Sleep

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Complete 3D full body scanning is now available at the Sleeping Disorders Centre. Scanning someone is simple. Patients simply stand on the turntable and hold still for 30 seconds, while the platform spins. With its razor sharp high resolution infrared images, Styku technology captures millions of data points in a matter of seconds in a fast, non-invasive process.

 

 

The Styku app gives professionals the ability to perform a full body scan, view 3D models, extract measurements, track changes in body shape, calculate fitness and health metrics, and much more. This technology is used at health clubs by fitness professionals and nutritionists, and now Snore Centre founder Michael Oko has identified the benefits the device can provide in a medical context. Improving fitness and weight loss is a key part of treating sleep apnoea, and the 3D body scanner allows this be assessed and monitored in a new and comprehensive way.

 


Watch a video of the scanner in action…

 

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Young woman cannot sleep

Can’t sleep? Join the unhappy club: according to the NHS, one in three people in the UK has trouble sleeping and every year it hands out more than ten million prescriptions for sleeping pills. There’s a range of products that claim to help, but how effective are they? The Daily Mail asked Sleeping Disorders Centre founder, Michael Oko, to give journalist Anglea Epstein his verdict on some of the latest.

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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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copperbed2

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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Continuous positive airway pressure is effective at treating sleep apnoea in older people, a new study has found. Previous studies have established the benefits of CPAP in middle-aged people with OSA, but until now there has been no research on whether the treatment is useful and cost-effective for older patients.

The new research found that CPAP reduces how sleepy patients feel in the daytime and reduces healthcare costs. The researchers say CPAP should be offered routinely to older patients with OSA, and more should be done to raise awareness of the condition.

The study, published today in Lancet Respiratory Medicine, involved 278 patients aged 65 or over at 14 NHS centres in the UK. It was led by researchers at Imperial College London and the Royal Infirmary of Edinburgh in collaboration with the Medical Research Council Clinical Trials Unit at UCL, and the Universities of Oxford and York. It was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme.

Around 20 per cent of the adult population experiences breathing problems during sleep. In four to five per cent of middle-aged people, these problems lead to sleepiness in the daytime, classified as obstructive sleep apnoea syndrome. The condition is thought to be more common in older people, but the true prevalence is unknown, in part because patients and their relatives may attribute their sleepiness to old age, or older people can compensate by napping. The disease is becoming more common because obesity is a major risk factor.

Professor Mary Morrell, co-principal investigator of the study from the National Heart and Lung Institute at Imperial College London, said: “Sleep apnoea can be hugely damaging to patients’ quality of life and increase their risk of road accidents, heart disease and other conditions. Lots of older people might benefit from this treatment. Many patients feel rejuvenated after using CPAP because they’re able to sleep much better and it may even improve their brain function.”

Patients with sleep apnoea sometimes stop breathing for 30 seconds or longer at night before they wake up and start breathing again. In these pauses, their blood oxygen levels fall.

“We think low oxygen levels at night might accelerate cognitive decline in old people, and studies have found that sleep apnoea causes changes in the grey matter in the brain. We’re currently researching whether treatment can prevent or reverse those changes,” said Professor Morrell.

Co-principal investigator Dr.Renata Riha, Consultant and Honorary Reader at the Royal Infirmary of Edinburgh, added that sleep medicine spans many disciplines and comprises an important area of research which deserves support and greater recognition by funding bodies, universities and public policy makers. “Sleep disorders, such as sleep apnoea, impact on a wide variety of chronic conditions, potentially leading to their development or worsening them, including diabetes, heart attacks, strokes and possibly even cancer. Successful treatment diminishes this risk but we still have a great deal of work to do in the area,” she said.

Source: Imperial College London

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In what is the largest study to date on the association between the two conditions, researchers in Canada demonstrated a link between obstructive sleep apnoea (OSA) – a common breathing disorder that affects people during sleep – and the development of type 2 diabetes.

The team led by Dr Tetyana Kendzerska of the University of Toronto analysed data from 8,678 adults with suspected OSA and without diabetes at baseline who took part in a diagnostic sleep study between 1994 and 2010. All of the participants were tested for OSA and graded according to the severity of their sleep apnoea, based on the number of apnoeas (complete blockage of the upper airway) and hypopnoeas (partial blockage of airway) experienced per hour of sleep, and followed for development of diabetes.

During follow-up, 1,017 (11.7%) of the participants were diagnosed with type 2 diabetes. After adjusting for known risk factors for the disease, including age, sex, BMI, neck circumference and smoking at baseline, those classed as having severe OSA had a 30% greater risk of developing type 2 diabetes compared to those without OSA. Diabetes risk was also 23% higher for patients with mild or moderate OSA. In addition, Rapid eye movement sleep, lack of oxygen in the blood, and activation of the sympathetic nervous system, as indicated by a higher average heart rate during sleep, were linked to higher diabetes risk.

“After adjusting for other potential causes, we were able to demonstrate a significant association between OSA severity and the risk of developing diabetes,” Dr Kendzerska said in a statement. “Our findings that prolonged oxygen desaturation, shorter sleep time and higher heart rate were associated with diabetes are consistent with the pathophysiological mechanisms thought to underlie the relationship between OSA and diabetes.”

The lead author added that the results “address some of the limitations of earlier studies on the connection between OSA and diabetes”, as their study involved a larger sample size and a longer median follow-up. The researchers did, however, acknowledge a few limitations to the study, including not being able to screen for family history of diabetes and ethnicity.

“The OSA-related predictors of increased diabetes risk that we found in our study may allow for early preventative interventions in these patients,” Dr. Kendzerska concluded.

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Both men and women appear to have a greater risk of stroke if they suffer from obstructive sleep apnea, researchers found.

Through up to 14 years of follow-up, stroke risk increased along with the obstructive sleep apnea index to a similar extent in both men and women, according to Suzanne Bertisch, MD, instructor in medicine at Harvard Medical School/Beth Israel Deaconess Medical Center in Brookline, Mass.

The 5-year probability of having a stroke with the least severe obstructive sleep apnea index was 0.4% for women and 0.6% for men, while the probability in the highest quartile of obstructive sleep apnea severity was 1.2% for women and 1.8% for men, she reported at the American Thoracic Society meeting in San Diego.

At 10 years, the probability of having a stroke if you were in the lowest quartile of the sleep apnea index was 0.9% for women and 1% for men, while the probability of having a stroke in the highest quartile of the apnea index was 2.3% in women and 3.1% in men.

All results were adjusted for various confounders, including age, race, education level, smoking status, diabetes, hypertension, and body mass index, she said.

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Sufferers of a common sleep-breathing disorder have diminished activity among neurons responsible for keeping heart rate low, reveals a new study published today [16 May] in The Journal of Physiology.

The research discovered that in obstructive sleep apnoea (OSA), neurons in the brainstem that control heart rate experience a blunting of their activity. The reduction of neuronal activity likely contributes to the increased heart rate, blood pressure and risk of adverse cardiovascular events that occur in patients with OSA.

OSA is a common cardiovascular disease, occurring in 24% of adult males and 9% of adult females, which causes repetitive interruptions of breathing during sleep. Lack of oxygen during these episodes brings the person to a lighter state of sleep or brief wakefulness to restore normal breathing. Cycles of interrupted breathing and arousal from sleep can occur as frequently as once per minute.

Dr David Mendelowitz, who led the study at The George Washington University USA, says:

“Lack of sleep leaves the mind and body tired, leading to poor mental and physical performance, and if untreated OSA increases a person’s risk of developing hypertension and irregular heartbeats. Therefore it is very important that we have discovered some of the underlying mechanisms that could injure the heart and other cardiovascular tissues.

“Our study shows that progression of blunted cardiovascular reflexes is accompanied, and likely maintained by, inhibition of neurons in the brainstem that protect the heart and normally maintain a low resting heart rate. This study would predict that patients who have OSA, and also take sleep medicines, might be at heightened risk for an exaggerated reduction of essential neuronal activity that protects the heart.”

The team explored these mechanisms in rats, by mimicking OSA for four weeks and studying the changes in blood pressure, heart rate, and synaptic activity in parasympathetic neurons that control heart rate.

Future work will need to build from this foundation and focus on finding targets to restore the usual cardio-protective function of these neurons to help reduce the risk of arrhythmias, elevated heart rate, and blood pressure that occur with this disease.

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People with sleep apnea, a common sleep disorder, may be at increased risk for the bone-thinning disease osteoporosis, especially women and older people, a new study suggests.

Sleep apnea causes repeated, brief interruptions in breathing during sleep. Untreated sleep apnea can increase a person’s risk of heart disease, heart attack and stroke.

“Ongoing sleep disruptions caused by obstructive sleep apnea can harm many of the body’s systems, including the skeletal system,” said study co-author Dr. Kai-Jen Tien, of Chi Mei Medical Center in Tainan, Taiwan.

“When sleep apnea periodically deprives the body of oxygen, it can weaken bones and raise the risk of osteoporosis,” Tien said. “The progressive condition can lead to bone fractures, increased medical costs, reduced quality of life and even death.”

For the study, published April 15 in the Journal of Clinical Endocrinology & Metabolism, researchers analyzed the medical records of nearly 1,400 people in Taiwan diagnosed with obstructive sleep apnea between 2000 and 2008. They compared them with more than 20,600 people who did not have the sleep disorder.

Over six years of follow-up, people with sleep apnea were 2.7 times more likely to be diagnosed with osteoporosis. The risk for the bone-thinning disease was highest among women and older people with sleep apnea, according to the study.

“As more and more people are diagnosed with obstructive sleep apnea worldwide, both patients and health care providers need to be aware of the heightened risk of developing other conditions,” Tien said in a journal news release. “We need to pay more attention to the relationship between sleep apnea and bone health so we can identify strategies to prevent osteoporosis.”

However, the study only noted an association between sleep apnea and osteoporosis. It does not prove that one causes the other.

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