The Classic SleepCast is a weekly blog dedicated to providing our patients with the latest in
sleep news and access to professionals who have dedicated their lives to this field.
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Barry Krakow, MD
Dr Krakow’s 27 years of sleep research have focused on the complex relationship between
physiological and psychological sleep disorders. Dr Krakow currently operates private sleep medical
center, Maimonides Sleep Arts & Sciences, Ltd., and serves as Classic SleepCare’s paid Medical Director.
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Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.
Many studies have assessed how untreated sleep apnea affects insulin resistance, which often precedes diabetes. Unfortunately, likely due to different study designs, results have been mixed, leaving a somewhat cloudy relationship between insulin resistance and sleep apnea. Inconclusive results may have been due a small number of study participants. In cases like this, it is often helpful to do a large, combinatory study that creates one large study population from many similar smaller studies. Recently, a group of researchers pooled together 5 studies on how sleep apnea affects insulin resistance, creating a sample of 244 subjects. Importantly, none of these subjects suffered from diabetes. Because diabetes often complicates the situation (because injections of insulin are usually involved), the researchers specifically excluded this group to examine endogenous levels of insulin. In addition, insulin resistance was measured in two groups of subjects – those treated with sleep apnea treatment (CPAP) and those...Read more
We have previously reported a study showing that sleep apnea treatment improves sexual functioning and also erectile dysfunction in men. Likely, some of the oxygen loss and sleep fragmentation caused by untreated sleep apnea has negative effects on hormone regulation necessary for proper sexual functioning. These improvements were short-term, but little has been done to examine the long-term changes in sexual functioning after successful treatment of sleep apnea. In this study, a group of about 90 men were followed-up after about 3 years of sleep apnea treatment (CPAP) usage. These men had previously been assessed for sexual dysfunction through questionnaires and self-reports about recent sexual encounters and issues. Questionnaires asked about things like sexual desire and intercourse satisfaction. They were asked about how often they used their CPAP and the current status of any sexual issues, including erectile dysfunction. Interestingly, the severity of sleep apnea prior to initiation of treatment...Read more
Understandably, babies, young children and older adults are the subject for much scientific research. Typically forgotten, though, are those between the ages of 12 and 18, who are considered adolescents. During this stage of early adolescence, crucial brain and body developments are taking place (remember puberty?), so studies investigating this age group are extremely important. Because a growing amount of adolescents are overweight or obese, sleep apnea is a concern. So does the presence of sleep apnea affect this generation? Might this sleep apnea affect the cognitive functioning of this age group as it does for younger children? With this question in mind, a research group recently set out to examine if sleep apnea, obesity, and cognitive functioning were all related. The study population included 37 severely obese adolescents, between the ages of 12 and 18. Sleep of the subjects was tested in the laboratory, and subjects also underwent cognitive...Read more
Sleep apnea treatment affects our body on a robust level by changing breathing patterns, which in turn changes other bodily functions (such as heart rate and overall oxygen levels). But are there biological effects of sleep apnea treatment on a deeper level? Could this treatment even be affecting our genes? Genes, of course, do not change over the lifespan, but the way they are expressed does change. Environmental factors, like diet or other health habits, can alter gene expression in a positive or negative way. That being said, it may be likely that the negative side effects associated with sleep apnea, such as repeated lack of oxygen and frequent awakenings, may alter our gene expression in a negative way. Until now, however, nobody had tested this theory. A recent innovative research study set out to examine whether initiation of CPAP treatment could have a beneficial impact on gene expression. This...Read more
Typically when we test how sleep apnea treatment improves lives, we test using discreet measurements. We test using questionnaires or blood pressure monitors, which only really account for a single parameter. What if we could find an activity that incorporates BOTH cognitive (mental) and motor (physical) skills? What if this activity happened to be something very enjoyable? What if this activity was golf? That’s right – a group of researchers set out to see if golf game could improve after initiating sleep apnea treatment (continuous positive airway pressure – CPAP). The measured variable here was handicap index, which, ideally, is very low. In this study, an experimental group and a control group were both selected. The control group did not suffer from sleep apnea, and the experimental group did suffer from sleep apnea and was instructed to begin CPAP use. All subjects reported their golf scores (and other measures, including...Read more
Although sleep apnea experts routinely try to enhance and create newer, more comfortable PAP equipment (including things like CPAP and AutoPAP), it remains difficult to predict who will use the treatment and who will not. However, there are many who specifically research this topic with hopes that pinpointing the poorer users will allow for targeted intervention, improving overall use in these subjects. Faulty machinery (leakiness and poorly fitting masks to name just a couple), disease severity, and race have all shown to be predictors of poor CPAP use. But what about mental health issues? Recently, a group of researchers tried to answer this question. They set out to examine whether or not mental health issues detected before PAP initiation could be predictors of poor treatment use. This question was tested using the AutoPAP (a CPAP-like device that automatically adjusts pressures throughout the night) use data. This data was obtained using...Read more
I’m often asked whether sleep apnea can kill somebody. This is a loaded question, because each person with sleep apnea has a different medical background that is complicated by varying factors. The short answer is: no – there have been no reports from somebody dying of an apnea. However, the risk of death from disorders associated with sleep apnea (such as cardiovascular disease) is often raised if the sleep apnea is untreated. People often overlook, though, a symptom of sleep apnea that many consider benign – sleepiness! Sleepiness itself probably can’t kill you. Although we have probably all felt that it certainly can when we are sitting in a boring meeting. If in a dangerous situation, though, in which vigilance is usually required, such as driving, sleepiness can certainly kill you. A very important study examined the number of driving accidents that have occurred in those with untreated and treated...Read more