Pulmonologists speak to US News about the best sleeping positions to prevent sleep apnea.

Sleeping on your stomach can be awkward, and some people who try it find they wake up with a stiff neck. Choosing a very thin pillow or a pillow made specifically for stomach sleepers may help reduce strain on the neck when lying face down.

When sleeping on your side, you’ll likely need a thicker pillow to support the head and neck. Some people prefer to cuddle up to a large body pillow to help keep them in the right position. There are lots of pillows that are marketed specifically for addressing sleep apnea concerns, so do a little research and try out a few to find one that feels right for you.

Losing weight is an effective treatment for obstructive sleep apnea (OSA), but why exactly this is the case has remained unclear. Now researchers in the Perelman School of Medicine at the University of Pennsylvania have discovered that improvements in OSA symptoms appear to be linked to the reduction of fat in one unexpected body part—the tongue.

Using magnetic resonance imaging (MRI) to measure the effect of weight loss on the upper airway in obese patients, researchers found that reducing tongue fat is a primary factor in lessening the severity of OSA. The findings were published in the American Journal of Respiratory and Critical Care Medicine.

“Most clinicians, and even experts in the sleep apnea world, have not typically focused on fat in the tongue for treating sleep apnea,” says Richard Schwab, MD, chief of Sleep Medicine, in a release. “Now that we know tongue fat is a risk factor and that sleep apnea improves when tongue fat is reduced, we have established a unique therapeutic target that we’ve never had before.”

A 2014 study led by Schwab compared obese patients with and without sleep apnea and found that the participants with the sleep disorder had significantly larger tongues and a higher percentage of tongue fat when compared to those without OSA. The researchers next step was to determine if reducing tongue fat would improve symptoms and to further examine cause and effect.

The new study included 67 participants with mild to severe obstructive sleep apnea who were obese—those with a body mass index greater than 30.0. Through diet or weight loss surgery, the patients lost nearly 10% of their body weight, on average, over six months. Overall, the participants’ sleep apnea scores improved by 31% after the weight loss intervention, as measured by a sleep study.

Before and after the weight loss intervention, the study participants underwent MRI scans to both their pharynx as well as their abdomens. Then, using a statistical analysis, the research team quantified changes between overall weight loss and reductions to the volumes of the upper airway structures to determine which structures led to the improvement

Procter & Gamble Ventures, the early stage startup studio within P&G, announced the four finalists for the 2020 P&G Ventures Innovation Challenge. Finalists have been awarded an all-expense paid trip to pitch their products live at The International Consumer Electronics Show at 9:30 am PST on Wednesday, January 8.

The live pitch competition will take place at the P&G LifeLab Stage, Booth #42131, Sands Expo Convention Center, Las Vegas. Winners will be announced via Twitter at @PGVStudio.

For the 2020 Innovation Challenge, P&G Ventures leveraged the KITE SRM platform and operating system to identify, recruit, evaluate, and select this year’s finalists. More than 100 contestants across the United States participated in this year’s challenge, seeking cash prizes, expert guidance from industry leaders, and entry into industry leading accelerators as P&G seeks partners for new CPG product development in women’s health, chronic conditions, enhanced sleep, aging at home, personal performance, male wellness, and non-toxic home care.

The 2020 P&G Ventures Innovation Challenge finalists are:

• Dr. Bryan Fuller, Founder and CEO of DermaMedics
• Dr. Sanna Gaspard, Founder and CEO of Rubitection
• Richard Hanbury, Founder of Sana
• Nicholas Michalak, CEO of SomniFix

Bryan Fuller is the founder and CEO of DermaMedics, a skin care company that specializes in the discovery of anti-inflammatory and anti-aging technologies for the dermatology market.

Sanna Gaspard is the founder and CEO of Rubitection, a medical device startup that is empowering anyone to take the health of their skin into the palm of their hands with a skin wellness tool, the Rubitect Assessment System, that improves the detection, assessment, and care management of dermatological and vascular conditions.

Richard Hanbury is the founder of Sana, a neuromodulation wearable for the control of chronic pain, addiction, and anxiety.

And in the sleep space, Nicholas Michalak is the CEO of SomniFix, an over-the-counter solution to a complex issue: snoring and CPAP noncompliance. SomniFix Strips are noninvasive sleep aids that curb mouth breathing, which SomniFix says is a primary cause of snoring and CPAP noncompliance. By reducing the incidence of mouth breathing, SomniFix Strips ensure that users maintain optimal nasal breathing patterns to

UC Davis uses the Nox T3 to speed the route to sleep-disordered breathing therapy for children with complex medical issues.

By Lisa Spear

When a baby came into the neonatal intensive care unit at UC Davis Medical Center with a plethora of complex medical issues, including severe snoring and trouble breathing throughout the night, the clinicians there knew they needed to conduct a sleep study.

To treat the child as fast as possible, physicians decided against prescribing a polysomnogram (PSG), often considered the gold standard in screening for sleep disorders, and opted for a home sleep study instead. By ordering the home sleep test, in this case the Nox T3 system (FDA approved for patients greater than 2-years-old), the providers were able to diagnose the baby with severe obstructive sleep apnea within 24 hours, instead of waiting potentially weeks to get the child’s health insurance company to approve a PSG.

“Sleep-disordered breathing can make underlying medical issues worse, so that explains the importance of diagnosing it early on in any children,” says Kiran Nandalike, MD, a pediatric pulmonologist at UC Davis Medical Center.

The patient was one of 51 hospitalized children, all under the age of 18, who have participated in an ongoing program in which the University of California hospital opted to use home sleep tests (HST) in pediatric patients with complex medical issues. Because the HST route facilitates patients being diagnosed and treated faster, over a few years, clinicians found that these less expensive tests contributed to faster recovery times and overall better outcomes in this patient population, says Nandalike, who spearheaded the program and trained the sleep lab technologists to work with pediatric patients.

“Now we have a system in place and after doing this for one to two years, we saw how it was making a good difference in these patients,” she says.

After seeing favorable results from their new screening protocol, one of the UC Davis medical fellows at the time, Gurinder Singh, MD, decided to take a look at the data. He and his colleagues compiled the results in a retrospective study, published in

Study results published in the International Journal of Pediatric Otorhinolaryngology show a connection between secondhand smoke and obstructive sleep apnea in children.

OSA has a relatively low prevalence in children (4%) compared with habitual snoring (10%). Few studies have assessed the role of SHS on OSA severity, and those that have demonstrate contradicting results.

The current retrospective, single-center, Institutional Review Board-approved study assessed the association between exposure to SHS and OSA severity in children between 3 and 18 years.

Data were obtained by querying Electronic Medical Records (EMR). Investigators analyzed SHS as a binary variable and OSA as a continuous variable, measured using OAHI from polysomnography (PSG) in all children.

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People who take long naps during the day or sleep 9 or more hours at night may have an increased risk of stroke. This is according to a study published in the December 11, 2019, online issue of Neurology, the medical journal of the American Academy of Neurology.

People who took a regular midday nap lasting more than 90 minutes were 25% more likely to later have a stroke than people who took a regular nap lasting from 1 to 30 minutes. People who took no naps or took naps lasting from 31 minutes to one hour were no more likely to have a stroke than people who took naps lasting from one to 30 minutes.

“More research is needed to understand how taking long naps and sleeping longer hours at night may be tied to an increased risk of stroke, but previous studies have shown that long nappers and sleepers have unfavorable changes in their cholesterol levels and increased waist circumferences, both of which are risk factors for stroke,” says study author Xiaomin Zhang, MD, PhD, of Huazhong University of Science and Technology in Wuhan, China, in a release. “In addition, long napping and sleeping may suggest an overall inactive lifestyle, which is also related to increased risk of stroke.”

The study involved 31,750 people in China with an average age of 62. The people did not have any history of stroke or other major health problems at the start of the study. They were followed for an average of 6 years. During that time, there were 1,557 stroke cases.

The people were asked questions about their sleep and napping habits. Midday napping is common in China, Zhang says. Eight percent of the people took naps lasting more than 90 minutes. And 24% said they slept 9 or more hours per night.

The study found that people who sleep 9 or more hours per night are 23% more likely to later have a stroke than people who sleep seven to less than 8 hours per night. People who sleep less than 7 hours per night or between 8

This course has been coordinated through the University of California, San Francisco Department of Otolaryngology-Head and Neck Surgery and the Penn Center for Sleep Disorders at the University of Pennsylvania. The program is designed to provide a comprehensive review and update on recent advances in sleep apnea and snoring. New approaches and controversies in the management of patients with sleep disordered breathing will be highlighted. Leaders in the field from Pulmonary and Critical Care Medicine, Otolaryngology – Head and Neck Surgery, Dentistry, Oral and Maxillofacial Surgery, Pediatrics, Bariatric Surgery, Neurology and Obesity Research will share their medical and surgical expertise in didactic sessions, case presentations and workshops with the intent to close practice gaps in physician knowledge and competence for diagnosing and managing sleep disordered breathing and complications resulting thereof. Patients with sleep disordered breathing are highly prevalent in every physician’s practice, and complications related to the disease can manifest in a number of ways to the detriment of patient health and well-being. There will be ample opportunity for interaction with participating faculty. An electronic course syllabus, complete with program outline and up-to-date references, will be provided to each participant. Please bring your laptop or tablet if you would like to view the syllabus during the didactic sessions.

TARGET AUDIENCE
This continuing medical education activity is intended for the physician in Sleep Medicine, Otolaryngology-Head and Neck Surgery, Pulmonary Medicine, Oral and Maxillofacial Surgery, Family Practice, Internal Medicine, Pediatrics, Cardiology, Neurology, Psychiatry, Anesthesia, and Geriatrics. Dentists, sleep respiratory therapy technologists, nurses, and other healthcare professionals are also invited to attend this program.