Articles by Michael Oko

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We know that some birds and mammals hibernate, but what is not known is whether humans have ever had this ability. There is evidence that humans tend to sleep longer and move around less in winter, in response to the cold and the need to conserve energy.

A facinating article on the subject- The Biology of Hibernation: Can Humans Hibernate? -argues that it may be possible given the correct circumstances and training:

“While we don’t have the need to hibernate for protection against the elements as animals do, did we once have the biological mechanisms to regulate our metabolic activity and temperature for long periods of time? Do we still have those mechanisms—and just not use them? The closest most humans come to hibernation these days seems be through meditation, sleep, and starvation. All three states are characterized by many of the same things as hibernation—decreased metabolic activity, decreased oxygen consumption, muscle relaxation, and decreased hormone production.”

Of particular interest to me as a sleep disorder specialist is the fact that restricted oxygen intake is a factor in hibernation, given that sleep apnoea causes exactly this problem for sufferers. Could there be an increased hibernation reflex in sleep apnoea patients?

According to Wikipedia there are many research projects currently investigating how to achieve “induced hibernation” in humans for medical and other purposes:

“The ability for humans to hibernate would be useful for a number of reasons, such as saving the lives of seriously ill or injured people by temporarily putting them in a state of hibernation until treatment can be given (compare induced coma). In addition, hibernation would be useful for humans during various proposed plans for interstellar travel in the future. Similar to human hibernation, suspended animation deals with the slowing of life processes in general, by external means and without termination.”

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While I was out in Abu Dhabi speaking at the World Health Care Congress I spoke to a journalist from the region’s leading daily, Gulf News, about the dangers of sleep apnoea for drivers.

Levels of awareness about the prevalence and fatal consequences of sleeping disorders are worryingly low, and judging by the comments of Dr Yousuf Al Tigani, a psychiatry specialist at Al Noor Hospital – that he had only seen one case in seven years – suggest that people do not know they are suffering from the condition. Given that around 5% of the population in the Gulf have sleep apnoea, this situation requires urgent action.

During my visit to Abu Dhabi I was presented with a Middle East Hospital magazine award recognising my efforts to raise awareness about sleep apnoea in the region by Riz Khan of Al Jazeera. Hopefully this award will help towards increasing knowledge about sleep apnoea and is dangers, and result in more people seeking treatment.

 

 

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Follow this link to read the November issue of the Snore Centre eNewsletter:

Snore Centre eNewsletter Nov2011

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The Charlotte Observer reports that a five-month investigation by NewsChannel 36 finds that one factor in the increasing number of trucking deaths is seldom reported and largely unregulated: sleep apnoea.

Drowsy driving kills more people on America’s highways than distracted driving, a top sleep expert recently told a motor carrier safety advisory panel. Dr. Charles Czeisler of Harvard University Medical School says sleep apnoea gets a lot less attention than other factors in deadly accidents involving tractor-trailers, but accounts for one in five crashes.

The number of Americans who died in commercial truck crashes grew slightly to about 4,000 last year, the Federal Motor Carrier Safety Administrator recently told Congress.

“I would argue that fatigue as a causal factor in truck-involved crashes is underreported, not over-reported,” said Don Osterberg, vice president of Safety for Schneider National Trucking. “Absent the commercial driver acknowledging that he or she fell asleep, law enforcement doesn’t record the crash as fatigue-related.”

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Lord Darzi presents Michael Oko with MEH award

Snoring Disorders Centre founder, Consultant ENT surgeon Michael Oko, will address senior healthcare executives from across the Middle East in Abu Dhabi next week.

At the World Health Care Congress Middle East (11-13 December 2011) Mr Oko will be speaking about the benefits of preventative treatment in delivering cost savings, using the example of Obstructive Sleep Apnoea (OSA) testing and treatment in Lincolnshire UK.

It is suspected that about 20% of car accidents are sleep related and research has shown that sleepiness can impair driving more than drink! Indeed, patients with Obstructive Sleep Apnoea have a 7-12 fold chance of a road traffic accident (RTA) compared to those who do not, and results in Lincolnshire have shown that treating the condition can reduce the accident rate dramatically.

In an interview to be published in Middle East Hospital magazine this month Mr Oko said,

“Fatal road accidents in Lincolnshire used to average about 79 per year. By December 2010, the number of fatal road traffic accidents had fallen from 79 to 45. A significant contributory factor in this success is that since 2006 the Snoring Disorders Centre has treated over 1,200 patients with sleep apnoea and these people are now able to drive more safely, rather than being in fear of falling asleep at the wheel. As well as the lives that have been saved by this initiative, this reduction in accidents also represents a saving of over £55 million to the economy, including the NHS.”

Mr Oko is bringing this message to the Middle East in a bid to raise awareness of the dangers of not addressing the rising incidence of OSA across the region,

“With the low level of awareness of sleep apnoea in the Middle East it’s no surprise that road accident rates in the Gulf region are dreadful. In fact road traffic accidents are the second major cause of death in the UAE and there are 3500 fatalities per year from RTAs in Saudi Arabia alone. I believe that the success I have had in Lincolnshire can be replicated in the Middle East by raising awareness of the condition, and forming long-term partnerships with local hospitals, doctors, and government departments.”

Mr Oko has already been very active in bringing this message to the healthcare community in the Middle East throughout 2011. For his work in this area Mr Oko was awarded the Middle East Hospital magazine award for excellence in respiratory care.

In January 2012 Mr Oko is opening a new private clinic at 150 Harley Street in London, to increase treatment capacity in the London area, and to cater for overseas patients. He also plans to open further satellite clinics throughout the UK.

 

Notes to editors:

Media contact: Guy Rowland, PR Consultant | +44 (0)7909 088369 | guyrowland@gmail.com

Launched in 2010, the World Health Care Congress Middle East (11-13 December 2011, Abu Dhabi), is the premier conference to feature global health care innovation. It attracts more than 600 senior health care thought leaders from all industry sectors, including hospitals, health systems, employers, government agencies, pharma, biotech and industry suppliers. WHCC Middle East is organized with sovereign partners the Health Authority-Abu Dhabi (HAAD) and the Abu Dhabi Tourism Authority (ADTA). Additional sponsorship is currently provided by The Abu Dhabi Health Services Company (SEHA) www.seha.ae and Children’s National Medical Center www.childrensnational.org

www.worldcongress.com/me

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The Wellcome Trust produced this video in 2009, and its well worth watching for anyone wanting know the basics of sleep apnoea. The Trust’s aim with this video was to explain the condition and treatment, but also to put a spotlight onto the work of Dr Mary Morrell, who studies the condition. At the time of filming she was about to embark on a major new trial in the elderly, for whom this problem is very common.

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A very interesting post on Fierce Healthcare blog about the link between patient satisfaciton and profit in the US. This is also highly relevant to the way the NHS is going. When revalidation comes doctors will be judged on how happy their patients are, and patients will choose doctors with the best track record.

“Hospitals with high performance scores in patient care are more profitable, according to a new Press Ganey report. The top 25 percent of U.S. hospitals with the highest scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question about performance were, on average, the most profitable and had the highest clinical scores, suggesting that patient experience, coupled with clinical outcomes, can mean financial profitability for the institution.

“It is interesting to note that the only hospitals that showed a positive profit margin were those that were highly rated by their patients,” the report states. “…Although there is not a lot of difference in the clinical measures among the four groups of hospitals segmented on patient rating score, the top quarter of hospitals based on HCAHPS overall rating score also have the highest average clinical score. Taken together, these [results] suggest that excellence in patient experiences, clinical outcomes and financial profitability often occur together.”

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A growing body of research has also found that sleep apnoea can be a drain on intimacy, causing erectile dysfunction in men and loss of libido in women.

Scientists suspect this may have to do with sex hormones like testosterone, which rise with sleep and fall when there is a lack of it. Because it causes intermittent waking and chronic sleep deprivation, apnea may directly drive down levels of these hormones, causing sexual dysfunction.

In the most recent study, published last month in The Journal of Sexual Medicine, scientists compared 80 women with obstructive sleep apnoea between the ages of 28 and 64 with 240 women without the condition. They found that the apnea patients had significantly higher rates of sexual dysfunction. Their findings echoed those of earlier studies on women and apnea.

In a study in 2009, researchers looked for signs of sexual problems in 401 men who showed up at a clinic for suspected sleep apnea. Of those who received the diagnosis, about 70 percent also had erectile dysfunction, compared with 34 percent in those without sleep apnea.

But on the bright side, treatment can make a difference. Patients who undergo surgery to correct facial abnormalities that contribute to apnea see improvements in intimacy, and those who start using masks at night that administer continuous positive airway pressure also report benefits in their sexual relationships.

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The October issue of the Snore Centre Patient eNewsletter is available to read here:

Snore Centre Patient eNewsletter October 2011

 

 

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A new study published in the European Respiratory Journal has found that a Mediterranean diet coupled with increased exercise and continuous positive airway pressure (CPAP) therapy may help to treat sleep apnoea.

The researchers, from the University of Crete in Greece examined 40 obese patients suffering from OSAS. Twenty patients were given a prudent diet to follow, while the other 20 followed a Mediterranean diet. Both groups were also encouraged to increase their physical activity, mainly involving walking for at least 30 minutes each day. In both groups, the patients also received CPAP  therapy, which involves wearing a mask that generates an air stream, keeping the upper airway open during sleep.

The results showed that people following the Mediterranean diet had a reduced number of disturbances, known as apnoeas, during the rapid eye movement (REM) stage of sleep, which usually accounts for approximately 25percent of total sleep during the night. The findings also revealed that people following the Mediterranean diet also showed a greater adherence to the calorie restricted diet, an increase in physical activity and a greater decrease in abdominal fat.

The researchers suggested that further studies in a larger sample are required to fully understand the benefits of this diet.

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