Sleep 2009 (day 1) - Most important sleep apnea abstract

There are is a lot of good research going on in the world sleep apnea medicine as evidenced by the "posters" or abstracts of research presented at the 2009 Associated Professional Sleep Societies meeting in Seattle Washington.

The one that really struck my eye is the following:
Sleep and Breathing: Care of CPAP Equipment a Factor of Compliance and Hygiene.

Quoting from the abstract...
This study was designed to test wheter patients have difficulty adequately cleaning CPAP interfaces and if contaminated equipment increases problems and eventual abandonment. Regular washingt of equipment should be an effectivemeans of controlling bacterial and fungal growth with older interfaces morelikely to be contaminated.

30 patients on CPAP for more than one month were studied. Baterical and fungal cultures were taken from the interfaces and humidifiers. Cultures were classified, photographed, and colonies counted. Culture growth was so significant on the first 20 patients, that a secondary trial of mask washing and repeat culture was added.

Although the cultures grew mostly normal flora, the colony counts were high: 21% of the patients had 100-500 colonies and 48% grew >2000 colonies per plate. There was no correlation of severity or cleaning frequency with colony counts. Mask age was important: with fungal growth from 100% > 1 year old, and only 25% aged 1-3 months. Gram negative bacteria increased almost linearly with mask age. In the secondary trial, interfaces were rewashed, resulting in 90% lower colony counts, unless they were > 1 year old when washing was ineffective,

Conclusion: This pilot study suggests there are high counts of bacterial and fungal flora on CPAP interfaces, despite routine washing, with the older interfaces, more contaminated and resistant to cleaning. Furhter research willbe required to determine wheter increasing frequnecy of mask replacement is effective at reducing bacterial contamination, and ultimely improve patient outcome by influencing CPAP adherence or infection risk.
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I spoke with the presenters and they indicated that they were using warm soapy water to clean the masks once a week to remove the contamination.

The message here is to clean your mask regularly and to replace the mask at least every six months.

Is someone on The Hill listening? A House Resolution on Sleep Apnea.

I got a call about month ago from the deputy chief of staff for Congressman Gus Bilirakis (R, FL -9) and he advised me that Congressman Bilirakis was introducing a resolution wanting to increase awareness about sleep apnea.
I was quite pleased to learn this and happy to have a copy to review. Here is the text of what was submitted:

111th CONGRESS
1st Session
H. RES. 384
Recognizing the importance of increased awareness of sleep apnea, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
April 30, 2009
Mr. BILIRAKIS submitted the following resolution; which was referred to the Committee on Energy and Commerce
RESOLUTION
Recognizing the importance of increased awareness of sleep apnea, and for other purposes.
Whereas sleep apnea is a common condition that affects more than 12,000,000 Americans, according to the National Heart, Lung, and Blood Institute at the National Institutes of Health;
Whereas there are several types of sleep apnea that cause people with this condition to repeatedly stop breathing throughout the night, often many times;
Whereas sleep apnea is a chronic condition that disrupts sleep three or more nights each week, leading to excessive daytime sleepiness;
Whereas sleep apnea becomes more common with age, and 1 in 10 people over the age of 65 suffers from it;
Whereas sleep apnea is more common in men than women, and more than half of the people with sleep apnea are overweight;
Whereas sleep apnea can strike anyone, at any age, at any time, including children;
Whereas untreated sleep apnea can lead to high blood pressure, heart attack, stroke, obesity, and diabetes;
Whereas untreated sleep apnea can also increase the chance of having work-related or driving accidents and adversely impact the quality of life of those suffering from this condition in other ways;
Whereas lifestyle changes, mouthpieces, surgery, and/or breathing devices can successfully treat sleep apnea in many people; and
Whereas the lack of public awareness of this serious condition leads to many undiagnosed and untreated cases: Now, therefore, be it
Resolved, That the House of Representatives--
(1) supports raising public awareness of sleep apnea; and
(2) encourages all Americans to educate themselves and others about the consequences of sleep apnea and its potential treatments.

I would have liked to help them with the language, but no matter, the idea is there and we are hopeful that something will come of it.

If you have expressed your sentiments to your Members of Congress and the President concerning sleep apnea and healthcare reform... please do, www.sleepapnea.org/advocacy.

I am in touch with the congressman's office and have offered to be a resource to him in his efforts to raise awareness about sleep apnea on Capital Hill.

Happy Memorial Day - thank you to all the service men and women, particularly those serving while treating their sleep apnea - our hope is that we serve you as well as you served us.