Nikhil Rao, MD, identified antidepressants that work well with specific sleep disorders, including insomnia, restless legs syndrome (RLS), and obstructive sleep apnea, reports Psychiatric Times.

Mirtazapine and trazodone are two antidepressants that help patients fall asleep and improve their sleep architecture. However, mirtazapine’s sedative effects are greater in the lower dose range (15 mg and below), which may not treat depression. Trazodone also has limitations.

Get the full story at www.psychiatrictimes.com

Neomi Shah, the associate division chief of Pulmonary Critical Care & Sleep Medicine at Mount Sinai, talked with MD Magazine while at ATS 2019 to define the currently-understood state of sleep condition-cardiovascular risk overlap.

So it’s a little puzzling, because we’ve shown that it is a risk factor for cardiovascular disease, but when we treated, it didn’t really make the impact that we were hoping for it to make. We’re in a state of a little bit of confusion, and we’re really trying to dig deep in terms of the mechanisms—as to what it is about the obstructive sleep apnea that was causing this increased risk factor. I think the awareness is there. It may not be as prominent as it is for diabetes, but I think it has been well-known.

Get the full story at www.mdmag.com

A study of more than 19,000 people has found that women with obstructive sleep apnea (OSA) are more likely to be diagnosed with cancer than men with the condition, according to research published in the European Respiratory Journal.

OSA, where the airways close completely or partially many times during sleep, reduces the levels of oxygen in the blood, and common symptoms include snoring, disrupted sleep, and feeling excessively tired. The new study suggests that people who experience more closures of the airways during sleep and whose blood oxygen saturation levels drop below 90% more frequently are more likely to be diagnosed with cancer than people without OSA.

The study also found that cancer was more prevalent among women with OSA than men, even after factors such as age, body mass index (BMI), smoking status, and alcohol consumption were taken into account, suggesting women with OSA may be at greater risk of being diagnosed with cancer than men with OSA.

The study was led by Athanasia Pataka, assistant professor of respiratory medicine at Aristotle University and who works at the

ResMed revealed several demographic and clinical factors affect adherence to PAP (positive airway pressure) therapy, according to a study it presented at the American Thoracic Society’s ATS 2019 International Conference.

The study found significant differences in one-year adherence between people of different ages and disease severity levels:

• Men with sleep apnea are 8.5 percentage points more likely to stay adherent on PAP therapy than women.
• People over age 60 were 7.3 percentage points more adherent than the entire study cohort (77.7% vs. 70.4%).
• People with self-reported severe sleep apnea were 78% adherent at the one-year mark, compared to 70.5% of those with self-reported moderate sleep apnea, and 65.2% of those with mild sleep apnea.

“Sleep specialists, pulmonologists, and primary care physicians should heed these results and ensure that their younger, female, and more mildly diagnosed patients have the proper supports to stay on therapy,” said Adam Benjafield, a study coauthor and ResMed’s vice president of Medical Affairs, in a release. “Regardless of why these gaps exist, we know they do, signaling the need to keep in close contact with patients

How to get your whole team on board with dental sleep medicine.

By Kent Smith, DDS, DABDSM, ASBA

The prevalence and under-treatment of obstructive sleep apnea (OSA) in the general population is alarming. To begin, an estimated 30 million Americans suffer from the disorder, yet 80% of those cases remain undiagnosed.¹ Couple that with the fact that the population of Americans age 65 and older—an age group at high risk for OSA—is projected to more than double from 46 million to over 98 million by the year 2060.²

For those who have been diagnosed with OSA, continuous positive airway pressure (CPAP) is the accepted gold standard for treating the condition. However, low adherence rates mean many patients remain ineffectively treated, leaving them at risk for a host of associated comorbidities and in need of an alternative option. The convergence of these realities provides dentists a golden opportunity to help address this public health epidemic by incorporating dental sleep medicine (DSM) and the administration of oral appliance therapy (OAT) into their dental practices.

When implemented correctly and

A woman’s life changes *dramatically* after discovering she had a sleep disorder, reports WPSD.

Krafton was scared. In 2014 she was diagnosed with sleep apnea. Five years later, she’s checking in with Dr. Lisa Buford regularly at the Midtown sleep Center. “She came to me with symptoms of snoring and increased daytime somnolence. Also a BMI body max index of 30 or greater is a risk factor of sleep apnea,” said Dr. Buford.

Get the full story at www.wpsdlocal6.com

For Duke University School of Medicine’s third and final “Neurology and Women’s Health” interview for 2019, Andrew Spector, MD, talks about how insomnia, sleep apnea, and other conditions affect women. 

Unfortunately, we still have a society where women are expected to not only do more work around the home, but studies shown that women also more work when they’re at work. Putting in longer hours of work, whether they’re paid or not, can reduce the opportunity to sleep. Doing more work often leads to less time to sleep. And women are vulnerable to the same lifestyle factors that affect all genders: alcohol, tobacco, and caffeine, for example, can all sabotage sleep and should be avoided close to bed. In fact, to get high-quality sleep, avoid caffeine after noon.

Get the full story at neurology.duke.edu

Srinivasan Devanathan, medical director of Parkview Health Sleep Centers, said that sleep apnea is a prevalent disorder and is getting diagnosed more and more each year because people are more aware of it, reports KPC News.

“People are often told that they snore, their bed partner may be concerned that they are holding their breath, snoring loudly, they may wake up with headaches in the morning, they can wake up with the sensation of having acid reflux, their chest could be pounding with the heart beating faster, waking up often to use the restroom and have excessive daytime sleepiness,” Devanathan said.

Get the full story at kpcnews.com