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A news story from the BBC mentioned today that a truck driver has been acquitted of killing the driver of another vehicle because the truck driver had been diagnosed with sleep apnea. In the aftermath of the trial, the victim’s father is calling for Great Britain to test all truckers for sleep apnea.

This is an understandable reaction. And the concept of testing is not without merit. In fact, we certainly support the testing of over the road truckers, bus drivers, pilots, air traffic controllers … anyone, in fact, who demonstrates certain risk factors of sleep apnea.

That’s important. “Blanket” testing of everybody, as some have called for, is not reasonable. But it certainly is reasonable to find a way to identify people who are at risk and, if their employment requires them to have the safety of others in their hands, get them tested for sleep apnea.

Certain factors that should be considered collectively are body mass index, neck circumference measurement, and signs of poor sleep … excessive daytime tiredness, frequent headaches, tendency to doze off even briefly at inappropriate times.

What do you think?

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Over the last two years, the Sleep Wellness Institute has partnered with Kleen Test Products (KTP) to study the effect of screening, testing and treatment of Obstructive Sleep Apnea (OSA) on a volunteer segment of their employee population. Through numerous benefits programs, Kleen Test rewards employees for healthy lifestyles and offers many programs to improve the well-being of all who work for them. This study offered a unique opportunity to learn about OSA, provide treatment to those employees affected and determine if OSA increased employee/employer healthcare costs.

KTP has a workforce of 585 employees. Our original recruitment target was to get sixty volunteer employees to come forward – with 20 in each group. After recruitment we were able to start with 65 employees (representing 11% of the company’s workforce.)
To cost-effectively determine which employees had OSA, we initially used an at-home portable ApneaLink screening device for one night. Those employees who showed potential OSA from the results of the ApneaLink screening were given an overnight sleep study. The results of each sleep study were interpreted by a board certified sleep physician to confirm if the employee had OSA. The results of the sleep studies demonstrated that 33 of the KTP employees showed no evidence of OSA, 27 showed evidence of OSA, and 5 subjects withdrew from the project.

We are still in the process of collecting data regarding healthcare usage during the 12 months each employee was in the study. Our targeted completion date is October 8, 2009. Once all data have been collected we will be able to make assertions and findings that are statistically significant. However, of the 65 employee volunteers there are 11 employees diagnosed with OSA using their CPAP devices for 4 or more hours per night, preliminary data shows a trend of reduction in healthcare spending. (To date, the reduction in spending in this group of employees is down from an average of approximately $3,900 per employee to $205 per employee.) The premise of the trial does appear to be valid – patients suffering from Obstructive Sleep Apnea use more healthcare than non-OSA sufferers. During the next year, we will continue to collect compliance and healthcare spending data to determine what effects CPAP set-up and screening have on healthcare costs of OSA patients.

The cost of diabetes in this country will rise to more than $200 billion per year. That point makes it more important than ever that medical professionals include asking questions about sleep while making their diagnosis, since it has now been shown that 58% of diabetics have some form of sleep disordered breathing.

At the same time, 40% of all obstructive sleep apnea (OSA) patients have diabetes.

In  patients who have both, the most commonly prescribed treatment for OSA, continuous positive airway pressure (CPAP) can help in the more effective management of diabetes, thereby reducing hospitalizations and healthcare costs related to diabetes.

If you or someone in your family has diabetes, snores at night and feels exhausted during the day, ask your physician about sleep apnea.  It’s too important to ignore.

Steve Gardner

Sleep Wellness Institute

We’ve spent a lot of time here in the Milwaukee area over the past year or so talking about how complications of sleep apnea kill 38,000 Americans each year. At first, people didn’t want to believe it.

But now Dr. Terry Young, professor of epidemiology at the University of Wisconsin-Madison, and his colleagues have published the results of the Wisconsin Sleep Cohort Study in an article entitled “Sleep-Disordered Breathing and Mortality: Eighteen-year Follow Up of the Wisconsin Sleep Cohort” in the Journal SLEEP.

Almost as important as the results of the study … essentially that those people with untreated sleep apnea are at a greater risk of death from causes such as cardiovascular disease and stroke … was Dr. Young’s comment that “I was surprised by how much the risks increased when we excluded people (from the study) who reported treatment with CPAP (continuous positive airway pressure).” Dr. Young said the findings suggest that people diagnosed with sleep apnea should be treated, “And if CPAP is the prescribed treatment, regular use may prevent premature death.”

Dr. Young and his colleagues have done a great service to those with undiagnosed sleep apnea. And now it is up to medical professionals and the public to take the next step … get checked for sleep apnea. If you snore at night and are exhausted during the day, take the time to find out. It could save your life.

Steve Gardner

Here’s good news for all those who use CPAP therapy for sleep apnea and would like some tips on making things easier.

Mark Stoiber, President of the Sleep Wellness Institute, has published a book entitled “How to Guarantee Your Experience with CPAP is a Happy One.” Mark has 21 years of experience in the sleep disorders field and has seen literally thousands of people turn their lives around from the misery of terrible sleep to the joy and relief of refreshing, restorative sleep through CPAP therapy.

You can download Mark’s book for $3.75 through clicking here. You can also order a paperback copy for $7.97. If you buy the paperback version, $1.00 will automatically be donated to the Reggie White Sleep Disorders Research & Education Foundation.

Steve Gardner

This is the fourth in a series of blog posts about alternatives to continuous positive airway pressure for people with obstructive sleep apnea.

Many people have heard of “CPAP Pro.”  This is advertised as “no mask.”  The reality is that the straps used on a mask are replaced with a bite guard to hold everything in place.  Any movement of the jaw or mouth can cause air to leak or the device to fall off.

The major problem with this product is that it leaks air.  Leaks prevent the effective positive pressure, prescribed by a physician, from reaching the patient.

 

This is another in a series of postings about products sometimes misinterpreted and misused as “treatments” for obstructive sleep apnea (OSA).

Provigil

This medication is approved for use in decreasing daytime sleepiness, which is one of many symptoms of sleep apnea, but is not considered a treatment for OSA.

  • The company’s website carries a disclaimer that clearly states “In patients with OSA, Provigil is used along with other medical treatments for this sleep disorder.  Provigil is NOT a replacement for your current treatment.
  • Patients may no longer feel sleepy during waking hours when taking Provigil, leading them to believe they no longer need to continue their OSA treatment.  But, the medical risks associated with OSA could still affect the patient.

OSA patients need to closely follow their doctor’s guidelines for treatment.

Luke Goodpaster

Director of Research

The Sleep Wellness Institute will open CPAP2GO, a retail store specializing in continuous positive airway pressure (CPAP) machines, masks and supplies that are used to help many people with obstructive sleep apnea, on July 8. It will be the only store of its kind in Wisconsin operated by a sleep disorders center.

The store, at 7017 S. 27th Street, Franklin, will be open Monday through Saturday, with evening hours Monday through Friday. It will be staffed by specially trained employees, most of whom are on CPAP therapy, themselves, and will feature the “30/30 Advantage” – an in-stock supply of more than 30 masks and a free 30 night comfort and fit guarantee. Much of the equipment will be covered by most health insurance.

According to Sleep Wellness Institute President Mark Stoiber, the store is a natural development given the success of the Institute’s professional CPAP services. “Our approach to working with people on CPAP has yielded more than an 85% compliance rate with treatment, as opposed to about 55% nationwide,” he explained. “We believe we can successfully grow our business while helping more people by having a store located in a convenient, high traffic retail business area.”

People with sleep apnea are aroused briefly several times per hour every night as the tissues around their airway collapse and prevent them from breathing. Complications can include cardiovascular disease, stroke, diabetes, depression, and even death. The CPAP equipment provides a continuous, gentle positive air flow that keeps the patient’s airway open and eliminates snoring. It is considered the “gold standard” in treatment for obstructive sleep apnea.

“Expert knowledge, wide selection and an unmatched dedication to customer service will be the hallmarks of CPAP2GO,” Stoiber said. “All too often we encounter people who have purchased CPAP equipment elsewhere, including from the internet, and then have been unable to get the follow-up service they need, at the times they need it. We intend to make a difference for those people.”

Stoiber said the store will offer the same CPAP products and service that are provided at the Sleep Wellness Institute, but in a second location that offers excellent freeway access and foot traffic. It is located in front of a Lowe’s Home Improvement center, he noted.

The store will be managed by Cody Glorioso, who is the director of the Sleep Wellness Institute’s durable medical equipment department. The store’s telephone number will be 414-761-CPAP (2727). A website, http://www.cpap2go.net provides more information.

NOTE:  A second store has opened in Waukesha.  See our blog post “New CPAP2GO Store Opens Today.”

The Sleep Wellness Institute is Wisconsin’s largest independent sleep disorders treatment center. It is fully accredited to diagnose and treat sleep disorders among adults and children by the American Academy of Sleep Medicine.

The CBS program “60 Minutes” took an interesting look at “The Science of Sleep” last night.  If you missed it, click here to visit the 60 Minutes website where you can view the entire segment.

One point that 60 Minutes missed, however:  when showing a young man whose sleep was being disrupted by beeping noises in a research study, reporter Lesley Stahl, who did an otherwise excellent job, failed to mention that the waking caused by those beeps is not at all dissimilar to what occurs for a patient with obstructive sleep apnea.

Mark Stoiber, President

West Allis, Wis. March 11, 2008 — The Sleep Wellness Institute, the state’s largest sleep disorders diagnosis and treatment center, will now offer an inexpensive sleep apnea screening tool for use in the home.

The SleepStrip® costs $25 and allows people who suspect that they may have sleep apnea, a potentially lethal disorder, an easy way to screen themselves for indications of the disease. According to Sleep Wellness Institute President Mark Stoiber, the new tool is the “first step” for people who may be reluctant to undergo full testing initially.

“Sleep apnea can only be diagnosed by a sleep study, and unattended ambulatory studies are considered somewhat less reliable, as shown by Medicare’s recent decision not to provide coverage for them,” he explained. “But for those people who are concerned that they might have sleep apnea and are reluctant to be evaluated, the SleepStrips offer them a way to screen themselves, in effect, and then contribute to a determination with a sleep center if a full sleep study is necessary.”

Stoiber acknowledged that the strip will allow some people to allay their fears by screening out those people who have no apnea present.

Manufactured by Sleep Sense®, a division of Scientific Laboratory Products, the strips are worn under the nose overnight. They contain sensors that track breathing and monitor apnea events. Events are displayed in a one digit number from 0 to 3 that the patient reports to the Sleep Wellness Institute. The reading, combined with information about the patient’s sleep and health history, can be used to make a determination of whether additional testing is necessary. If so, the patient will be invited to consult with a Sleep Wellness Institute sleep specialist.

“We believe that offering the SleepStrip will increase awareness and help to identify people who need treatment for sleep apnea,” Stoiber said. He noted that approximately 16 million Americans are believed to have undiagnosed sleep apnea, roughly the same number of people with diabetes, depression, and asthma.

He stressed that while the new strips should be used for screening purposes only, they could help prevent added expense for some people who will learn that they do not need an overnight study in a sleep center. They are not a replacement for a physician’s diagnosis, he stressed. The strips are approved for use by the FDA, he said.

Steve Gardner