CPAP Therapy Associated With Slight Weight Gain
(#7833, Tuesday, November 3, 3:45 PM ET)
Continuous positive airway pressure (CPAP), a common therapy for sleep apnea, is associated with a slight but temporary weight gain in patients. Researchers from the University of Toledo Medical College in Ohio followed 152 patients who underwent CPAP therapy for 1 month. Of the patients, 119 (78 percent) gained an average of 3 lbs. Weight gain occurred in 81 percent of men and 73 percent of women. A subgroup of 71 patients who remained on therapy demonstrated gain in mass at 4 weeks, which did not persist at 6 months. Researchers speculate that the weight gain is due to increased vascular volume.
Tonsil Size May Predict Sleep Apnea in Kids
(#8090, Tuesday, November 3, 3:45 PM ET)
Children with large tonsils may be at an increased risk of developing obstructive sleep apnea-hypopnea syndrome (OSAHS). Researchers from the Philippines assessed the link between obesity and OSAHS in 285 children who snored. Of the patients, 118 patients (41 percent) were found to be obese. Among the obese patients, 34 percent had OSAHS, while 50 percent of patients who were not obese also had the condition. Results indicated that the BMI Z-score, a measure of obesity, did not demonstrate a significant risk factor or predictor for the presence and severity of OSAHS. Yet, tonsillar size, the presence of witnessed apneas in the sleep history, and presence of nasal congestion due to allergic rhinitis were found to be significant risk factors for the presence of OSAHS.
Oral Appliance Provides Military With Alternate Sleep Apnea Treatment
(#8604, Tuesday, November 3, 5:30 PM ET)
New research finds that an oral appliance (OA) may be an effective alternate sleep apnea therapy for patients who do not respond to continuous positive airway pressure (CPAP) or who are not able to accommodate CPAP, such as military service members. In a retrospective review, researchers from Walter Reed Medical Center in Washington, DC, assessed 638 patients (86.5 percent men) diagnosed with obstructive sleep apnea who were undergoing polysomnographic and OA titrations. Overall, OA titrations were successful in 49.8 percent of patients. OA titrations were successful in 65.3 percent of patients with mild disease, 49.6 percent with moderate disease, and 35.1 percent with severe disease. In addition, 24.8 percent of patients had an unsuccessful titration, and 25.4 percent were intolerant to the OA. Researchers conclude that while OA is more effective in patients with mild disease, those with moderate to severe disease may also benefit. Furthermore, an OA may provide an alternate treatment option for military service members with OSA who are intolerant to CPAP or require therapy in a deployed setting.
Sleep Apnea Moves Past Stereotypes
(#8820, Wednesday, November 4, 1:30 PM ET)
Obstructive sleep apnea (OSA) has long been associated with older, obese patients who snore. However, new research shows that this may not be an accurate representation of those who suffer from OSA. Researchers from Albert Einstein Medical Center in Philadelphia, PA, reviewed demographic and polysomnographic data of 611 patients referred for OSA evaluation, 452 of which had OSA. In the total study group, a 1 unit higher BMI corresponded with 8 percent higher odds of having OSA, and for each 10-year increase in age, the odds of having OSA increased by 4 percent. Men had 4.7 times the odds of having OSA. In a subgroup of 105 nonobese patients, 54 patients (51.4 percent) had OSA, and men had 11.7 times the odds of having OSA. In addition, for each 10-year increase in age, the odds of having OSA increased by 44 percent. Researchers conclude that age and male gender were the only independent predictors of OSA in both study groups. They also caution that the preconception that OSA is restricted to older, obese patients who snore leads to underdiagnosis of the disease in other populations at risk.
ICU Nurses' Abnormal Sleep Habits May Increase Errors
(#9016, Wednesday, November 4, 1:30 PM ET)
Nurses working in the ICU may experience more abnormal sleep and more errors compared with nurses working on the floor. Researchers from Baylor College of Medicine in Houston assessed the overall sleep quality and vigilance among ICU nurses at the beginning and end of their shift, and compared findings with similar measurements in floor nurses. All nurses filled out the Pittsburgh Sleep Quality Index Questionnaire (PSQI) and were assessed for vigilance at the beginning and end of the same 12-hour shift. Results showed that errors at either end of the shift were different only in the ICU group but not in the floor group (2.48±4.18 vs 3.57±6.45). Furthermore, the PSQI score was more abnormal in the ICU group (7.40±3.24) vs the floor group (5.73±2.59). Among both floor and ICU nurses, the slow reaction times were unchanged across the shift; however, there was a significant reduction in fast reaction time between either ends of the shift only in the floor nurses. Researches speculate that the abnormal sleep and fall in vigilance demonstrated among ICU nurses may have implications for patient safety.