Several of Wednesday’s presentations were particular
provocative.
The first session of the day focused the thorny issue of
scoring. At present there are several criteria for evaluating or scoring a
sleep study. How the study is scored can
change the key measure of disease, the apnea-hypopnea Index or AHI. The
presenter reviewed how two different scoring techniques, “Chicago” and American
Academy of Sleep Medicine 7, could affect the estimate of prevalence of
sleep-disordered breathing in the general population. Without getting into a
lot of detail, suffice it to say that addressing this issue is critical to
having consistency in our research.
This type of conference is also a venue for researchers to
present preliminary data from their work. These “poster sessions” are occasions
for researchers to get feedback positive and negative. Sometimes the work
continues after this check-in. Sometimes it ends right there.
Two of these check-ins caught my attention this day – “Time-
but not dose-dependent amelioration of obstructive sleep apnea by dronabinol”
and “Predictive utility of a risk assessment for nonadherence to CPAP: nap
index.”
The first is looking at using dronabinol, a cannabinoid
medication (yup, you guessed it), to reduce OSA. Interestingly this component
of marijuana affects the vagal nerve, which among things works on the muscles
involved in the control of breathing. This research still in its early phases
is exploring the possibility of a drug that could help treat sleep apnea,
either alone or in conjunction with other treatments.
The second involves the use of a risk assessment tool that
helps predict whether a patient prescribed PAP therapy will have difficulty
adjusting to the treatment. The value of this tool will be better identification of people who may need special
attention early in treatment.
Another feature of these meetings is “industry-sponsored”
presentations. Companies often present data about their products as well as
details on what they produce. I was particularly interested in the
Philips/Respironics offering titled “CPAP Compliance.” The first talk by Dr.
Luigi Ferini Strambi of Milan – “What is the rationale for using CPAP and how
much use is enough?”— was certainly a provocative title. Ferini provided a
comprehensive review of the current medical literature on the benefits of using
PAP therapy on cardiovascular, metabolic, and mental health issues. As to the question of how much use is enough
– the more the better.
This is an exciting time to be involved in the field of
sleep medicine, and I am pleased to serve as a conduit conveying information to
patients.
No comments:
Post a Comment