Articles by Michael Oko

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A study of more than 11 000 children followed for over six years has found that young children with sleep-disordered breathingare prone to developing behavioural difficulties such as hyperactivity and aggressiveness, as well as emotional symptoms and difficulty with peer relationships, according to researchers at Albert Einstein College of Medicine of Yeshiva University.

Their study, the largest and most comprehensive of its kind, published online in the Journal Pediatrics.

“This is the strongest evidence to date that snoring, mouth breathing, and apnoea [abnormally long pauses in breathing during sleep can have serious behavioural and social-emotional consequences for children,” said study leader Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynaecology and women’s health at Einstein.

“Parents and paediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life.”

Children whose symptoms peaked early—at six or 18 months—were 40% and 50% more likely, respectively, to experience behavioural problems at age seven compared with normally-breathing children. Children with the most serious behavioural problems were those with SDB symptoms that persisted throughout the evaluation period and became most severe at 30 months.

Researchers believe that SDB could cause behavioural problems by affecting the brain in several ways: decreasing oxygen levels and increasing carbon dioxide levels in the prefrontal cortex; interrupting the restorative processes of sleep; and disrupting the balance of various cellular and chemical systems.

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A very interesting post on CNN by Lisa Shives MD:

“The thin child with OSA does not usually act sleepy in the daytime. On the contrary, they often act hyperactive or inattentive. In fact, their symptoms can mimic attention deficit hyperactivity disorder. Large tonsils and adenoids are the primary cause of OSA in thin children because these and surrounding tissues can relax during sleep and block the airflow to the lungs. In fact, 80 to 90% of such cases of pediatric OSA are cured by surgically removing the tonsils and adenoids.

“Overweight or obese children are not such an easy fix. They usually present with loud snoring and significant daytime sleepiness. In obese children, the tonsils often become enlarged due to fatty tissues in the upper airway. Fat deposits in the neck and chest also add to the collapsibility of the upper airway during sleep.

“Unfortunately, a tonsillectomy/adenoidectomy is curative in only about 50% of overweight kids who have OSA. The others are encouraged to try continuous positive airway pressure (CPAP) which is the most common treatment for severe OSA.”

Read full post…

 

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Read the January 2012 Snore Centre eNewsletter, with info about the new Harley Street Clinic, Michael Oko’s editorial in the “Baby Book”, and a real life story of sleep apnoea from one of our patients:

Snore Centre eNewsletter Jan12

 

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Leading UK sleep specialist, consultant ENT surgeon Michael Oko, today announced the opening of a new clinic at 150 Harley Street, London. The Snoring Disorders Centre adds the prestigious London location to its existing clinics in Boston and Spalding, Lincolnshire.

Mr Oko said, “As well as catering for private patients in London and the South East of England the new Snoring Disorders Centre clinic will serve a growing number of international patients who come for treatment from all corners of the world.

“The Snoring Disorders Centre provides a life-changing service for sufferers of obstructive sleep apnoea and other sleep-related disorders. Problem snoring and sleep apnoea are a more widespread problem than most people think. Often people do not even realise that they are a sufferer, which is why there has traditionally been a low awareness of, and a lack of provision for, this illness.”

Consultant ENT surgeon Mr Michael Oko opened the first Snore Centre clinic in 2006 in the Bostonian wing of Pilgrim Hospital in Boston. Prior to this there was no sleep apnoea service across Lincolnshire, leaving a population of 700,000 people with little provision for sleeping disorders. Due to increased access to resources more people are now able to address their sleeping problems and enhance the quality of their lives, and in 2008 the Snore Centre gained recognition for this achievement by winning the NHS East Midlands Healthcare Award for service transformation.

Mr Oko actively campaigns for greater awareness of the dangers of sleep apnoea in regions with high incidence such as the Middle East. In 2011 Mr Oko was recently presented with an award for his contribution to healthcare in the Middle East region by Riz Khan of Al Jazeera.

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Severe obstructive sleep apnea was associated with a risk of cardiovascular death in women, but continuous positive airway pressure (CPAP) seemed to reduce the risk, according to a small Spanish study.

In a 116-patient, observational study, those with severe obstructive sleep apnea had a cardiovascular mortality rate of 3.71 per 100 person-years compared with the control group’s rate of 0.28 per 100 person years, Francisco Campos-Rodriguez, MD, from Valme University Hospital in Seville, Spain, and colleagues found.

Women with mild to moderate apnea had a mortality rate of 0.94 per 100 person-years (P=0.034 compared with the control group), they reported in the Annals of Internal Medicine.

Despite prevalence data suggesting that 2% to 3% of middle-age women have obstructive sleep apnea, most of the studies on both apnea and cardiovascular effects have been done exclusively in men. The researchers were interested in investigating this issue in a large group of women.

Source: Medpage Today

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I am very thankful for the help I have been given by Mr Oko and the time taken up to listen to me to help me overcome my fears. This is the first step in a huge hurdle for me and with your help I know i will get there. I hope my experience will help others too.

I havent actually started treatment as yet, but thats my own fault really….. I first went to see Mr Oko back in November 2011 and within no time he arranged a Visilab Sleep Study for me. I had envisaged my problem to just be ‘snoring’, so when i went back a couple of week’s later for the results of the Visilab test I was rather alarmed to find I did in fact have Severe Obstructive Sleep Apnoea!

Not expecting this and not really knowing that much about the CPAP treatment I was too scared to give it a go. I opted for a Mandibular Advancement Device to at least help the situation instead. So whilst waiting for this to  be made up, I did plenty of research on the internet and over the Christmas period wrote out many questions.

Today I have been back to see Mr Oko saying that I have changed my mind and would like to give the treatment a try. He couldn’t have been more helpful. He never rushed me and never pressured me. He answered all my concerns and has sorted out a suitable mask for me to try….all I need to do now is wait for my machine to arrive.

Ok, I know I haven’t actually got any CPAP experience to share with everyone as yet, but my experience of nerves after the initial diagnosis will hopefully help others who may be feeling the same, come forward. I will update as my treatment continues as I would like to help and hopefully others will do the same and I can also gain from their experiences of the condition.

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I am always interested to hear about people’s experiences as a sufferer of sleep apnoea or the partner of a sufferer. The information, knowledge and advice on how to handle the condition from experienced patients can also be invaluable to other sufferers, and raise awareness of the seriousness of sleep apnoea amongst the public.

I would therefore like to invite any sleep apnoea sufferers at any stage of treatment (and their often long-suffering partners) to become guest bloggers for the Snore Centre Blog and let the online community benefit from your experiences.

If you would like to contirbute to the blog please either leave a comment below or contact guyrowland@gmail.com

 

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This is an article I have written for You and Your family, who send out the baby book to all expectant mothers:

Pregnancy and then a new baby can make getting enough sleep difficult, especially if your partner suffers from Sleep Apnoea…

When your baby arrives you will want to be on top form in order to give him or her all the care and attention they need, day or night. The chances are that you will also be among the three quarters of women who have difficulty getting enough sleep during pregnancy.

Leg cramps, heartburn, frequent toilet trips, can all make sleep difficult. So when you have the opportunity for sleep you need to make the most of it. Good practices to avoid insomnia include taking daily exercise, not smoking or drinking alcohol, avoiding caffeine in the evenings, and not eating a big meal too close to bedtime.

However, it could be your partner that is giving you sleepless nights if he has a snoring problem; and it could be due to a medical condition. The most common sleep disorder is called Obstructive Sleep Apnoea, and men are twice as likely to suffer from this than women.

The problem itself is a disrupted breathing pattern during sleep caused by a closing of the upper airways of the lungs when you relax and a period of time when your body stops breathing. Common indicators of Sleep Apnoea are loud snoring, daytime fatigue, memory loss, frequent urination, and loss of interest in sex.

Sleep Apnoea also carries significant health risks, increasing the risk of high blood pressure, heart attack, stroke, type 2 diabetes, and obesity.

Sleep Apnoea can usually be treated by making small lifestyle changes, but moderate or severe Sleep Apnoea may require wearing a CPAP machine while you sleep. This is a mask attached to a machine that helps you to breathe at night by providing a steady supply of air.

If you are concerned that you or your partner may be suffering from Sleep Apnoea it is advisable to consult your GP, who can then refer you to specialist for diagnosis and treatment.

When your new baby arrives you will need all the rest you can get, so it makes sense to get a sleeping disorder treated in plenty of time for the birth.


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The Sleep Alliance has released an important report into how untreated sleep disorders are damaging the UK.

“The Sleep SOS Report presents a comprehensive overview of how excessive sleepiness is damaging the health
and economy of the nation. Sleep disorders are a major contributing factor to fatal road accidents, heart
disease, strokes, lost productivity and the breakdown of marriages, in addition to impaired quality of life for
hundreds of thousands of patients in the UK. Yet whilst the prevalence of sleep disorders is rising, the provision
of medical services is in desperate need of attention.”

• Approximately 6% of adults suffer from excessive sleepiness – over 3.5 million people in the UK.
• 20% of accidents on motorways are caused by excessive sleepiness.
• Untreated cases of a single sleep disorder – obstructive sleep apnoea – are costing the NHS
£432 million per year.

The report ends with this call to action:

“The Sleep Alliance calls on the Government and NHS for a commitment to sleep medicine
and improved funding of sleep services, to allow optimal diagnosis and management of
excessive sleepiness, particularly OSAHS – the most common treatable condition. In addition,
the Sleep Alliance calls for improved awareness of excessive sleepiness amongst healthcare
professionals and the general public through education and greater recognition of the
impact of sleep disorders on patients’ lives and society as a whole.”

Read the Sleep SOS Report: Sleep SOS Report – 20111231

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Happy New Year from everyone at the Snore Centre!

Please click below to read the Snore Centre eNewsletter for December 2011

Snore Centre eNewsletter Dec11 (pdf)

 

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