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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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!”
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
Sleep apnea is common in people with multiple sclerosis and may contribute to their fatigue, a new study shows. Fatigue is one of the most frequent and debilitating symptoms experienced by MS patients. The study included 195 people with MS who completed a sleep questionnaire and were assessed for daytime sleepiness, insomnia, fatigue severity and sleep apnea.
One-fifth of the patients had been diagnosed with sleep apnea and more than half were found to have an elevated risk for the condition. The researchers also found that sleep apnea risk was a significant predictor of fatigue severity.
MS is a chronic, frequently disabling disease that attacks the central nervous system, according to the National Multiple Sclerosis Society. Symptoms range widely, from mild signs such as numbness in the limbs to severe symptoms including paralysis or loss of vision.
The new findings suggest that sleep apnea may be a common but under-recognized contributor to fatigue in MS patients, and doctors should not hesitate to check these patients for sleep problems, study author Dr. Tiffany Braley, an assistant professor of neurology at the University of Michigan Multiple Sclerosis and Sleep Disorders Centers, said in an AASM news release.
“Obstructive sleep apnea is a chronic illness that can have a destructive impact on your health and quality of life,” and MS patients at high risk for sleep apnea should undergo a comprehensive sleep evaluation, academy president Dr. M. Safwan Badr said in the news release.
The study appears in the Feb. 15 issue of the Journal of Clinical Sleep Medicine, an AASM publication. About 400,000 people in the United States have MS, according to the National Multiple Sclerosis Society. Up to 7 percent of men and 5 percent of women have sleep apnea, according to the AASM.
Sleeping Disorders Centre founder, Consultant ENT surgeon Michael Oko, will address senior international healthcare executives, public servants, and academics at the 1st International Road Traffic Accident Conference at the Rose Wood Hotel, Abu Dhabi, on 11th March 2014.
Mr Oko, a UK government advisor on Obstructive Sleep Apnoea (OSA) strategy, will be speaking about the benefits of preventative treatment in reducing road traffic accidents, using the example of Lincolnshire UK, where traffic fatalities have fallen significantly since sleep apnoea testing and treatment began. Professor Ram Dhillon (Middlesex University and Sleeping Disorders Centre) will also address the conference on “Snoring & Preventable Deaths on the Road: A Common, medically treatable, and often missed cause of Road Traffic Accidents.”
Mr Oko said:
“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 OSA 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. 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 high. 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. For his work in this area Mr Oko was awarded the Middle East Hospital magazine award for excellence in respiratory care in 2011 and 2013.
Writing in Arab News, leading sleep apnoea expert, Professor Ram Dhillon of the Sleeping Disorders Centre, spells out the dangers of sleep apnoea. Professor Ram Dhillon and his colleague, Sleeping Disorders Centre founder Michael Oko, will be speaking at the 1st International Road Traffic Accident Conference being held in May 2014 in Abu Dhabi, UAE.
“Untreated or inadequately treated OSA is associated with major medical problems. If one considers the OSA event as a strangulation leading to poor oxygen levels to every cell in the body it is easy to understand the detrimental consequences. It may lead to high blood pressure, cause a pre-diabetic state and make existing diabetes more difficult to manage. There is an increased incidence of heart problems such as heart attacks and heart rhythm disorders. There is also an increased likelihood of suffering a stroke and the kidneys can also be damaged. Studies reveal untreated severe OSA will lead to death in 15% of patients and a major heart event in 30 percent over a 12-year period.
“There is an increasing awareness of the relationship between OSA and falling asleep during the boredom of driving, particularly on long straight roads. This is an issue for all road users but is likely to be a much greater problem in the haulage industry.”
• Professor Ram Dhillon is the consultant surgeon at Middlesex University, School of Health and Social Sciences, London. Michael Oko, consultant surgeons and Department of Health Adviser on Sleep Apnea, UK National Health Service, also contributed to this report.
Source: Arab News
The risk of death goes up with the severity of a person’s obstructive sleep apnea, according to a new study in Korea.
The Journal of Clinical Sleep Medicine study is the first to find that sleep apnea severity is linked with death risk in an Asian population, said researchers from Chosun University Hospital, Seoul National University College of Medicine and the Seoul National University Bundang Hospital. Previous studies had only looked at Western populations.
Researchers analyzed data from 2,240 people ages 40 and older with sleep apnea or snoring who visited the Sleep Center of Seoul National University Bundang Hospital at some point between 2003 and 2009. All the study participants underwent a full-night polysomnography testing, through which researchers were able to deduce the number of times they stopped breathing throughout the night due to their sleep apnea. They were then grouped into categories based on sleep apnea severity (no sleep apnea, moderate sleep apnea, moderate sleep apnea and severe sleep apnea).
All the participants who had at least mild sleep apnea (about 1,800 of the participants) were assigned to undergo surgery, CPAP, a mandibular advancement device, or a combination of the three.
The participants were followed up with until Dec. 31, 2011; the average participant was observed for 61.4 months, or a little more than five years. Of those with at least mild sleep apnea, 735 received treatment for the condition; the other 1,065 were not treated either because they refused treatment, they became lost during the follow-up period, they wanted to try losing weight, or they wanted to try sleeping in a different position.
Over the study period, 69 people (3.08 percent of the study group) died. Researchers found that the death rate was higher in the groups of people with more severe sleep apnea, compared with less severe or no sleep apnea. Specifically, 1.81 percent of people with no sleep apnea died over the study period, 2.18 percent of people with mild sleep apnea died, 3.54 percent of people with moderate sleep apnea died and 4.2 percent of people with severe sleep apnea died. Heart disease and strokes were the cause of about a third of the deaths.
Overall, the risk of dying was 2.47 times higher among people with severe sleep apnea compared with people without sleep apnea.
Source: Huffington Post
This conference aims to raise the profile of the preventability of road traffic injuries and promote good practices in order to achieve safe roads, safe speeds, safe vehicles, and safe people.
The Lincolnshire experience
In 2002 they were 104 fatal car accidents in Lincolnshire with a population of 700,000, so the Road safety Partnership (consisting of The NHS, Police and local Council) was formed to try and address and reduce this carnage on the roads. It was successful in reducing this figure to 79 per annum by a concerted effort to raise driver awareness via media messages with a budget of £3 million per annum, but seemed to stall at this figure.
In Lincolnshire we had a perfect storm of (similar in many respects to UAE):
(1) No existent service,
(2) The most obese population in Europe,
(3) Hazardous or dangerous roads
(4) No rail or other transportation infrastructure of note.
In 2006 an ObstructiveSleepApnoeaservice was commissioned (it affecs 4-6 % of the population) to treat all the drivers that may fall asleep at the wheel and by 2008 fatal RTAs caused 52 deaths per annum and by 2012 it was 39 per annum.
This approach can also be successful in UAE
Sleep apnoea potentially affects 20% of UAE population, It could be responsible for a high number of car accidents, so if it is properly treated there should be a big reduction in car fatalities.
The conference is an important forum to inspire and connect leaders, decision makers, Health professionals, public servants, academics and advocates, bringing International keynote speakers and participants to seek, develop, and exchange views on what works to prevent road traffic accidents and how best to bring it to fruition in policy and practice for government and the private sector
1st International Road Traffic Accident Conference
21-22 November 2013
Emirates Palace Hotel, Abu Dhabi, UAE
The severity of sleep apnoea can independently predict the aggressiveness of malignant skin melanoma, according to a new study.
The research, presented at the European Respiratory Society (ERS) Annual Congress, adds new evidence to a number of studies that have found a link between cancer and the sleep disorder.
Previous studies have looked at a link between sleep apnoea and both mortality and incidence rates from cancer. Some experimental studies in mice have also shown that reduced oxygen levels in the blood, which is common in sleep apnoea, enhanced tumour growth. This is the first study in humans to look at the link between a specific type of cancer (skin melanoma) and sleep apnoea.
Researchers studied 56 patients diagnosed with malignant skin melanomas. They measured the aggressiveness of the cancer along with the presence and severity of sleep apnoea.
60.7% of the patients had sleep apnoea and 14.3% had severe sleep apnoea. The results found that the melanoma was more aggressive as the severity of sleep apnoea increased. This was the case for all three measurements for sleep apnoea severity. The severity measurements were also linked with other factors of aggressiveness, including the growth rate or the depth of invasion of the tumour.
Lead author, Dr Francisco Campos-Rodriguez, from the Hospital de Valme in Seville, Spain, said: “This is the first study in a human sample to show that sleep apnoea can worsen the outcomes of melanoma. The findings are from a preliminary small sample, but if the results are confirmed in larger studies, this would have important clinical implications, particularly as sleep apnoea can be easily treated and this could open up new therapeutic possibilities for people with both conditions. We have just begun a bigger prospective trial enrolling 450 patients with cutaneous melanoma to analyse this link further.”
Medical Xpress reports that women diagnosed with gestational diabetes are nearly seven times more likely to have obstructive sleep apnoea than other pregnant women, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). Gestational diabetes causes glucose levels in the bloodstream to rise above normal levels. This form of diabetes occurs during pregnancy, typically in the second trimester. Between four and eight of every 100 pregnant women in the United States develop gestational diabetes.
The new study found a link between gestational diabetes and sleep apnoea, which causes brief interruptions in breathing during sleep. If sleep apnea goes untreated, it can raise the risk for stroke, cardiovascular disease and heart attacks.
“It is common for pregnant women to experience sleep disruptions, but the risk of developing obstructive sleep apnea increases substantially in women who have gestational diabetes,” said Sirimon Reutrakul, MD, who conducted the research at Rush University Medical Center in Chicago. “Nearly 75 percent of the participants in our study who had gestational diabetes also suffered from obstructive sleep apnoea.”
In a series of observational case control studies, researchers monitored 45 women for sleep apnoea and other sleep disruptions. The research examined sleep health in 15 pregnant women who had gestational diabetes, 15 pregnant women who did not have the condition and 15 women who were not pregnant and did not have diabetes.
The study found a strong association between obstructive sleep apnoea and gestational diabetes in this group of mostly overweight or obese women. Pregnant women who did not have gestational diabetes were able to get an additional hour of sleep and had less fragmented sleep than women who had gestational diabetes. Past research has shown lost sleep, fragmented sleep and shorter periods spent in deep sleep – all symptoms of sleep apnoea – are likely to raise the risk a person will develop diabetes.
“Based on these findings, women who have gestational diabetes should be considered for evaluation for obstructive sleep apnoea, especially if other risk factors such as hypertension or obesity are present, and women already diagnosed with sleep apnoea should be monitored for signs of gestational diabetes during pregnancy,” Reutrakul said.