Study Links Sleep-disordered Breathing to Age Acceleration

Increasing severity of sleep-disordered breathing and sleep disruption are associated with epigenetic age acceleration, according to preliminary results of a new study.

Results show that each standard deviation increase in the apnea-hypopnea index, a measure of sleep-disordered breathing severity, was associated with the equivalent of 215 days of biological age acceleration. Similarly, each standard deviation increase in the arousal index, a measure of sleep disruption, was associated with the equivalent of 321 days of age acceleration.

“People’s biological age might not be the same as their chronological age,” said lead author Xiaoyu Li, ScD, a postdoctoral research fellow in the Division of Sleep and Circadian Disorders in the Department of Medicine at Brigham and Women’s Hospital and the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts. “Individuals whose biological age is higher than their chronological age exhibit age acceleration or fast aging. In our study, we found that more severe sleep-disordered breathing is associated with epigenetic age acceleration. Our data provide biological evidence supporting adverse physiological and health effects of untreated sleep-disordered breathing.”

Sleep-disordered breathing, such as obstructive sleep apnea, is characterized by abnormalities of respiration during sleep. Episodes often result in reductions in blood oxygen saturation and are usually terminated by brief arousals from sleep. Nearly 30 million adults in the U.S. have obstructive sleep apnea. Common warning signs include snoring and excessive daytime sleepiness.

According to the authors, epigenetic age acceleration is a DNA methylation-based marker of fast biological aging, and it is associated with modifiable lifestyle factors. Although sleep-disordered breathing is associated with multiple age-related health disorders, its relationship with epigenetic aging has not been well studied.

The study involved 622 adults with a mean age of 69 years; 53.2% were women. Participants were measured for blood DNA methylation, and their sleep was evaluated at home by polysomnography. Age acceleration measures were calculated as residuals from the regression of each epigenetic age on chronological age. The association of each sleep-disordered breathing trait with age acceleration was estimated using linear regression, controlling for socio-demographics, health behaviors, body

Snoring Remedies That Actually Work

We all want a good night’s sleep. That’s why we all look forward to sleeping when we get home from work. It’s the ultimate break from all the chaos and stress of the day. We all need to get a good night’s sleep to be able to rejuvenate. Unfortunately, there’s a major road block to getting a good night’s sleep and that is snoring.

According to The National Sleep Foundation, frequent snoring affects more than 100 million people in the U.S. Even more people experience infrequent snoring and may suffer from poor quality sleep. It will affect both the snorers and their partners, and may cause disrupted sleep for your entire family. It explains the high interest in quick fixes by snorers.

(Via: https://theinscribermag.com/snoring-remedies-for-a-better-night/)

We snore because the airflow in our nose and mouth is restricted. It is blocked by the tissues surrounding both our nose and mouth.

Snoring is caused by restricted airflow in the mouth and nose. When it is blocked by your esophageal and nasal tissues, air will cause an increased likelihood of vibration, which will be translated into sound.

(Via: https://theinscribermag.com/snoring-remedies-for-a-better-night/)

There are several causes of snoring. Allergies, sleeping pills, and heavy intake of alcohol could all cause someone to snore. Sleep apnea can definitely cause someone to snore all the time.

Common causes of snoring include underlying medical conditions such as sleep apnea, and allergies, or the use of sleeping pills or alcohol before bed.

(Via: https://theinscribermag.com/snoring-remedies-for-a-better-night/)

Not all snores are the same. Interestingly, there are different kinds of snorers.

Depending on the tissue involved, there are several types of snorers. Nasal snorers will experience snoring because of blocked passages or a deviated septum. Tongue-based snorers will often snore when the tongue is in a hyper-relaxed state. Mouth snorers sleep through their mouth while sleeping, which may cause the soft palate tissues to vibrate against each other.

(Via: https://theinscribermag.com/snoring-remedies-for-a-better-night/)

Whether the snore is coming from the nose, tongue, or the mouth, one thing is the same. The snore is irritating and it can hinder a peaceful sleep. Luckily, there are snoring …

3 Biggest Bedtime Mistakes

If your little one’s not sleeping well, the first place to look for the problem is at bedtime. A well-crafted, consistent bedtime routine is the foundation for great sleep skills, but what’s the secret to crafting one that works? I’ve got three great tips for you in today’s video to help you do just that!

Rather read than watch? Click here.

A Tale To Tell: A Funny Story On Snoring

Here’s a funny story. It’s about a husband who learned to stop his snoring on his own. Well, actually he got some help from his wife. But of course, he won’t admit that.

He starts his story animatedly, describing how his wife recorded his snoring.

My wife complained that I snore.

Ever forgiving in other aspects of our co-habitation, she decided to record me in the act.

She played it back while I was sleeping. She played it back in all its orchestral glory, thinking this might cure me.

But she says I broke into a two-part harmony.

She tried giving me left hooks and I woke up with bruises up my arm.

She said, “I thought you were dead. You stopped breathing.”

I heard, “You stopped breeding.”

“I was doing it in my sleep!” I exclaimed.

(Via: https://www.theglobeandmail.com/life/first-person/article-how-i-learned-to-stop-snoring-reluctantly/)

Aside from his snoring issues, the husband obviously has some hearing issues as well. Poor wife has to put up with both. Then again, you got to hand it to the husband, he eventually admitted that he had a snoring problem.

It takes a certain amount of self-criticism to reach the conclusion that your wife might be right about: a) your snoring, and b) about the need to do something about your snoring. So, as the final submission of the snorer to the snoree, I agreed to go to a sleep clinic to be tested.

(Via: https://www.theglobeandmail.com/life/first-person/article-how-i-learned-to-stop-snoring-reluctantly/)

So, he went to a sleep clinic. He checked himself in right in the middle of winter. You’d think the sleep clinic would be a posh, comfortable place. Based on his description, it was a far cry from it.

The bedroom I was assigned to was like a room in the Bates Motel. The art on the wall was enough to give me nightmares – blackbirds with yellow eyes, although the caption read, “Moonlight over the Prairies.”

The technician went to work on me. He placed suction caps with wires on my head and face. The wires were inserted into a box at my bedside that would transmit my brainwaves and

How to Find The Right Pillow

pillows

When you purchase your first bed, you can easily spend more than 1000 dollars. After that, you may be tempted to settle for an inexpensive set of pillows. That could be a mistake. Choosing a pillow is an important task. It can seriously impact the quality of sleep you get each night. If you select a low-quality pillow, or simply one that is wrong for you, that can lead to poor sleep. Do you suffer from neck or shoulder pain? Your pillow could be the issue. It’s time to answer the question, ‘what pillow is best for me?’

What Type of Pillow do I Need?

Let’s talk about how you sleep. Even those of us who move tend to have a preferred position, side, back, or stomach. The best way to tell is to remember the position you’re in when you wake up. Test this over a few nights, and choose the position you are in most of the time. Different pillows are a better fit for different sleep styles.

Matching Your Pillow Type to Your Sleep Style

If you discover that you’re a side sleeper, check out pillows that are relatively thick and firm. These will provide the neck support you need without sacrificing comfort. Stomach sleepers are rare, but if this is you, go for soft and relatively flat. If possible, consider going out a pillow. A flatter pillow will keep your silhouette straight so that your neck isn’t craned in an awkward position. Finally, back sleepers need a mid-thickness pillow. You don’t want it so thick that it pushes your chin into your chest though.

How to Pick a Pillow: What’s on The Inside Really Does Matter

Your pillow can be filled with a variety of different things. This can impact price, comfort, and whether or not the pillow is what you need. Before you look, make a list of any health conditions you have that could be impacted by your choice.

Remember that your pillow impacts the position of your head and neck. It will be touching your bare skin for eight hours or so each …

An App To Track Snoring

This app is interesting. It’s called the Sleep Cycle and it’s exactly what it is, a sleep tracking app.

Sleep-tracking app Sleep Cycle is bringing a new feature to its Android app to help snoring users track the sleep effects of their rather loud ailment.

(Via: https://techcrunch.com/2018/09/24/sleep-cycle-adds-snore-detection-to-its-sleep-tracking-android-app/)

For obvious reasons, it’s hard to track your sleep yourself. You can’t really rely on your partner to do it. The most that you can get from your partner is a litany of complaints, most especially if you’ve been a snorer for the longest time. Most likely, your partner is already fed up with you. So, don’t expect to get a decent feedback from a partner who has been putting up with you snore for the longest time.

That’s why the Sleep Cycle app is perfect for you.

Sleep Cycle is a great little app that helps you learn about your quality of sleep and helps wake you up at a time where you’re more likely to wake up feeling refreshed than groggy. There are a lot of smart home sleep trackers that do something similar with a linked pillow sensor, but Sleep Cycle just opts to use your phone’s sensors to gather data, which proves similarly robust.

(Via: https://techcrunch.com/2018/09/24/sleep-cycle-adds-snore-detection-to-its-sleep-tracking-android-app/)

If you’re wondering how it works, read on.

Basically it seems the app pairs the sound measurements with the accelerometer data from the phone placed on your bed and determines how closely tied your snoring is to restless movement, rolling that to help determine its “sleep score” metric.

If you don’t actually know if you’re snoring, the app will clue you into that as well with the feature enabled. You’ll be able to see how many minutes you snored, and listen to it as well.

The new feature is available now for the app’s Android version.

(Via: https://techcrunch.com/2018/09/24/sleep-cycle-adds-snore-detection-to-its-sleep-tracking-android-app/)

You can now download Sleep Cycle on Android.

With the Sleep Cycle, you will have a good idea as to how much you snore. You’ll know how long your usual snore is and the best thing is that you can actually listen …

Andrew Varga, MD: How Sleep Apnea Affects Elderly Spatial Orientation

In an interview with MD Magazine, Andrew Varga, MD,  explains the most cognitively-affected OSA patient population, and expanded on the association between sleep apnea and psychiatric conditions.

Varga: This was a group of older people, average age was around 68 years old. One of the really interesting things is that these were people that were recruited from the community and didn’t intrinsically have any sleep complaints. So they were not necessarily complaining that they had  snoring or any other breathing issues with sleep apnea. They were not complaining of any cognitive complaints, were not complaining of any sleepiness.

from Sleep Review http://www.sleepreviewmag.com/2019/05/andrew-varga-md-how-sleep-apnea-affects-elderly-spatial-orientation/…

A Reference for Referrals [Editor’s Message]

What makes a clinician-friendly medical referral form? An engineer publishes tested recommendations to close the communication loop.

You’ve likely heard the advice before: Provide user-friendly consultation order forms to your referring providers. Be sure the referral forms promote the transmittal of clear, complete, and correct data to your sleep or dental sleep practice.

But what exactly makes for a clinician-friendly referral template? Recommendations have been published before, but recently a human factors engineer went a step further. April Savoy, PhD, a research scientist with the VA Center for Health Information and Communication at the Richard L. Roudebush Veterans Affairs Medical Center, and colleagues implemented several recommendations into a scenario-based simulation experiment. They tested a control electronic referral form and their recommendation-incorporating prototyped form with primary care clinicians who were referring patients to a variety of specialists.

Some of the communication problems that Savoy’s team hoped to resolve included unclear goals in referral, specialists rejecting a consultation pending more information, missing details that needed to be provided by the patient, and phone tag between busy professionals. The researchers found that implementing a few recommendations from the referral communication literature significantly improved clinicians’ satisfaction, workload, and efficiency. You could implement several of the successful features immediately into your own referral templates.

Include a checklist of “urgency” options. The prototype form allowed for “routine (30 days),” “stat,” or “specific time,” as well as a free-text field for comments. “Referrers, who are most familiar with their patients’ typical health, are best equipped to gauge urgency, not consultants or schedulers,” the authors note.

Remind referring providers of your expectations at a glance. Include an “About Us” section with a few bullet points, such as “Individuals with sleep irregularities manifested by daytime sleepiness, snoring, witnessed apneas, morning headaches, insomnia, or abnormal nocturnal movements or behaviors would benefit from a sleep evaluation.” Bulleted information on how to avoid cancelled consults is also appreciated. For example, a dental sleep medicine practice may want to include verbiage such as, “Interpreted sleep study results, from a home or in-lab study done in the past 12 months, must

3 Ways to Stop a Toddler Tantrum

You’ll probably never completely avoid the toddler meltdown scenario, (if you do, myself and every other mom on earth wants to know your secret!) but there are ways to keep them as short and civil as possible. Today, I’ve got a few tips for helping to settle your little one when they start to go off the rails.


Rather read than watch? Click here.

Therapy Update: Implanted Neurostimulators for Sleep Apnea

Inspire Medical, Respicardia, LivaNova, and Nyxoah share the latest data on their devices.

FDA APPROVED

Inspire Medical Systems Inc Inspire Upper Airway Stimulation

 

Inspire Stimulator

Information source: Howard Green, vice president of marketing

FDA status: FDA approved in April 2014.

Size: 15 cc

Implant location: Inserted just under the skin of the neck and chest through 3 incisions.

Lead location: The sensing lead is placed in the intercostal muscle area; the stimulation lead is wrapped around the hypoglossal nerve (which controls the muscles and movements of the tongue).

How it works: As a patient sleeps, Inspire senses when they breathe in and delivers mild stimulation nudging the tongue forward, opening the airway. The patient uses a sleep remote to turn Inspire on when they go to sleep and off when they wake up.

Treats: Moderate-to-severe obstructive sleep apnea. AHI between 15 and 65.

Titration: Inspire is turned on about a month after it’s implanted. The patient is given a sleep remote and initial settings are established. The patient uses Inspire at home for 2-3 months and adjusts the amplitude using the remote to find a level that gives them comfortable, restful sleep. After this, the patient has an overnight sleep study where stimulation levels can be adjusted to optimize patient outcomes.

Future titrations: The vast majority of patients find stable settings after one lab titration. Inspire is customizable so any adjustments can be made simply in the physician’s office.

Overall efficacy: A recent peer-reviewed publication on the ADHERE Registry concluded that: median patient AHI was reduced from 34.0 to 7.0 events/hour; quality of life: ESS was reduced from 12 to 7; after 12 months, patients used Inspire 5.7 hours per night; 94% of physicians rated improvement in patients after Inspire implant. Patient-reported response to therapy experience: 94% stating they would undergo Inspire implant again; 96% of patients reported they would recommend Inspire to family and friends; 94% of patients reported they were overall satisfied with Inspire therapy.

Efficacy by demographic: Men and women within the FDA-approved AHI range (15-65) benefit equally from Inspire therapy. The ADHERE registry concluded: