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Continuous positive airway pressure (CPAP) is effective at increasing work productivity, according to a new study.
The study will be presented today (11 April 2013) at the Sleep and Breathing Conference in Berlin, organised by the European Respiratory Society and the European Sleep Research Society.
Previous research has demonstrated that people with sleep apnoea are less productive at work, usually due to excessive daytime sleepiness. This study aimed to assess whether continuous positive airway pressure (CPAP) improved productivity at work.
The researchers used the Endicott Work Productivity Scale, a questionnaire designed to assess productivity at work, and the Epworth Sleepiness Scale, a globally accepted questionnaire which assesses daytime sleepiness. Included were 45 patients with sleep apnoea of working age (between 40 and 56 years), who completed the questionnaires at the outset and after 3 months of CPAP treatment.
The results showed that 35 of the patients who had good adherence to CPAP treatment showed significant improvement in their productivity at work and in their daytime sleepiness. The 10 patients who did not follow the treatment programme had no significant improvement in symptoms or work productivity.
Lead author, Evangelia Nena MD, PhD, said: “Continuous positive airway pressure (CPAP) is the gold standard treatment for moderate-to-severe obstructive sleep apnoea. Previous research has shown the potential benefits of CPAP to patients’ health and quality of life and our findings add to this body of evidence, demonstrating the advantages the treatment can have on productivity at work.”
Dan Smyth, Sleep Apnoea Europe, said: “This study underlines the positive benefits of compliant use of Continuous Positive Airway Pressure (CPAP) Treatment Therapy for Sleep Apnoea sufferers. It also confirms that the symptoms of the condition can be controlled and that the patient can remain an effective member of the workforce.”
An online survey conducted by the Sleeping Disorders Centre has found that almost three quarters of respondents were at a high risk of suffering from sleep apnoea. Half of the 52 respondents were classified as obese (with a BMI over 35), a key indicator of risk, 69.2% said that they snored loudly, and 92.2% complained of feeling tired during the daytime. 55.8% of all respondents to the survey were men, who traditionally have a higher risk level than women, although recent evidence suggests this gap is closing.
Michael Oko, consultant ENT surgeon, and Sleeping Disorders Centre founder, said:
“Sleep apnoea prevents people from getting a good night’s sleep by preventing air getting to the lungs. This leads to tiredness and irritability, and marital problems, and can also contribute to serious illnesses such as diabetes, hypertension and heart disease. Once people are aware they are suffering from the condition there are various treatments that can help them to overcome it, the most common being wearing a Continuous Positive Airway Pressure (CPAP) mask at night.”
Mr Oko, who recently appeared as an expert on a BBC1 programme about sleeping disorders “Goodnight Britain”, actively campaigns to raise awareness of sleep apnoea and writes a regular blog on the subject. He will be addressing the 10th Middle East Update in Otolaryngology in Dubai on 21st April 2013. He added:
“Almost all the survey respondents felt tired during the day, and must have suspected a sleeping disorder to have visited the site and completed the survey. I hope that more and more people will take this test and get help if they need it, as the survey shows; if you think you may have a sleeping disorder, the chances are that you do.”
Visitors to the Sleeping Disorders Centre website were asked to complete the STOP-BANG questionnaire, a set of eight questions regarded as the most accurate means of indicating a person’s level of risk of suffering from sleep apnoea from a self-conducted survey. Answering yes to three or more of the eight questions (measuring BMI, age, sex, neck size, snoring, fatigue, blood pressure, and observed apnoeas) indicates a high risk and that the person should visit their GP or go to a sleep clinic for an assessment.
The International Hospital & Healthcare Management Conference
Date now changed to 4-5 July 2013
Date now changed to 4-5 July 2013
This event comes at a difficult time for Cyprus, and I very much hope that some of the outcomes will be beneficial. I will be talking about how to set up cost-effective and successful sleep clinics such as the Sleeping Disorders Centre. The event provides a platform for discussing various strategies to improve cost efficiency in the hospital sector while, at the same time, improving the quality and safety of patient care.
Read an article about the the conference: MEH March 2013 Cyprus Feature
Philips Electronics have announced the results of an extensive new scientific study into sleep apnea, conducted over the last two years by Philips in collaboration with University of Twente.The study, which surveyed 4,206 Philips employees in the Netherlands, revealed that 6.4% of them suffered from sleep apnea. A striking finding was that 78% of the people surveyed who reported symptoms of sleep apnea were entirely unaware that they were suffering from this sleep disorder.
Never before has research into sleep apnea been conducted among such a large group of people. 29% of all Philips employees in the Netherlands took part in the study, comprising men and women of different ages and levels of education, with different types of job and different cultural backgrounds. Previous screening studies were based on considerably smaller populations. For example, an often cited study published in 1993 examined a group of 602 people. It was estimated in this study that 2% of women and 4% of men in the middle-aged work force suffer from sleep apnea.
Piet-Heijn van Mechelen, Chair of Dutch patient organization ApneuVereniging and Project Leader for the survey, is pleased that the study has produced clear results. “Hundreds of thousands of people have symptoms but don’t know what the problem is,” he says. “This study provides valuable new insights into how often the condition occurs. And with the new screening method that was developed for this study, sleep apnea can be identified at an earlier stage and the quality of life of patients suffering from the condition can be greatly improved with treatment.”
My name is Lisa, little Lisa, little’un, or wee one, as I’m usually referred to by friends and family, or even, “that little lass with the loud mouth”, as I’ve also been fondly referred to by my acquaintances. I have a confession to make; I’m a snorer. But that’s not all, I raise the rafters, sound like a train, and snore like a pig or any other animal you can think of, I’m it, and I do it well. As well as snoring I had a habit of falling asleep in the most embarrassing places at the most embarrassing times, I can tell you a few stories about that, but first of all let me tell you why I see it as a confession.
Well my long suffering husband and I run a Bed & Breakfast in the bracing seaside town of Skegness. My husband cooks breakfast and I serve it. While doing this I have often had comments like, “I heard your husband snoring last night”, and similar. Then one day a nice lady looked at me pityingly, while gently patting my hand, and whispered to me: “I’m married to a snorer sweetie so I sympathise with you, the sleepless nights, thinking he’s stopped breathing and waking up just to nudge him so he breathes, those gaps can be very frightening dear so I know what it’s like. You should really get him to see someone about that for both your sakes”. I blushed and thanked her for the concern and advice, as I did whenever anyone else had made similar comments, but the truth was…….. I’m the one that they heard. I was too ashamed to admit this; I mean petite ladies like myself are not supposed to snore are they? It’s supposed to be middle aged men that are overweight isn’t it, just like only overweight people have high cholesterol. This not true either, I’ve always been slim but here I am with both of these problems.
My husband had often complained about my snoring keeping him up, how tired he was, and was now talking about us having separate rooms. I was a little shocked about this and didn’t know the impact it was having on him, after all he had always known I was snorer! Back when I was 18 years old my husband and I were courting we’d had a couple of dates, then two weeks after we’d first met I was invited to dinner with his family. I was a little nervous, but excited that his family wanted to meet me. I went along to dinner and afterwards we settled down to watch a film in the lounge. All the family where there including his sister, her husband, and their children, it was so relaxing and I was really enjoying myself. The next thing I remember was being woken up as no one could hear the television because I’d fallen asleep and was snoring so loudly! I was sooo embarrassed I asked him to call me a cab, thanking his family for their hospitality, and went home. I was so upset because I really liked this one, but didn’t really expect him to call me again after that.
Now here we are 25 years 2 children and a grandchild later and he wants to have separate rooms, the first step to a relationship break down in my mind. I really didn’t want this so I plucked up the courage to speak to my GP about it. The GP also told me that this may have been a contributing factor to the TIA (mini stroke) I had suffered and that I should have come to see him earlier, he then referred me to Dr Oko’s clinic.
That was three years ago now and I’m at the point where I can see that, one, it’s nothing to be ashamed of, and two, the wasted time I spent being ashamed could have been spent getting treatment earlier and improving my health and quality of life for myself and my family. I mean, I’ve had my children wake me when I’ve woken them up in the night with the snoring, and I’ve tried to hold down working full time, raising a family, and running a business, while being tired all the time. I’ve fallen asleep at dinner parties, at training courses, while assessing people in their own homes, and have been judged as being bad mannered or rude for doing this. It had been a great family joke that, “our Lisa can fall asleep on a washing line in a storm”, and it’s true, I could. But until seeing Dr Oko I had never realised that it was also affecting my health and wellbeing and that of those close to me.
I had tried all the old wives remedies; tennis ball stuffed in my night wear; pillow behind me, etc. But none worked because it didn’t matter how I slept, if I laid on my back, front, side, or even sat up; I will still snore. I tried things on the roof of my mouth, the strips across the bridge of my nose, the olbus oil under my pillow, the plug-ins; been there done that, I still snore. I met with Mr Oko and he went through a few options with me.
I slept over at the sleeping clinic and we discussed what the problem was and what treatment might work for me. First I had the mouth guard, I had this fitted and tried it for a few nights. I hated it and couldn’t get on with it all. Then I had an operation, they straightened my nose (thanks for that!), took my tonsils out, and lasered the extra flesh from the roof of my mouth. I was quite sore after this but had placed all my hopes on it, rather a drastic move but the outcome was going to be worth it, or so I thought. That wasn’t the case at all, I had a vascular bleed 10 days after the op, it was quite scary and I was in a lot of pain, but it would all be worth it, wouldn’t it ?
NO is the answer to that, it wasn’t. It didn’t work and I was now desperate. As well as making all this noise when I slept I also now made noises when I ate, I often choked on drinks, and had a garden pea come out of my nose one time, and the snoring had gotten worse. What to do now? Mr Oko, however, never lost hope, he again asked me about the cpap machine. Me, all I could see was Darth Vader from the star wars films, and my husband’s face when he saw it!
Mr Oko reminded me of my health and gave me time to weigh up the pros and cons. I did, and agreed to give it a try. I tried the mask that went over your mouth and nose first. I hated it, I struggled to sleep with it on, and if I moved the air escaped and made my eyes sore. When I did fall asleep it woke me up when I turned over as it moved, so I felt panicked and took it off. I kept trying but couldn’t get on with it. Next time I tried one on that was smaller, it just covered my nose, this wasn’t much better again, I would get sore eyes, cold-like symptoms, and felt I was getting less sleep and feeling even more tired.
Next I tried the full face mask so I didn’t get sore eyes, and it was less likely to move if I turned over. Still it didn’t work, so now as well as being tired, keeping my husband awake, and being short tempered, I was feeling like a failure. Mr Oko must also have been losing patience with me, I mean how hard can it be? I just want to sleep, why did I have to be so awkward?
Eventually, Mr Oko gave me a new mask to go with the latest, “Lisa I don’t think you grasp how important this is”, lecture. This mask was much less intrusive, a tiny little thing that fits to my nostrils, and I took Mr Oko’s advice to try and desensitise myself to it. I wore it while watching TV and reading, my family would joke about it, and instead of it being my nightmare, it turned into a fun thing. My granddaughter even asks about it now, and asks if she can have one. I have since redoubled my efforts and got over the stigma of wearing it with the support of my family (a unique type of support that only my lot would do; sneaking pics and sending them to me, modelling in it, and laughing about it)
I think it has actually changed my life, I am sleeping better now (not that I ever had a problem sleeping), by that I mean the sleep I’m getting is better quality, I wake feeling better, more refreshed, I’m not falling asleep in the day, or sleeping 16 hours and still waking up tired. I’m getting on with life now and not worrying about dropping off in public places, and looking forward to taking the card to my next appointment with Dr Oko and finally having my last sleepover at the clinic wearing my mask so he can see we did it. We did it as a team if you like, me, Dr Oko, and my family. I don’t wear it every night, sometimes my granddaughter stays over and sleeps with me, I’d hate to frighten her in the night if she wakes, but on the whole I think I’m getting there. I’m not quite full of beans yet but I’m getting there, well, as much as be expected at my age anyway!
A new research paper published in the Journal of Sleep Research claims that attentional control is partially impaired in obstructive sleep apnoea syndrome.
“In the current study, we investigated whether attentional control is deficient in obstructive sleep apnoea syndrome. Attentional control processes were investigated through conflict adaptation and conflict frequency paradigms. These neuropsychological paradigms were assessed by using the Simon, Flanker and Stroop tasks. We additionally analysed post-error slowing data within these tasks. Error processing is another index of cognitive control that is mediated by frontal lobe functioning.”
The sample consisted of 14 healthy adults and 24 patients with untreated moderate–severe obstructive sleep apnoea syndrome.
“Results indicated that attentional control is partially dysfunctional among patients with obstructive sleep apnoea syndrome. Attentional control processes were deficient when focal attention (Flanker task) processes were involved, but were intact when observed using the Simon and Stroop tasks. A non-significant trend in post-error slowing data suggested that error processing, assessed with the Flanker task, was diminished among patients with obstructive sleep apnoea syndrome. These results support the view that obstructive sleep apnoea syndrome leads to some amount of frontal lobe dysfunction, and that attentional control and error processing might be particularly affected by obstructive sleep apnoea syndrome.”
White-collared, globe-trotting executives over the age of 45 need to watch out for sleep apnoea, according to a recent study by the Madras ENT Research Foundation.
“Our estimates show that 24 per cent of men and 9 per cent of women above 45 years in the country suffer from this problem,” says Mohan Kameswaran, Managing Director of the foundation.
Those with obesity, diabetes and a sedentary lifestyle are more prone to sleep apnoea. Smoking, excessive consumption of alcohol and heavy snoring are other risk factors associated with this disorder. It is common among middle-aged working professionals.
“With intense travelling, they have very little time for physical activity and exercise. They do not maintain a good diet. When you are young, your muscle tone is good. But it slows down after 45,” cautions Kameswaran.