An award-winning NHS service to help patients with diagnosis and management of obstructive sleep apnoea (OSA) is opening at Hampton Hill Medical Centre (TW12 1NY) on 12  September.

OSA is caused by an obstruction blocking the airway of the throat so that the air cannot reach the lungs, leaving the sufferer gasping for breath. Men are three times more likely to have the condition, which affects around 1.5 million adults in the UK. If left untreated, OSA can cause heart disease, hypertension, stroke and exacerbate diabetes.

Symptoms of OSA may include:

  • breath holding/struggling to breath at night (apnoea)
  • very loud snoring
  • daytime fatigue and drowsiness
  • short-term memory loss
  • multiple trips to urinate through the night
  • early morning headaches
  • loss of interest in sex

Richmond Clinical Commissioning Group (CCG) has commissioned a community based OSA service, which is available to people who have been referred by their GP. It is one of the first of its kind in the country and allows patients to be assessed and monitored in the comfort of their own home.

The service has been developed in partnership with consultant ear, nose and throat surgeons and Department of Health OSA advisors, Professor Ram Dhillon and Mr Michael Oko.

Dr Graham Lewis, local GP and chair of Richmond CCG, said: “For some people who snore, the cause will be OSA. It is a common, treatable condition, but many people don’t know they have it and require diagnosis. It is important to make an appointment to see your GP if you have any symptoms.”

The service allows many of the patients with suspected OSA or those with established OSA to be diagnosed and monitored in their own bed, without having to spend a night away from home.

Dr Lewis continues: “The good news is that we can help 80% of patients manage the condition at home, without the need for surgery. This could be anything from lifestyle changes to state-of-the-art technology which enables us to track the progress of a patient at the touch of a button.

“We are very pleased to be offering this innovative service for people living in the borough of Richmond who have suspected obstructive sleep apnoea.”

 

The Office for Health Economics and The British Lung Foundation have published a report this month which clearly demonstrates the cost of undiagnosed sleep apnoea to the NHS.

Despite the clear evidence of benefit and value for money, there is evidence from recent research estimating that about 85 per cent of OSA cases currently are undiagnosed and untreated in the UK.

Research found the following OSA prevalence in the UK:

1.5 million adults living with OSA
45 per cent have moderate and severe OSA: 667,000 people
55 per cent have mild OSA

 

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Considering only direct benefits, the report estimates the NHS in the UK would be saving a total of £55 million and producing 40,000 QALYs annually if all people with moderate to severe OSA (45 per cent of the total OSA patient population) were diagnosed and treated with CPAP, relative to none being diagnosed and treated.

If everyone estimated to have moderate to severe OSA in the UK were treated, compared with the estimated current treatment level, the NHS would be saving £28 million pounds and producing 20,000 QALYs annually. Approximately 40,000 road accidents could be prevented.

In addition to direct health benefits to patients and costs/savings to the NHS, treating OSA produces wider economic benefits, including increased productivity due to reduced sleepiness at work, and also quality of life improvements for people close to OSA patients (their bed partners).
Conclusion

The evidence found in the literature demonstrates that OSA patients, the NHS and the wider society in the UK have not yet obtained all of the economic and health benefits that could be achieved. An increase in the rate of uptake of CPAP could double the savings to the NHS and the health benefits to patients compared to the current situation.

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STAYING up late for a few nights to meet work deadlines may bring relief when the assignment is completed, but how will such an employee function at work the next day?

Tired employees are often in a foul mood. They cannot handle stress and may fly off the handle at the smallest offence. They are unable to think as clearly or imaginatively as others, and tasks are more challenging.

Researchers based at hospitals with sleep laboratories have charted the effects of a lack of sleep. Short-term effects include less healthy food choices, a higher likelihood of road accidents and being prone to infectious ailments. The person may be less gregarious and more emotional. Memory and focus suffer, and, most seriously, a recent study in the journal Sleep linked one night without sleep to a loss of brain tissue.

Long-term effects are more alarming: the risk of developing cancer may increase; obesity risk rises abruptly; the risk of having a stroke quadruples; people are more likely to develop heart disease or diabetes; and the sperm count in men decreases.

Another study shows that less than six hours of kip a night significantly increases mortality risk.

What can company directors and managers do to ensure employees function at their peak during the working day? Some have installed nap rooms or energy pods that allow workers to catch up on sleep.

Google, Procter & Gamble, Huffington Post and Nationwide Planning have incorporated napping into daily office life. Mike Karalewich, chief compliance officer of Nationwide Planning, swears by it, saying it “really allows me to approach the second half of the day with a lot more force”.

Nathaniel Hindman, a former editor and reporter at the Huffington Post, concurs: “Sleep makes us more productive, creative, less stressed and much healthier and happier.”

Irshaad Ebrahim, specialist neuropsychiatrist in sleep disorders at the Constantia Sleep Centre and the London Sleep Centre on Harley Street, says people don’t only need enough sleep, but enough “good sleep”. His “2-Q Rule of Sleep” is to seek both quality and quantity.

“The best measure of your sleep quality is how you feel when you wake up in the morning — if you are getting adequate quantity but still wake up unrefreshed, tired and feel sleepy during the daytime, you should book a sleep assessment at your nearest sleep centre,” he advises. “Common conditions that affect sleep quality are snoring, sleep apnoea, restless leg syndrome and medical conditions like cardiac disorders and diabetes.”

A University of California study found there are “short-sleepers”, who go to bed around midnight and wake each morning — between 4am and 5am — feeling completely refreshed.

Lead study author Ying-Hui Fu and her colleagues discovered a tiny mutation in the DEC2 gene that seemed present in “short-sleepers”, who function just as well on limited sleep as those who get eight hours.

According to Fu, “Sleep is vitally important. If you sleep well, you can avoid many diseases, even dementia.”

The brain performs repair work on its cells during sleep, removing toxins, restoring energy levels and laying down memories for future reference.

Fu says many people who thought they were short-sleepers volunteered for the study and discovered they were suffering from insomnia. “We wanted to focus on people who slept for just a few hours and still felt great. These individuals are all very energetic, very optimistic. It’s very common for them to feel they want to cram as much into life as they can, but we’re not sure how or whether this is related to their gene mutations.”

While Ebrahim believes that the decision by some corporates to enhance sleep health by installing nap rooms or pods is admirable, he says the focus should be on the reasons people need daytime naps.

Companies should instead tackle the underlying causes of the sleep debt — the amount of sleep a brain is deprived of and needs to repay. “Once we address the underlying causes, there may well be no need for sleep pods at work,” he says.

Source: BDLive

 

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In July 2014 the Prime Minister David Cameron called on global action to tackle the threat of resistance to antibiotics echoing the mounting voices of microbiologists and infection prevention teams nationwide. Growing numbers of bacterial and viral infections are resistant to antimicrobial drugs, but no new classes of antibiotics have come onto the market for more than 25 years. About 25,000 people die each year in Europe alone from infections resistant to antibiotics. The World Health Organisation (WHO) has described this as one of the most significant global risks facing modern medicine.

Read full article in Hospital healthcare Europe 2015:

Antimicrobial Copper Surfaces article

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This World Sleep Day, 86% of Brits won’t be fully rested and our habits are to blame
March 13th marks World Sleep Day – a day designed to celebrate all things sleep-related. A recent survey into the nation’s pre-sleep habits shows that a massive proportion of Brits are not doing enough to get quality sleep.
Poor sleep routines, where two thirds of all pre-sleep activity is centred on electronic devices, lead nearly one in ten to say they find it ‘virtually impossible’ to get up in the mornings. A further three quarters to confess to feeling less than fresh the next day.
A staggering nine out of ten of us watch TV, half use a computer and over a third use a smartphone. It is likely that the same people are using multiple electronic devices in the run up to bedtime, giving their brains sparse opportunity to wind down.
The research carried out by luxury bath mat makers Turtle Mat found that although most of us think it’s important to relax, only one in four undertake activities that allow their brains to start switching off, whether it be by taking a bath or reading a book. Many put this lack of relaxation down to being too busy, with a further six percent of the population going as far as saying they feel guilty for it.
The knock-on effect of these activities is clear: if our brains aren’t being prepared for sleep, we won’t get the rest we need.
Dr Michael Oko, consultant ENT surgeon and founder of the Snoring Disorders Centre, describes the impact using an electronic device prior to bed can have on the brain to affect sleep:
“These devices emit blue light which stimulates the brain and inhibits melatonin metabolism for a few hours. This has the effect of resetting your body clock (circadian rhythm) and sleep cycle. If you do not get enough quality sleep you cannot perform at your best the next day.”
Those glued to electronic devices before bed are running the risk of major long-term health effects, including obesity, diabetes, heart disease and some cancers. As Dr Oko says, “We are yet to see the true long term impact on the younger generation of this recent advancement in technology.”
With the help of Dr Oko, Turtle Mat has created a self-assessment quiz with positive actions to take this World Sleep Day which can be found here. The survey also found:
• The South West of the country gets the best quality of sleep with over 2/3 waking up rested
• Older people drink more alcohol before bed than younger generations, younger people use the most electronic devices before bed
• Leicester is the city that feels the most guilty for relaxing whilst Londoners take the most baths and wake up fresher for it

Rebecca Wilson, Marketing Manager at Turtle Mat, says of their research “The health impact that our pre-sleep habits are having on our minds and bodies is a real cause for concern, but to think that we don’t fully know what the long-term impacts may be is shocking. We set out to explore if people were taking enough time to relax and the reasons they don’t, but once we got started a much more worrying trend started to emerge.”
So what can be done to improve quality of sleep? Dr Oko describes what is known as “Sleep Hygiene” and offers some pointers: “It is essentially “powering down” your mind so it can go into “Sleep Mode”. In today’s 24/7 society you have to plan to sleep well so you can be as efficient as possible. Turn off your devices 2-3hrs before you intend to sleep, your bedroom is only for two things; Sleep & Sex!”

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Scotland has more snorers than anywhere else in the UK a recent sleep study has found. The study was conducted by Ergoflex UK- a memory foam mattress company- who have created a map highlighting the regions with the most snores.

A total of 2,438 Britons aged 18 and over, all of whom stated that they were in a co-habiting relationship were quizzed about their sleeping patterns, habits and those of their partner. Scotland topped the list of snorers with 61% saying either they or their partner snored. The East of England was second with 55%, West Midlands third with 52% and North East was the least snoring region with 9%.

The respondents were asked a series of questions such as: ‘Does your partner ever wake you up in the night?’ Almost three quarters of respondents, 72%, stated ‘yes’, with ‘their snoring’ (42%) and ‘moving around’ (26%) topping the list of ways they did so.

The study also found that 13% of respondents admitted that at one point or another they had woken themselves up snoring.

Mr Michael Oko FRCS(ORL-HNS), Consultant ENT Surgeon of 150 Harley Street, commented:

“Sleep takes up between a quarter and a third of our lives and serves to refresh and restore our bodies, yet snoring is damaging for so many. Severe snoring is not only socially disruptive to partners, often leading to couples being forced to sleep in separate rooms at night, it can also signal more severe sleep disorders such as Obstructive Sleep Apnoea with which patients stop breathing periodically at night, waking up grumpy and tired with early morning headaches. If you or your partner snore so badly that you cannot even share the same room, you need to see your doctor and get it checked out.”

Jed MacEwan, Managing Director of Ergoflex said: “Snoring is commonly seen as amusing, but in reality it’s anything but funny.

“Living with a partner who regularly snores of course jeopardises your own sleep quality, and experiencing disrupted sleep over a sustained period of time isn’t ideal for your health and wellbeing. For the snorer themselves it could well be a symptom of more serious problems, so simply ‘accepting’ the condition could be a dangerous decision. We’d implore anyone who suffers from snoring to take it very seriously, for their own good as well as their partner’s.”

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The Spalding Guardian has an article on the increase in outpatients attending clinics at Johnson Hsopital.

“Already in the five years that the Outpatients Department at Johnson Community Hospital has been open there has been a dramatic increase in the services that it offers and in the number of patients who attend.

“When the department opened in 2009, we saw approximately 53,239 patients through the doors. In 2014 to date, we have already seen 11,743 more patients than by the end of 2009 and are set to see on average 2,000 more patients each month by the end of the year.

“During this time, our team at Lincolnshire Community Health Services NHS Trust has worked with other health and care providers in the county to develop the range of clinics and services available locally. By doing so, we have been able to help reduce the distance patients with certain conditions have to travel for their appointments.

“Next year we are pleased to be welcoming and expanding clinics run by our colleagues at United Lincolnshire Hospitals NHS Trust.

“Onel clinic increasing available appointments in the department is Sleep Apnoea. The great advantage for patients with this clinic increase overall is that some clinics will run on a Saturday, allowing a lot more flexibility for patients to attend out of work time. However, as always, we do ask that patients let us know if they are unable to attend any of their appointments so that it can be offered to someone else.”

Read the article in the Spalding Guardian

 

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