Sleep Apnea: How Is It Related to Heart Disease and What Can I Do About It?

There has been a lot of information in the last few years about the connection between sleep apnea and heart disease. In this report, Dr. Lee Surkin, a cardiologist and sleep medicine specialist, explains the link between heart disease and sleep apnea.

Dr. Surkin says that physicians have learned a lot in the past decade or so about the link between sleep apnea and heart disease. There are close associations that include heart disease, heart failure, heart rhythm disturbances, high blood pressure, obesity, and diabetes. Sleep apnea is not just associated with these problems; it may cause them.

Screening a patient for sleep apnea involves looking at the symptoms. The first symptom is snoring, a sign that there is a resistance in the airway to the flow of air. Snoring is not proof of sleep apnea, but it is suggestive. Another thing to consider is how someone feels when they wake up. People who feel they need more sleep and who are tired during the day may suffer from sleep apnea. Also, people who have headaches in the morning may have sleep apnea. Awakening with a dry mouth can be a symptom of sleep apnea.

Once someone has symptoms suggestive of sleep apnea, there are two diagnostic approaches. One is a home sleep apnea test that allows a potential sleep apnea patient to test for the problem at home. The testing is done for a period of one to three nights. The other approach, called in-center testing, requires a patient to spend a night in an accredited sleep laboratory to determine if sleep apnea is present.

Once sleep apnea is diagnosed, there are several treatment options. The most common one is the use of a CPAP (continuous positive airway pressure) device. The procedure involves breathing room air under enough pressure to keep the airway open. Another treatment approach is oral appliance therapy. This involves having a dental sleep physician take a mold of a patient’s teeth and create an oral appliance that goes into the patient’s mouth at bedtime. The appliance moves the lower jaw forward slightly to keep the airway open.

Another approach is the use of a product called Provent that works with the nostrils to splint the airway open. A very recently approved treatment is a hypoglossal nerve stimulation device. By stimulating the nerve that controls the tongue, the device causes the tongue to avoid dropping back to block the airway. Another thing sleep apnea patients should probably do is lose weight. Yet another approach involves surgery to enlarge the airway.

Dr. Lee Surkin, MD, FACC, FCCP, FASNC is a cardiologist in Greenville, North Carolina and is affiliated with multiple hospitals in the area, including Martin General Hospital and Vidant Medical Center. He received his medical degree from Drexel University College of Medicine and has been in practice for more than 20 years. He is board certified in Cardiology, Nuclear Cardiology and Sleep Medicine. He is the founder of the American Academy of Cardiovascular Sleep Medicine. The Health and Wellness Network is a featured network of Sequence Media Group.

Coronary Artery Disease: What Is It and What Treatments Are Available?

Coronary artery disease is a serious health problem. It is the most common type of heart disease and the leading cause of death in the United States for both men and women. In this report, Dr. Lee Surkin, a cardiologist and sleep medicine specialist, explains coronary artery disease, discusses risk factors, and describes preventive and reparative treatment.

“Coronary artery disease,” Dr. Surkin explains, “is a build-up of plaque in the heart arteries.” It develops after there has been damage to the inside lining of those arteries. The damage causes the body to undertake a repair process that leads to the plaque build-up and perhaps a blockage of the arteries.

The causes of the disease are related to risk factors. Those factors include high blood pressure, high cholesterol, smoking, family history, diabetes, obesity, high stress, and obstructive sleep apnea.

Screening for the disease is not always invasive, Dr. Surkin says. His office begins by getting a patient’s history and an electrocardiogram. Then comes the decision as to the kinds of non-invasive tests to be used. These include an ultrasound study of the heart, a stress test, and a CAT scan or MRI scan. If the tests suggest that an invasive test is needed, the next step is a cardiac catheterization in which a dye solution is injected into the cardiac arteries to get a direct image of plaque build-up in those arteries.

The good news, Dr. Surkin says, is that the condition can sometimes be reversed. “The treatment depends on an aggressive approach to modifying the risk factors.” All the risk factors previously listed need to be evaluated and treated. Some studies show that aggressive lowering of a patient’s cholesterol level—using exercise, improved diet, and drugs called statins—can reduce the extent of arterial blockage.

Prevention and treatment of coronary artery disease “involves a multifaceted approach.” The first step, called primary prevention, is to keep the disease from occurring. Secondary prevention involves dealing with a disease that is already established and keeping it from getting worse. Once again, treatment requires an aggressive look at all the risk factors and mitigating them.

If a patient has the disease and if it is serious enough, the physician may have to directly manipulate the coronary arteries. Using coronary angioplasty, the plaquing can be pushed off to the side, Dr. Surkin explains. The physician inflates a balloon inside the artery to push the plaque to the side, then inserts a metal stent to keep the artery open.

The other surgical treatment is coronary artery bypass. In this procedure, a blood vessel taken from under a patient’s breastbone or from the leg is plugged directly into the heart to bypass the damaged artery.

Dr. Lee Surkin, MD, FACC, FCCP, FASNC is a cardiologist in Greenville, North Carolina and is affiliated with multiple hospitals in the area, including Martin General Hospital and Vidant Medical Center. He received his medical degree from Drexel University College of Medicine and has been in practice for more than 20 years. He is board certified in Cardiology, Nuclear Cardiology and Sleep Medicine. He is the founder of the American Academy of Cardiovascular Sleep Medicine. The Health and Wellness Network is a featured network of Sequence Media Group.

Polio-Like Illness is Striking More U.S. Kids

Polio was eradicated from the U.S. months ago, but now reports of a polio-like illness is on the rise. The US Centers for Disease and Prevention says Acute flaccid myelitis is a rare illness that anyone can get. As of August 2016, 50 people in 24 states were confirmed to have AFM. Most of the cases were children. 

AFM affects a person’s nervous system, specifically the spinal cord, causing paralysis. The CDC says they are testing and researching the disease, but at this point they don't know the cause or how to prevent it. They say practice typical illness prevention -- wash your hands and protect yourself against mosquito bites.

 

Study Says Humans Life Expectancy Limit At 115 Years Old

A new study reported in the scientific journal, Nature, says the longest a human can live is 115.
Dr. Jan Vijg of the Albert Einstein College of Medicine and his colleagues came up with 115 by analyzing years of demographic data from the Human Mortality Database and the International Database on Longevity.

During an interview with NPR, Dr. Jan Vijg said "We cannot break through that ceiling. The take-home message essentially is this whole ever-increasing life expectancy of humans cannot go on."
The report says the age of the world's oldest person hasn't increased since the 1990's and the likelihood of survival declines after the age of 100.

FDA Approves First 'Artificial Pancreas' for Diabetes

The FDA approves the first artificial pancreas. The device is an automated insulin pump, known as the MiniMed 670G. It was developed by medical device company Medtronic for patients with Type 1 diabetes. The MiniMed is the size of a cell phone. It monitors a patient's blood sugar levels and delivers insulin as needed. This means type-1 diabetes sufferers won't have to prick their fingers to check their blood sugar levels and then inject insulin.

The device has a sensor that measures blood sugar levels, an insulin pump strapped to the body and an infusion patch with a catheter that delivers insulin. The FDA approved the device for people 14 years and older with type 1 diabetes. The system won't be available until spring.