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New study finds epilepsy drug could reduce sleep apnoea symptoms

<p>New research has found that a drug used for epilepsy could be used to reduce the symptoms of sleep apnoea. </p> <p>Obstructive sleep apnoea, which affects about one in 20 people, according to the National Institute for Health and Care Excellence in England, includes symptoms like snoring and it causes a person's breathing to start and stop during the night, with many requiring an aid to help keep their airways open. </p> <p>An international study has identified that taking sulthiame, a drug sold under the brand name Ospolot in Europe, may help prevent patients' breathing from temporarily stopping. </p> <p>This provides an additional option for those unable to use mechanical breathing aids like the Cpap machines. </p> <p>“The standard treatment for obstructive sleep apnoea is sleeping with a machine that blows air through a face mask to keep the airways open. Unfortunately, many people find these machines hard to use over the long term, so there is a need to find alternative treatments,” Prof Jan Hedner from Sahlgrenska university hospital and the University of Gothenburg in Sweden said. </p> <p>Researchers conducted a randomised controlled trial of almost 300 obstructive sleep apnoea patients across Europe, who did not use Cpap machines. </p> <p>They were divided into four groups and given either a placebo or different strengths of sulthiame. </p> <p>The study measured patients’ breathing, oxygen levels, heart rhythm, eye movements, as well as brain and muscle activity while asleep. </p> <p>It found after 12 weeks, those taking sulthiame had up to 50% fewer occasions where their breathing stopped, and higher levels of oxygen in their blood. However, a bigger study needs to be done to confirm the beneficial effects on a larger group. </p> <p>The findings, were presented at the European Respiratory Society Congress in Vienna, Austria. </p> <p>Erika Radford, the head of health advice at Asthma + Lung UK said the findings were a positive step forward in moving away from having to rely on mechanical breathing equipment.</p> <p>“This potential alternative to the current main treatment would make it easier for people to manage their condition,” she said. </p> <p><em>Image: Shutterstock</em></p>

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Why Barnaby Joyce’s TV diagnosis of insomnia plus sleep apnoea is such a big deal

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>The <a href="https://theconversation.com/view-from-the-hill-how-does-david-littleproud-handle-the-latest-barnaby-joyce-embarrassment-223289">health</a> of Nationals MP Barnaby Joyce is in the news again, this time with a diagnosis of a sleep disorder made <a href="https://www.afr.com/companies/media-and-marketing/barnaby-joyce-to-be-diagnosed-with-a-sleep-disorder-on-live-tv-20240223-p5f79q">while filming</a> a TV documentary.</p> <p>Joyce’s diagnosis of insomnia plus sleep apnoea arose while filming <a href="https://www.sbs.com.au/whats-on/article/australias-sleep-revolution-with-dr-michael-mosley/nuyko305b">Australia’s Sleep Revolution with Dr Michael Mosley</a> in 2023. SBS has confirmed episode three, in which my Flinders University colleagues reveal his sleep disorder, is set to air on March 20.</p> <p>I was not involved in the program and have no knowledge of Joyce’s <a href="https://www.theaustralian.com.au/weekend-australian-magazine/australias-sleep-crisis-has-flinders-university-cracked-the-code-to-a-better-nights-sleep/news-story/d3b82617af33fff82487da2534722733">ongoing health care</a>. But I was part of the research team that in 2017 <a href="https://doi.org/10.1016/j.smrv.2016.04.004">coined the term COMISA</a> (co-morbid insomnia and sleep apnoea), the official name of Joyce’s on-screen diagnosis. Since then, I’ve led research into this <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> sleep disorder.</p> <p>Here’s why it’s so important to diagnose and treat it.</p> <h2>What was Joyce’s diagnosis?</h2> <p>People can be diagnosed separately with <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">insomnia</a> or <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/obstructive-sleep-apnoea">sleep apnoea</a>.</p> <p>Insomnia includes frequent difficulties falling asleep at the start of the night or difficulties staying asleep during the night. These can result in daytime fatigue, reduced energy, concentration difficulties and poor mood. Over time, insomnia can start to impact your <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and quality of life.</p> <p>Sleep apnoea (specifically, obstructive sleep apnoea) is when people experience repeated interruptions or pauses in breathing while they sleep. This reduces oxygen levels during sleep, and you can wake up multiple times at night. People with sleep apnoea may be aware of loud snoring, gasping for air when they wake up, or feeling exhausted the next morning. However, not all people have these symptoms, and sleep apnoea can go undiagnosed for years.</p> <p>But in Joyce’s case, both insomnia and sleep apnoea occur at the same time.</p> <p>We’ve known this could happen since <a href="https://doi.org/10.1126/science.181.4102.856">the 1970s</a>, with <a href="https://psycnet.apa.org/doi/10.1037/0022-006X.67.3.405">evidence growing</a> over <a href="https://doi.org/10.1378/chest.120.6.1923">subsequent decades</a>. Since then, sleep researchers and clinicians around the world have learned more about how <a href="https://doi.org/10.1016/j.smrv.2019.01.004">common</a> this is, its <a href="https://doi.org/10.1183/13993003.01958-2021">consequences</a> and how best to <a href="https://doi.org/10.1111/jsr.13847">treat it</a>.</p> <h2>How do you know if you have it?</h2> <p>Many people <a href="https://doi.org/10.1016/j.sleep.2005.08.008">seek help</a> for their sleep problems because of fatigue, exhaustion, physical symptoms, or poor mood during the day.</p> <p>If you think you have insomnia, a GP or sleep specialist can talk to you about your sleep pattern, and might ask you to complete <a href="https://www.sleepprimarycareresources.org.au/insomnia/assessment-questionnaires">brief questionnaires</a> about your sleep and daytime symptoms. You might also be asked to fill in a “sleep diary” for one to two weeks. These will allow a trained clinician to see if you have insomnia.</p> <p>If you or your GP think you may have (or are at risk of having) sleep apnoea, you may be referred for a sleep study. This normally involves sleeping overnight in a sleep clinic where your sleep patterns and breathing are monitored. Alternatively, you might be set up with a recording device to monitor your sleep at home. A trained medical professional, such as a sleep and respiratory physician, will often make the diagnosis.</p> <p><a href="https://doi.org/10.1016/j.smrv.2021.101519">Up to 50%</a> of people with sleep apnoea report symptoms of insomnia. About <a href="https://doi.org/10.1016/j.smrv.2021.101519">30–40%</a> of people with insomnia also have sleep apnoea.</p> <h2>What are the consequences?</h2> <p>Insomnia and sleep apnoea (individually) are associated with reduced <a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">sleep quality</a>, <a href="https://theconversation.com/insomnia-and-mental-disorders-are-linked-but-exactly-how-is-still-a-mystery-212106">mental health</a> and <a href="https://theconversation.com/health-check-heres-what-you-need-to-know-about-sleep-apnoea-26402">physical health</a>.</p> <p>Importantly, people with both at the same also tend to <a href="https://doi.org/10.3390/brainsci9120371">experience</a> worse sleep, daytime function, mental health, physical health and quality of life, compared with people with no sleep disorder.</p> <p>For instance, we know having both conditions comes with an <a href="https://doi.org/10.1111/jsr.13563">increased risk</a> of diseases of the heart.</p> <p><a href="https://doi.org/10.2147/NSS.S379252">In</a> <a href="https://doi.org/10.1183/13993003.01958-2021">three</a> <a href="https://doi.org/10.1016/j.sleepe.2022.100043">studies</a>, we found people with both insomnia and sleep apnoea have about a 50–70% higher risk of dying early from any cause, compared with people with neither sleep condition. People with insomnia alone and sleep apnoea alone did not have an increased risk of dying early.</p> <p>However, there are effective treatments to reduce these health consequences.</p> <h2>How is it treated?</h2> <p>In general, it is best for people to access evidence-based treatments for both disorders. These treatments vary according to the patient and the severity of their condition.</p> <p>For instance, wearing a <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/cpap-continuous-positive-airway-pressure">CPAP mask</a> while sleeping improves breathing during sleep and reduces many of the daytime consequences of obstructive sleep apnoea. However, other effective treatments may be recommended based on each person’s symptoms, such as weight management, avoiding sleeping on your back, <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/oral-appliances-to-treat-snoring-and-obstructive-sleep-apnoea-osa">oral devices</a> (which look a bit like a mouthguard), or surgery.</p> <p>The <a href="https://theconversation.com/how-can-i-get-some-sleep-which-treatments-actually-work-212964">most effective</a> treatment for insomnia is cognitive behavioural therapy for insomnia, also known as <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a>. About four to eight sessions often lead to improvements in sleep, daytime function and mental health that are maintained for many <a href="https://doi.org/10.1080/16506073.2021.2009019">years</a>. This can be delivered by trained therapists such as psychologists, nurses or GPs, as well as via <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online</a> programs.</p> <p>Last year, we drew together evidence from more than 1,000 people with both conditions. We found CBTi is an <a href="https://doi.org/10.1111/jsr.13847">effective treatment</a> for insomnia in people with treated and untreated sleep apnoea.</p> <h2>New treatments and approaches</h2> <p><a href="https://www.frontiersin.org/articles/10.3389/frsle.2024.1355468/abstract">We</a> and <a href="https://doi.org/10.1186/s13063-022-06753-4">other teams</a> internationally are developing and testing new ways of delivering CBTi.</p> <p>Several groups are testing devices, which <a href="https://doi.org/10.1002%2Flio2.761">stimulate</a> the tongue muscles during sleep, to treat sleep apnoea in people with both disorders.</p> <p>And we’re still working out the best order for patients to access treatments, and the best combination of treatments.</p> <h2>The power of TV</h2> <p>Joyce’s public diagnosis of both insomnia and sleep apnoea will no doubt raise awareness of what we suspect is an underdiagnosed condition.</p> <p>Based on how common insomnia and sleep apnoea are in Australia, we estimate Joyce is one of about <a href="https://doi.org/10.1016/j.sleep.2021.03.023">5–10%</a> of Australian adults to have both at the same time.</p> <p>The Conversation contacted Joyce’s spokesperson for comment but did not hear back before deadline.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224616/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-barnaby-joyces-tv-diagnosis-of-insomnia-plus-sleep-apnoea-is-such-a-big-deal-224616">original article</a>.</em></p>

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The growing epidemic affecting tens of thousands of Kiwis

<p>There’s a growing epidemic in New Zealand and it’s costing the nation more than just a good night’s rest – almost <a href="https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2010/vol-123-no-1321/article-gander" target="_blank"><strong><span style="text-decoration: underline;">$40 million each year</span></strong></a>, in fact. And, as our waistlines widen and obesity rates increase, as does the number of people affected by this epidemic. What is it, you may ask? Obstructive sleep apnoea (OSA).</p> <p>According to the <a href="https://www.sleep.org.au/documents/item/78" target="_blank"><strong><span style="text-decoration: underline;">Australasian Sleep Association</span></strong></a>, OSA is defined as “a disorder in which breathing is repetitively interrupted during sleep due to collapse of the upper airway.” Untreated, OSA can lead to hypertension, cognitive impairment, diabetes, sexual dysfunction and even heart disease and stroke – not to mention the impact it can have on the sufferer’s quality of life.</p> <p><strong>Who’s most likely to get it?</strong></p> <p>Obesity is considered to be the main cause of OSA, regular alcohol consumption (particularly at night), certain illnesses (generally thyroid conditions, large tonsils, certain medications, nasal congestion and even facial bone structure can also be contributing factors. It can strike anyone at any age, but men over the age of 65 and those who have a family history of the disorder have a higher risk of developing OSA.</p> <p><strong>The symptoms</strong></p> <p>The severity of each case of OSA varies, but the most common signs include:</p> <ul> <li>Snoring</li> <li>Unrefreshing sleep</li> <li>Tiredness during the day</li> <li>Waking during the night and gasping for air or choking</li> <li>Headaches in the morning</li> <li>Poor memory and concentration</li> <li>Waking up with a sore throat or dry mouth</li> <li>Restlessness and irritability</li> <li>Frequently needing to urinate during the night</li> <li>Weight gain or difficulty losing weight</li> </ul> <p>While normal sleepers’ breathing is interrupted less than five times per hour, OSA sleepers may experience 5 to 15 interruptions (mild), 15 to 30 (moderate) or even more than 30 (severe). These interruptions may last for 10 seconds or more.</p> <p>OSA sufferers usually do not exhibit all these symptoms, but experiencing one or more should be cause for further investigation.</p> <p><strong>Treatment</strong></p> <p>There is currently no cure for the condition, however it is treatable via a number of methods. Making certain lifestyle changes (losing weight, adjusting sleep position, improving sleep habits, lowering alcohol consumption and quitting smoking), may help improve OSA, but Continuous Positive Airway Pressure (CPAP) therapy is the most successful currently available. A CPAP machine involves pumping continuous pressure through the airway via a mask worn over the mouth, nose or both. It essentially holds the airway open and prevents it from closing during sleep.</p> <p>If you’re worried you may be experiencing symptoms of OSA, visit your doctor as soon as possible.</p>

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The growing epidemic affecting hundreds of thousands of Australians

<p>There’s a growing epidemic in Australia and it’s costing the nation more than just a good night’s rest – more than <a href="http://www.sleephealthfoundation.org.au/component/content/article.html?id=76:research" target="_blank"><strong><span style="text-decoration: underline;">$5 billion each year</span></strong></a>, in fact. And, as our waistlines widen and obesity rates increase, as does the number of people affected by this epidemic. What is it, you may ask? Obstructive sleep apnoea (OSA).</p> <p>According to the <a href="https://www.sleep.org.au/documents/item/78" target="_blank"><strong><span style="text-decoration: underline;">Australasian Sleep Association</span></strong></a>, OSA is defined as “a disorder in which breathing is repetitively interrupted during sleep due to collapse of the upper airway.” Untreated, OSA can lead to hypertension, cognitive impairment, diabetes, sexual dysfunction and even heart disease and stroke – not to mention the impact it can have on the sufferer’s quality of life.</p> <p><strong>Who’s most likely to get it?</strong></p> <p>Obesity is considered to be the main cause of OSA, regular alcohol consumption (particularly at night), certain illnesses (generally thyroid conditions, large tonsils, certain medications, nasal congestion and even facial bone structure can also be contributing factors. It can strike anyone at any age, but men over the age of 65 and those who have a family history of the disorder have a higher risk of developing OSA.</p> <p><strong>The symptoms</strong></p> <p>The severity of each case of OSA varies, but the most common signs include:</p> <ul> <li>Snoring</li> <li>Unrefreshing sleep</li> <li>Tiredness during the day</li> <li>Waking during the night and gasping for air or choking</li> <li>Headaches in the morning</li> <li>Poor memory and concentration</li> <li>Waking up with a sore throat or dry mouth</li> <li>Restlessness and irritability</li> <li>Frequently needing to urinate during the night</li> <li>Weight gain or difficulty losing weight</li> </ul> <p>While normal sleepers’ breathing is interrupted less than five times per hour, OSA sleepers may experience 5 to 15 interruptions (mild), 15 to 30 (moderate) or even more than 30 (severe). These interruptions may last for 10 seconds or more.</p> <p>OSA sufferers usually do not exhibit all these symptoms, but experiencing one or more should be cause for further investigation.</p> <p><strong>Treatment</strong></p> <p>There is currently no cure for the condition, however it is treatable via a number of methods. Making certain lifestyle changes (losing weight, adjusting sleep position, improving sleep habits, lowering alcohol consumption and quitting smoking), may help improve OSA, but Continuous Positive Airway Pressure (CPAP) therapy is the most successful currently available. A CPAP machine involves pumping continuous pressure through the airway via a mask worn over the mouth, nose or both. It essentially holds the airway open and prevents it from closing during sleep.</p> <p>If you’re worried you may be experiencing symptoms of OSA, visit your doctor as soon as possible.</p>

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