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June 08, 2010

Sleep Apnea: Higher Health Risks, New Treatments


A  case of sleep apnea, as physicians are well aware, involves more than just the annoyance and embarrassment of night-time snoring. It's a serious health risk. In fact, new data from the Sleep Heart Health Study indicates that obstructive sleep apnea more than doubles the risk of stroke in men. Men with moderate to severe cases were three times more likely to suffer strokes; men with mild cases and women with severe OSA were also at increased risk.

This new study on sleep apnea and stroke risk adds to the already long list of health problems associated with OSA. According to the National Institute of Health, these include high blood pressure, heart attack, irregular heartbeats, heart failure, obesity, diabetes, and death from any cause. However, while more than 12 million Americans are believed to have the condition, very few of them are being diagnosed and treated.

On a brighter note, there have been a number of announcements in the last few months about new products in OSA diagnosis and treatment, including those reported on the Medgadget web site. These treatments range from improvements in appearance and comfort for PAP users, to the development of sophisticated hospital-based diagnostic tools.

Portable Sleep Lab
GE Healthcare recently introduced the MARS Virtual Sleep Lab, which integrates a sleep disorder diagnostic tool into a hospital cardiac care setting. Designed to work with any GE-monitored inpatient bed, it offers a 'streamlined view of quantitative cardiac and sleep apnea analysis,' with the goal of increasing the speed of diagnosis. According to GE's Press Release, OSA impacts up to 50 percent of all heart disease patients; early diagnosis and treatment has been shown to improve cardiac conditions.

The MARS VSL is powered by the WideMed Morpheus Hx sleep apnea diagnosis program, and it automatically reports on data such as apnea hypopnea index, sleep staging, and respiratory events. The device also provides quantitative Holter analysis, and directly links into a central station monitor that can assimilate data from multiple monitoring sources.

PAP Advances
Back in October, Philips announced the next generation of their Respironics Sleep Therapy System. The new product line features event detection software and expanded reporting capabilities, which can detect symptoms beyond OSA. A three-layer algorithm distinguishes between obstructed and clear airway apneas and periodic breathing. Also featured are enhancements to the data management system, the user interface, humidity control, and patient comfort.

In addition, a few months later Philips (News - Alert) introduced the BiPAP autoSV Advanced for treating more complicated cases such as complex sleep apnea or Cheyne-Stokes Respiration. The BiPAP autoSV Advanced features an auto adjusting EPAP, which can distinguish between obstructed and clear airway apneas and adapt pressure as patients' conditions change.

Fisher & Paykel also announced a new CPAP, the ICON, which made its debut in Australia and New Zealand and will expand to other markets later in the year. ICONs are billed as 'stylish, compact, and intelligent.' The devices are designed with a small footprint, and include a digital clock, alarm, and music playing capabilities.

The new ICONs incorporate existing Fisher & Paykel technologies such as SmartStick, ThermoSmart, SensAwake, and InfoSmart.

Neurostimulation
ImThera Medical, Inc, a San Diego start-up, announced development of its Targeted Hypoglossal Neurostimulation system as a surgical alternative for the substantial number of OSA patients who do not comply with CPAP. Using a multi-contact electrode and a programmable implantable pulse generator, the aura 6000 system delivers neurostimulation to the hypoglossal nerve to control tongue muscles and prevent the tongue from collapsing into the upper airway.

Oral Appliance
And finally, SomnoMed of Australia is marketing an oral device for the treatment of OSA, called the SomnoDent MAS. It's worn during sleep 'to maintain the patency of the upper airway by increasing its dimensions and reducing collapsibility.' The device is custom-made, and has a fin coupling component that maintains mandible protrusion while allowing the mouth to open and close normally. The device features 'a streamlined design with minimal bulk.'

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