectomy in the United States. Since more than 530,000  tonsillectomies are performed annually on children younger than the age  of 15, primarily for SDB, clear and actionable guidance on optimal use  of PSG is strongly needed. Read the rest of this entry

Impaired brachial flow-mediated dilation (FMD) is associated with risk for subsequent cardiovascular events in patients after myocardial infarction (MI). These patients often have obstructive sleep apnea (OSA). We tested the hypothesis that patients with OSA post MI will exhibit more severe impairment in FMD.

What is polysomnography and why is it important?

• Polysomnography (PSG), also called a sleep study, is the best test for diagnosing sleep-disordered breathing, which can include snoring, gasping, choking episodes, and breath-holding (apnea).
• PSG is like getting an EKG but while asleep: children stay overnight, with their parent, in a special sleep lab with stick-on electrodes that record oxygen levels, respiratory effort, heart rate, and other factors.
• PSG is important because it helps doctors and families make evidence-based decisions about tonsillectomy and whether the surgery can be ambulatory (out-patient) or requires an overnight hospital stay.

The Importance of Polysomnography Guideline

• First – and only – national, evidence-based guideline on PSG prior to tonsillectomy in children. Read the rest of this entry

Watermark Medical, Inc. (“Watermark”), the leader in Health Information  Technology for managing chronic diseases, has aligned with the American Academy  of Sleep Medicine (AASM) in expanding requirements for board certified doctors  on their end to end cloud based platform for diagnosing Obstructive Sleep Apnea  (OSA).In addition, Watermark announced today the commercial availability of WM  Secure Sleep Study™ (WM S3). The WM S3 integrates with the ARES™ home sleep test to provide “chain of custody” (CoC) validation to support occupational testing  of commercial truck drivers in the comfort of their home or cab. The  transportation industry’s growing recognition of the liability, cost and health  risk resulting from untreated OSA has caused a call to action to implement more  robust screening and testing protocols. Read the rest of this entry

A new computer screening tool developed and patented by a UB physician is helping to detect severe obstructive sleep apnea in cardiovascular patients who have not yet been diagnosed with this common and potentially dangerous condition.

The study, funded by the U.S. Department of Veterans Affairs, is being conducted by a UB researcher at the Veterans Affairs Western New York Healthcare System.

The goal is to evaluate how well the computer screening tool developed at UB diagnoses sleep apnea in patients with heart disease, compared to an overnight sleep study, or polysomnography, considered the ‘gold standard’ for diagnosing sleep apnea.

“The importance of this grant is that it may give us a faster way to screen for sleep apnea in patients who are already at high risk but who are undiagnosed,” says principal investigator Ali A. El Solh, professor of medicine, School of Medicine and Biomedical Sciences, and professor of social and preventive medicine, School of Public Health and Health Professions. Read the rest of this entry

Removing enlarged tonsils and adenoids may help prevent high blood pressure and heart damage in children who suffer from obstructive sleep apnea (OSA), according to a study conducted at Cincinnati Children’s Hospital Medical Center. In some children with obstructive sleep apnea (OSA), adenotonsillectomy can result in significantly lower blood pressure within 24 months of the procedure.

The results will be presented at the ATS 2011 International Conference in Denver.

Children with enlarged tonsils and adenoids are particularly prone to developing obstructive sleep apnea (OSA), said study lead author Lisa Burns, MD, (Pulmonary Fellow at Cincinnati Children’s Hospital Medical Center). And, in children and adults, obstructive sleep apnea (OSA) has been linked with elevations in both daytime and nighttime blood pressure. obstructive sleep apnea (OSA) can also interfere with the normal “dip” in blood pressure levels that occur during sleep. Persistent elevations in blood pressure can result in organ damage, including heart damage. Read the rest of this entry

Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity and mortality, and increased sympathetic activity is considered to be a causative link in this association. Higher levels of sympathetic activity have been reported in children with Obstructive sleep apnea syndrome (OSAS).

Sympathetic predominance is indicated on heart rate variability (HRV) analysis by increased heart rate (HR) and a higher ratio of low-frequency to high-frequency band power (LF/HF). Improvement in Obstructive sleep apnea syndrome (OSAS) after adenotonsillectomy (AT) in children with Obstructive sleep apnea syndrome (OSAS) could, therefore, be associated with reduced HR and reduced LF/HF.

Ventus Medical  Inc reported positive results from a 19-center clinical trial using  its FDA-cleared Provent Sleep Apnea Therapy device to treat obstructive  sleep apnea. Provent Therapy uses the patient’s own breathing to create  expiratory positive airway pressure (EPAP) to keep the airway open  during sleep.

“This randomized, sham-controlled study demonstrates that Provent  Therapy significantly improves the apnea hypopnea index (AHI), a scale  to measure the number of breathing interruptions or stoppages per hour  of sleep, as well as subjective sleepiness, as measured by the Epworth  Sleepiness Scale (ESS), in patients with obstructive sleep apnea,” said  study author Richard B. Berry, MD, professor of medicine at the  University of Florida College of Medicine, medical director of the  University of Florida and Shands Sleep Disorders Center, and former  president of the American Sleep Medicine Foundation. “Importantly,  self-reported patient adherence on Provent Therapy was almost 90%.” Read the rest of this entry

A free information and orientation session for those interested in becoming a polysomnographic technologist, or sleep technician, will be held at Linn-Benton Community College from 9 a.m. to 11 a.m. Tuesday, April 19, in the Calapooia Center, room CC-213, 6500 Pacific Blvd. S.W., Albany.

Polysomnographic technologists assist sleep physicians to help patients with sleep disorders such as sleep apnea.Technologists ready the patient for testing, track the patient’s sleep patterns, and write and interpret the results for the physician.

LBCC’s Polysomnographic Technologist program combines online and in-class instruction with a clinical practicum.Skill areas covered include the physiology of sleep with an emphasis on sleep disorders and their treatment.The program also covers how to administer, interpret and score a variety of sleep tests.Attendance at the orientation session is mandatory before applying for the program.

Classes start June 20 and run through March 17, 2012. Applications for the program are being accepted.Cost is $7,500.

Check the LBCC website for prerequisites at www.linnbenton.edu/go/forms.For more information, contact LBCC Health Occupations and Workforce Education at 541-917-4923.