Sleep Apnea patients at increased risk while flying

This is an interesting study reported in The New York Times which highlights the effects of sleep apnea on the overall physiology of the body and again highlights the importance of diagnosis and treatment.

Sleep Disorder Raises Heart Risks While Flying
People with obstructive sleep apnea may be at greater risk for heart troubles during air travel, a new study shows.
Travelers with sleep apnea face higher heart risks. (Noah Berger/Associated Press)
Sleep apnea is a common condition characterized by temporary breathing interruptions during sleep, often due to an upper airway obstruction. People with sleep apnea often snore loudly and gasp for air during sleep.
In a new study, Australian researchers looked at oxygen levels and breathing patterns in healthy people and in 22 people with severe sleep apnea during a simulated flight. All study subjects were awake, and the conditions in the simulator mimicked oxygen and pressure levels typically found on commercial airline flights.
The researchers found that people with obstructive sleep apnea had lower levels of oxygen in their blood before and during the simulated flight. People with apnea experienced higher heart rates, physiological stress and demand for oxygen than healthy people, according to the findings, presented this weekend at the American Thoracic Society’s 2008 International Conference in Toronto.
“We addressed obstructive sleep apnea because it is becoming so much more common as obesity increases and there are greater numbers of obese passengers on commercial flights,'’ said lead researcher Leigh Seccombe, a senior scientist in the department of thoracic medicine at Concord Repatriation General Hospital in Sydney.
The results suggest patients with obstructive sleep apnea are at higher risk for heart problems during air travel, and raise questions about whether patients with severe apnea should travel with supplemental oxygen, the way patients with lung diseases do.
http://well.blogs.nytimes.com/2008/05/19/sleep-disorder-raises-heart-risks-while-flying/

Spring is here!

This bee is very busy collecting pollen. Luckily he is not allergic to it. If you are not so lucky, then we can help...
SacENT has a fully equipped allergy department and our doctors are well versed in the most up to date allergy medications. There are some new very effective agents available to control your miserable allergies.

(photo by Dr Evans in his backyard just before a sneeze which aggravated said bee).

Difficult to treat high blood pressure may be due to sleep apnea

The American Heart Association has issued consensus guidelines for treating resistant hypertension, a common, difficult-to-manage condition. Hypertension is called resistant if a patent's blood pressure remains elevated despite taking three medications to lower it, guideline chair David A. Calhoun, M.D., of the University of Alabama , and colleagues reported online in Hypertension. Resistance is also established if hypertension is controlled but it's taken four or more drugs to get there.

The committee's diagnostic advice:
1. Confirm treatment resistance. In addition to use of medications as noted above, office blood pressure, taken with good technique, should be greater than 140/90 or over 130/80 in patients with diabetes or chronic kidney disease;
2. Rule out the "white-coat effect" by use of ambulatory monitoring, if necessary;
3. Identify and reverse contributing lifestyle factors, such as obesity, physical inactivity, excessive alcohol ingestion, high salt and low-fiber diet;
4. Discontinue or minimize interfering substances, such as non-steroidal anti-inflammatory agents, diet pills, decongestants, stimulants, oral contraceptives, licorice, and ephedra;
5. Screen for secondary causes of resistant hypertension, such as obstructive sleep apnea, renal artery stenosis, primary aldosteronism, Cushing's syndrome, aortic co-arctation, and pheochromocytoma.

Our office treats many patients with obstructive sleep apnea. Typical symptoms include daytime sleepiness, falling asleep when you shouldn't, or a headache upon awakening in the morning. Patients with sleep apnea typically have snoring and sleeping partners may observe pauses in the breathing pattern. If any of these apply to you, then the only way to diagnose this condition with certainty is with a sleep study.