ALLERGY, RESPIRATORY
Climate Change Could Sting Allergy, Asthma Sufferers
'Safe' Ozone Levels May Not Be for Some
Asthmatics Who Quit Smoking May Reverse Lung Damage
ALTERNATIVE MEDICINE
Needling Away Your Headaches With Acupuncture
Eight Spiritual Universal Principles in the Art of Practice
Indian Spice May Thwart Liver Damage
ANIMAL CARE
Separation Anxiety, Canine-Style
Beware of Dog Bites
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
For All Their Plusses, Pets Pose a Risk for Falls, Too
A Little Drink May Be Good for Your Bones
Study Shows Exercise Shields Against Osteoporosis
CANCER
Vitamin C Shows Promise as Cancer Treatment
Supplement Hampers Thyroid Cancer Treatment
Low Vitamin D Levels May Initiate Cancer Development
CAREGIVING
Many Hospital Patients Can't ID Their Doctors
Stressed Health Care Workers Battle 'Compassion Fatigue'
MRSA Infections Spreading to Kids in Community
CIRCULATORY SYSTEM
Night Shift Work Hard on the Heart
Bye, Bye Back Fat?
Smog Tougher on the Obese
COSMETIC
Gum Chewing May Cut Craving for Snacks
Mouse Study Finds Molecule That Tells Hair to Grow
Contact Lenses Boost Kids' Self-Image
DENTAL, ORAL
Gummy Bears Join Cavity Fight
Toothbrushing May Stave Off Heart Woes
Gum Disease May Reactivate AIDS Virus
DIABETES
Findings Challenge Tight Glucose Control for Critically Ill Patients
Study Shows Turmeric May Prevent Type 2 Diabetes
Chamomile Tea May Ward Off Diabetes Damage
DIET, NUTRITION
The Food Irradiation Story
Coffee Drinking Lowers Women's Stroke Risk
Is Coffee Good or Bad for Your Health?
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Global Warming Linked to Heightened Kidney Stone Risk
Smog Tougher on the Obese
Cats Can Trigger Eczema in Some Infants
EYE CARE, VISION
Protein Might One Day Prevent Blindness
It's a Whole New Outlook for Cataract Patients
When Gauging Age, the Eyes Have It
FITNESS
Fall Cleanup Is a Prime Time for Accidents
You Can Get Great Exercise In The Garden
Football Can Shrink Players
GASTROINTESTINAL PROBLEMS
Intestinal Bacteria Trigger Immune Response
Olive Oil May Protect Against Bowel Disease
Peppermint Oil, Fiber Can Fight Irritable Bowel
GENERAL HEALTH
Have a Goal in Life? You Might Live Longer
Zen May Thicken Brain, Thwart Pain
How Weight Loss Can Help the Heart
HEAD & NECK
Many Children Will Outgrow Headaches
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Subway Defibrillators Save Lives
Study Suggests Link Between Cell Phones and Brain Tumors
Imaging Sheds Light on How Acupuncture Works
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Western Diet Linked To Heart Disease, Metabolic Syndrome
Women Who Run May Benefit From Extra Folic Acid
Omega-3, Some Omega-6 Fatty Acids Boost Cardiovascular Health
INFECTIOUS DISEASE
Dry Weather Boosts Odds of Flu Outbreaks
Swine Flu Loves a Crowd
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
3 Home Habits Help Youngsters Stay Slim
Wood Fires Can Harm the Youngest Lungs
Eating Fish, Breast-Feeding Boost Infant Development
MEN'S HEALTH
Sunlight May Help Protect Men From Kidney Cancer
Exercise May Prevent Prostate Cancer: Study Shows
Whole Grains, Bran May Fight Hypertension in Men
MENTAL HEALTH
Meditation, Yoga Might Switch Off Stress Genes
Fear Response May Stem From Protein in Brain
Optimism May Boost Immune System
PAIN
Are We Exercising Pain Away? Not So Much.
Tai Chi May Help Ease Fibromyalgia
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Exercise Boosts Bone Density in Breast-Feeding Moms
Prenatal Stress May Boost Baby's Asthma Risk
Music of Mozart Soothes the Preemie Baby
SENIORS
Martial Arts Training May Save Seniors' Hips
The Healthy Habits of Centenarians
Life Expectancy in U.S. Hits New High
SEXUAL HEALTH
SLEEP DISORDERS
Moderate Aerobics May Ease Insomnia Symptoms
Lose Weight, Sleep Apnea May Improve
6 to 8 Hours of Shut-Eye Is Optimal for Health
WOMEN'S HEALTH
Supplements Might Reduce Breast Cancer Risk
Woman in America Are Delaying Motherhood, Study Says
Active Young Women Need Calcium, Vitamin D
Add your Article

New Options Offered for Sleep Apnea

By Steven Reinberg
HealthDay Reporter

MONDAY, May 18 (HealthDay News) -- Two new treatments -- one surgical and the other an appliance that adjusts the jaw -- might help people with sleep apnea, which has proven tough to treat.

In sleep apnea, the upper airway becomes blocked, and people stop breathing during sleep, usually in 10- to 20-second bouts that can occur 30 or more times an hour. The problem is usually treated with a device that increases air pressure in the throat, keeping the airway open. Called continuous positive airway pressure, or CPAP, the therapy involves wearing a mask attached to a machine.

Though effective, many people find it uncomfortable.

"Whilst continuous positive airway pressure is the gold standard treatment, it does not adequately serve all patients, with some that fail to tolerate treatment and others that simply refuse treatment," said Dr. Neville Patrick Shine, of St. Johns Hospital in Edinburgh, Scotland, and the lead author of a study that tested a surgical treatment for sleep apnea.

The surgery, called transpalatal advancement pharyngoplasty, enlarges the space behind the roof of the mouth.

When the obstruction is significant, "the choice may lie between surgery or no treatment, with the potential attendant cardiovascular and neurocognitive sequelae of sleep apnea," Shine said. "So in this cohort, transpalatal advancement surgery offers a reasonable treatment option."

For the study, Shine and his colleague Dr. Richard Hamilton Lewis, from the Royal Perth Hospital in Perth, Australia, reviewed the medical records of 60 people who had this surgery to treat sleep apnea.

The researchers looked for reductions in sleep disturbances and increases in the amount of oxygen in the individual's blood. With these criteria, the surgery was deemed successful in 38 people. Sleep apnea was cured in 21 people.

"One of the limitations of the procedure is the inability to accurately predict the positive responders to surgery from preoperative characteristics, and all patients undergoing this surgery must be made aware of this fact," Shine said.

"Although this surgery is not a magic bullet treatment for sleep apnea, it does have a role in those patients who have failed conservative treatment, have putative retropalatal disease and are willing to undergo surgery with no absolute guarantee of success," he said.

Dr. Jose W. Ruiz, an assistant professor of otolaryngology at the University of Miami Miller School of Medicine, noted that the surgery is only one of the surgical procedures used to treat sleep apnea.

"Most sleep apnea surgeries have success rates that range from 50 percent up to 70 percent," Ruiz said. "Most of it comes down to selecting the correct patient for the surgery and doing the right surgery. We haven't found the best surgery to do for everyone. That's why we are coming out with new techniques every year."

The ideal candidate for surgery is someone who has tried CPAP therapy but cannot tolerate it, Ruiz said. The success rate of CPAP therapy is very high, more than 90 percent, he noted.

"The problem is that only about 50 percent of the people tolerate it," Ruiz said. "So even though it works really well, most people don't use it." In fact, he said, some people have had surgery to make CPAP therapy more tolerable.

Another new study, though, offers a different alternative to surgery. Its findings are published in the May issue of Archives of Otolaryngology, Head & Neck Surgery, as is Shine's study.

The alternative tested in the study was an appliance called a mandibular advancement device, designed to prevent the airway obstruction of sleep apnea. It does this by moving the lower jaw forward.

A research team led by Dr. Chul Hee Lee, from Seoul National University Bundang Hospital and Seoul National University College of Medicine, evaluated 50 people with sleep apnea who used the device. Based on reductions in shallow or stopped breathing, the device worked in 37 of the participants, including a mix of people with mild, moderate and severe sleep apnea, the researchers found.

"The mandibular advancement device is a simple, non-invasive, easy-to-manufacture and easy-to-use device and showed good treatment outcome in nocturnal respiratory function and sleep quality in Korean patients with obstructive sleep apnea," including those with a severe condition, the researchers wrote. They described it as a "good alternative option" for anyone with obstructive sleep apnea.

However, Dr. Shirin Shafazand, an assistant professor of medicine in the Division of Pulmonary and Critical Care Medicine at the University of Miami Miller School of Medicine, said that devices such as the one tested in the Korean study, are really for people with mild sleep apnea and should be prescribed only after people have undergone sleep studies to determine the severity of their condition.

"It wasn't a surprise that there is improvement," Shafazand said. "But the numbers are too small to know whether people with severe sleep apnea will truly benefit long-term with this device."

She noted that the severity of the condition was reduced in those with severe sleep apnea, but the best result still reduced it only to the level of moderate sleep apnea.

There are a number of devices available that do the same thing, Shafazand said. But, she added, over-the-counter devices don't really work very well.

"The oral appliances that we recommend are to patients who have the sleep studies, so we know their level of severity," Shafazand said. "If their sleep apnea is mild, and they don't want to use continuous positive airway pressure therapy or can't tolerate it, we refer them to a dentist that fits them properly."

However, given the available options, Shafazand said she prefers to start most people on CPAP therapy.

"I always advise patients to try continuous positive airway pressure therapy, especially if it's moderate to severe," Shafazand said. "It's my first-line agent. If they absolutely can't do continuous positive airway pressure therapy, then oral appliances and surgery are alternatives -- but they are not perfect alternatives."

More information

The U.S. National Heart, Lung, and Blood Institute has more on sleep apnea.



SOURCES: Neville Patrick Shine, F.R.C.S., St. Johns Hospital, Edinburgh, Scotland; Shirin Shafazand, M.D., assistant professor, medicine, Division of Pulmonary and Critical Care Medicine, University of Miami Miller School of Medicine, Miami; Jose W. Ruiz, M.D., assistant professor, otolaryngology, University of Miami Miller School of Medicine, Miami; May 2009, Archives of Otolaryngology, Head & Neck Surgery

Last Updated: May 18, 2009

Copyright 2009 ScoutNews, LLC. All rights reserved.

More articles at www.eholistic.com