Loud, explosive snoring is a hallmark of obstructive sleep apnea, which affects up to 25% of men and 10% of women. This nighttime breathing problem often disrupts sleep, leaving people tired and irritable during the day. But sleep apnea also can boost blood pressure and may increase the risk of clogged heart arteries, heart rhythm disorders, heart failure, and stroke. The gold standard treatment, called positive airway pressure or PAP — which uses a bedside machine that provides a stream of air through a face mask — is very effective. But it's a tough sell for many people, who find the device challenging to use consistently.

Because of difficulty tolerating the device, some people don't use their PAP machine every single night, while others remove it halfway through the night. However, troubleshooting some common issues with PAP may help (see "Tips for using a PAP machine"). "For people who use PAP machines, it's also important to get periodic check-ups with a sleep medicine specialist, who can adjust your machine's programming and make it easier for you to use consistently," says Dr. Lawrence Epstein, associate physician with the Division of Sleep and Circadian Disorders at Harvard-affiliated Brigham and Women's Hospital.

Losing weight can improve sleep apnea; so can treating nasal stuffiness, getting more exercise, and avoiding alcohol near bedtime. But these lifestyle changes don't always work. If that's the case, and using a PAP machine proves unsuccessful, another possible option is a therapy to stimulate the upper airway. The FDA-approved therapy, called hypoglossal nerve stimulation, features a small device similar to a pacemaker that's surgically implanted in the upper chest and a wire that runs under the skin to the neck.

The system (commonly called by its trade name, Inspire) monitors your breathing and stimulates nerves around your tongue and airway to prevent them from collapsing. Currently, the procedure is being done in specialized centers on people with moderate to severe sleep apnea and a body mass index of 32 or lower who are unable to use PAP. "People seem to tolerate the device well, and the success rate is about 60%, making it a promising new way to treat sleep apnea," says Dr. Epstein.

 

                                                    

Source:https://www.health.harvard.edu/heart-health/strategies-for-sleep-apnea

SOURCE:https://www.sciencedaily.com/releases/2018/11/181106073233.htm

While continuous positive airway pressure (CPAP) continues to be the gold standard for treatment of sleep apnea, the cumbersome machines are often not well tolerated by patients. Because of this, less obtrusive oral appliances that thrust the jaw forward during sleep are becoming more popular. Mandibular protrusion enlarges the pharynx and stabilizes the upper airway. A new study in CHEST® demonstrates that mandibular movements (MM) monitoring can be used to assess the efficacy of these oral appliances.

MM during sleep are accurate reporters for increased respiratory effort and micro arousals found in people with sleep apnea. In this sleep study, 56 patients with obstructive sleep apnea (OSA) were fitted with a custom mandibular advancement splint (OAT) and had their midsagittal mandibular movement tracked. Patients were evaluated at the end of the titration procedure. During the titration procedure different degrees of advancement are trialed up and down to find the single best amount to control apnea events for that patient.

"The novelty of the study related to tracking sleep MM in order to assess oral appliance therapy effectiveness," explained lead investigator Jean-Benoit Martinot, MD, Sleep Laboratory, CHU UCL Namur Site Sainte-Elisabeth, Namur, Belgium. "Our study suggested for the first time that MM monitoring represents a powerful tool for assessing the efficacy of OAT treatment." Investigators found that by the end of titration, all indications of OSA decreased compared with baseline. Overall, patients showed a reduction of vertical respiratory MM and sleep respiratory effort, as well as a dramatic decrease in obstructive hypopnea. Scores from the apnea-hypopnea index and oxygen desaturation index also dropped.

 

                                                 

Researchers have found evidence of the critical role quality sleep plays on our overall health. And addressing the common causes of excessive daytime sleepiness (EDS) could have huge implications for the prevention of Alzheimer’s disease. From sleep apnea which, left untreated, can lead to high blood pressure, heart disease, stroke, depression, diabetes and other ailments, to Alzheimer’s disease, researchers continue to discover why we need to sleep.

Investigators from the Intramural Research Program (IRP) of the National Institute on Aging (NIA) are saying feeling excessively sleepy during the day could be a sign of increased risk for the brain pathology of Alzheimer’s disease. According to a new study published in the September 25, 2018 issue of the journal Sleep, older adults who felt sleepy during the day when they wanted to be awake were almost three times more likely to have deposits of beta-amyloid—the protein that clumps in the brain as part of Alzheimer’s pathology.

                                                

source:https://www.forbes.com/sites/robinseatonjefferson/2018/10/29/mounting-evidence-links-sleep-disturbance-to-alzheimers-disease/#1f6be67561da

October 29, 2018
Category: Uncategorized
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A burning tongue, or burning mouth syndrome (BMS), is a condition that causes a sensation of burning in the mouth. People with this condition often describe the burn as feeling similar to a hot drink scald. There are several known causes of BMS, but the reason for its onset can be unclear. The treatment will depend on the cause. According to the American Academy of Oral Medicine (AAOM), approximately 2 percent of people in the United States have BMS. It can affect the following parts of the mouth: tongue the roof of the mouth and as well as inside of the cheeks, gums, and lips.True BMS may be primary, meaning that it results from a direct cause, or secondary, which means that the cause is indirect. According to the Genetic and Rare Diseases Information Center, the primary form of BMS results from damage to the nerves that control taste and pain sensations. Secondary BMS may occur because of other medical conditions or treatments, including: allergies to specific foods or dental products. BMS commonly affects the tongue, but people may also experience discomfort in the: lips gums throat roof of the mouth inside of the cheeks.

                                                            

Source:https://www.medicalnewstoday.com/articles/323424.php

Vaping prevents wounds from healing properly, warns new research. Patients are already advised to stop smoking normal cigarettes for at least a month before operations such as plastic surgery. Nicotine, the addictive ingredient, is known to restrict blood flow and raise the risk of of complications for cigarette smokers.

Although e-cigarettes strip out the combustible chemicals of tobacco, a new study shows the devices have the same effect, hampering the process where injured flaps of skin join together. Surgeons recommend patients quit smoking for several months prior to surgery, whenever possible.

Vaping is gaining popularity and there has not yet been significant research done about whether it is a safer alternative - particularly before an operation. Studies suggest e-cig fluids contain more cancer causing chemicals, such as formaldehyde. Others show vaping pens can release heavy metals, chemicals and glass particles found in the welding material and tubing for the device.

 

                                                        

SOURCE/ CREDIT:https://www.dailymail.co.uk/health/article-6290933/Vaping-increases-risk-surgery-complications.html





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Fedele E. Vero, D.D.S., P.C.
Christine N. Fumo, D.M.D.
Alec J. Ganci, D.D.S

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