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.
New to Classic SleepCare? Read more about us
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.
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
Let’s forget about the numbers for a second. Apnea-hypopnea index, blood pressure readings, glucose counts, pounds on a scale. Don’t get me wrong, these things are all extremely important. However, sometimes it’s easy to forget about these things as we go through the day-to-day motions in our busy lives. There is one thing that is difficult to forget about, though – the way our face looks. For the sake of those who do not care much about physical health but do care about their appearance, let’s take a look into a recent study that examined how untreated sleep apnea can affect physical appearance. In this study, researchers used subjects who suffered from sleep apnea but had been previously untreated with continuous positive airway pressure (CPAP) and reevaluated them after 2 months of CPAP treatment. Pictures were snapped of each person before and after treatment. Photogrammetry, which is a fancy photo...Read more
It is sometimes difficult to tease apart the consequences of obesity and consequences from sleep apnea. Because being overweight is the biggest risk factor for developing sleep apnea (at least in the young to middle-aged population), more often than not, the apnea sufferer is over what is considered a healthy weight. This makes it complicated when trying to decide whether body weight or sleep apnea worsen problems such as hypertension, depression, or diabetes. In particular, insulin resistance and insulin sensitivity, two of the issues associated with diabetes, are associated with both excess weight and also sleep apnea. So how can we get to the bottom of whether apnea affects these things independently of weight? A research team cleverly devised a method of testing out this question. By examining a group of subjects with sleep apnea but without obesity, a direct relationship could be examined without that messy weight factor getting...Read more
Portion control. The secret to good health, as some would say, is eating in moderation. Certain societies and cultures are often criticized for chronic over-portioning. Obviously, large portions can lead us to eating more than we might typically eat. If not paying attention to hunger signals, it is easy to over-stuff yourself if the food is right in front of you. But could there be a physiological reason why some of us just can’t control our portions? A lack of quality sleep has been previously tied to increased cravings, so might sleepiness cause us to consume larger portions? This would be an important question to answer, considering those with untreated sleep apnea often undergo many nights of poor quality sleep. With this idea in mind, a team of researchers set out to see whether sleep deprived subjects are more likely to suffer from “portion-blindness” (my words, not theirs) compared with...Read more
Often discussed are sleep apnea in children, sleep apnea in those who are middle-aged, and also apnea in the elderly. There is a large gap there. Adolescence, sometimes referred to as the teenage years, includes a wide range of changes in the human body. I won’t discuss what happens during puberty (I’m sure you remember), but the body basically starts to become more adult-like. Some define adolescence as lasting into the early 20s, which brings on even more bodily changes. These changes, of course, include brain changes as well. Oftentimes, though, this age group is ignored by researchers. Luckily, sleep apnea researchers have recently set out to see just how many “normal” adolescents suffer from the disorder. In this study, over 1,000 13-16 year olds were recruited and questioned thoroughly (as were their parents) to look for any sign of breathing troubles during sleep. The research team asked about any...Read more