Can Snoring Harm Your Health?
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Transcript of Can Snoring Harm Your Health?
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Can Snoring Harm Your Health?
Presented by:Alison S. Kole, MD/MPH
Director, Sleep Disorders Center19 November 2015
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Overview• Importance of Healthy Sleep• How sleep apnea affects your health• Who is at risk for sleep apnea• Options for diagnosis and treatment• Preventative strategies
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Importance of Healthy Sleep
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Importance of Healthy Sleep
• AASM and SRS Consensus Statement1
“Adults should sleep 7 or more hours per night on a regular basis to promote optimal health”
• Official American Thoracic Society Statement2
“Sleep is an essential biological function with major roles in recovery, energy conservation, and survival”
“It is clear that good-quality sleep is critical for good health and overall quality of life”
1. Journal of Clinical Sleep Medicine, Vol 11, No 6, 20152. Am J Respir Crit Care Med Vol 191, Iss 12, 1450-1458, Jun 15, 2015
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Sleeping < 7 hours per night1
• Weight gain and obesity
• Diabetes• High blood pressure• Heart disease• Stroke• Depression
• Immune dysfunction• Greater risk of
accidents• Increased risk of
death
Associated with:
1. Journal of Clinical Sleep Medicine, Vol 11, No 6, 2015
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Airway Anatomy
Picture reference: http://stopsnoringrx.com/why-do-we-snore/
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Airway during Sleep
Picture reference: http://www.dreamstime.com/royalty-free-stock-image-snoring-sleep-apnea-image27809776
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Obstructive Sleep Apnea (OSA)3
• Apnea Pause in breath for ≥ 10 seconds
• Hypopnea Flow of breath decreases by 30% of baseline
for ≥ 10 seconds associated with a fall in oxygen saturation by 3%
3. AASM Scoring Manual Version 2.2, 2015
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Obstructive Sleep Apnea• Upper airway
closes• Increased
blood pressure
• Increased heart rate
• Oxygen level drops
Picture reference: http://advan.physiology.org/content/32/3/196
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Sleep Apnea Severity
Apnea Hypopnea Index (AHI)
Picture reference: http://www.google.com/patents/WO2010107894A1?cl=en
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Health Affects of OSA• 26% general US
population has OSA4
• 48% diabetes6
• 35% high blood pressure5
• 30% coronary artery disease5
• 60% stroke5
OSA
Picture reference: http://binghamtontmjandsleep.com/adult-sleep-disorders/risks-and-effects-of-osa-factors/4. Rising prevalence of sleep apnea in U.S. threatens public health. National Healthy Sleep Awareness ProjectMonday, September 29, 2014 5. Sleep Apnea and Cardiovascular Disease. Circulation, 2012, 126: 1495-1510 6. Prevalence of Sleep Apnea in a Population of Adults With Type 2 Diabetes Mellitus. Endocr Pract. 2007;13(4):355-362
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Health Affects of OSA
Lily Eunhae Studer, 7/29/15
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Health Affects of OSA• Untreated OSA:
2.5x higher risk of accidents7
• Effective treatment cuts this risk by 70%7
Huffington Post 4/7/2014 “Engineer Involved In Fatal
Metro-North Train Derailment Had Undiagnosed Sleep
Apnea” 7. Risk of motor vehicle accidents is higher in people with sleep apnea. American Academy of Sleep MedicineTuesday, March 10, 2015
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Risk Factors for OSA
• Personal history • Family and ethnic risk• Post menopausal women
Picture reference: https://utswim.wordpress.com/tag/pulmonary/
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Options for DiagnosisPolysomnography
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Options for DiagnosisHome Sleep Testing
Picture reference: http://join.sleepgroupsolutions.com/products/watermark-ares/
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Options for Treatment
• CPAP (continuous positive airway pressure) therapy
• APAP (auto-positive airway pressure therapy
Picture reference: http://www.schofieldmedical.com/Catalog/Online-Catalog-Product/2076/Prsystem-One-Remstar-Auto
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Alternative Therapies
NONSURGICAL SURGICAL
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Positional Therapy• Tennis ball T-shirt
Picture: http://www.tennisballtshirt.com/Stop_Snoring_Remedy_%3A_Tennis_Ball_T_Shirt_%3A_Anti_Snore_Cure.html
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Zzoma belt
Picture reference: http://www.medicare.ie/zzoma-positional-device-887.html
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Night Shift Positional device
Picture reference: Assessment of a Neck-Based Treatment and Monitoring Device for Positional Obstructive Sleep Apnea. J Clin Sleep Med 2014;10(8):863-871. http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29591
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Provent
Picture reference: http://www.lunar.com/blog/lunar-designed-ventus-provent-sleep-apnea-therapy-wins-gold-idea/Picture reference: http://www.sleepwa.com.au/mas-and-provent-Therapy
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Oral Appliance Therapy
Panthera Herbst
Mouthpieces
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Oral Appliance Therapy• Dental Device Titration (MATRx)
Determining who benefits from mouthpieces
Coming January 2016 to SMG Warren Sleep Laboratory!
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Surgical Treatment of OSAUvulopalatopharyngoplasty (UPPP)
• removal of upper airway soft tissues including the uvula, soft palate, tonsils, and adenoids
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Surgical Treatment of OSAMaxillomandibular advancement (MMA)
• Currently the most effective surgical option for OSAPicture reference: http://www.homesleepclinic.com/desktop/treatment-options.html8. Oral Appliance Treatment for Obstructive Sleep Apnea: An Update. J Clin Sleep Med 2014;10(2):215-227.
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Hypoglossal Nerve Stimulation
Picture reference: Upper-Airway Stimulation for Obstructive Sleep Apnea. N Engl J Med 2014; 370:139-149
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Preventative strategies• WEIGHT LOSS
Diet, exercise, weight loss surgery• Avoidance of alcohol• Avoidance of prescription sleep aids• Quit smoking!
Picture reference: http://users.rowan.edu/~blondi74/Expert.page.2.html
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Comprehensive Sleep Evaluation
Kole
Bakal Kohn (Pediatrics)
Bass BlausteinWilt
Livingston campusFlorham Park campus
Berkeley Heights campusFlorham Park campus
Berkeley Heights campus
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Thank You!
I mustache you a question…