What Is It About Sleep Apnea That Seems To Predict Heart Risks?

Notes from Dr. Norman Blumenstock

This is a serious issue.

Posted: 02/06/2014 9:01 am EST Updated: 02/06/2014 9:59 am EST

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It's well-established that obstructive sleep apnea is linked with increased heart risks. But now, a new study teases apart what exactly it is about the sleep disorder, characterized by pauses in breathing during sleep leading to disrupted sleep, that seems to predict these cardiovascular events.

Obstructive sleep apnea is measured by the number of times a person stops breathing during sleep (the apnea-hypopnea index, or AHI). However, researchers found that there were a number of other elements of sleep apnea that seemed to be predictive of cardiovascular events. The biggest one: the amount of time spent sleeping when the oxygen saturation was below 90 percent.

Other elements associated with a cardiovascular event included heart rate, daytime sleepiness, number of awakenings during the night, sleep time and leg movements, the researchers found. While the apnea-hypopnea index was associated with cardiovascular events when it was looked at by itself, it was no longer considered a significant predictor once all the other elements were factored in.

The study, published in the journal PLOS Medicine, is based on 10,149 people with obstructive sleep apnea who underwent diagnostic polysomnography between 1994 and 2010; 1,172 of those people developed cardiovascular disease.

"We believe a revision of the operative definition of OSA [obstructive sleep apnea] may be necessary, to reflect not simply the frequency of apneas and hypopneas, but the actual physiologic consequences that result -- the severity of oxygen desaturation, sleep fragmentation, sleep deprivation and sympathetic activation," the University of Toronto and St. Michael's Hospital researchers said in the study. "It is these 'downstream' phenomena that we have found to be more predictive of CV [cardiovascular] risk."

Wife who was fed up with her husband's snoring is charged with attempted murder after stabbing him with a butcher's knife as he slept

• 
  Dawn Weiser, 44, left her husband with a punctured spleen, lacerated liver and three other stab wounds
• She plead not guilty in court on Wednesday
• Doug Weiser managed to fight his wife off him and call police

By PAUL THOMPSON

PUBLISHED: 12:22 EST, 4 October 2013 | UPDATED: 14:04 EST, 4 October 2013

An Arkansas woman who was fed up with her husband's incessant snoring has been charged with attempted first degree murder after repeatedly stabbing him in his sleep with a butcher's knife.

Dawn Weiser, of Springdale, plead not guilty in court on Wednesday after leaving her husband with a punctured spleen, lacerated liver and three other stab wounds from the attack.  

The 44-year-old mother of two was sleeping in a spare room with her son after an argument earlier in the evening with her husband Doug about his snoring.

Dawn Weiser (left) has been charged with first degree attempted murder for stabbing her snoring husband Doug (pictured right)

She is alleged to have crept back into the bedroom in the early hours of the morning and began stabbing her husband with a butcher's knife.

Her 43-year-old husband was able to wrestle the knife from her and call police, after being stabbed several times.

 

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Mrs Weiser told police she awoke to a loud noise during the night and walked in to find her husband with stab wounds. 

She went on to insist that an intruder was responsible for the stabbing, despite her husband saying she was responsible for his wounds.

Dawn Weiser tweeted about her husband's snoring before the attack

Dawn Weiser is pleading not guilty to charges of attempted first degree murder after the attack with a butcher's knife

Investigators say Dawn later confessed to stabbing her husband and hiding the knife and told police she couldn't stand being kept awake any longer.

Dawn was so angry at her husband's snoring that she had spoken about it on social media.

A week before the alleged attack she wrote on her Twitter account: 'A certain someone is about to have an appointment made to address SNORING. #notnamingnames.'

Details of the attack, which took place on August 29th, came out as Mrs Wesier made her first court appearance on Wednesday on an attempted first degree murder charge.

She pleaded not guilty and has been sent for trial in December.

The court was told her husband filed for divorce a week after the alleged attack.

Doug Weiser pictured fishing before the attack, which left him with three stab wounds

Snoring can interfere with marriages everywhere.

Snoring, lack of romance blamed for Saudi Arabia divorce rates

Marriage contractor reveals what most women in Saudi Arabia complain about

• By Habib Toumi, Bureau Chief
• Published: 12:31 August 20, 2013
• Manama: Up to 80 per cent of the divorce cases in Saudi Arabia are initiated by women, mostly within one year of marriage.
  “The women start the procedures and insist on the divorce often for trivial issues,” a marriage contractor said, quoted by local daily Al Youm. “These are mainly snoring, the look of the husband inside the house and the lack of romance as a result of the influence of dramas and media on the impressionable minds of young wives,” he said.
  The figures and causes for divorce were discussed at a meeting of religious figures tasked with drafting marriage contracts in Al Qateef in eastern Saudi Arabia.
  Ways to address the rising figures of divorce rates in the kingdom included urging families to check the background of men who propose instead of relying on matchmakers.
  Most marriages are arranged in Saudi Arabia where the mixing of the sexes is strictly controlled and limited, giving women matchmakers great opportunities to promote potential spouses.
  “Parents have a highly significant role in ensuring that the men who want to marry their daughters have a good reputation and a satisfactory behaviour,” Judge Mohammad Al Jirani said, quoted by the daily.
  Other suggestions included not rushing into making final decisions on the divorce until all ways for a reconciliation are exhausted and the spouses are given ample time to reconsider their options.
  Divorce is permitted in Islam, but only as a last resort when it is no longer possible for the marriage to continue.

  
  

  Originally Published at:  http://gulfnews.com/news/gulf/saudi-arabia/snoring-lack-of-romance-blamed-for-saudi-arabia-divorce-rates-1.1222214

Divorce Reasons: Couple Splits Due To Husband's Incessant Snoring

Posted: 08/15/2013 3:21 pm EDT  |  Updated: 08/15/2013 3:30 pm EDT

Weird divorce stories are nothing new, but this may be one of the strangest we've ever heard.

According to China.org, one man's snoring was so disruptive it prompted his wife to file for divorce. In the filing, she claimed that she hasn't gotten a full night's sleep since they married. She also mentioned that the man's heavy snoring made her ill and caused her to lose a significant amount of weight.

The divorce was granted and the judge asked the man to pay his ex a settlement of 5,000 yuan, or $806.45.

Sure, snoring may be a strange reason to file for divorce, but it's happened before.In 1997, an Iranian man filed to divorce his wife because of her snoring; she admitted to drugging him with sleeping pills at the beginning of their marriage so he wouldn't notice her snoring habit.

Other odd-ball grounds for a split? In 2012, a Nigerian woman divorced her husbandbecause he talked too much, and a Taiwanese woman divorced her husband in 2013 because his penis was too small.

Originally Posted At: http://www.huffingtonpost.com/2013/08/15/divorce-reasons_n_3763023.html

Snoring Gives Away Suspect Hiding From Police

Source: CBS Detroit  http://detroit.cbslocal.com/2013/08/01/snoring-gives-away-suspect-hiding-from-police/

August 1, 2013 6:52 PM

INDEPENDENCE TOWNSHIP (WWJ) – A Pontiac suspected of stealing a car picked the wrong time for a nap.

Authorities say it all started Tuesday morning when a car was stolen from a Waterford gas station. An Oakland County Sheriff’s Deputy quickly located the vehicle and gave chase, but the suspect was able to get away near Independence Oaks County Park.

About three hours later, said Oakland County Sheriff Mike Bouchard, is when the man managed to reveal his hiding place while he was sleeping.

“A homeowner in Independence Township heard something outside — she thought she heard someone snoring,” Bouchard said. “And she saw a set of feet under her deck.”

The woman called 911, deputies arrived, and the 49-year-old man was taken into custody outside at the home in the 5400 block of N. Ridge Trail.

Bouchard said this is not typical criminal behavior.

“You wouldn’t expect, with the adrenaline of the possibilities of what’s going to happen to him would allow him to simply fall asleep on someone else’s property,” Bouchard said.

The man, a recent parolee, is charged with car theft and fleeing and eluding police. Officials say the suspect may also be involved in a breaking and entering in Waterford Township and another in Independence Township that same night.

His name was not immediately released.

The Science of Sleep: Delta Air Lines on Flipboard

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Is Snoring Affecting Your Relationship With Your Significant Other?

Posted: Jun 11, 2013 5:47 PM CDTUpdated: Jun 11, 2013 5:47 PM CDT

By Randy Key, WJBF Web Content Producer - email

By ABC News

New York City -

A quarter of married couples say they sleep in separate beds just to get a good night sleep.

"I can't deal with this anymore! I can't sleep!" says Nancy, from Michigan.

"It usually turns out someone stomping out to the couch!" says Gina, from New Jersey.

Dr. Jennifer Ashton, reporting: I'm embarrassed to admit. I often move to a different room."

"She says I disrupt her sleep. I snore," says my husband, Rob.

It causes me to wake up from my sleep three or four times a night.

Even though we're both doctors, we have long laughed and debated what's really going on, so we called in professional help, sleep researcher Dr. Wendy Troxel.

"What's your goal here?" asks Dr. Troxel. I would like to sleep next to my husband every single night.

She put us to the test, measuring our brain activity while we slept.

Dr. Ashton: "The sleep study will confirm scientifically that rob's snoring disrupts my sleep."

The first night, side-by-side...snoring woke me up.

With Rob, I had 173 awakenings, which is sleep science lingo for coming out of deep sleep. The next night couldn't come soon enough.

Dr. Ashton: "I get to sleep by myself."

But, to my great suprise: alone, I had 135 awakeningsnearly as many as when I slept with Rob.

"There was a link between Rob's snoring and you having these little awakenings from sleep, but it wasn't all Rob's fault. You continued to have awakenings throughout the night, even when Rob had stopped snoring."

That's because science confirms women are lighter sleepers than men. Biologically, our brains are conditioned to just wake up, but the good news is women are better sleepers than men and quickly fall back to sleep again.

But, Dr. Troxel says the bad news for women is we often think we sleep worse than we really do. I was proof, the study actually showed my overall sleep quality was actually excellent both nights.

"Your sleep when you were sleeping with Rob, compared to the night you were sleeping alone, was virtually identical," Dr. Troxel says.

But for Rob...a bigger impact...he got an extra twenty minutes of deep sleep with me by his side.

"So, I am telling you there is actually health benefits, at least for Rob, to sleeping with you," says Dr. Troxel. "Now, I feel really guilty," I said.

Because research shows that men sleep better with a partner than alone...and protecting sleep, for both of us, means protecting our marriage.

Doctors say it's important to rule out medical causes for snoring and insomnia, like sleep apnea. But, they say making sleep a priority is important for good health and your marriage.

Aaron Taylor’s Wake-Up Call

Aaron Taylor

Aaron Taylor is easily recognizable, even in the most packed of rooms. We see his smiling face and tailored plus-sized designer suits every week of the fall during CBS college football broadcasts, a position through which his 6-foot-4-inch 300-pound frame accumulates more than 100,000 airline miles each year.      

“I was tired of waking up with bruises on my sides every morning from my wife elbowing me.” Taylor, 39, said laughing. At the time, Taylor was feeling overly tired and struggled finding energy for his day-to-day routine. “I wasn’t feeling rested, and my memory was off. I had just gone to work with ABC, and there were all these coaching changes - things I knew I had studied, and at times I would just go blank. I wanted to get tested for sleep apnea to rule it out as a possibility” he said.

Read The Full Article by Visiting This Link...
http://www.austinchronicle.com/blogs/sports/2012-03-29/aaron-taylors-wake-up-call/

Article by Alex Dunlap, 2:22PM, Thur. March 29, 2012 

Sleep Apnea Treatment May Lower Heart Risks

Study: CPAP Can Lower Many Risk Factors for Heart Disease, Stroke
By Salynn Boyles
WebMD Health News
Dec. 15, 2011 -- In addition to improving sleep, an effective treatment for sleep apnea can also improve blood pressure and other risk factors for heart attack, stroke, and type 2 diabetes, new research shows.

Continuous positive airway pressure therapy, or CPAP, helps patients with sleep apnea breathe better during sleep by pushing air into the nose through a mask to keep airways open.

The treatment has been shown to improve daytime sleepiness and reduce blood pressure, but its impact on heart disease, stroke, and diabetes risk factors that are common in patients with sleep apnea has not been well understood.

Results from a study published in the Dec. 15 issue of the New England Journal of Medicine suggest that CPAP is associated with a lower risk for metabolic syndrome, a cluster of symptoms that increase the risk for heart disease, stroke, and diabetes.

Researcher Surendra K. Sharma, MD, PhD, of the All India Institute of Medical Sciences in New Delhi tells WebMD that along with weight loss and lifestyle modification, treatment with CPAP may be an important way to lower heart attack, stroke, and diabetes risk in patients with sleep apnea.

A Visual Guide to Sleep Disorders

Sleep Apnea, CPAP, and the Heart

More than18 million adults in the U.S. have sleep apnea, according to the National Sleep Foundation, and a significant percentage of them are overweight or obese.

Other than weight loss, CPAP is considered the most effective nonsurgical treatment for patients with moderate to severe sleep apnea.

The new study included 86 patients with sleep apnea, including 75 who had metabolic syndrome.

Study participants were treated with either CPAP or a fake therapy for three months, followed by a month of no treatment and three additional months of the opposite treatment.

Before and after each phase of the study, researchers recorded the participants’ blood pressure, blood sugar, blood fats called triglycerides, hemoglobin A1c levels, neck artery thickness, abdominal fat, and insulin resistance, which measures the body's ability to use insulin efficiently.

When compared to the fake therapy, three months on CPAP was associated with significantly lower blood pressure, total cholesterol, triglycerides, and LDL cholesterol, the so-called bad cholesterol.

Treatment with CPAP was also associated with a significant decrease in abdominal fat and body mass index (BMI).

It was also associated with a significant decrease in hemoglobin A1c values, which indicate average blood sugar levels over the past two to three months. And 1 in 5 patients with metabolic syndrome before starting CPAP treatment no longer had the condition after three months of treatment.

Lack of Sleep and Chronic Disease

Sleep specialist Meir Kryger, MD, of the Yale University School of Medicine and the VA Connecticut Health System, tells WebMD the findings highlight the growing recognition that sleep disturbances play a significant role in chronic disease.

Kryger is a board member with the National Sleep Foundation.

“It is now clear that patients with heart disease or a metabolic disease like type 2 diabetes should be asked about their sleep habits, and they should be treated if they have sleep apnea,” he says.

Cardiologist Tara Narula, MD, of Lenox Hill Hospital in New York City, says sleep issues have not been a major focus in cardiology in the past. But she says this is changing.

“We are seeing more and more studies linking sleep disorders and stress to [heart disease and stroke risk],” she tells WebMD. “This study suggests that a simple, effective treatment for sleep apnea may help reverse the abnormalities that lead to heart attack and stroke.”

While CPAP may be simple and effective, Kryger acknowledges that most patients don’t like wearing a mask while they sleep.

But he adds that CPAP technology and masks have improved dramatically over the last few years. Most new machines are even able to monitor how often the treatment is used and how well it is working.

Study finds that combination therapy reduces pauses in breathing caused by obstructive sleep apnea

AADSM Public Relations

Tuesday, May 31, 2011

EMBARGOED FOR RELEASE: June 11, 2011, at 1:30 p.m. CDT

DARIEN, Ill. – According to new research that will be presented Saturday, June 11, at the 20th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM), in Minneapolis, Minn., the apnea-hypopnea index (AHI) in patients with severe obstructive sleep apnea (OSA) was more improved by a combination treatment of a mandibular advancement splint (MAS) and positive airway pressure (PAP) therapy than by continuous positive airway pressure (CPAP) therapy alone.

Results show that without lowering the pressure substantially, CPAP tolerance can be improved and severe OSA can be effectively treated using a MAS that physically supports and stabilizes the position of nasal pillows (TAP®-PAP).

The study involved data from 10 male and female patients who were first treated for severe OSA. Polysomnogram (PSG) data were obtained from patients’ initial diagnostic CPAP titration, and combined MAS-PAP titration studies. The seven patients who completed the study had a mean AHI of 66 breathing pauses per hour of sleep prior to treatment, 4.4 events per hour with CPAP therapy alone, and 2.6 events per hour with combined MAS-PAP. Epworth Sleepiness Scale (ESS) scores were also obtained to measure excessive daytime sleepiness. ESS scores decreased from 10.1 to 7.9 to 4.9, respectively.

“The primary finding of the study is that patients with severe OSA who were non-compliant with CPAP and suffered from effects of nightly hypoxia and poor quality of sleep are now compliant with MAS-PAP,” said lead investigator John White DDS, D. ABDSM.

Home sleep tests (Watch-Pat™) were obtained prior to MAS delivery, after MAS titration, and with combined MAS-PAP. The patients’ mean AHI was 54.4 events per hour before MAS delivery, 40.2 events per hour using MAS alone, and 10 events per hour with combination therapy. The amount of sleep time during which oxygen saturation was less than 90 percent decreased from 20.8 percent to 11.5 percent to 3 percent, respectively.

Patients reported reasons for intolerance using a 13-item checklist. With traditional CPAP therapy, each patient reported two to six reasons for intolerance. Most commonly reported reasons were: ‘can’t keep in place’ (85.7 percent), ‘unconsciously remove’ (57.1 percent); ‘mask uncomfortable,’ ‘mask leaks,’ and ‘claustrophobia’ (42.9 percent each). With combination therapy, only two patients reported a single negative experience: ‘unconsciously remove,’ ‘pull of hose applies force to teeth.’

“These results are important because a patient with severe OSA who is unable to comply with CPAP has no other viable treatment options,” said White. “This therapy offers patients a significant improvement in quality of sleep, which leads to improved moods, performance, and overall outlook on life.”

This abstract will receive the Clinical Research Award at the AADSM 20th Anniversary Meeting.

The AADSM 20th Anniversary Meeting will bring together nearly 800 international clinicians and researchers in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and primary snoring. This three-day scientific meeting will be held in conjunction with SLEEP 2011, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, in Minneapolis, Minn.

Abstract Title: Efficacy and tolerance of combination therapy using MAS supported nasal pillows.
Presentation Date: Saturday, June 11, 2011
Category: Clinical Research Award
Abstract ID: 015

Loud Snoring: First Sign of Sleep Apnea

For years, loud snoring has been a go-to joke in movies and television shows and many families have been affected by the "loud snorer" in the household. In fact, family members and friends are commonly the first people to realize that someone snores loudly, which can lead to denial and arguments. But loud snores may not just be a joke or an irritation: loud snoring may be the first sign of sleep apnea, a medical condition where breathing temporarily stops.

Sometimes, loud snoring may occur because there is a blockage of some kind in the upper airway. The air that is able to pass results in a loud 'snoring' sound. The resulting silence after a period of snoring is when the sleep apnea, lack of breathing, takes place. This happens because very little or no air is passing through the airway. When the snoring starts again, it usually begins with gasping or a sharp snort as the body tries to take in air around the blockage once more.

There are other factors involved in sleep apnea, but loud snoring can be one of the first signs, if not the first. People can have sleep apnea for years without knowing it. If you have any reason to believe that you are a "loud snorer", or have a loved one who snores loudly through the night, fill out our questionnaire and find out if an appointment with Dr. Blumenstock would be beneficial.

Read more on snoring solutions

What Should You Know About Sleeping Disorders

Sleep disorders can involve sleeping difficulties such as difficulty falling asleep, staying asleep, falling asleep at inappropriate times, excessive sleep, or abnormal behaviors associated with sleep. Dr. Blumenstock specializes in a sleeping disorder known as sleep apnea. Sleep apnea is a serious sleep disorder that occurs when breathing is interrupted during sleep. A person with this disorder may stop breathing repeatedly during sleeping hours. This could happen sometimes hundreds of times during one night of sleep. Ceasing breathing during any time means the brain and the rest of the body does not receive the oxygen they need to function.

Sleep apnea can affect anyone at any age, even children. You may be at risk for sleep apnea if you fall under one of the following categories: male in gender, being overweight, prone to snoring, over the age of forty, having a neck size of 17 inches or greater for men and 16 inches or greater for women, having large tonsils, large tongue, or small jaw bone, having family history of sleep apnea, having GERD, and any nasal obstruction due to deviated septum, allergies, or sinus problems.

Sleep apnea is a serious sleeping disorder. If you are suspicious or fall into any of the above categories, you should look into being tested. Make an appointment with Dr. Blumenstock today, and be one step closer to better sleep.

Read more on Sleep Apnea in NJ