Sleep, Brain, Heart Smart

                     A Spokane forum helping translate medical research into practical tools
                                               for patients and  local organizations.



PREVENTIVE MEDICINE

Cognitive Fitness
a new online course from Harvard Medical School

Declining brain health and memory loss are not inevitable parts of aging! 

This course will show you: ·  Why high blood sugar is linked to memory loss ·  The key to being able to fight the brain changes linked to dementia and Alzheimer's disease ·  Why sleep may help wash away beta-amyloid plaques linked to Alzheimer's disease ·  How exercise lowers the risk for dementia and boosts development of new neurons ·  Two new tests that help doctors treat Alzheimer's earlier



Breast Cancer Mortality Doubled by Short Sleep and Frequent Snoring

In a longitudinal  study of 21,230 women diagnosed with a first primary invasive cancer, sleeping less than 6 hours per night and frequent snoring (5 or more nights per week) was associated with an increase in mortality – especially for breast cancer patients, who showed a two-fold increase in the risk of dying from this malignancy, when compared to control patients.

Short Sleep Duration Along with Frequent Snoring May Influence Breast Cancer Survival




Sleep Apnea and Atrial Fibrillation

Obstructive sleep apnea (OSA), which occurs in 21% to 80% of patients with atrial fibrillation (AF), has been shown to decrease the effectiveness of  treatments for AF.  For untreated OSA patients, the rate of AF recurrence was more than double that of non-OSA cases (Fein 2013).  However,  in apnea  patients who were treated with CPAP, the rate of atrial fibrillation recurrence was much lower – similar to patients without OSA. Since atrial fibrillation is a risk factor for stroke and heart failure, prompt identification and treatment of OSA  is an important aspect of AF management.

 Atrial fibrillation and sleep-disordered breathing

 Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation.


Periodontal bacteria increase risk of heart attack

The odds of a heart attack increase with the severity of gum disease and the presence of certain bacterial species. In particular, the presence of P. gingivalis is associated with a 13-fold increase in the risk of an acute myocardial infarction. 

Clinical periodontal and 
microbiologic parameters in 
patients with acute 
myocardial
infarction
.




A cardiology perspective on systemic inflammation - causes and treatment

Cardiologist Jason Wischmeyer talks about the Oral Systemic link and coordinated inflammatory risk management 

Youtube Videos

https://www.youtube.com/watch?v=j1sw9_Hkth4

https://www.youtube.com/watch?v=LOP7D7-9xxo



Sleep Apnea and Sleep Deprivation: The Less You Sleep, the More you Eat!

Virend Somers, M.D., Mayo Clinic, shares the correlations between sleep, obesity, healthy behaviors and overall wellness.

See Youtube Video

https://www.youtube.com/watch?v=I8oXCiLw5tA


 















BRAIN HEALTH

Prevention Still Key in Controlling Alzheimer's Disease

Pfizer is ending a massive research effort for drugs to treat Alzheimer's and Parkinson's, according to NPR.  This is “further evidence that pharmaceutical approach to Alzheimer’s is not the solution. Prevention is.” comments Dr Ayesha Zahir Sherzai, Co-Director of the Brain Health and Alzheimer's Prevention Program at Loma Linda University and author of

The Alzheimer's Solution: A Breakthrough Program to Prevent and Reverse the Symptoms of Cognitive Decline at Every Age


Sleep Apnea Triples the risk of Parkinson’s Disease in Women

In a study of over 9000 patients, women with obstructive sleep apnea who were followed over a period of 5 years had more than triple the risk of developing Parkinson’s Disease, when compared to similar patients without sleep-disordered breathing. The reseachers speculate that  the intermittent hypoxia typical of sleep apnea, which is known to cause inflammation and oxidative stress, may also affect the dopaminergic system.



Sleep Apnea a Risk Factor for Dementia  

A 2011 study published in JAMA showed that women with moderate to severe sleep apnea were almost twice as likely to develop mild cognitive impairment or dementia (OR 1.85).

Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women



Sleep Apnea Promotes Earlier Onset of Alzheimer's Disease 

Patients with untreated sleep apnea showed mild cognitive impairment about 13 years earlier and Alzheimer’s disease 5 years earlier than patients with no sleep-disordered breathing, according to a 2015 Neurology study.  However, treatment with CPAP delayed the age of cognitive impairment onset by approximately 10 years.

Sleep-disordered breathing advances cognitive decline
in the elderly


Slowing Down Cognitive Decline in Alzheimer's Patients

While the prevalence of sleep apnea in elderly patients with dementia is 48%  (Onen 2010), a 2014 study shows that CPAP treatment of severe sleep apnea in mild-to-moderate Alzheimer’s Disease patients was associated with significantly slower cognitive decline over a three-year follow-up period.

Treatment of sleep apnoea syndrome decreases cognitive 
decline in patients with Alzheimer's disease

 Obstructive sleep apnea and cognitive impairment in the elderly


Gum Disease a Major Risk Factor in Stroke and Alzheimer's 

Patients with severe periodontitis have 3 times the chance of experiencing a stroke compared to controls. The risk of dementia increases nine times in subjects with a history of  ischemic stroke. 

 Alzheimer’s disease and periodontal disease: mechanisms underlying a potential bidirectional relationship.




SLEEP TIPS AND HEALTH CARE TRENDS

Why can't I stay asleep?

For most insomniacs with middle-of-the-night awakenings, often undiagnosed breathing events are the most common cause of insomnia

A Missing Link: Dr Barry Krakow’s Research on Insomnia and SDB


Second-Hand Snoring?

Bed partners of snorers 
can lose one hour of sleep per night, are 3 times more likely to develop insomnia and 3 times more likely to sleep apart. 

“Anchor Sleep” Approach to Management of Sleep Disorder in Shift Workers

Designating 3-4 hours that will remain constant on both workdays and off-days increases the quantity of sleep and makes sleep schedules more consistent, while minimizing lifestyle disruption. “Light brake”, melatonin, family schedule changes may also help establish a supportive sleep pattern. 

http://www.sleepreviewmag.com/2016/03/anchor-sleep-survive-shift-work/

 


Cognitive Behavioral Therapy Recommended as First Treatment for Chronic Insomnia

New Guidelines from the American College of Physicians recommend that Cognitive Behavioral Therapy be used as a first line therapy by primary care physicians for the management of insomnia, with sleep medications to be considered if CBT-I alone is not successful. Cognitive behavioral therapy (which includes behavioral interventions such as sleep restriction and stimulus control, and education such as sleep hygiene) has fewer side effects and long-term benefits, while sleep meds should ideally only be used for only a few weeks. “Before continuing drug therapy, doctors should consider treatable secondary causes of insomnia such as depression, pain, enlarged prostate, substance abuse disorders, and other sleep disorders like sleep apnea and restless legs syndrome”, according to Dr. Wayne Riley, ACP President.

http://www.sleepreviewmag.com/2016/05/acp-recommends-cognitive-behavioral-therapy-initial-treatment-chronic-insomnia/


Mobile App to Increase CPAP Adherence

Patients struggling with CPAP can now get help through a new mobile app. A new study shows that users of Phillips Respironics' SleepMapper app were 22 percent more adherent to continuous positive airway pressure than non-users. Patients can access the usage data generated by their CPAP machine, then receive  feedback and specific goals which attempt to increase adherence through a behavior-changing protocol.

P SleepMapper app boosts CPAP adherence 22 percent


MySleep101, developed by a physician at the Johns Hopkins Center for Sleep, provides quickly accessible information on the most common conditions resulting in poor sleep quality, including sleep apnea, insomnia, hypersomnia, circadian rhythm disorder, restless leg syndrome, PTSD and parasomnia.  





Tips on better sleep strategies from Harvard expert Dr. Charles Czeisler

See Youtube Video




Treating Sleep Apnea Improves Depression Symptoms

A 2014 meta-analysis published in PLoS Med shows that both CPAP and Oral Appliance Therapy resulted in significant improvement in depressive symptoms when compared to controls.


Also see 

CLEVELAND CLINIC Video