Driving on Labor Day Weekend

It's hard to believe but Labor Day is only one week away. Despite high gas prices, it's estimated that more than 30 million Americans will be driving this Labor Day weekend.

Most people are aware of the dangers of drinking and driving, but few are aware of the dangers of sleepiness and driving. The 2008 Sleep in America Poll found that

64 percent of drivers who work at least 30 hours per week report they have driven a
vehicle while feeling drowsy in the past year, and more than one-third, 36
percent, have actually fallen asleep at the wheel. Sleep-related crashes
are most common in young people, especially men, shift workers, commercial
drivers, and people with untreated sleep disorders. NHTSA conservatively
estimates that 100,000 police-reported crashes are the direct result of
driver fatigue each year. This results in an estimated 1,550 deaths, 71,000
injuries, and $12.5 billion in monetary losses each year.

Be sure to get adequate sleep before any road trip this coming weekend and if you have been told that you snore, have had your bed partnhttp://www.blogger.com/img/gl.link.gifer tell you that you stop breathing during sleep, know that you have high blood pressure and that you are tired despite sleeping 7 - 8 hours at night - get yourself checked out for sleep apnea. For more information, visit snoringisntsexy.com

Have a great weekend and drive safely.

Dr. Barsh

Want to Look Better and Live Longer? First, Stop Smoking

In the August 14 issue of the New York Times in the style section (where we all get our medical news apparently), there was an article that plastic surgeons are refusing to do face lifts for men and women who smoke. Hmmm... approaching a life endangering habit from a cosmetic point of view. Very much the same way we at Snoring Isn't Sexy.com approach snoring and sleep apnea.

While we are on the subject of smoking, two recent scientific articles point to the dangers of smoking and sleep apnea.

In February, 2008 an article was published in the Proceedings of the American Thoracic Society:

...obstructive sleep apnea is also being recognized as an independent risk factor for several clinical consequences, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism.
Factors that increase vulnerability for the disorder include age,male sex, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol use.

And in March in Sleep Medicine, Dr. Peretz Lavie published an article that stated that smoking interacts with sleep apnea to increase risk of heart disese:

There is a synergistic effect between cigarette smoking and sleep apnea on some of the biochemical cardiovascular risk markers. Patients with severe sleep apnea who smoke are at a greater cardiovascular risk than smokers with mild-moderate sleep apnea and patients who do not smoke.

We recommend quitting smoking at any age for any reason but if you smoke and have sleep apnea, you are at risk.

Quiet Now!

Dr. Barsh

New Website You might be Interested In

There's a new web site that features a video diary Dr. Jonathan Lown's experience of living with CPAP that may develop into a resource that you want to keep your eye on over the next few months. The site features the ability to use what they call a "Still Sleepy Tracker" that apparently you can download and develop your own diary of sleepiness. The site is at StillSleepy.com.

While the video diary is interesting, there are a couple of problems that I find with the site.

First, there is no way to contact the developer of the site. When you visit any medical site, it is imperative that you be able to contact the web developer. As I mentioned in an earlier blog, many sites that offer medical information where, in fact, developed with the sole purpose of attracting search engines and cashing in on the advertising in the side bar.

Second, the site is actually a commercial for a pharmaceutical called Provigel. While there is a cost associated with development and maintenance of a web site, there is a serious conflict of interest at the site.

Third, the "Still Sleepy Tracker" is nothing more than the Epworth Sleepiness scale without attribution. While being able to measure daytime sleepiness it is not diagnostic for sleep apnea. It measures only one factor - daytime sleepiness - which could be due to a variety of reasons.

Finally, the video diary contains a video of a Dr. Jonathan Lown but fails to provide any background information as to whether Dr. Lown is a physician or a PhD. When you visit a medical information site, you should always be able to be able to access information about the medical authority featured on the site.

Dr. Barsh
Snoring Isn't Sexy

Sleep Apnea and increased risk of death (continued)

Several other points need to be made in relation to this study:

• The increased risk of death that was associated with severe sleep apnea was reduced when patients were treated with CPAP
• Milder forms of sleep apnea did not seem to increase the risk of death
• CPAP improved the symptoms of sleep apnea and may reduce the risk in severe case

Dr. Terry Young talks about the study:


Two points become very clear as a result of this study:

First - if you snore heavily and have stopped breathing during sleep, get evaluated for sleep apnea. I know I've said this before but it's worth repeating!

Second, if you are a dentist, whether you choose to work with colleagues to manage patients with sleep apnea or not, it is your obligation to screen all patients that you treat for sleep apnea. You screen now, or if not should screen, for oral cancer and high blood pressure and you encourage smoking cessation - add one minute to your examination and ask 4 short questions:

1. Do you snore loudly?
2. Do you often feel tired, fatigued or sleepy during the daytime?
3. Has anyone observed you stop breathing during sleep?
4. Do you have or are you being treated for high blood pressure?

(The STOP Questionnaire, Frances Chung)

Dr. Barsh

People with Sleep Apnea have a high risk of death

A study was released in the Journal Sleep that showed that people with severe sleep apnea have a much higher mortality risk than people without sleep apnea.

From eScience News:

A study in the August 1 issue of the journal Sleep shows that people with severe sleep apnea have a much higher mortality risk than people without sleep apnea, and this risk increases when sleep apnea is untreated. Results show that people who have severe sleep apnea, which involves frequent breathing pauses during sleep, have three times the risk of dying due to any cause compared with people who do not have sleep apnea. This risk is represented by an adjusted hazard ratio of 3.2 after controlling for age, sex and body mass index. When 126 participants who reported regular use of continuous positive airway pressure (CPAP) therapy were removed from the statistical analysis, the hazard ratio for all-cause mortality related to severe sleep apnea rose to 4.3.

"We found that both men and women with sleep apnea in the general population - not patients - mostly undiagnosed and untreated, had poorer survival compared with persons without sleep apnea, given equal BMI, age and sex," said principal investigator and lead author Terry Young, PhD, professor of epidemiology at the University of Wisconsin-Madison.

According to Young, most previous studies of sleep apnea and mortality have involved patients referred for a clinical sleep diagnostic evaluation; the mortality risk for sleep apnea in the general population has not been previously reported.

This is serious business folks.

If you snore, have been observed to stop breathing and then gasp and choke while asleep, have high blood pressure and feel tired during the day SEE YOUR PHYSICIAN OR SLEEP MEDICINE DENTIST for an evaluation.

No joke - let's go a little further with a recommendation, if you snore loudly and regularly see a sleep medicine dentist or a physician - it's your life.

Dr. Barsh