4 Best Sleeping Positions to Improve Sleep Apnea

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

“Sleep apnea is often worse in the supine (on your back) position because of gravity,” Tsai says. “The tongue falls back and blocks the airway,” so sleeping on your side “may improve sleep apnea and symptoms.” Fotinakes adds that sleeping on your side or in a prone (on your stomach) position “may lessen or even eliminate snoring and apnea in many cases.”

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.

If you must sleep on your back – some people who have sleep apnea also have acid reflux, and sleeping on your back with your head elevated is often recommended to reduce symptoms of that condition – try elevating the head of the bed, Tsai says. “Sleeping with the head as elevated and upright as possible, such as with an adjustable bed or in a recliner, may be helpful in improving sleep apnea symptoms.” Wedge-shaped pillows made of foam (rather than a squishier material) can help you achieve the right position that keeps the airway more open. Some people even elevate the head of a conventional bed with bricks or a bed riser to get the necessary height to lessen symptoms of sleep apnea.

Get the full story at health.usnews.com.

from Sleep Review http://www.sleepreviewmag.com/2020/01/sleeping-positions-improve-sleep-apnea/…

We Know Losing Weight Lessens Sleep Apnea Severity. This New Study Helps Explain Why.

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

SomniFix Is a Finalist in P&G Ventures 2020 Innovation Challenge

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

At a California Hospital, Children Diagnosed via Home Sleep Tests Have Better Outcomes Than Those Who Wait for PSG Approval

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

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

Secondhand Smoke May Increase Risk for Obstructive Sleep Apnea in Children

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.

from Sleep Review http://www.sleepreviewmag.com/2019/12/secondhand-smoke-risk-obstructive-sleep-apnea-children/…

Sleep More Than 9 Hours? Your Stroke Risk May Be Higher

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

26th Annual Advances in Diagnosis and Treatment of Sleep Apnea and Snoring

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.

from Sleep Review http://www.sleepreviewmag.com/events/26th-annual-advances-diagnosis-treatment-sleep-apnea-snoring/…

How I Transitioned My Dental Practice to a Dental Sleep Medicine Practice

Four dentists discuss their motivations, challenges, and rewards of treating patients who have obstructive sleep apnea.

Dental sleep medicine is now a viable career path for dentists looking to expand their professional horizons and help a growing number of patients who are experiencing sleep-related health problems.

But the bigger question is how? How can a dentist make the transition? What are some of the pitfalls to avoid? What are the unexpected rewards?

As the following four dental sleep medicine practitioners explain, there’s no single way to make the transition, just the one that works best for you, your practice, and your patients.

Don Johnson, DDS, Idaho

Don Johnson

Don Johnson, DDS, has been practicing dental sleep medicine for the past decade. Photo courtesy of Don Johnson, DDS

Don Johnson, DDS, has been providing dental sleep medicine services for about 10 years at his practice in Coeur d’Alene, Idaho, which includes the Northwest Snoring Center.

“The main reason I started doing sleep dentistry is because sleep apnea kills people,” Johnson says. “All you have to do is open the obituaries and you’ll see a young person who died of ‘natural causes.’ You don’t die of natural causes if you’re 39. More likely it was sleep apnea.”

And to that point, Johnson’s mission is clear: to save lives.

It’s a mission Johnson, who’s practiced general dentistry for 40 years, is quite passionate about. But his passion didn’t supersede preparation.

“You can’t do a weekend course and you’re qualified to practice sleep dentistry. It’s a huge investment in time and equipment,” says Johnson, who emphasizes that learning “everything that you can” about the temporomandibular joint (TMJ) and its disorders is essential.

Johnson not only continued his education formally, but he also found a mentor with whom he spends time with regularly to better comprehend facets such as billing and building a referrer network. “You really have to learn how to work with physicians,” he says. “And you have to get paid, including learning how to bill medically—and hire specialists to help you. If you don’t accept insurance, you’re losing a lot.”

Among

Treating Mild Sleep Apnea Results in Higher Vitality Scores

CPAP can improve energy levels and vitality in people who experience mild sleep apnea—that is, those with an apnea-hypopnea index between 5 and 15 events per hour—according to a new study.

This is the finding from a new study of over 200 patients, published in the journal The Lancet Respiratory Medicine, led by Imperial College London.

The research was conducted at 11 National Health Service (NHS) sleep centers across the United Kingdom, including the Royal Brompton & Harefield NHS Foundation Trust. Although previous trials have found a CPAP machine to improve symptoms of moderate to severe cases, the researchers say the significance of this study is it is the first large trial to find that mild cases of OSA can also be treated with this technology.

Lead author Mary Morrell, PhD, professor of Sleep and Respiratory Physiology at the National Heart and Lung Institute at Imperial, says in a release, “We are seeing increasing cases of sleep apnea, and in a wide range of patients. Although the condition was previously thought to mainly affect overweight men, we now know it also strikes post-menopausal women, the elderly, and even children.”

Morrell, who is also honorary researcher at the Royal Brompton Hospital, says, “Around 60% of all cases of sleep apnea are classed as mild, but until now we didn’t know whether a CPAP would be helpful to these patients.”

In the study, 115 patients were asked to use the CPAP for three months, while 118 received were given advice on improving sleep and avoiding anything that can exacerbate the condition, such as drinking alcohol before bed.

The research revealed those who used the CPAP machine had an improvement of 10 points on a vitality scale, compared to those who received standard care. The vitality scale assesses a range of factors such as sleep quality, energy levels, and daytime sleepiness. The researchers also saw improvements in a number of additional factors among the patients who used the CPAP, including fatigue, depression, and social and emotional functioning.

The researchers have not yet conducted an economic analysis of the cost to the NHS

AASM Issues Position Statement on Chronic Opioid Therapy and Sleep

Patients and medical providers should be aware that chronic opioid use can interfere with sleep by reducing sleep efficiency and increasing the risk of sleep-disordered breathing, according to a position statement from the American Academy of Sleep Medicine (AASM).

In addition to understanding the risks of opioid addiction and abuse, it is important for health care providers to be aware that chronic opioid use is associated with changes in sleep architecture and an increased risk of respiratory depression during sleep.

“This statement increases awareness among health care providers of the important adverse events that can occur in patients on chronic opioid therapy,” says co-author R. Nisha Aurora, MD, associate professor of medicine at Rutgers Robert Wood Johnson Medical School in New Jersey, in a release. “The paper also highlights the need for providers to recognize and diagnose sleep-related breathing disorders that are frequently seen with chronic opioid use.”

The position statement was developed by the AASM board of directors and is published in the Nov 15 issue of the Journal of Clinical Sleep Medicine.

Patients who have chronic pain often experience fatigue and disturbed sleep. Studies have shown that chronic opioid therapy has the potential to further disrupt sleep by reducing sleep efficiency, slow wave sleep, and rapid eye movement sleep. Another adverse effect of opioid use is respiratory depression, which can increase the risk of sleep-related breathing disorders such as sleep-related hypoventilation, central sleep apnea and obstructive sleep apnea.

Medical providers who care for patients on chronic opioid therapy need to be aware of the signs of disrupted sleep, such as snoring and excessive daytime sleepiness, in order to provide their patients with high quality care.

“Because of the complex relationship between pain, sleep, daytime functioning, and opioid therapy, a strong collaboration between pain specialists, sleep physicians, and primary care providers is needed to optimize patient benefit and minimize complications when opioids are part of chronic therapy,” says Aurora.

While opioid therapy can contribute to sleep disruption and sleep disorders, it can be an effective treatment for patients with restless legs syndrome (RLS), a sleep disorder associated