вторник, 7 декабря 2010 г.

Sleep Apnea Is Linked To Dietary Hqbits

This study on sleep qpneq is the first to explore the dietary habits of people suffering from severe obstructive sleep apnea, a sleep disordered breathing condition.
A study in the October 15 issue of the Journal of Clinical Sleep Medicine shows that unrelated to obesity, people with severe SDBs consume a more unhealthy diet, which may be a factor contributing to greater cardiovascular morbidity and mortality. These findings were most evident among women.
Stuart Quan, MD, division of sleep medicine at Harvard Medical School, said, "We found that persons who had severe obstructive sleep apnea ate a diet that was unhealthy with increased intake of cholesterol, fat and saturated fatty acids."
Findings showed that, on average, all participants with extremely severe SDB, or those with respiratory disturbance index (RDI) above 50 disruptions per hour, consumed 88.16 more milligrams of cholesterol per day compared to people who have less severe OSA. On average, women participants with severe SDB consumed 21.96 more grams of protein, 27.75 more grams of total fat and 9.24 more grams of saturated fatty acids. These results remained significant after controlling for BMI, age and daytime sleepiness.
Results indicated that among the 320 participants, increasing RDI severity was associated with greater consumption of cholesterol, protein and trans-fatty acids. There also was a trend towards greater ingestion of total saturated fatty acids and total fat, but not carbohydrates, sucrose or dietary fiber. With the exception of cholesterol, these associations occurred primarily in women. The mechanism producing the higher dietary consumption of unhealthy nutrients in persons with extremely severe SDB appears to exaggerate behaviors already observed among obese women.
Compared with the 2005 U.S. Dietary Guidelines, participants "ate less than the recommended proportion of calories from carbohydrate and more than recommended from total and saturated fat."
It is unlikely that sleep deprivation or obesity explain the results of the study. It has been suggested that fatigue and sleepiness, as well as sleep deprivation influence dietary intake via alterations in neuroendocrine control of feeding behavior; however, controlling for Epworth Sleepiness Scale score did little to affect our results and in bivariate analysis, total sleep time was not associated with alterations in dietary intake.
According to Quan, the physical activities findings in the study were unexpected. "All of us suspect that patients with sleep apnea engage in less recreational activity. This was confirmed in the study," said Quan. "However, the findings were explained entirely by obesity. We thought that because sleep apnea patients are sleepy they would engage in less physical activity even after accounting for the effect of obesity."
It is well known that obese people are more likely to consume diets high in fat and cholesterol. The persistence of these results even after controlling for BMI suggests that a high RDI has an independent effect on dietary intake. Researchers of this study suggest that independent of sleep duration, OSA may affect levels of appetite-regulating hormones. Also, sleep disruptions related to OSA may in some way increase the craving for fatty foods.
Obstructive sleep apnea, (OSA), which is a form of SDB is characterized by repetitive episodes of complete or partial airway obstruction during sleep is currently estimated to affect 18 million Americans. OSA is associated with alterations in leptin and ghrelin, which are important in appetite regulation. It has been demonstrated that sleep deprivation, a common occurrence among people with OSA, is associated with increased body max index (BMI) and increased cravings for carbohydrates. The change in hormones results in leaves that may increase appetite and thus impact dietary intake.
To investigate the relationships between dietary intake, physical activity, OSA, sleep and obesity, the study used data from a subset of the Apnea Positive Pressure Long-Term Efficacy Study (APPLES), a randomized, double-blinded, two-arm, sham-controlled, multicenter, six-month, intent-to-treat study of continuous positive airway (CPAP) efficacy on neurocognitive function in OSA.
The study included 320 participants – 263 from the University of Tucson in Arizona and 57 from the St. Mary Medical Center in Walla Walla, Washington. More than half of the participants were obese. In addition to receiving polysomnography (PSG) studies and neurocognitive assessment, participants were asked to complete detailed dietary and physical activity questionnaires prior to the initial diagnostic PSG and at the end of the four-month clinical APPLES examinations.
Poor sleep quality, a consequence of OSA, is associated with fatigue and sleepiness, which may curtail physical activity; low sleep quality may also result in a compensatory increase in caloric intake in an effort to boost energy levels, both of which promote weight gain. This study provides important new information on the dietary habits of people with OSA, which may be another mechanism through which SDB leads to serious health conditions such as cardiovascular disease, hypertension and stroke. Based on the study's findings, unhealthy dietary and activity patterns warrant further study of their role in cardiovascular and metabolic syndrome development in patients with OSA.

пятница, 3 декабря 2010 г.

Zolpimist Mouth Spray Insomnia Treatment OKed By FDA

NovaDel Pharma, Inc. has received approval from the FDA for the insomnia treatment drug containing the active ingredient found in Ambien. The drug Zolpimist, is delivered as a mouth spray, and is approved for insomnia treatment short-term. The drug contains Zolpidem, found in Ambien, one of the most popular drugs on the market used for the treatment of insomnia.
Steven B. Ratoff, Chairman of the Board and Interim CEO of NovaDel, says, "We believe the FDA's approval of Zolpimist provides patients with an important treatment option for insomnia, as Zolpimist provides rapid absorption from the oral mucosa. This achievement is another major milestone for NovaDel as it further validates our ability to develop innovative drugs based on the NovaMist technology. We are actively seeking a partner to commercialize this innovative product and believe that this approval should enhance those efforts." Zolpidem is the second drug developed by the company as a mouth spray.
The drug is approved for use in those who has difficulty falling asleep, and should be taken immediately before going to bed.
Warnings about the insomnia treatment spray include avoidance of driving or operating heavy machinery the morning after using the insomnia spray. The company also warns of the possibility of sleepwalking, the same warning that comes with the oral drug Ambien. Other warnings include drug dependence, dizziness and headache.
Criteria for insomnia include difficulty falling asleep, or staying asleep. The mouth spray developed by the company is designed for rapid absorption when compared to conventional pills that are taken by mouth. Studies also show that drugs sprayed into the mouth are easier metabolized by the liver, as they are is eliminated from the body.
Other drugs for the treatment of angina, nausea, central nervous system disorders and migraine headache are also available as oral sprays. The company says using mouth sprays for drug delivery improves patient adherence and the inconvenience of swallowing a pill. Zolpimist for insomnia treatment is the newest addition.
The new mouth spray to treat insomnia is the latest addition to a multi-million dollar market for the treatment of insomnia.

воскресенье, 28 ноября 2010 г.

Sleep Apnea Increases Heart Disease Risk

Obstructive sleep apnea, or periodic interruptions in breathing throughout the night, thickens sufferers' blood vessels. Moreover, it increases the risk of several forms of heart and vascular disease. Emory researchers have identified the enzyme NADPH oxidase as important for the effects obstructive sleep apnea has on blood vessels in the lung.
The results are published in the May 1 issue of the American Journal of Respiratory Cell and Molecular Biology. C. Michael Hart, professor of medicine at Emory University School of Medicine and Atlanta Veterans Affairs Medical Center, is senior author.
Obstructive sleep apnea is thought to affect one in every 50 women and one in every 25 men in the United States. Standard treatment involves a mechanical application of air pressure. Anything that blunts sleep apnea’s effects on blood vessel physiology could reduce its impact on disease risk, Hart says.
Cyclically depriving mice of oxygen – researchers call this “chronic intermittent hypoxia” -- in a way that simulates obstructive sleep apnea gives them pulmonary hypertension. Pulmonary hypertension, which can be life threatening, is a condition in which the right side of the heart has trouble pumping blood because of resistance in the lung’s blood vessels.
Chronic intermittent hypoxia forces the blood vessels in the lung to make more NADPH oxidase, Hart and his colleagues found. Mice that lack NADPH oxidase are immune to hypoxia’s effects.
NADPH oxidase is a helpful enzyme because it is responsible for making superoxide, a reactive free radical that the immune system uses to kill bacteria. But superoxide also interferes with nitric oxide, a signal that allows blood vessels to relax.
Humans with mutations in genes for NADPH oxidase have recurrent bacterial infections because their ability to fight the bacteria is weakened. Thus Hart says inhibiting the NADPH oxidase enzyme in the entire body may be harmful, and he favors an indirect intervention.
"We think that strategies to lower NADPH oxidase expression induced by hypoxia may be useful in preventing hypoxia-induced pulmonary hypertension," says Hart.
The research was funded by the National Institutes of Health and the Veterans Affairs Research Service.

среда, 24 ноября 2010 г.

Sleep Apnea Patients Experience Higher Depression Levels

Patients who experience a range of ear, nose, and throat-related health problems exhibited a greater prevalence of depression than is observed in the general population, says new research presented at the 2008 American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF) Annual Meeting %26amp; OTO EXPO in Chicago, IL.
In any given one-year period, approximately 9.5 percent of the population, or about 18.8 million American adults suffer from a depressive illness. The new study, which analyzed the health of 12,516 distinct otolaryngology patients, found that 30 percent of these patients either had been diagnosed with depressive illness or took antidepressants.
The study further broke down different otolaryngologic diagnoses to determine which conditions had the highest co-morbidity with depression.
Researchers found that patients diagnosed with sleep apnea had the highest levels of depression and use of antidepressant medications (21 percent and 46 percent).
Findings from this study could help clinicians diagnose and treat co-morbid depressive and otolaryngolic symptoms in patients.

пятница, 19 ноября 2010 г.

Restless Leg Syndrome Interrupts Sleep for Fibromyalgia Patients

Researchers find that adults with fibromyalgia are 11 times more likely to suffer from restless leg syndrome (RLS) compared to individuals without the disease. The findings suggest treatment could help sleep and improve quality of life for adults diagnosed with the condition.
Dr. Nathaniel F. Watson, associate professor of neurology at the University of Washington in Seattle, Washington who contributed to the study says, "Sleep disruption is common in fibromyalgia, and often difficult to treat. It is apparent from our study that a substantial portion of sleep disruption in fibromyalgia is due to restless legs syndrome."
The study was led by Dr. Mari Viola-Saltzman of Loyola University Medical Center in Maywood, Ill. The team of scientists studied 172 people with fibromyalgia - 93 percent were female, with an average age of 50. They were compared to 63 healthy individuals with an average age of 41 years.

Sleep Problems more Severe with Fibromyalgia and RLS

Restless legs syndrome is characterized by the urge to move the legs, especially at night. The result is lack of sleep and worsening fatigue that already accompanies fibromyalgia.
The study looked at the prevalence of restless leg syndrome among in 172 people diagnosed with the disease. The researchers used the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale to evaluate sleep disturbance among participants with RLS.
The authors note the study does not show fibromyalgia causes RLS, but the two diseases share similar sensory pathways that regulate the neurotransmitter dopamine. Exercise improves restless leg syndrome and also improves fibromyalgia. Another overlap could be the use of antidepressants prescribed for fibromyalgia treatment that can induce RLS.
The results show that sleep problems were more severe among fibromyalgia patients who also have Restless Leg Syndrome. The authors suggest clinicians routinely screen fibromyalgia patients for symptoms of Restless Leg Syndrome that is treatable and can "potentially improve sleep and quality of life..."