OSA and the heart problems it can lead to; Improving new mothers and their babies' sleep

Obstructive sleep apnea (OSA), a sleep related breathing disorder that causes your body to stop breathing during sleep, can disturb your sleep numerous times on any given night. As a result, you may experience daytime sleepiness. Daytime sleepiness brought on by OSA may put you more at risk for cardiovascular problems, according to a study published in the December 1st issue of the journal SLEEP.

The study, lead by Joel E. Dimsdale, MD, of the University of California, San Diego, focused on 86 patients with an average age of 47 years. All subjects were suspected of having OSA and submitted to a polysomnogram. Stroke volume and cardiac output were measured using impedance cardiography, while daytime sleepiness was quantified using the Epworth Sleepiness Scale.

The results showed that a higher Epworth Sleepiness Scale score, suggesting more daytime sleepiness, was independently associated with decreases in cardiac function.

"Patients with sleep apnea commonly complain of daytime sleepiness," said Dimsdale. "Sleep physicians have sensibly attributed this sleepiness to the massively disrupted sleep in apnea. However, our findings suggest a darker side to this sleepiness, as well. The cardiac function in these patients is subtly impaired, perhaps contributing to the perception of sleepiness and fatigue that is so disabling for these patients."

OSA occurs when the tissue in the back of the throat collapses and blocks the airway. This keeps air from getting into the lungs.

While the effects of OSA, including daytime sleepiness, alertness and concentration as well as increased risk of stroke, diabetes and heart disease, are real and severe, there are safe and effective treatments available for those who have OSA. Scientific evidence shows that continuous positive airway pressure (CPAP) is the best treatment for OSA. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels.

Following the birth of a baby, it is common for new mothers to awaken to the sound of their baby's cry several times a night. Constantly getting out of bed to tend to their baby's needs causes a disruption in the mother's sleep, which may affect her physical and emotional well-being the next day. However, a study published in the December 1st issue of the journal SLEEP states that a behavioral-educational intervention may bring some much-needed relief to both mother and baby.

The study, conducted by Robyn Stremler, RN, PhD, and colleagues at the University of Toronto in Toronto, Ontario, Canada, focused on 30 first-time mothers and their infants, who were randomly assigned to sleep intervention or a control group. The sleep intervention included a 45-minute meeting with a nurse to discuss sleep information and strategies, an 11-page booklet and weekly phone contact to reinforce information and problem solve. The control group received a 10-minute meeting during which only maternal sleep hygiene and basic information about infant sleep were discussed, a one-page pamphlet and calls on the third and fifth week to maintain contact without provision of advice.

Questionnaires were completed at the beginning and after six weeks. Sleep diaries, along with mother and infant actigraphy, were completed at six weeks.

The results showed that the mothers in the sleep intervention group averaged 57 minutes more nighttime sleep and, as compared with the mothers in the control group, fewer rated their sleep as a problem. In addition, infants in the sleep intervention group had fewer nighttime awakenings and had maximum lengths of nighttime sleep that were, on average, 46 minutes longer than those in the control group.

"Everyone recognizes that sleep is very important for mental and physical health, but new mothers struggle to get enough sleep in the first few weeks after birth," said Stremler. "What is exciting about this research is the clear evidence that the Tips for Infant and Parent Sleep (TIPS) program improves mothers' and babies' sleep six weeks after birth. By providing new moms with strategies for settling babies, teaching babies the difference between day and night, and developing healthy adult and infant sleep habits, sleep significantly improved for both mothers and babies."

Those who have trouble sleeping are advised to discuss their problem with their primary care doctor, who will determine whether a visit to a sleep specialist is necessary.

SLEEP is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the AASM and the Sleep Research Society.

SleepEducation.com, a Web site maintained by the AASM, provides information about the various sleep disorders that exist, the forms of treatment available, recent news on the topic of sleep, sleep studies that have been conducted and a listing of sleep facilities.