Can Snoring Harm Your Health?
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Transcript of Can Snoring Harm Your Health?
Can Snoring Harm Your Health?
Presented by:Alison S. Kole, MD/MPH
Director, Sleep Disorders Center19 November 2015
Overview• Importance of Healthy Sleep• How sleep apnea affects your health• Who is at risk for sleep apnea• Options for diagnosis and treatment• Preventative strategies
Importance of Healthy Sleep
Importance of Healthy Sleep
• AASM and SRS Consensus Statement1
“Adults should sleep 7 or more hours per night on a regular basis to promote optimal health”
• Official American Thoracic Society Statement2
“Sleep is an essential biological function with major roles in recovery, energy conservation, and survival”
“It is clear that good-quality sleep is critical for good health and overall quality of life”
1. Journal of Clinical Sleep Medicine, Vol 11, No 6, 20152. Am J Respir Crit Care Med Vol 191, Iss 12, 1450-1458, Jun 15, 2015
Sleeping < 7 hours per night1
• Weight gain and obesity
• Diabetes• High blood pressure• Heart disease• Stroke• Depression
• Immune dysfunction• Greater risk of
accidents• Increased risk of
death
Associated with:
1. Journal of Clinical Sleep Medicine, Vol 11, No 6, 2015
Airway Anatomy
Picture reference: http://stopsnoringrx.com/why-do-we-snore/
Airway during Sleep
Picture reference: http://www.dreamstime.com/royalty-free-stock-image-snoring-sleep-apnea-image27809776
Obstructive Sleep Apnea (OSA)3
• Apnea Pause in breath for ≥ 10 seconds
• Hypopnea Flow of breath decreases by 30% of baseline
for ≥ 10 seconds associated with a fall in oxygen saturation by 3%
3. AASM Scoring Manual Version 2.2, 2015
Obstructive Sleep Apnea• Upper airway
closes• Increased
blood pressure
• Increased heart rate
• Oxygen level drops
Picture reference: http://advan.physiology.org/content/32/3/196
Sleep Apnea Severity
Apnea Hypopnea Index (AHI)
Picture reference: http://www.google.com/patents/WO2010107894A1?cl=en
Health Affects of OSA• 26% general US
population has OSA4
• 48% diabetes6
• 35% high blood pressure5
• 30% coronary artery disease5
• 60% stroke5
OSA
Picture reference: http://binghamtontmjandsleep.com/adult-sleep-disorders/risks-and-effects-of-osa-factors/4. Rising prevalence of sleep apnea in U.S. threatens public health. National Healthy Sleep Awareness ProjectMonday, September 29, 2014 5. Sleep Apnea and Cardiovascular Disease. Circulation, 2012, 126: 1495-1510 6. Prevalence of Sleep Apnea in a Population of Adults With Type 2 Diabetes Mellitus. Endocr Pract. 2007;13(4):355-362
Health Affects of OSA
Lily Eunhae Studer, 7/29/15
Health Affects of OSA• Untreated OSA:
2.5x higher risk of accidents7
• Effective treatment cuts this risk by 70%7
Huffington Post 4/7/2014 “Engineer Involved In Fatal
Metro-North Train Derailment Had Undiagnosed Sleep
Apnea” 7. Risk of motor vehicle accidents is higher in people with sleep apnea. American Academy of Sleep MedicineTuesday, March 10, 2015
Risk Factors for OSA
• Personal history • Family and ethnic risk• Post menopausal women
Picture reference: https://utswim.wordpress.com/tag/pulmonary/
Options for DiagnosisPolysomnography
Options for DiagnosisHome Sleep Testing
Picture reference: http://join.sleepgroupsolutions.com/products/watermark-ares/
Options for Treatment
• CPAP (continuous positive airway pressure) therapy
• APAP (auto-positive airway pressure therapy
Picture reference: http://www.schofieldmedical.com/Catalog/Online-Catalog-Product/2076/Prsystem-One-Remstar-Auto
Alternative Therapies
NONSURGICAL SURGICAL
Positional Therapy• Tennis ball T-shirt
Picture: http://www.tennisballtshirt.com/Stop_Snoring_Remedy_%3A_Tennis_Ball_T_Shirt_%3A_Anti_Snore_Cure.html
Zzoma belt
Picture reference: http://www.medicare.ie/zzoma-positional-device-887.html
Night Shift Positional device
Picture reference: Assessment of a Neck-Based Treatment and Monitoring Device for Positional Obstructive Sleep Apnea. J Clin Sleep Med 2014;10(8):863-871. http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29591
Provent
Picture reference: http://www.lunar.com/blog/lunar-designed-ventus-provent-sleep-apnea-therapy-wins-gold-idea/Picture reference: http://www.sleepwa.com.au/mas-and-provent-Therapy
Oral Appliance Therapy
Panthera Herbst
Mouthpieces
Oral Appliance Therapy• Dental Device Titration (MATRx)
Determining who benefits from mouthpieces
Coming January 2016 to SMG Warren Sleep Laboratory!
Surgical Treatment of OSAUvulopalatopharyngoplasty (UPPP)
• removal of upper airway soft tissues including the uvula, soft palate, tonsils, and adenoids
Surgical Treatment of OSAMaxillomandibular advancement (MMA)
• Currently the most effective surgical option for OSAPicture reference: http://www.homesleepclinic.com/desktop/treatment-options.html8. Oral Appliance Treatment for Obstructive Sleep Apnea: An Update. J Clin Sleep Med 2014;10(2):215-227.
Hypoglossal Nerve Stimulation
Picture reference: Upper-Airway Stimulation for Obstructive Sleep Apnea. N Engl J Med 2014; 370:139-149
Preventative strategies• WEIGHT LOSS
Diet, exercise, weight loss surgery• Avoidance of alcohol• Avoidance of prescription sleep aids• Quit smoking!
Picture reference: http://users.rowan.edu/~blondi74/Expert.page.2.html
Comprehensive Sleep Evaluation
Kole
Bakal Kohn (Pediatrics)
Bass BlausteinWilt
Livingston campusFlorham Park campus
Berkeley Heights campusFlorham Park campus
Berkeley Heights campus
Thank You!
I mustache you a question…