Sleep, Obesity-related disease Archives - Page 2 of 3 - PulmCCM
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Sleep, Obesity-related disease Articles

“First dibs” on patients by sleep docs increased CPAP adherence (CHEST)

 Sleep, Obesity-related disease  Comments Off on “First dibs” on patients by sleep docs increased CPAP adherence (CHEST)
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]

Lay press eats helping of hype on sleep apnea & “silent strokes”

 Sleep, Obesity-related disease  Comments Off on Lay press eats helping of hype on sleep apnea & “silent strokes”
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]

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

 Cardiovascular Disease, Policy, Ethics, Education, Sleep, Obesity-related disease  Comments Off on Sleepy cops abound; you won’t like them when they’re angry (JAMA, NYT)
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]

In people with coronary artery disease, is fat a friend or foe? (RCT, CHEST)

 Cardiovascular Disease, Sleep, Obesity-related disease  Comments Off on In people with coronary artery disease, is fat a friend or foe? (RCT, CHEST)
Jan 072012
 

One thing I thought I knew was that overweight and obesity cause coronary artery disease and make it worse. People with CAD who are obese should lose weight … right? Recent research shows it’s not that simple (although the answer is still “yes, probably”). Did you know about the “obesity paradox?” Or the “lean paradox,” [… read more]

Get more sleep — it’ll improve your jump shot (Sleep)

 Sleep, Obesity-related disease  Comments Off on Get more sleep — it’ll improve your jump shot (Sleep)
Dec 262011
 

Mah et al followed 11 Stanford varsity basketball players for ~7-10 weeks. During the first ~3 weeks, players maintained their usual sleep schedules. For the next ~6 weeks, they were encouraged to sleep as long as possible each night, with a goal of 10 hours in bed. After the sleep extension period, their shooting accuracy [… read more]

Kids who sleep less get fatter? (FLAME study)

 Clinic and Consults, Sleep, Obesity-related disease  Comments Off on Kids who sleep less get fatter? (FLAME study)
Dec 262011
 

Carter et al followed 244 children in New Zealand from birth to age 3-7. Between ages 3-5, each additional hour of sleep was associated with a 0.48 reduction in BMI, and a 61% reduction in the risk of being obese or overweight by age 7, after controlling for multiple covariates. BMJ 2011;342:d2712. FREE FULL TEXT

For most with OHS, ventilatory drive was oxygen-sensitive

 Randomized Controlled Trials, Sleep, Obesity-related disease  Comments Off on For most with OHS, ventilatory drive was oxygen-sensitive
Dec 262011
 

Wijesinghe et al randomized and crossed-over 24 people who were recently diagnosed with obesity hypoventilation syndrome to breathe either 100% oxygen or room air for 20 minutes on 2 separate days, while measuring their minute ventilation, expired tidal pCO2, and dead space-to-tidal volume ratio. In 44% of patients, pCO2 increased by at least 4 mm [… read more]

Trouble sleeping? Don’t read this, it’ll only make it worse

 Cardiovascular Disease, Sleep, Obesity-related disease  Comments Off on Trouble sleeping? Don’t read this, it’ll only make it worse
Dec 072011
 
Trouble sleeping? Don't read this, it'll only make it worse

If you spend your nights lying awake worrying about having a heart attack, you’re entirely justified. But you’re probably just making it more likely. Lars Laugsand et al followed 52,610 Norwegian people for 11 years after the subjects completed an initial survey (investigators can do this in Norway, since they’ve got everyone’s health records in [… read more]

Nov 112011
 

Obesity may impose extra burdens on critical care staff (think turning, transport, intubation and central line placement), but reviews suggest people with “ordinary” obesity (BMI 30-39) with have the same mortality from critical illness as overweight or healthy-weight people. In fact, obese people may have a survival advantage, despite possible longer durations of mechanical ventilation and ICU stays. But what about extreme obesity (BMI > [… read more]

Reduced poverty = reduced obesity and diabetes (RCT)

 Policy, Ethics, Education, Sleep, Obesity-related disease  Comments Off on Reduced poverty = reduced obesity and diabetes (RCT)
Oct 312011
 

Poor people have higher rates of obesity. There are those who believe that’s because the poor lack self-control and discipline, overeating when they should be pulling themselves up by their bootstraps. That hard-core personal responsibility ethic is hard to refute, maybe because it contains a grain of truth, maybe because it lets all us non-poor [… read more]

Think NIPPV overnight is useless for stable hypercapneic COPD? TURN IT UP, MAN!

 Clinic and Consults, COPD, Mechanical Ventilation, Sleep, Obesity-related disease  Comments Off on Think NIPPV overnight is useless for stable hypercapneic COPD? TURN IT UP, MAN!
Oct 072011
 

Non-invasive positive pressure ventilation (NIPPV or NPPV or NIV), overnight or during the day, has not been shown to help most people with stable COPD and daytime hypercarbia. Citing their own previous findings, Dreher, Windisch et al argue that’s because you can’t just use wimpy ordinary settings — you’ve got to crank that sucker to [… read more]

Obesity associated with increased risk of severe seasonal influenza (not just H1N1)

 Infectious Disease and Sepsis, Sleep, Obesity-related disease  Comments Off on Obesity associated with increased risk of severe seasonal influenza (not just H1N1)
Aug 232011
 

Obesity was named as a risk factor for severe H1N1 influenza during the pandemic. What about for influenza in general? Kwong et al analyzed community survey data in Ontario over 12 influenza seasons, 1996-2008. Severe obesity (BMI >= 35) carried an odds ratio of 2.1 for respiratory hospitalization during flu season. In those with no [… read more]

Sleep-disordered breathing predicted future cognitive dysfunction in older women

 Sleep, Obesity-related disease  Comments Off on Sleep-disordered breathing predicted future cognitive dysfunction in older women
Aug 202011
 

Obstructive sleep apnea and other sleep disorders have long been associated with cognitive dysfunction, but so far not in a prospective study. So, Yaffe et al followed 298 older women (~82 years) who had already had polysomnography as part of an osteoporosis study. 105 had sleep disordered breathing (cases), defined as an apnea-hypopnea index >= [… read more]

A little longitudinal data on the enigmatic “complex sleep apnea”

 Sleep, Obesity-related disease  Comments Off on A little longitudinal data on the enigmatic “complex sleep apnea”
Aug 192011
 

A minority of people develop central sleep apneas during polysomnography with continuous positive airway pressure titration for obstructive sleep apnea. Others develop central apneas later, discovered on interrogation of their CPAP machine. The fact is, no one knows much about this so-called complex sleep apnea — its natural course, prognosis / risks, and whether or [… read more]

People with OSA have greater impairment in endothelial function after MI

 Cardiovascular Disease, Sleep, Obesity-related disease  Comments Off on People with OSA have greater impairment in endothelial function after MI
Jul 212011
 

Kuniyoshi et al prospectively observed people admitted to Mayo for myocardial infarction, performing polysomnography and measuring flow-mediated dilation in their brachial arteries. A whopping 69% (45 of 64) were found to have obstructive sleep apnea. Those with moderate to severe OSA had poorer arterial responsiveness, a surrogate marker for subsequent cardiovascular risk, compared to people [… read more]

Nasal and full-face CPAP masks generally equivalent for OSA treatment

 Randomized Controlled Trials, Sleep, Obesity-related disease  Comments Off on Nasal and full-face CPAP masks generally equivalent for OSA treatment
Jul 152011
 

Teo et al randomized 24 people with newly diagnosed obstructive sleep apnea (AHI > 15) to crossover between nasal and oronasal (full-face) masks during 2 consecutive nights of CPAP titration. The nasal mask had more leaks and people wearing it had more arousals. However, they liked it better than the face mask, and there was [… read more]

Patients unimpressed by flexible pressure CPAP

 Sleep, Obesity-related disease  Comments Off on Patients unimpressed by flexible pressure CPAP
Jun 262011
 

Flexible pressure CPAP reduces pressure briefly during expiration, to try to make it more comfortable. Bakker & Marshall meta-analyzed 10 randomized trials in >500 patients testing flexible pressure vs standard CPAP in people with obstructive sleep apnea; there were no differences in compliance or any other outcome. CHEST 2011;139:1322-1330.

Gabapentin enacarbil for restless legs syndrome (PIVOT RLS II trial)

 Randomized Controlled Trials, Sleep, Obesity-related disease  Comments Off on Gabapentin enacarbil for restless legs syndrome (PIVOT RLS II trial)
Jun 032011
 

Lee et al report phase III trial results for this prodrug of gabapentin. It improved symptoms in people with moderate-to-severe RLS at the end of 12 weeks, compared to placebo. However, time (placebo) also worked well. The FDA approved the drug for moderate-to-severe RLS in April 2011. J Clin Sleep Med 2011;7:282-292.

Weight loss effectively treated OSA in men

 Sleep, Obesity-related disease  Comments Off on Weight loss effectively treated OSA in men
Jun 012011
 

In 63 Swedish men with obstructive sleep apnea, a one-year weight loss program initiated by a supervised 9-week crash diet resulted in a ~12 kg weight loss. At one year, patients’ apnea-hypopnea index improved by ~17 events / hour; 48% no longer needed CPAP, and 10% were cured. The more weight lost, the greater the [… read more]