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Tag: obstructive sleep apnea

  • Obstructive sleep apnea may be linked to microbleeds in the brain

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    Maybe you know you snore like a bear, but you don’t feel much urgency to look into it. Or maybe you have been told to wear a continuous positive airway pressure, or CPAP, machine for sleep apnea, but it is just so cumbersome.A new study shows that it is important to take obstructive sleep apnea seriously now –– it could impact your risk of dementia and Alzheimer’s disease later.Moderate to severe obstructive sleep apnea is associated with a greater risk for new microbleeds in the brain, according to the study.”Cerebral microbleeds are a common finding in the aging brain,” said Dr. Jonathan Graff-Radford, professor of neurology at Mayo Clinic College of Medicine in Rochester, Minnesota. He was not involved in the research.Microbleeds increase with age, and people who have them have a slightly higher risk of future strokes and faster cognitive decline, Graff-Radford said. “Anything that increases microbleeds is relevant to brain aging,” he added.More evidence you need to treat sleep apneaObstructive sleep apnea is a condition in which a blockage of airways by weak, heavy or relaxed soft tissues disrupts breathing during sleep. The condition is different from central sleep apnea, in which the brain occasionally skips telling the body to breathe.There are a few ways to treat obstructive sleep apnea, including relying on oral devices that keep the throat open during sleep, regularly using a CPAP or similar machine, and having surgeries.The study has a strong methodology and should stress the importance of screening for sleep apnea to clinicians and treatment to patients, said Dr. Rudy Tanzi, professor of neurology at Harvard Medical School and director of the Genetics and Aging Research Unit at Massachusetts General Hospital in Boston. He was not involved in the research.”Don’t ignore it. Do something about it,” he said. “It’s not just the immediate risk for down the road for bleeds, but also later down the road for Alzheimer’s disease as well.”Not addressing obstructive sleep apnea is a double whammy, Tanzi said. Not getting enough good-quality sleep –– which can be hard to do when your breathing is impaired during the night –– has been associated with brain aging, but the microbleeds that could result may increase the risk for dementia down the line.The study, which was published in the journal JAMA Network Open Tuesday, is observational, which means that it can only establish that obstructive sleep apnea and microbleeds are associated, not that one definitively causes the other. Further studies will need to examine if treating sleep apnea can prevent microbleeds.Know the signsWhen is it time to ask your doctor about obstructive sleep apnea?Loud, frequent snoring is a good indicator, Tanzi said. If your partner notices pauses in your breathing while you sleep or gasping and choking, that’s another sign you should look into sleep apnea.Problems during the day can be a good indicator, too. Sleepiness, trouble concentrating, irritability and increased hunger are signs you may not be getting quality sleep and that it may be time to get assessed for sleep apnea.Night sweats might also be a sign of sleep apnea, as research has shown that about 30% of people with obstructive sleep apnea have reported night sweats.Waking up at least two times in the night, teeth grinding, and morning headaches might also indicate a problem.The latest study “urges (people) to take it more seriously, because the damage that can come from obstructive sleep apnea can definitely be more severe than you think,” Tanzi said.

    CNN —

    Maybe you know you snore like a bear, but you don’t feel much urgency to look into it. Or maybe you have been told to wear a continuous positive airway pressure, or CPAP, machine for sleep apnea, but it is just so cumbersome.

    A new study shows that it is important to take obstructive sleep apnea seriously now –– it could impact your risk of dementia and Alzheimer’s disease later.

    Moderate to severe obstructive sleep apnea is associated with a greater risk for new microbleeds in the brain, according to the study.

    “Cerebral microbleeds are a common finding in the aging brain,” said Dr. Jonathan Graff-Radford, professor of neurology at Mayo Clinic College of Medicine in Rochester, Minnesota. He was not involved in the research.

    Microbleeds increase with age, and people who have them have a slightly higher risk of future strokes and faster cognitive decline, Graff-Radford said. “Anything that increases microbleeds is relevant to brain aging,” he added.

    More evidence you need to treat sleep apnea

    Obstructive sleep apnea is a condition in which a blockage of airways by weak, heavy or relaxed soft tissues disrupts breathing during sleep. The condition is different from central sleep apnea, in which the brain occasionally skips telling the body to breathe.

    There are a few ways to treat obstructive sleep apnea, including relying on oral devices that keep the throat open during sleep, regularly using a CPAP or similar machine, and having surgeries.

    The study has a strong methodology and should stress the importance of screening for sleep apnea to clinicians and treatment to patients, said Dr. Rudy Tanzi, professor of neurology at Harvard Medical School and director of the Genetics and Aging Research Unit at Massachusetts General Hospital in Boston. He was not involved in the research.

    “Don’t ignore it. Do something about it,” he said. “It’s not just the immediate risk for down the road for bleeds, but also later down the road for Alzheimer’s disease as well.”

    Not addressing obstructive sleep apnea is a double whammy, Tanzi said. Not getting enough good-quality sleep –– which can be hard to do when your breathing is impaired during the night –– has been associated with brain aging, but the microbleeds that could result may increase the risk for dementia down the line.

    The study, which was published in the journal JAMA Network Open Tuesday, is observational, which means that it can only establish that obstructive sleep apnea and microbleeds are associated, not that one definitively causes the other. Further studies will need to examine if treating sleep apnea can prevent microbleeds.

    Know the signs

    When is it time to ask your doctor about obstructive sleep apnea?

    Loud, frequent snoring is a good indicator, Tanzi said. If your partner notices pauses in your breathing while you sleep or gasping and choking, that’s another sign you should look into sleep apnea.

    Problems during the day can be a good indicator, too. Sleepiness, trouble concentrating, irritability and increased hunger are signs you may not be getting quality sleep and that it may be time to get assessed for sleep apnea.

    Night sweats might also be a sign of sleep apnea, as research has shown that about 30% of people with obstructive sleep apnea have reported night sweats.

    Waking up at least two times in the night, teeth grinding, and morning headaches might also indicate a problem.

    The latest study “urges (people) to take it more seriously, because the damage that can come from obstructive sleep apnea can definitely be more severe than you think,” Tanzi said.

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  • Some people tape their mouths shut at night. Doctors wish they wouldn’t

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    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.Doctors say don’t do it.Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.”The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.It is better to breathe through your nose most of the timeMouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.Don’t rush to use mouth tapeBut even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.And meanwhile, there are the potential dangers to be avoided.Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.Mouth breathing could be a sign of something serious — so find outThe safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.”The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.

    Doctors say don’t do it.

    Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.

    “The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.

    It is better to breathe through your nose most of the time

    Mouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.

    If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.

    Don’t rush to use mouth tape

    But even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.

    There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.

    And meanwhile, there are the potential dangers to be avoided.

    Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.

    Mouth breathing could be a sign of something serious — so find out

    The safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.

    You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.

    “The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”

    The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

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  • Some people tape their mouths shut at night. Doctors wish they wouldn’t

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    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.Doctors say don’t do it.Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.”The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.It is better to breathe through your nose most of the timeMouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.Don’t rush to use mouth tapeBut even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.And meanwhile, there are the potential dangers to be avoided.Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.Mouth breathing could be a sign of something serious — so find outThe safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.”The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

    Having your mouth taped shut is the stuff of nightmares — but some people are doing just that to themselves. And in an attempt to sleep better, no less.

    Doctors say don’t do it.

    Some on social media say it’s a hack for getting more and better sleep and to reduce snoring. The claims — which are not backed by science — are taking off on places like TikTok, sometimes pushed by people working for companies selling related products.

    “The studies behind mouth tape are small, the benefits are modest and the potential risks are there,” said Dr. Kimberly Hutchison, a neurologist and sleep medicine expert at Oregon Health & Science University. Some of those risks include making sleep disorders like sleep apnea worse, or even causing suffocation.

    It is better to breathe through your nose most of the time

    Mouth breathing in adults is not a major health problem, but it is better to breath through your nose, experts say. Your nose is a natural filtering system, trapping dust and other allergens before they can get to your lungs.

    If you’re breathing with your mouth open at night, you could wake up with a dry mouth and irritated throat, which can contribute to bad breath and oral health problems. Mouth breathing is also associated with more snoring.

    Don’t rush to use mouth tape

    But even though breathing through your nose is better than breathing through your mouth, taping your mouth shut isn’t the best way to fix the issue.

    There’s no strong evidence it helps improve sleep. A few studies have been conducted, most of which showed little or no impact, but they were so small experts say conclusions should not be drawn from them.

    And meanwhile, there are the potential dangers to be avoided.

    Dr. David Schulman, a sleep doctor at Emory University, said there are other things to try, like prescription mouth pieces that can open up your airway, or a CPAP machine. If you’re a smoker or are overweight, for example, quitting smoking and losing weight can help.

    Mouth breathing could be a sign of something serious — so find out

    The safest approach is to figure out why exactly you are breathing with your mouth, because there could be something else going on.

    You may be breathing through your mouth because you have obstructive sleep apnea, a sleep disorder where breathing repeatedly stops and starts during sleep because of a blocked airway. The disorder is linked to both open mouth breathing and snoring, and is typically treated with a CPAP machine.

    “The reason sleep apnea can be bad is that any decrease in the quality of sleep can affect you day to day or over the course of your life,” said Dr. Brian Chen, a sleep doctor at the Cleveland Clinic. “Depending on how bad the sleep is, you may just feel sleep deprived or require more sleep.”

    The best thing to do, Emory’s Shulman says, is get a sleep test, some of which can be done at home. “It’s always better to know than not know,” he said. “And if you know that something’s going on and you choose not to pursue therapy, at least you know you’re making an educated decision.”

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  • Cannabis Provides Benefits for Sleep Apnea Patients

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    Forty percent of sleep apnea patients enrolled in Minnesota’s medical cannabis access program experienced significant and sustained improvements in their sleep following the use of medical cannabis products, according to data provided by researchers at the Minnesota Office of Cannabis Management.

    State investigators analyzed data from 3,102 first-time patients with obstructive sleep apnea (OSA). They reported that 40 percent of patients “experienced significant improvement in their sleep within four months of beginning treatment and were able to maintain the sleep improvement for an additional four months.” Over half of those who experienced moderate to severe fatigue upon enrollment also reported significant improvements in their symptoms.

    “These numbers show meaningful changes in disturbed sleep and fatigue for patients after starting medical cannabis,” said OCM Senior Researchers Grace Christensen. “Obstructive sleep apnea can affect a patient’s mental health and physical health, so helping patients treat their symptoms can have a holistic outcome on their well being.”

    Over a third of OSA patients who reported experiencing symptoms of depression or anxiety upon enrollment also acknowledged mental health improvements following cannabis treatment.

    The study is the largest ever conducted assessing cannabis use in patients with obstructive sleep apnea.

    Clinical trials have previously concluded that the use of oral THC (dronabinol) mitigates symptoms in sleep apnea patients. Several studies have also linked the use of cannabis to improvements in patients with insomnia. Data published in 2022 in the Journal of Cannabis Research found that over half of adults who consume cannabis for purposes of self-medication do so to address sleep disturbances.

    “Consumers have long utilized cannabis as a sleep aid and these new data substantiate their experiences,” NORML’s Deputy Director Paul Armentano said. “Those involved with Minnesota’s medical access program are to be commended for not only providing regulated cannabis products to those who need them, but also for collecting and making available this important data so that it can be shared with other regulators, policymakers, patients, and their physicians.”

    Over 26 percent of adults between the ages of 30 and 70 years are estimated to suffer from sleep apnea. However, most patients are unaware that they have it. Sleep apnea is a chronic disease that increases one’s risk of high blood pressure, heart disease, Type 2 diabetes, stroke and depression.

    Minnesota regulators added obstructive sleep apnea to its medical cannabis program as a qualifying condition in 2018.

    Prior analyses of patients enrolled in Minnesota’s medical cannabis registry have reported that those suffering from chronic pain and post-traumatic stress experience clinically meaningful reductions following cannabis therapy.

    The full text of the study, “Obstructive Sleep Apnea Patients in the Minnesota Medical Cannabis Program,” is available from the Minnesota Office of Cannabis Management. Additional information on cannabis and sleep apnea is available from NORML’s publication Clinical Applications For Cannabis & Cannabinoids.

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  • Overactive Bladder: How a Bladder Diary Can Help

    Overactive Bladder: How a Bladder Diary Can Help

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    Overactive bladder (OAB) is an umbrella term for several urinary symptoms. The most common symptom is a sudden urge to urinate that you can’t control. Other symptoms include leaking urine, frequent urination, and waking up at night to urinate. 

    OAB is a common condition, affecting as many as 40% of women and 30% of men in the United States. It can usually be managed with lifestyle changes, prescription medications, botulinum toxin (Botox) treatments, nerve stimulation, and, in severe cases, surgery. 

    Whether you’ve already been diagnosed with OAB or you suspect you have it, you may want to consider keeping a bladder diary. This can give you clues about what’s behind your OAB symptoms and even help you manage them. 

    “The bottom line is, these are very easy to do,” says Howard Goldman, MD, a urologist at Cleveland Clinic. “They don’t cost anything, there’s no risk, and many of the guidelines on how to treat overactive bladder suggest that a keeping a diary before starting treatment can be very helpful.”

    How a Bladder Diary Can Help

    There are several reasons you may want to start a bladder diary.

    To gather data for yourself: “If you think something might be going on, keeping a bladder diary could be really helpful just to see how often you’re really going to the bathroom and when you leak urine,” says Margaret Mueller, MD, a urogynecologist at Northwestern Medicine in Chicago. 

    That said, Mueller notes that women in particular tend to think that they urinate too frequently because “their bladder is interfering with their being able to do 100 million things in a day.” In reality, she says they’re often within the range of normal. A bladder diary can show this and give you reassurance.

    To take to your health care provider: If you decide to see your health care provider about your symptoms, it’s helpful to have a bladder diary completed. For instance, keeping track of how much you’re urinating can give your provider a much better sense of how much your bladder can hold and how much you’re actually going to the bathroom. “We have patients who think they’re going all the time, but you see their diary and they’re only going five times,” says Goldman. “It’s a big difference if someone’s holding just 6 ounces in their bladder versus 15 ounces.”

    To pinpoint behaviors that you can change: Maybe you’re having bothersome symptoms like having to go to the bathroom too often or needing to run to get to the bathroom in time. Goldman says a bladder diary may show you some behaviors that you can change on your own before you even go to the doctor. 

    For example, you might see that you’re drinking a lot right before you go to bed or consuming more Diet Cokes a day than you thought. “Sometimes, part of the OAB problem is that someone may be taking in too much fluid or too much caffeine, which may be an underlying contributing factor,” Goldman says.

    When your health care provider requests it: Goldman has his patients keep a bladder diary when he first sees them. “It’s most important right at the start to get some idea of what’s going on,” he says.

    Both Mueller and Goldman also sometimes have their patients keep a bladder diary when they start a new treatment or to measure their response to treatment. “There are some therapies where we may do a trial. In those cases, we may do a diary beforehand and then during the therapy to get a sense of how much it’s helping,” Goldman says.

    Mueller uses a bladder diary to see how often her patients leak urine with a strong urge to go to the bathroom and how often they leak urine with coughing, sneezing, etc. She also wants to see how often they’re urinating. This combination helps her determine what treatment may be needed.

    “Let’s say there’s no leakage, but they’re going to the bathroom every 30 minutes,” Mueller says. “You might be able to do an intervention called timed voiding, which is basically retraining the bladder. This has been shown to be effective.” In this example, you would try to stretch out going to the bathroom to an hour instead of 30 minutes. Gradually, you would keep adding another 30 minutes until you’re urinating every 2 hours.

    When you get up multiple times during the night: A bladder diary is important for people who urinate often at night “because we can see if they’re putting out more urine at night than they should,” says Goldman. Typically, you should urinate less than a third of your total volume of urine at night, he explains. If you’re voiding more than that, this could indicate other medical problems that are causing your body to put out more fluid in the evening.

    One of the more common causes of making too much urine at night, known as nocturnal polyuria, is obstructive sleep apnea. “When you have obstructive sleep apnea, you make less antidiuretic hormone because the body thinks it’s daytime and makes urine like normal,” says Mueller. If someone has risk factors for sleep apnea such as snoring, overweight, or obesity, “we’ll typically have them referred for a sleep study to see if that might be part of the picture,” she says. “The benefit is that sleep apnea is reversible and getting treated for it can really reduce those bladder symptoms.”

    How to Keep a Bladder Diary

    Pick your tracking method. You can write your bladder diary in a notebook, download a template and print it out (Goldman recommends this one), or find an app for your phone. There are even companies that sell cups that measure your urine and automatically upload your volume to an app, according to Goldman. “Your average person probably doesn’t need to be that fancy though,” he says.

    Keep the diary for 3 days. One day isn’t enough because things can change too much from day to day, Goldman says. “There have been studies that show that a 3-day diary isn’t much different than longer diaries, so 3 days is short enough to get a sense of what’s going on but long enough to give you an accurate idea,” he explains. 

    Use 24-hour periods. Start tracking when you wake up in the morning. You don’t have to track for 3 days in a row, but you should do 24 hours at a time. For example, if you get up at 7 a.m. the first day, fill out your diary until 7 a.m. the next day.

    Measure your urine. You’ll need a cup unless you have a collection device from your health care provider. A measuring cup is a good choice so you can see exactly how much you’ve passed. You’ll need to rinse the cup or collection device with water after every use. Be sure to measure and keep track of how much urine you pass both during the day and at night.

    What to Track

    Use a bladder diary to track information and symptoms such as:

    • How much fluid you drink
    • How often you drink
    • How often you urinate
    • How much you urinate
    • How often you feel an urgent need to urinate
    • When and how much urine you leak, if applicable

    Talk to Your Health Care Provider

    Goldman stresses that it’s important to have your health care provider check everything out if you have OAB symptoms. “There’s everything now, from certain exercises to plenty of medications to Botox injections and pacemakers,” he says. “We can do all kinds of things, so OAB is not something people should have to live with.”

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