From: Brian Phillips (deepbluehalo@earthlink.net)
Date: Sat Jul 13 2002 - 19:42:04 MDT
From: Damien Broderick <d.broderick@english.unimelb.edu.au>
Oz radio science show interview today with Dr Peter Farrell of ResMed
(`Entrepreneur of 2001'), who claims that there's a marked correlation
between poor sleeping patterns, snoring, sleep apnea and hypertension,
leading to increased stroke, heart attack deaths, etc. He has a gadget that
prevents these horrors. His company's stock is currently low. >>
Apparently Farrell is in the CPAP business. CPAP is Continous Positive
Air Pressure therapy. It's basically a strap on mask that blows a
humidified
airstream down your airway.
CPAP is generally highly effective for *obstructive* sleep apnea (OSA).
It is largely ineffective against central sleep apnea (CSA). The caveat
here
is that CPAP/PAP/BIPAP therapies cannot be tolerated by all patients,
many people feel constricted, threatened or otherwise claustraphobic when
asked to where a mask which covers their entire mouth and nose. I have
tried it in the interests of patient empathy... it's the sort of thing one
must be *highly* motivated to tolerate.
There are various workarounds to assist in patient toleration of the
therapy
but they have only modest effectiveness levels overall. CSA is caused
by brain dysfunction, patients who have this are in the same category
with most neuro patients, not much can be done.
Claims of marked correllation are likely correct, as the *classic* OSA
patient is a middle-aged or older man, overweight, who snores.
Most of my sleep patients (the ones who come in for snoring or suspected
OSA, not the ones who are possible narcoleptics or idiopathic hypersomniacs)
are overweight and older, and (not suprisingly) they are usually
hypertensive
and/or have a history of cardiology consults (cholesterol meds often enough
too). The correlation is likely indirect, via a common cause.
OSA is an obstruction of the airway caused by obstructive tissues in
the airway. Snoring is usually present and precedes clinical emergence of
OSA. Surgical treatments (such as a UPPP) are quite effective against
snoring, and seem to have variable outcomes on the OSA patients (to
judge by the patient appointment/consult flows in my clinic).
The above is FYI background material I have no knowledge or
opinion on Mr. Farrell's business acumen or history, YMMV.
regards,
Brian
(who is utterly amazed that a neurodiagnostic thread emerged on the list,
holy shit!!!)
"Every normal man must be tempted at times to spit upon his hands, hoist the
black flag, and begin slitting throats."
- - Henry Louis Mencken (1880-1956)
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