SleepMed Logo
Brilliant Minds, Better Sleep  
Newsletter of Sleep Medicine Associates of Texas, P.A.
October 9, 2009 Edition VIII
In This Issue
Does CPAP Prolong Life?
How Does SMAT Increase
Snoring is a Nuisance
 
 
Car accident
 
 Snoring is the most common complaint we hear.  Assess your bed partner's snoring and we can recommend a solution.   
 
Car accident
 
CPAP units are necessary but can be annoying.
Sleeping Pills 
If chronic insomnia is causing you to turn to over-the-counter sleeping pills, our experts can find an effective long-term treatment.  For more information, 
 
Forward this newsletter
 to someone you care about or
 
 
 Heartburn and Sleep

Call Today! 214.750.7776
 
Does CPAP Prolong Life?
 

Sleep Apnea_Man

 
The doctors at Sleep Medicine Associates consider patients with severe obstructive sleep apnea (OSA) to be at significant increased risk for death and disability.  Many studies have shown that people with  OSA have a higher risk for death from cardiovascular disease and stroke. A study in the medical journal Sleep, August 2008 suggests that treatment with continuous positive airway pressure (CPAP) may reduce these risks. The Wisconsin Sleep Cohort Study followed 1,522 participants (age 30-60) for 18 years.  In the study, 4% began the research study with severe OSA, 20% had mild to moderate OSA, and 76% were normal.
 
19% of the people with severe OSA died over an average 13 years of follow-up, compared with 7.3% of those with mild and moderate OSA, and only 4% of those without OSA.  The people with severe OSA had a 3.2 times greater death rate than those without OSA.  Most of the differences in death rates were due to cardiovascular disease or stroke.

The study then looked at the people with severe OSA who did not use CPAP routinely.  In the group who failed to treat severe OSA, the death rate was even more dramatic:  4.3 times higher compared to those without OSA.  More importantly, deaths from cardiovascular disease were 5.2 times higher in the subjects who did not use CPAP.  In contrast, the patients with severe OSA who were using CPAP had a lower death rate (2.9 times higher than those without OSA). This means that CPAP use was associated with a 2.3 fold reduction in cardiovascular deaths in those with severe OSA who used CPAP compared to those who did not use CPAP.

Although additional research is needed, it appears that CPAP may help people with severe OSA live longer by reducing the risk of heart-related deaths and strokes.

People who sleep next to a person who snores know that snoring becomes louder with a shift to the back. The loud snorer will be told to "roll over" and may receive the prompt of an elbow or fist to the ribs to move back to his/her side. In addition, sleep studies show that OSA is worse when the person sleeps on the back. Snoring and OSA are caused by narrowing behind the tongue, which become more significant when sleeping on the back due to the gravitational pull on the jaw and the backward shift of the tongue that reduces the opening behind the tongue.

How Does SMAT Increase Success with CPAP?

Some people may have difficulty adjusting to CPAP. Studies show that as many as 50% will stop using CPAP or will use it an inadequate amount of time per night. This is similar to the results of studies looking at the percentage of people who regularly take their medications as prescribed.

Studies have also shown that when CPAP is prescribed to the appropriate people and with adequate education and support along the way, the rate of use can be substantially improved.  For example, in our clinic, around 80% of the patients we see will use CPAP nightly. 

In a future newsletter, we will discuss how a team approach to CPAP can help with the initial adjustment to CPAP and with settling in for the long term. After all, it does not matter how great the benefits of CPAP are, if the people who need it will not use it.
Sincerely,
 
 
John R. Debus, MD
Sleep Medicine Associates of Texas, P.A.