New studies link poor sleep, OSA in the elderly to increased Dementia risks

A new study by the Pacific Health Research and Education Institute in Honolulu has found that elderly patients who spend less time in deep ‘slow wave’ sleep are significantly more likely to lose brain cells than those who sleep more deeply. The research also showed that the lack of oxygen caused by obstructive sleep apnea, a common condition marked by snoring, increases the risk of the small areas of brain damage linked to the development of conditions such as Alzheimer’s. Researchers say that it is not yet clear whether the early stages of dementia are causing poor sleep quality, or if the lack of deep wave sleep is exacerbating the disease process.

The study, published in the online edition of the journal Neurology, involved 167 Japanese American men from Hawaii with an average age of 84 who had sleep tests conducted at their homes. After death, post mortem examinations were conducted on their brains to look for changes such as loss of neurons and ‘micro infarcts’ - areas of dead tissue caused by oxygen starvation. These can be triggered by obstructive sleep apnea (OSA); a condition in which the airway repeatedly becomes blocked, often waking sufferers as they struggle for breath.

The men who had the worst oxygen levels during sleep were four times more likely to have brain damage caused by micro infarcts. Of the 37 men who spent the least time in slow wave sleep, 17 had brain cell loss compared with only seven of the 38 who spent the most time in slow wave sleep. The results remained the same after accounting for factors such as smoking and body weight, and excluding those who died early in the follow-up period. However, the study found no association between poor sleep and the brain plaques  that are a hallmark of Alzheimer’s disease.

Researchers say that the findings suggest that low blood oxygen levels and reduced slow wave sleep may contribute to the processes that lead to cognitive decline and dementia. More research is needed to determine how slow wave sleep may play a restorative role in brain function and whether preventing low blood oxygen levels may reduce the risk of dementia.

A separate study earlier this week showed that brains of healthy people who were sleepy during the day contained higher levels of a toxic protein called beta-amyloid, which is also linked to Alzheimer’s: some of those having scans were as young as 50 and none had memory problems.

A good night’s sleep is important for proper brain function in the short term. For more information on the treatment of OSA and snoring, visit us online at HoustonSleep.net

Treating sleep problems improves conditions not typically considered by most physicians.

Over the past decade many Sleep Testing centers have opened throughout the country; most focus on evaluating patients with snoring complaints to determine if they have Obstructive Sleep Apnea (OSA). Once diagnosed these patients are typically placed on CPAP for treatment. Typically a second sleep study is performed to determine the best settings for the CPAP machine, with most centers taking the basic approach  rooted in standards developed when less was known about sleep abnormalities.

As a result, many patients who have abnormalities during sleep are not accurately diagnosed and patients are left without an effective treatment plan. Many patients may have a subtle breathing problem during sleep known as Upper Airway Resistance Syndrome (UARS). Patients with UARS have normal oxygen levels throughout the night and do not stop breathing, but they work harder to breathe and the increased effort causes brief disruptions called micro arousals. Recently accepted minimum standards in the field miss out on the identification of abnormalities such as UARS.

Some centers differentiate themselves in their ability to properly diagnose and treat patients with sleep disturbances by using refined approaches and assessing more sensitive parameters during sleep. Additionally, many conditions not typically thought to be rooted in abnormalities of sleep are now recognized and treated more effectively. In Houston, Jerald H. Simmons, MD, a Triple Board-Certified Neurologist specializing in sleep disorders, directs several sleep centers that clearly stand out from the crowd. His centers use methods beyond what is required by sleep centers for accreditation.

Dr. Simmons points out that "Every path has a starting point and we learn new things along the way. It is great that the field of Sleep Medicine is developing standards but unfortunately the current standards fall short of being able to properly diagnose and treat patients with complicated conditions. By identifying the more subtle abnormalities, we have been successful in providing care to patients who were previously left struggling by the health care system."

In example, a common cause for recurrent morning headaches is OSA or UARS. Many of these patients also have bruxism during sleep (clenching or grinding the teeth at night) and this can lead to TMJ Disorder. Research conducted by Dr. Simmons has shown that bruxism during sleep actually helps keep the airway open by moving the tongue and jaw forward; this is the body's attempt to prevent OSA or UARS. By treating the airway problems during sleep Dr. Simmons and Dental Sleep Specialist Dr.Ron Prehn have demonstrated improvement in both bruxing and TMJ pain.
When appropriate Dr. Simmons treats patients with OSA or UARS by using dental appliances as an alternative to the CPAP machine, and is performing pioneering research on the use of combined treatment approaches using both CPAP with dental appliances.


Additionally, most patients with fibromyalgia have poor sleep. Proper treatment of their sleep problems frequently improves the symptoms of Fibromyalgia. Signals from pain nerve fibers throughout the body constantly send a low level of signals to the brain, but the brain normally filters these out. If the brain is not properly rested it loses the ability to filter these signals which results in common fibromyalgia pain.
Treatments geared to improving sleep continuity restore the brain's pain filter mechanism, and the pain symptoms resolve.

The underlying sleep disturbances causing these symptoms is not always identified by sleep centers, and the treatment opportunities are missed. In many of these patients UARS can be at the root of the problem. Once the sleep disturbance is properly treated, fatigue resolves.

The sleep centers directed by Jerald H. Simmons, MD utilize advanced methods to properly diagnose and treat patients with conditions, such as those described above. Dr.Simmons concludes that "In the future we will look back and see how much we didn't understand, but unless we embrace the knowledge of our experience we will never reach that future perspective."

For more information on sleep disorders and the sleep centers of Dr. Simmons, visit HoustonSleep.net and gain the knowledge you need to obtain a better night's sleep.

TMJ (TMD) and sleep Bruxism associated with OSA. Diagnosis and Treatment...

Temporal Mandibular Joint Dysfuntion (TMJ) causes pain and headaches in millions of people each year. This common problem is caused by clenching and grinding the teeth, typically while asleep.
 Research conducted by Dr. Jerald Simmons and Dr. Ronald Prehn has demonstrated that bruxism during sleep is the body's attempt to open up the airway and improve breathing, particularly for people who suffer from Obstructive Sleep Apnea. When Dr. Simmons has implemented treatments for OSA, such as CPAP or dental appliances (TAP or other mandibular advancing devices), their TMJ symptoms usually resolve.

Many of these patients can not be placed on a mandibular advancing dental appliance initially because of inflammation from the TMJ; once this improves through the use of other methods such as CPAP, then a mandibular advancing appliance can be used successfully. The physiology of this has been demonstrated and is explained by Dr. Simmons in this video.
Visit our web site for more information at http://www.Houstonsleep.net

SLEEP APNEA SUPPORT GROUP IN HOUSTON!

THE SLEEP EDUCATION CONSORTIUM (S.E.C.) is Excited to Announce the Start of the A.W.A.K.E. GREATER HOUSTON Monthly Patient Advocacy Group for Individuals Suffering from Obstructive Sleep Apnea and Other Sleep Disorders.

A.W.A.K.E. is a national patient advocacy group sponsored by the American Sleep Apnea Association. Its mission is to increase awareness and education about Obstructive Sleep Apnea.
The A.W.A.K.E. GREATER HOUSTON chapter will meet monthly on a rotating cycle of three locations: the Houston Medical Center, The Woodlands, and Sugar Land. Meetings will start with patient discussion, followed by a brief interactive lecture about varying sleep disorders. These lectures will be given by local sleep specialists and will encourage patient Sleep Disorders. and education about Obstructive Sleep Apnea. involvement in the topics discussed.

The first meeting will be on Tuesday, August 26, 2014
At Comprehensive Sleep Medicine Associates
15423 Creek Bend Drive, Sugar Land, TX 77478

Patient Discussion Begins – 6:30 P.M.
Physician presentations:
Overview of Obstructive Sleep Apnea – 7:00 P.M.
Dental Appliances as an alternative treatment to CPAP – 7:20 P.M.
Discussion will follow the conclusion of the lectures.

RSVP by calling 281-269-7881 or by sending an email to AWAKEGreaterHouston@gmail.com

Engineer in fatal Bronx train derailment had sleep apnea

The commuter train engineer at the center of last year's deadly derailment in the Bronx was found to have obstructive sleep apnea that went undiagnosed before the Dec. 1 derailment, a sleep medicine doctor said in the National Transportation Safety Board's investigation docket. Rockefeller told investigators that he felt fine that day, but experienced something like highway hypnosis as he stared straight ahead at the tracks. "I came up with that hypnotized feeling, dazed, that's what I was in," he said. "The only thing that shook me out of it was the feeling of the train. Something wasn't right with it.
" He activated the emergency brake, but it was too late. The train derailed as it headed around a sharp curve at 82 miles per hour, nearly three times the speed limit.

A report on Rockefeller's medical history revealed he had never been tested for a sleeping disorder by any of his doctors prior to the accident. He had a history of snoring but "not of choking or gasping" awake. His sleep was disrupted as much as 65 times per hour, the report stated.
Sleep apnea occurs when a person involuntarily stops breathing while asleep. Rockefeller's lawyer said that
"...He had absolutely no idea of this condition prior to the diagnosis. It was exacerbated by the change in shifts two weeks earlier."

 Excessive daytime drowsiness is a tendency to sleep at inappropriate times regardless of activity or circumstance. It can manifest itself in mild or severe forms.
Excessive daytime sleepiness is a common problem in today's society. It is so common that in some circles people almost consider it a normal aspect of a productive society. The fact is that daytime sleepiness and fatigue are leading causes of accidents, both on the job and on the road. The cost to society is estimated in billions of dollars per year. There are several common causes for increased daytime sleepiness. The simplest cause of daytime sleepiness that can be corrected results from insufficient sleep.

A common medical problem that can cause increased daytime sleepiness results from having a breathing problem during sleep. Snoring for example, is a form of obstructed breathing. Obstructive breathing can make it difficult to breathe properly during sleep and can even cause a complete blockage in the airway during which breathing stops. Breathing is re-established with a brief disruption of sleep and possibly a brief gasp or choking sound.

Another common medical problem causing frequent disruptions of sleep is called Periodic Limb Movements of Sleep. This occurs when a person has multiple brief leg movements every 20 to 60 seconds for long periods during the night. These leg movements can fragment sleep, resulting in increased daytime sleepiness. Frequently people with this problem also have what is called Restless Legs Syndrome (RLS). RLS occurs when a person is sitting still or lying in bed, which makes it difficult to keep their legs still. This frequently can keep people awake, causing insomnia. People with this problem feel that moving their legs relieves this restless sensation.

These problems are all treatable. Unfortunately, many physicians are not yet familiar with treating these conditions. Ask your doctor about treatment and feel free to have your doctor contact us for questions on diagnosis and treatment for these conditions.
If you have a problem with daytime sleepiness and you have increased your sleep length without improving your daytime sleepiness, then you should be evaluated by a Sleep Disorders Specialist. With proper care most people can obtain the treatment they need to improve this problem. Contact us today at 281-407-6222 or visit www.houstonsleep.net  for more information.

Don't let Snoring Break Your Heart!

For years people have thought of snoring as nothing more than a simple annoyance during the night: snoring is so common that we do not view it as a medical problem. Recent statistics suggest that this seemingly simple noise problem may in fact increase the risk of high blood pressure, stroke, heart attack, and daytime sleepiness.

Snoring typically occurs when the tongue and throat muscles relax during sleep causing the airway space in the back of the throat to narrow. Breathing through a narrow airway causes a vacuum that pulls on the throat's soft tissue causing it to vibrate, which creates the snoring sound. This vacuum in the throat also spreads to the chest where the heart is located, causing a strain on the heart and the possibility for oxygen in the bloodstream to drop to dangerously low levels. When these factors occur night after night, year after year, they instigate the problems listed above. Additionally, new studies have also shown OSA causes increased insulin resistance resulting in poorly controlled diabetes.
Studies have demonstrated that in many people, snoring can cause an increase in chest pressures which can influence blood flow in the heart and lungs. This may be the cause of some of the medical problems in people who snore.

CSMA's sleep centers throughout Greater Houston provide treatment to patients sufferering from snoring and obstructive sleep apnea disorders. For more information on how to stop snoring and obtain help for sleep apnea call us today at (281) 407-6222.

Many people who snore have another problem known as sleep apnea. Apnea is a Greek word, which means, "want to breathe." People with obstructive sleep apnea have pauses in their breathing while asleep. These pauses in breathing occur when the airway collapses during sleep. After a few seconds the person briefly awakens, frequently producing a grunting, gasping, or snorting sound.
Obstructive sleep apnea is more common in obese people and more common in men, but it is not just obesity that can cause this problem. People with a small jaw, large tongue, or large tonsils are at higher risk of having this problem as well. In fact, any condition which can narrow the opening in the back of the throat or possibly the nasal passages can increase the risk of obstructive sleep apnea.
It is important to know the consequences of this problem if left untreated. Some of the more common problems associated with obstructive sleep apnea are excessive daytime sleepiness and an increased risk of high blood pressure, heart attacks and stroke.

What can someone do if they want to know if they have Sleep Apnea?

See your physician and ask about being referred to a sleep disorders center. This is a special testing facility that evaluates people for sleeping problems. If your doctor does not feel this is necessary, don't be discouraged. Most physicians have not been taught very much about sleep medicine in medical school and therefore may not recognize this problem in their patients. Be persistent. You can be seen by a sleep specialist and, if needed, a sleep study can be performed on you during the night.

What can be done if a person snores or has Sleep Apnea?

The most effective treatment to date for sleep apnea is called nasal CPAP (Continuous Positive Airway Pressure). An individual wears a mask on their nose at night that administers air pressure, keeping the upper airway open. This allows the individual to breathe throughout the night without repetitive awakenings. If a person only snores and does not suffer from excessive daytime sleepiness, then CPAP is not the appropriate treatment.
Dental appliances have been used for snoring. Sometimes these devices can also prevent apnea as well. Studies have demonstrated that dental appliances work for snoring and sleep apnea, but not in all patients. Surgery has been used to treat these problems. The most frequently performed surgery is a procedure where the soft tissue in the back of the throat including the uvula is cut away or reduced in size with a new microwave needle or a laser. Although this may work well for snoring, unfortunately most patients who have sleep apnea are not adequately treated with these procedures. There are other more extensive surgeries that can be performed for sleep apnea.

A sleep specialist who is very familiar with these procedures should explain them to you. If you snore at night and think you might have sleep apnea, contact your doctor. If your doctor is not familiar with this type of problem, have him or her contact us directly.
For more information on Snoring, Sleep Apnea and treatment options in the greater Houston area, visit www.HoustonSleep.net

Treating Snoring Problems

SNORING Threatens Your Health!

Snoring can be a sign of  Obstructive Sleep Apnea (OSA), which has been linked to high blood pressure, heart disease and an increased risk of heart attacks and stroke.

For years people have thought of snoring as nothing more than a simple annoyance during the night: snoring is so common that we do not view it as a medical problem.
Snoring typically occurs when the tongue and throat muscles relax during sleep causing the airway space in the back of the throat to narrow. Breathing through a narrow airway causes a vacuum that pulls on the throat's soft tissue causing it to vibrate, which creates the snoring sound.
This vacuum in the throat also spreads to the chest where the heart is located, causing a strain on the heart and the possibility for oxygen in the bloodstream to drop to dangerously low levels.
When these factors occur night after night, year after year, they instigate the problems listed above. Additionally, new studies have also shown OSA causes increased insulin resistance resulting in poorly controlled diabetes.

Studies have demonstrated that in many people, snoring can cause an increase in chest pressures which can influence blood flow in the heart and lungs. This may be the cause of some of the medical problems in people who snore.
Many people who snore have another problem known as sleep apnea. Apnea is a Greek word, which means, "want to breathe." People with obstructive sleep apnea have pauses in their breathing while asleep. These pauses in breathing occur when the airway collapses during sleep. After a few seconds the person briefly awakens, frequently producing a grunting, gasping, or snorting sound.
Obstructive sleep apnea is more common in obese people and more common in men, but it is not just obesity that can cause this problem. People with a small jaw, large tongue, or large tonsils are at higher risk of having this problem as well. In fact, any condition which can narrow the opening in the back of the throat or possibly the nasal passages can increase the risk of obstructive sleep apnea.
It is important to know the consequences of this problem if left untreated.
Some of the more common problems associated with obstructive sleep apnea are excessive daytime sleepiness and an increased risk of high blood pressure, heart attacks and stroke.

What can someone do if they want to know if they have Sleep Apnea?

See your physician and ask about being referred to a sleep disorders center. This is a special testing facility that evaluates people for sleeping problems. If your doctor does not feel this is necessary, don't be discouraged. Most physicians have not been taught very much about sleep medicine in medical school and therefore may not recognize this problem in their patients. Be persistent. You can be seen by a sleep specialist and, if needed, a sleep study can be performed on you during the night.

What can be done if a person snores or has Sleep Apnea?

The most effective treatment to date for sleep apnea is called nasal CPAP (Continuous Positive Airway Pressure). An individual wears a mask on their nose at night that administers air pressure, keeping the upper airway open. This allows the individual to breathe throughout the night without repetitive awakenings. If a person only snores and does not suffer from excessive daytime sleepiness, then CPAP is not the appropriate treatment.

Dental appliances have been used for snoring. Sometimes these devices can also prevent apnea as well. Studies have demonstrated that dental appliances work for snoring and sleep apnea, but not in all patients. Surgery has been used to treat these problems. The most frequently performed surgery is a procedure where the soft tissue in the back of the throat including the uvula is cut away or reduced in size with a new microwave needle or a laser. Although this may work well for snoring, unfortunately most patients who have sleep apnea are not adequately treated with these procedures. There are other more extensive surgeries that can be performed for sleep apnea.

Comprehensive Sleep Medicine Associates, PA. (CSMA) treats the full spectrum of sleep disturbances in patients ranging from pediatrics to geriatrics.

A sleep specialist who is very familiar with these procedures should explain them to you. If you snore at night and think you might have sleep apnea, contact your doctor. If your doctor is not familiar with this type of problem, have him or her contact us directly.

 If you or someone you know has one or more of these symptoms, a sleep disorder may be the cause and an evaluation is needed; help is available by Dr. Jerald H. Simmons and his dedicated team at  CSMA.  Dr. Simmons established CSMA as an outreach program in the Greater Houston area and now has facilities in the Houston Medical Center, Sugar Land and The Woodlands. The Sleep Medicine Specialists at CSMA can help you determine the cause of your sleep problems and restore night after night of healthy, restful sleep. 

Possible Texas Dental Law Changes May Enhance Collaboration of Physicians & Dentists in Treating Obstructive Sleep Apnea (OSA)

 The Texas State Board of Dental Examiners does not recognize OSA diagnosis and treatment within the current scope of dentistry and Houston sleep expert Jerald H. Simmons, MD recognizes the partnerships needed to treat this sleep disorder. This team-based care will be the focus at the 9th Annual Sleep Education Consortium's (SEC) conference, Feb 8-9, 2013 in Houston that brings the dentist and the physician together for continuing education classes, said SEC's Founding-Director, Dr. Simmons. 

Obstructive sleep apnea (OSA) is a medical condition where repeated narrowing of the throat occurs during sleep which either partially or completely blocks the airway. This blockage can repeatedly stop breathing for many that lasts 20 seconds or longer. OSA can occur at any age and it is estimated that more than 12 million Americans have this disorder. According to the American Academy of Sleep Medicine about 80 to 90 percent of adults with OSA remain undiagnosed.
Many physicians are not recognizing the problem leaving so many untreated. This has created a niche for those dentists who may recognize the symptoms of OSA and step-in to fill this void. However, many dentists are now providing services to patients for OSA, a medical condition, which is technically outside of the scope of dentistry. Recognizing this trend, the Texas State Board of Dental Examiners (TSBDE) is evaluating the situation to determine a formal position on this topic. Jerald H. Simmons, MD, who is triple board-certified by the American Board of Sleep Medicine, American Board of Psychiatry and Neurology and the American Board of Clinical Neurophysiology presented to the dental board his expert opinion at their January 25th Austin meeting.
To view the full article please visit our PRWEB release.
For more information on Obstructive Sleep Apnea visit www.dr-jhsimmons.com