Thoracic and Sleep Group Queensland People caring for how you breathe and sleep

April 28, 2017

April 27, 2017

April 26, 2017

Another reason to lose weight

Filed under: Blog — Tags: , , — Trent Segal @ 3:32 am

Snoring and sleep apnoea occurs in people for a number of reasons.  Anatomical susceptibility to airway collapse, inflammation of the upper airway often caused by smoking, nasal congestion or upper airway muscle weakness which can deteriorate with age.  Perhaps the most well documented and common cause is weight gain which has been identified as a predictor for obstructive sleep apnoea (OSA).  This is a result of additional fat deposits both blocks the airway and act to ‘weigh it down’ making it more likely to collapse.  OSA is also often worse when lying flat on your back (supine) as gravity contributes to weighing down of tissue on the airway compounding the likelihood of collapse.

So can losing weight cure obstructive sleep apnoea?

A recent study in the Journal of Sleep has looked into weight loss as a treatment, to see if the effect differs when lying in different positions.

60 obese subjects with a BMI between 35 – 55 with a diagnosis of OSA and an apnoea hypopnoea index (AHI) >20 events/hour were studied.  Half underwent either gastric band surgery or a very low calorie diet and had a follow up sleep study after 2 years.

22% of patient demonstrated a normal non-supine AHI on follow up compared to 0% at baseline.  Those were younger and lost significantly more weight compared to those with a residual non-supine AHI.  The AHI was reduced more in the non-supine position than the supine position.

For some people who are able to stay sleeping on their side, this could be an appropriate treatment option.

Read the following articles for more information:

https://academic.oup.com/sleep/article-abstract/doi/10.1093/sleep/zsx047/3746886/Improvement-in-Obstructive-Sleep-Apnea-With-Weight?redirectedFrom=fulltext

https://www.hindawi.com/journals/sd/2012/163296/

Get the coffee, its going to be a late night!

Filed under: Blog — Tags: , , , , — Phil Teuwen @ 3:27 am

For the procrastinators out there, the last minute cram session is a normal part of studying… but does it work? Well it might, but there are many reasons why it may not be a good idea. Joseph Chandler from USA Today College gives us three reasons why the old all nighter may not be a great idea. He states:

  1. YOUR BRAIN WON’T RETAIN ALL THE INFO YOU’RE TRYING TO CRAM INTO IT.

The neurochemical processes that transform experience into memories are most active during sleep. In fact, the way the brain talks to itself changes during sleep just to facilitate the memory process. The flow of information shifts from external experience to internal strengthening of that experience, creating connections to prior knowledge and a deep understanding of new material.

Even if you study hard, then don’t sleep, you’re pouring water into a leaky cup. You can spend all the time you want taking in the information, but without sleep it simply slips away. This is not just theoretical. There are several studies that link missed sleep to bad grades during finals. The worst grades tend to come when students report having stayed up all night before the exam, regardless of prior achievement.

It is best to think of successful studying as having two parts: 1) taking in the information gradually and repeatedly leading up to exam day and 2) giving that information a chance to stick around by sleeping well during that period.

  1. AND THEN YOU MIGHT GET SICK.

Let’s say you just didn’t get there this time. You waited and waited and absolutely had to cram. You stayed up all night, took the exam, then passed out for 6 hours in the middle of the day. You got up, found food, then headed back to sleep.

When you woke up the next morning you felt terrible – sore throat, runny nose, the works. You’ve caught the dreaded finals flu! Is this a coincidence? Probably not.

As you were up cramming, you weren’t just jeopardizing your grade, you were preventing your body from building your immune system. The production of macrophages, the type of white blood cell that seeks out and destroys infectious agents, occurs during sleep. The clearing of pro-inflammatory cytokines, substances that make you feel achy and swollen, occurs during sleep. The coordination of T cells and illness-specific antibodies is also optimized during sleep.

  1. AND YOU’LL FEEL DEPRESSED.

Now you’ve got a bad grade and a bad cold. You feel defeated and depressed, and can’t seem to shake it. Why? Emotional regulation, the ability to handle stress, also strengthens during sleep.

One of the first things to break down during sleep deprivation is mood, and that is by nature’s design. Sleep deprivation turns up the drama so you’ll break away from the group and go to bed. It is the first line of feedback to tell you staying up any longer is a bad idea. When you ignore that message, the bad mood mounts until you find yourself yelling at your best friend for breathing too loud.

Original article: http://college.usatoday.com/2017/04/18/3-reasons-why-you-shouldnt-pull-that-all-nighter-ahead-of-your-final/

April 25, 2017

The Cost of Not Taking Your Medicine

Filed under: Blog — Mark Russell-Pavier @ 10:58 pm

There is an out-of-control epidemic in the United States that costs more and affects more people than any disease Americans currently worry about. It’s called nonadherence to prescribed medications, and it is — potentially, at least — 100 percent preventable by the very individuals it afflicts.

The numbers are staggering. “Studies have consistently shown that 20 percent to 30 percent of medication prescriptions are never filled, and that approximately 50 percent of medications for chronic disease are not taken as prescribed,” according to a review in Annals of Internal Medicine. People who do take prescription medications — whether it’s for a simple infection or a life-threatening condition — typically take only about half the prescribed doses.

This lack of adherence, the Annals authors wrote, is estimated to cause approximately 125,000 deaths and at least 10 percent of hospitalizations, and to cost the American health care system between $100 billion and $289 billion a year.

Former Surgeon General C. Everett Koop put it bluntly: “Drugs don’t work in patients who don’t take them.” This partly explains why new drugs that perform spectacularly well in studies, when patients are monitored to be sure they follow doctors’ orders, fail to measure up once the drug hits the commercial market.

More important, it explains why so many patients don’t get better, suffer surprising relapses or even die when they are given drug prescriptions that should keep their disorders under control.

Studies have shown that a third of kidney transplant patients don’t take their anti-rejection medications, 41 percent of heart attack patients don’t take their blood pressure medications, and half of children with asthma either don’t use their inhalers at all or use them inconsistently.

“When people don’t take the medications prescribed for them, emergency department visits and hospitalizations increase and more people die,” said Bruce Bender, co-director of the Center for Health Promotion at National Jewish Health in Denver. “Nonadherence is a huge problem, and there’s no one solution because there are many different reasons why it happens.”

For example, he said parents often stop their children’s asthma treatment “because they just don’t like the idea of keeping kids on medication indefinitely.” Although a child with asthma may have no apparent symptoms, there is underlying inflammation in the lungs and without treatment, “if the child gets a cold, it can result in six weeks of illness,” Dr. Bender explained.

When Dr. Lisa Rosenbaum, a cardiologist at Brigham and Women’s Hospital in Boston, asked patients who had suffered a heart attack why they were not taking their medications, she got responses like “I’m old-fashioned — I don’t take medicine for nothing” from a man with failing kidneys, peripheral vascular disease, diabetes and a large clot in the pumping chamber of his heart. Another common response: “I’m not a pill person.”

When Dr. Rosenbaum told her hairdresser that she was studying why some people with heart disease don’t take their medications, he replied, “Medications remind people that they’re sick. Who wants to be sick?” He said his grandmother refuses to take drugs prescribed for her heart condition, but “she’ll take vitamins because she knows that’s what keeps her healthy,” so he tells her that the pills he gives her each night are vitamins.

Other patients resist medications because they view them as “chemicals” or “unnatural.” One man told Dr. Rosenbaum that before his heart attack, he’d switched from the statin his doctor prescribed to fish oil, which unlike statins has not been proved to lower cholesterol and stabilize arterial plaque.

“There’s a societal push to do things naturally,” she said in an interview. “The emphasis on diet and exercise convinces some people that they don’t have to take medications.”

Dr. Bender said, “People often do a test, stopping their medications for a few weeks, and if they don’t feel any different, they stay off them. This is especially common for medications that treat ‘silent’ conditions like heart disease and high blood pressure. Although the consequences of ignoring medication may not show up right away, it can result in serious long-term harm.”

Some patients do a cost-benefit analysis, he said. “Statins are cheap and there’s big data showing a huge payoff, but if people don’t see their arteries as a serious problem, they don’t think it’s worth taking a drug and they won’t stay on it. Or if they hear others talking about side effects, it drives down the decision to take it.”

Cost is another major deterrent. “When the co-pay for a drug hits $50 or more, adherence really drops,” Dr. Bender said. Or when a drug is very expensive, like the biologics used to treat rheumatoid arthritis that cost $4,000 a month, patients are less likely to take them or they take less than the prescribed dosage, which renders them less effective.

Dr. William Shrank, chief medical officer at the University of Pittsburgh Health Plan, said that when Aetna offered free medications to patients who survived a heart attack, adherence improved by 6 percent and there were 11 percent fewer heart attacks and strokes, compared with patients who paid for their medications and had an adherence rate of slightly better than 50 percent.

“There are so many reasons patients don’t adhere — the prescription may be too complicated, they get confused, they don’t have symptoms, they don’t like the side effects, they can’t pay for the drug, or they believe it’s a sign of weakness to need medication,” Dr. Shrank said. “This is why it’s so hard to fix the problem — any measure we try only addresses one factor.”

Still, there is hope for improvement, he said. Multiple drugs for a condition could be combined into one pill or packaged together, or dosing can be simplified. Doctors and pharmacists can use digital technology to interact with patients and periodically reinforce the importance of staying on their medication.

With fear of side effects a common deterrent to adherence, doctors should inform patients about likely side effects when issuing a prescription. Failing that, patients should ask: “What, if any, side effects am I most likely to encounter?”

Forgetting to take a prescribed drug is a common problem, especially for those ambivalent about taking medication. Patients can use various devices, including smartphones, to remind them to take the next dose, or use a buddy system to make adherence a team sport. Dr. Shrank suggested making pill-taking a habit, perhaps by putting their medication right next to their toothbrush.

April 21, 2017

Sleep Deprivation Impairs Your Ability to Recognise Specific Facial Expressions

Filed under: Blog — Tags: , , — Natalie Eriksson @ 7:10 am

It is no secret that sleep deprivation can impair your emotional processing, but a new study has found that your ability to recognise certain emotional facial expressions can deteriorate as you get tired. Interpreting subtle expressions such as happiness and sadness, which are prosocial emotions, can be affected by a night without sleep or a very restless sleep. Interestingly though, your ability to recognise primitive survival-based emotions, like anger and fear, remain intact.

So why is this? One thought is that while emotions such as fear and anger could indicate a threat, social emotions such as happiness and sadness are less necessary for us to recognise in immediate survival situations. When we’re tired, it seems we’re more likely to dedicate our resources to recognizing those emotions that could impact our short-term safety and well-being.

Other studies have shown that when people are sleep deprived, a disconnect occurs between the prefrontal cortex and the amygdala in the brain, which is one of the key emotionally responsive areas of the brain.

This current study is based on data from 54 participants, who were shown photographs of the same male face expressing varying degrees of fear, happiness, sadness, anger, surprise and disgust. Participants were asked to indicate which of those six emotions they thought was being expressed the most by each face.

In order to assess participants’ ability to interpret more subtle emotional expressions, 180 images were presented of composite photos showing commonly confused facial expressions morphed together by a computer program. Participants’ baseline responses to the images were compared to their responses after they were deprived of sleep for one night.

Researchers found that blatant facial expressions, such as an obvious grin or frown were easily identifiable regardless of how much sleep a participant got. Sleep deprived participants had a harder time, however, correctly identifying more subtle expressions of happiness and sadness, although their performance on the other emotions was unchanged.

While the difference in performance was not overwhelming, it is enough that it could have a significant impact in critical social interactions. You may end up responding inappropriately to somebody that you just don’t read correctly, especially those prosocial emotions. Or you may not be as empathic. Your spouse or significant other may need something from you and you’re less able to read that. Perhaps one of the biggest problems could be that this could lead to problems in your relationships or problems at work.

 

Story Source:

University of Arizona. “Sleep deprivation impairs ability to interpret facial expressions.” ScienceDaily. ScienceDaily, 23 March 2017. <www.sciencedaily.com/releases/2017/03/170323132524.htm>.

 

Journal Reference:

William D.S. Killgore, Thomas J. Balkin, Angela M. Yarnell, Vincent F. Capaldi. Sleep deprivation impairs recognition of specific emotions. Neurobiology of Sleep and Circadian Rhythms, 2017; 3: 10 DOI: 10.1016/j.nbscr.2017.01.001

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