Sleep-Related Exhibitors at Medtrade Spring Reflect Keen Interest in Sleep

Las Vegas – Last year brought unprecedented academic and consumer attention lavished on sleep medicine, and that trend is continuing in 2014. Sleep research originating in the United States and abroad continues to pour forth on almost a weekly basis.

The interest in sleep is reflected in the exhibitor list at Medtrade Spring, which includes the following sleep/sleep accessory companies:

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New Trucking Study Says Two Nights Sleep Safer than One

The U.S. Department of Transportation’s Federal Motor Carrier Safety Administration (FMCSA) released findings from what government officials are calling a “real world, third-party study” that shows two nights rest is better than one.

The FMCSA news release says the latest study provides further scientific evidence that the restart provision in the current hours-of-service rule for truck drivers is more effective at combatting fatigue than the prior version.

“Safety is our top priority, and this new study shows more data-driven evidence that our safety standards help truckers stay well-rested, alert and focused on the road,” said U.S. Transportation Secretary Anthony Foxx. “The hours-of-service rule is helping to reduce truck driver fatigue and making every traveler on our highways and roads safer.”

Scientists measured sleep, reaction time, sleepiness and driving performance in the study. They found that drivers who began their work week with just one nighttime period of rest, as compared to the two nights in the updated 34-hour restart break:

• exhibited more lapses of attention, especially at night;

• reported greater sleepiness, especially toward the end of their duty periods; and

• showed increased lane deviation in the morning, afternoon and at night.

“This new study confirms the science we used to make the hours-of-service rule more effective at preventing crashes that involve sleepy or drowsy truck drivers,” said Federal Motor Carrier Administrator Anne S. Ferro. “For the small percentage of truckers that average up to 70 hours of work a week, two nights of rest is better for their safety and the safety of everyone on the road.”

The study “Field Study on the Efficacy of the New Restart Provision for Hours of Service“ was conducted by the Washington State University, Spokane – Sleep and Performance Research Center and Philadelphia-based Pulsar Informatics, Inc. FMCSA officials claim it is one of the largest real-world studies ever conducted with commercial motor vehicle drivers, and included 106 participants, 1,260 days of data and nearly 415,000 miles of driving that were recorded by the truck-based data acquisition systems.

According to FMCSA, working long hours on a continuing basis is associated with chronic fatigue, a high risk of crashes, and a number of serious chronic health conditions in drivers. The updated 34-hour restart, includes two nighttime periods from 1 to 5 a.m., and is intended to provide sufficient time for a driver to recuperate from cumulative fatigue if they work beyond the weekly maximum on-duty limits.

Source: FMSCA

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Connection Between Fragmented Sleep and Tumor Growth?

A study funded by the National Institutes of Health (NIH) is the first to show (in an animal model) how fragmented sleep directly impacts tumor growth and aggressiveness. The study titled “Fragmented sleep accelerates tumor growth and progression through recruitment of tumor-associated macrophages and TLR4 signaling” appeared in Cancer Research. According to a summary of the study, sleep-deprived mice given the same cancer-inducing treatment developed larger, more aggressive tumors than well-rested mice.

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Cleveland Clinic Highlights Sleep Disorders at Wellness Expo

The Cleveland Clinic and ABC News (NewsNet5) collaborated to raise awareness about sleep disorders at a recent Wellness Expo. The Clinic’s facility in Lyndhurst, Ohio, hosted the event which focused on various sleep issues, as well as some possible fixes for the afflicted.

On an local news broadcast, experts at the Sleep Disorders Center at the Cleveland Clinic estimated that 10% to 15% of Americans suffer some form of insomnia. Disorders such as insomnia may become more pronounced in the winter, a fact bolstered by Michelle Drerup, Psy.D., who works with the Sleep Disorders Center. “Their insomnia will worsen in the winter time when there’s a lack of sunlight,” said Drerup on the broadcast.

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No Play, No Pay in France

Remote monitoring for CPAP compliance is alive and well in France, and if usage falls below certain levels, patients could be rated as “non compliant” and costs may no longer be reimbursed.

An recent article reports that people in France treated for sleep apnea have been subjected to remote monitoring where medical data is being recorded, transmitted (generally via the internet), and interpreted elsewhere—possibly leading to decisions on subsequent treatment. Patients’ associations have complained but reporter Dr. Nicoloas Postel-Vinay at the Georges Pompidou Hospital in Paris says their objections have so far gone unheeded.

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Genes Out of Sync with Day Time Sleep?

Whether it’s caused by jet lag or sleep-disordered breathing, sleeping during the day is a familiar coping mechanism for many sleep-deprived people. However, a new study suggests that about one third of a person’s genes can be “disrupted” by a mid day snooze.

This type of “shifted sleep” appears to disrupt gene activity even more than not getting enough sleep, according to research published in Proceedings of the National Academy of Sciences. The article “Mistimed sleep disrupts circadian regulation of the human transcriptome” is presented by British researchers who put 22 healthy, young volunteers in a dimly lit sleep lab for three days.

“During the first day, they disrupted the participants’ sleep at regular intervals to reset their body clock to its innate rhythm,” writes HealthDay reporter Brenda Goodman. “On the second and third days, the volunteers ate and slept on a 28-hour schedule, so their longest period of sleep was from noon until about 6:30 p.m.”

Researchers reportedly drew blood samples all three days so they could watch what happened to the timing of gene activity. During the first day, when the body reset its circadian rhythm, nearly 1,400 genes—about 6.4% of all genes that were analyzed—were in sync with that rhythm. On the days of shifted sleep, however, the number of genes tied to the body’s clock dropped dramatically, to 228 genes, or only 1% of genes analyzed.

“Researchers estimated that the sleep disruptions would ultimately impact about a third of a person’s genes,” writes Goodman. “That’s an even greater disruption than scientists saw in a previous study when they tested the effects of sleep deprivation on gene activity. In that study, which had study volunteers sleeping about five and half hours each night, the number of genes that were in sync with the body’s clock dropped from about 9% to 7%.”

“These are quite fundamental processes that are being affected,” said senior study author Derk-Jan Dijk, a professor of sleep and physiology at the University of Surrey, in the United Kingdom. “We think that may be related to the negative health outcomes associated with long-term shift work.

Click here for abstract

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Private pilots are a step closer to securing the same sleep apnea “rulemaking” mandate that commercial truckers bagged last year

Newly introduced Senate bill S 1941, a companion to HR 3578, would compel the Federal Aviation Administration (FAA) to go through the more stringent “rulemaking” process before implementing policy changes related to sleep disorders. The current practice of issuing “guidelines” makes it easier to regulate private pilots when it comes to sleep-related problems.

According to a report in the Aircraft Owners and Pilots Association (AOPA), the legislation was introduced by Senators Joe Manchin (D-WVa) and Jim Inhofe (R-Okla), who are both AOPA members.

“The legislation comes in response to the FAA’s unilateral announcement of a policy that would require pilots with a body mass index (BMI) of 40 or greater to undergo expensive and intrusive sleep apnea testing,” writes AOPA reporter Elizabeth Tennyson. “The FAA initially said it planned to lower the BMI requirement over time, potentially affecting more than 120,000 pilots with a BMI of 30 or higher.”

“As a pilot myself, I recognize that there is nothing more important than making sure our skies are safe, and I appreciate the FAA’s efforts to offer the best guidance on how to do so,” said Manchin on the AOPA Web site. “I also believe that government should work as a partner with the private sector. It’s just common sense to let the pilot community provide public feedback during the rulemaking process before the FAA finalizes any new guidelines.”

“This bill protects our nation’s pilots by ensuring that any changes to the medical certification requirements are done in a manner consistent with the well-established rulemaking process that allows for thorough consideration and adequate public input,” added Inhofe. “This is a classic ‘bureaucrats know best’ effort by the FAA regarding the personal health of those in the aviation industry. I am proud to join Sen. Manchin in introducing legislation that would enforce transparency with FAA’s latest change to its medical certification requirement and ensure pilots, air traffic controllers, and other stakeholders who would be potentially impacted have a voice.”

Source: AOPA

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Use A.M. Deprogrammers to Boost your Practice’s Profits

The A.M. Deprogrammer manufactured by Gergen’s Orthodontic Lab safely repositions a patient’s bite after nighttime TMJ or oral sleep appliance therapy, dramatically reducing the chance of a bite complication. Adding these devices to your sleep and TMJ treatment plans will increase patient comfort and your sleep or TMJ practice’s profits.

The A.M. Deprogrammer from Gergen’s Orthodontic Lab ought to be placed over the patient’s lower teeth immediately after the patient removes his or her nighttime appliance. This means that the patient should be advised not to swallow, bite, or grind their teeth before placing the deprogrammer. Once the deprogrammer has been placed, the patient should perform bite exercises for roughly twenty minutes – singing in the shower is an easy way to complete this step.

While all A.M. deprogrammers reduce bite change complications and the practitioner’s liability, the appliance manufactured by Gergen’s Orthodontic labs offers advantages over its competitors. Most deprogrammers, such as the Patterson TAP A.M. Aligner, are manufactured from thermoplastic wafers that are heat molded to fit the patient’s teeth, which causes them to wear out quickly. However, the A.M. Deprogrammers manufactured by Gergen’s Orthodontic lab, are custom made using hard acrylic, which assures a lab-perfected fit and a long lasting product.

 These deprogrammers can increase your practice’s profits. Each deprogrammer can be billed to insurances companies under bill code S82262. Most insurance companies will typically pay between $500 and $1500 for the treatment. However, Medicare cannot be billed for A.M. Deprogrammers. But, Medicare patients can be charged for the service if they have already completed an Advance Beneficiary Notice.

Whether using a Sleep Herbst, a Respire, a Silencer, or any other oral appliance, the A.M. deprogrammer can increase any sleep or TMJ patient’s comfort during treatment, and can even increase your practice’s profits at the same time.

David Gergen CDT

David Gergen CDT

David Gergen, CDT and President of Pro Player Health Alliance, has been a nationally respected dental lab technician for over 25 years. He received the award for “The Finest Orthodontic Technician in the Country” given by Columbus Dental in 1986. He also has been appointed Executive Director of the American Sleep and Breathing Academy Dental Division, a national interdisciplinary academy dedicated to sleep training and education with over 60,000 members. David rolled out of bed on December 4, 1982 and had his career “ah ha” moment. He knew he was going to be an orthodontic technician and he knew he was going to help people all over the country to help treat their sleep disorders in partnership with their dentists. He has worked for some of the pioneers in the orthodontic and sleep dentistry fields. He was the personal technician for the likes of Dr. Robert Ricketts, Dr. Ronald Roth, Dr. A. Paul Serrano, Dr. Clark Jones, Dr. Harold Gelb, Dr. Joseph R. Cohen, Dr. Rodney Willey, Dr. Allan Bernstein, and Dr. Thien Pham. One of his proudest achievements is receiving The National Leadership award for Arizona Small Businessman of the Year in 2004.

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Surgical Implant for Sleep Apnea Shows Promise

Researchers surgically implanted an upper-airway stimulation device in patients with obstructive sleep apnea who had difficulty accepting or adhering to CPAP therapy.

According to an abstract in the New England Journal of Medicine, the primary outcome measures were the apnea–hypopnea index (AHI, with a score of ≥15 indicating moderate-to-severe apnea) and the oxygen desaturation index (ODI; the number of times per hour of sleep that the blood oxygen level drops by ≥4 percentage points from baseline).

NEJM Abstract Link

Secondary outcome measures were the Epworth Sleepiness Scale, the Functional Outcomes of Sleep Questionnaire (FOSQ), and the percentage of sleep time with the oxygen saturation less than 90%. Consecutive participants with a response were included in a randomized, controlled therapy-withdrawal trial.

The NEJM reports that in this uncontrolled cohort study, upper-airway stimulation led to significant improvements in objective and subjective measurements of the severity of obstructive sleep apnea.

Several media outlets, including Gizmodo, reported that the “pacemaker-like electronic implant could reduce symptoms by nearly 70%, by directly stimulating the muscles in the throat to keep the airway open during sleep. It’s like autopilot for breathing.”

Reporter Robert Sorokanich writes that the apnea device is implanted under the skin of the chest. “A sensor placed between the fourth and fifth ribs monitors breathing patterns, sending a signal to the hypoglossal nerve with each breath,” he writes. “The nerve signal stimulates the muscle at the back of the tongue, keeping the airway open to allow normal breathing. Patients use a remote control to turn the device on at bedtime, and switch it off when they get up.”

Source: AP

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