Sleep, Obesity-related disease Archives - PulmCCM
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Sleep, Obesity-related disease Articles

Jun 262014
 
CPAP better than oxygen for obstructive sleep apnea

About half of people diagnosed with obstructive sleep apnea (OSA) can’t or won’t use the most effective therapy, overnight continuous positive airway pressure (CPAP). Most people with untreated OSA experience multiple episodes of hypoxemia — sometimes hundreds per night. For many patients declining CPAP treatment, their doctors provide overnight oxygen, in the hope that it might [... read more]

May 072014
 
FDA approves implantable tongue-buzzer for obstructive sleep apnea treatment

Image: Inspire Med Systems Hypoglossal Nerve Stimulation for Sleep Apnea Wins FDA Approval The U.S. Food and Drug Administration approved Inspire Medical Systems’ pacemaker-like hypoglossal nerve stimulator for patients with moderate to severe obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure (CPAP). The Inspire device stimulates key airway muscles controlled by the hypoglossal [... read more]

Jan 182014
 
Implantable tongue-buzzer improves obstructive sleep apnea by 70%

Source: Inspire Med Systems Update: Inspire’s hypoglossal nerve stimulator was approved by the FDA in April 2014. Hypoglossal Nerve Stimulation Markedly Improves OSA An estimated 15% of men and 6% of women in the U.S. have clinically significant obstructive sleep apnea, meaning it worsens their daytime cognitive functioning, cardiovascular risk, or both. In obstructive sleep [... read more]

Dec 112013
 
Management of obstructive sleep apnea: New guideline from ACP

The American College of Physicians released a new clinical practice guideline for the management of obstructive sleep apnea, published in Annals of Internal Medicine. ACP advises people with obstructive sleep apnea should use CPAP therapy or other airway opening devices such as mandibular advancement devices, and should be encouraged and assisted in losing weight. The guideline was [... read more]

Nov 282013
 
CPAP for sleep apnea improved drug-resistant hypertension

Most people with obstructive sleep apnea (OSA) have high blood pressure (hypertension), but treating OSA with continuous positive airway pressure (CPAP) has been shown to reduce blood pressure only minimally (by about 2.5 mm Hg). A randomized trial in the November 2013 Chest suggests that in people with severe drug-resistant hypertension with OSA, CPAP can [... read more]

Nov 082013
 
"CPAP cures metabolic syndrome" paper in NEJM: retracted!

In early 2012, PulmCCM breathlessly reported the results of a New England Journal of Medicine (NEJM) paper by Surenda K. Sharma et al, claiming to show that continuous positive airway pressure (CPAP) can reverse metabolic syndrome (obesity, dyslipidemia, and insulin resistance). Whoops. The authors retracted the article after keen-eyed academics smelled something fishy and asked [... read more]

Oct 172013
 
Home testing for sleep apnea bankrupting U.S. sleep centers

Home Sleep Apnea Testing: New Standard is Bad Deal for Sleep Docs Sleep doctors in the U.S. have been doubling up on their Prilosec and putting their accountants on speed-dial since the federal government and insurers began signaling they plan to eventually run the $2,000-per-sleep-study gravy train off its rails. With an estimated 18 million people [... read more]

Jul 272013
 
Diagnosing and managing obstructive sleep apnea, before and after surgery (Review)

Obstructive Sleep Apnea and Perioperative Complications: A Review Obstructive sleep apnea and other sleep disorders may affect as many as 70 million U.S. adults — 1 in 4 men and 1 in 10 women. People with obstructive sleep apnea are usually obese, have other medical conditions, and are more likely to undergo surgery than people [... read more]

Apr 042013
 
Got sleep apnea? Climbing Everest? Pack your Diamox (RCT)

Acetazolamide Improved Obstructive Sleep Apnea at High Altitudes by Blair Westerly, MD Obstructive sleep apnea (OSA) is common, and so is travel to the mountains for work and play, therefore encounters with patients with OSA who travel to mountain destinations is not infrequent.  We all learn early in training that altitude affects oxygenation, and patients [... read more]

Dec 202012
 
CPAP cures metabolic syndrome in obstructive sleep apnea (Retracted)

CPAP Improves Metabolic Syndrome in Obstructive Sleep Apnea This paper has been RETRACTED! Continuous positive airway pressure (CPAP) therapy reversed elements of the high cardiovascular risk profile known as metabolic syndrome in a substantial minority of Indians with treatment-naive obstructive sleep apnea, according to this article in the New England Journal of Medicine. More than [... read more]

Aug 082012
 
CPAP gives the heart a tune-up for 1 year or 30 million beats, whichever comes first

Obstructive sleep apnea (OSA) might be the perfect disease to describe the American health care system. The condition is overwhelmingly due to our over-indulgence and under-activity; its expensive diagnosis (polysomnography) and best treatment (CPAP) help physicians and device manufacturers prosper while consternating those who pay (the government and insurance companies), who then threaten to cut off [... read more]

Apr 162012
 
NYT runs press release for new OSA treatment Provent. Does it work?

Provent is the trade name for disposable, stick-on nose plugs made by Ventus Medical that are a relatively new (second-line) treatment for obstructive sleep apnea. The bandage-like device has pinholes cut in the nostrils that let air in during inspiration, but create back pressure during exhalation, helping prevent airway collapse. The New York Times just [... read more]

Mar 182012
 

Sleep docs don’t come off looking so hot in this recent NPR story, which paints some of them as opportunistic plunderers of the nation’s health care dollars, over-ordering expensive sleep studies to make a buck. As reporter Jenny Gold points out, the number of sleep studies performed in the U.S. has quadrupled over the past [... read more]

Mar 152012
 

Diaphragmatic dysfunction can result from nerve damage, primary muscle problems, or problems with the muscle’s interaction with the chest wall. The true incidence of diaphragmatic paralysis is unknown, since many patients are asymptomatic. Treatment for diaphragmatic dysfunction usually consists of watchful waiting, addressing underlying causes, with mechanical ventilation if respiratory failure develops. Causes of Diaphragmatic [... read more]

Mar 082012
 
Obstructive sleep apnea increases risk for postop complications (CHEST)

Mayo investigators reported back in 2001 that people with obstructive sleep apnea had a higher rate of perioperative complications including hypoxia and longer lengths of stay. Since then, there have been other signals that this is a real phenomenon, but perhaps surprisingly, the evidence hasn’t exactly piled up to unequivocally prove the intuitive point. That’s [... read more]

Feb 292012
 
"First dibs" on patients by sleep docs increased CPAP adherence (CHEST)

In the face of criticism from insurers and the government for a perceived excessive zeal for profits, and mounting evidence that uncomplicated obstructive sleep apnea (OSA) can be diagnosed at home and managed by primary physicians, you can’t blame sleep specialists for feeling down-in-the-mouth lately. Sushmita Pamidi et al report some brighter news in the [... read more]

Feb 022012
 

Here’s a great example of how weak findings in small, underpowered studies — findings which should be at most viewed as hypothesis-generating — become transmuted into Serious Studies With Important Implications when the lay press give them too much credit. In this case, the Los Angeles Times, Huffington Post, and CNN took the bait after [... read more]

Jan 072012
 
Sleepy cops abound; you won't like them when they're angry (JAMA, NYT)

Did you ever wonder what that police officer is really doing while you wait forever in your car for him to write you your ticket? According to new research, it’s possible he’s taking a quick nap. And you’d best save your snarky comment when he brings you the citation: sleepy cops, it turns out, tend to be [... read more]