The Utility of the Elbow Sign in the Diagnosis of OSA

Is this the future of triaging patients for potential OSA? This has been a long-standing process by partners of people who snore or in some cases stop breathing. Who knew we were helping to lead a medical advancement? All I was trying to do was get a good night’s sleep. A small clinical observation reported by co-author Mark Fenton, MD, of the University of Saskatchewan reported that among patients with partners a repeated statement made by partners was the need to poke or elbow patients who snore loudly or stop breathing to help restore regular breathing. This led to Fenton’s team developing a questionnaire that consists of just two questions: 1) Do you get elbowed for snoring too loudly? and/or 2) Do you get poked/elbowed because you stop breathing? Fenton states that “The questionnaire would be easy to incorporate into a clinical history and use in the diagnosis of OSA.” Since this study was only done in one center a more thorough case study would need to be completed to form a true result validating practical use of the questions in diagnosing...

Six Tricks to Help You Stop Snoring

Help may be available for the 37 million Americans who snore (and their partners), thanks to a new therapy. The treatment is called oral myofunctional therapy. The treatment employs a series of exercises to strengthen the tongue and soft palate. Exercises are particularly beneficial for individuals with mild to moderate snoring who do not have sleep apnea. Studies show these exercises may reduce snoring by as much as 36 percent. To perform oral myofunctional therapy, repeat the following exercises 20 times: Press your tongue against the top of your mouth and slide it backward. Suck your entire tongue upward so that it is flush with the roof of your mouth. Push the bottom of your tongue against the floor of your mouth. Make sure the tip of your tongue continues to touch the bottom of your lower teeth. Say “ahh” while you lift the roof of your mouth and uvula. With clean hands, press your right index finger against the inside of your left cheek. Use your cheek muscles to press against your finger. Repeat the exercise on the other cheek. When chewing, make sure you alternate using each side of your mouth so that you chew...

Another Reason to Sleep Well

Recent research has shown that only one additional hour of sleep made a woman 14% more likely to have sex with her partner the next day. This in itself is not that surprising, considering that women who are sleep deprived could be too tired for sexual activity, or depressed and thus sleep deprived. However, this didn’t seem to fully account for the results. Even when researchers took into account fatigue and mood, the same findings resulted. Dr. David Kalmbach of the University of Michigan Medical School was the lead author of the study. For two weeks, 171 healthy young women, would complete questionnaires that focused on sleep, mood, and sexual functioning within the past 24 hours. The women got about 7 1/2 hours of sleep per night on average, though some only got 6 1/2. The women who got more sleep on a given night would have more sexual desire on the following day. They also had less frequent problems with vaginal lubrication. There are a few potential explanations for this phenomenon. One involves testosterone, which posters a healthy sex drive in both men and women. Sleep loss is known to diminish the male libido, and it seems like the same may be true in women. Additionally, during REM sleep, men have erections and women have higher blood flow to the vagina. As such, in women who are well rested, genital tissue is supplied with oxygen rich blood throughout the night. It makes sense then that being deprived of sleep could diminished a woman’s sexual appetite. In general, sleep will help a person feel happy and energetic, which is...

Mood lifts for partners of patients treated for sleep apnea and snoring

People with obstructive sleep apnea, also known as OSA, and snoring problems are not the only ones who suffer as a result of the condition. According to a study published in the journal “Sleep and Breathing,” the nightly disturbances can also cause depression in partners who share a bed with them. The study participants had both a full-night sleep study and two sessions of a procedure called radio-frequency tissue ablation that uses microwaves to reduce the size of the tongue or the palate. There were a total of 36 participants, ranging in age from 24 to 63. All suffered from either snoring or OSA. Short-term follow-ups within a few months indicated improvement in both patients and their bed partners scores for depression and mood. Average scores for patients and their partners on tests measuring emotional state improved by nearly three points. Patients took a PSG (Polysomnography) sleep study, and their AHI (Apnea Hypopnea Index) was found to have dropped to 10.69 from 13.16. A Beck Depression Inventory-Second Edition for their partners showed a decrease to 9.17 from...

Americans Report Good Sleep Quantity, not Quality

According to the results from a recent study conducted by The National Sleep Foundation, Americans are getting enough sleep. Yet, the quality of that sleep remains an open question. Respondents to the Study were, on average, getting more than 7 hours of sleep per night. The typical respondent went to bed at around 11 pm and woke up at around 6:30 am. Respondents also admitted to sleeping almost an hour longer on weekends. Over one third of respondents classified their sleep quality as poor, however. About 25 percent of women in the study stated they did feel refreshed when they awoke; only a little over 10 percent of the men surveyed felt this way.  Further study is needed to determine the reason(s) for this discrepancy. Getting a good night of sleep is important. According to The National Sleep Foundation, sleep is a key factor in creating a healthy lifestyle. Individuals who believe their sleep quality is lacking should consult with their...

OSA May Affect Blood Flow Response in the Brain

People think obstructive sleep apnea (OSA) simply causes poor-quality sleep. Recent studies suggest, however, that there may be more to it than that. Indeed, results from specialized MRIs designed to monitor brain activity indicated a weakened blood flow response in some patients suffering from OSA. People affected by OSA often experience decreased perfusion, the heart’s ability to pump oxygenated blood to parts of the body, and inadequate blood regulation in the brain. to determine the effect OSA had on blood flow in the brain, researchers subjected study participants, with and without OSA, to global blood volume and oxygen dependent signals, which allowed the visual assessment of differences in blood flow response during three activities: a breathing exercise that raised the pressure in the chest, a hand grip challenge, and the submersion of one foot in icy water. While participants had fairly comparable results during the breathing activity, a weaker blood flow response was recorded in participants with OSA in the other two challenges. The study suggests that the part of the brain affected by OSA may delay the transmission of nerve signals from the arms and legs regarding sensation and muscle movement. Thus, the weakened blood flow response seems to directly impact nerve response. This idea is supported by the fact that the breathing exercise, which resulted in similar measurements between participants, did not require muscle movement, therefore not eliciting the same response from the brain as the other two activities. While the study did not address additional OSA-related problems, these findings can lead to more informed diagnosis and...