March 23, 2010

A sleep apnea what if....

We know that untreated obstructive sleep apnea (OSA) results in nighttime intermittent hypoxia. This occurs when no air is getting in the lungs and no oxygen into the bloodstream due to obstructions at the opening to the upper airway.

A byproduct of the intermittent hypoxia, current research shows is the development of cardiovascular disease which can result in heart attack and sudden cardiac death.

What if there is a mechanism in the body that protects the heart from infarction and ischemic results by increasing the number of blood vessels providing more oxygen in patients with some level of OSA. That is, the body "grows" more blood vessels called coronary collateral vessels (CCV) to serve the heart when it needs more oxygen.

An intriguing study published in the March 2010 issue of Chest puts forward this theory. The publication includes a letter to the editor by Drs. Peretz and Lena Lavie referencing other published work & work they did that supports the hypothesis of this original research.

Interestingly, the benefit seems to accrue to older people with mild to moderate OSA. Perhaps, because it takes time to develop the CCVs and that if the OSA is too severe, the cardiovascular insult is too great to withstand early death.

The study has a small sample (190 subjects) and the authors themselves indicate a number of limitations.

The concluding sentence of the study - In summary, there is an association between sleep apnea and collateral vessel growth. We speculate that OSA(S) may be a significant factor affecting growth of CCVs as a compensatory mechanism.

Not something you can take to the bank, but an interesting hypothesis and tantalizing enough that I will continue to watch with great interest.

March 14, 2010

Sleep Apnea on World Sleep Day March 19th

Sleep Apnea Awareness Day 2010 was pretty quiet this year, this notwithstanding that the ASAA celebrates its 20th anniversary.

A lot of our attention is focused on the upcoming sleep apnea and trucking conference scheduled for May 11-12. If you aren't familiar with what we are planning, check it out.

We have other activities planned to celebrate the beginning of our 20th year of service to the public as the leading patient organization for education, support and advocacy for sleep apnea. Stay tuned.

I want to call people's attention to World Sleep Day this coming week - March 19th. Organized by the World Association for Sleep Medicine, it is a global effort to call attention to the importance of sleep and recognizing there are there are a number of disorders that interfere with it. Their catchphrase this year - SLEEP WELL, STAY HEALTHY. The organizers have simplified the rules for good sleep hygiene into a list of ten "commandments."

Another reason why I want to call your attention to March 19th is that World Sleep Day is part of a yearlong, worldwide recognition of lung health - The Year of the Lung. Most of the respiratory medical professional and patient organizations from all over the world are partnering to focus on the many issues that affect lung health and sleep apnea is one of those issues.

Our colleagues at the American Thoracic Society, founding partners for the Year of the Lung have taken as one of their charges promoting World Sleep Day.

We join with them to share the following declaration for March 19, 2010 - World Sleep Day:

Whereas, sleepiness and sleeplessness constitute a global epidemic that threatens health and quality of life,

Whereas, much can be done to prevent and treat sleepiness and sleeplessness,

Whereas, professional and public awareness are the firsts steps to action,

We hereby DECLARE that the disorders of sleep are preventable and treatable medical conditions in every country of the world.

Take time this week to think about how you and other members of your family sleep (particularly your children and grandchildren) . Share the ten commandments with those who would benefit from a change in their sleeping habits.

Remember - Sleeping well is a key to staying healthy.