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Posts Tagged ‘medical

brain-damage

Studies show that obstructive sleep apnea (OSA) affects much more than just your sleep. It can even damage your brain.

A recent brain imaging study from France involved 16 adults. Each of them had just been diagnosed with sleep apnea.

In numerous brain regions the study found a loss of “gray matter.” This is brain tissue that contains fibers and nerve cell  bodies. There also was a decrease in brain metabolism.

The authors suggest that these changes may explain some of the impairments that often occur in people with sleep apnea. Examples include attention lapses and memory loss. The study was published in March 2009 issue of the Journal of Sleep Research.

The results are similar to those found by a research team from UCLA. Their study was published in Neuroscience Letters in June 2008. They reported that people with sleep apnea have tissue loss in the “mammillary bodies.” These are brain regions that help store memory.

In July 2008 the UCLA team published another brain imaging study in the journal Sleep.It involved 41 people with moderate to severe sleep apnea. It also included 69 control subjects matched by age.

Results show that people with sleep apnea have extensive alterations in “white matter.” This is nerve tissue in the brain. It contains fibers that are insulated with myelin -a white, fatty sheath. The structural changes appear in brain regions that help control mood and memory. These regions also play a role in adjusting your blood pressure. Damage also was found in fiber pathways that connect these brain regions.

What causes the brain damage? The authors suggest that oxygen, blood flow and blood pressure may be involved. Sleep apnea involves breathing pauses that can occur hundreds of times a night of sleep. These pauses can produce drastic changes in oxygen levels.

These breathing pauses also reduce blood flow in the brain. People with sleep apnea also are at risk for high blood pressure. Both of these conditions create a potential for brain tissue damage.

Dr. Ronald Harper of UCLA said that the studies show how important it is for sleep apnea to be treated. CPAP is the most common treatment for sleep apnea. The findings make it all the more imperative that OSA be treated as soon as possible to prevent further injury. The long-term effects of OSA are terribly damaging to memory and thinking processes.

Can treatment reverse the brain damage caused by sleep apnea? The authors are uncertain if the changes are permanent.

But studies show that CPAP does help your heart, it may even save your life.

saving money

 Current economic conditions in the U.S. are forcing many consumers to cut back on health care expenses. Yet sleep experts advise that the cost of a sleep study is a sound investment for millions of people who suffer from a sleep disorder.

The Centers for Disease Control and Prevention reports that about 15 million adults in the U.S. did not receive needed medical care in 2005 because they could not afford it. In July, the National Association of Insurance Commissioners conduted a national survey. Results show that 22 percent of people have reduced the number of times they visit the doctor because to current economic conditions.

 In such a challenging economy, should your sleep needs be a priority?

Sleep is one of the cornerstones of good health. It affects everything from your weight and blood pressure to your energy and mood. If you have been struggling with an ongoing sleep problem, then a sleep study may be just what you need. It could be the key that unlocks the door to a dramatic improvement in your health and a better quality of life for you.

 Losing sleep over the economy, but losing sleep over an undiagnosed problem is no fun.

People are notorious for underestimating how sleepy they are. People assume that thier disrupted sleep and level of sleepiness when awake is normal for their age. Symptoms of some sleep disorders also can go unnoticed. For example loud snoring and gasping for breath durning sleep are two warning signs for sleep apnea. But you may be unaware of these sym if you live or sleep alone. As a result, millions of people go through each day wondering why they can’t stay awake. Others go to bed each night wondering why they can’t sleep. The answers to these questions often can be found by a sleep study…

    Here are some benefits to think about:
Research shows that there are numerous benefits to detecing a sleep disorder with a sleep study.  The study pinpoints the nature and cause of your sleep problem. This provides the foundation for an effective treatment plan. Treating a sleep disorder promotes heath, productivity and well-being. In the long run it also can save you money!

  • Improved Health
    Research has linked sleep disorders to many other health problems. These include heart disease, high blood pressure, stroke, diabetes and obesity. A study in the journal Sleep even shows that people with severe, untreated sleep apnea have five times the risk of dying from a heart problem. Effective treatment of a sleep disorder can reduce the risk and severity of other related health challenges.
  • Reduced Spending
    Studies have linked undetected and untreated sleep disorders to an increase in health-care utilization and spending. You are likely to make more visits to the doctor’s office each year. You are also likely to spend more money on your health care. Expenses may include testing, medications and hospitalization. Research shows that effective treatment of a sleep disorder can reduce your health-care spending. Compared to the high cost of remaining untreated, treating most sleep disorders is relative inexpensive.
  • Greater Productivity
    Studies have linked sleep disorders to lower productivity and more absences at work. A severe sleep disorder may even prevent you from being able to stay employed. Effective treatments of a sleep disorder can enable you to improve your job performance.
  • Better Safety
    Research has linked sleep disorders to an increased risk of work-related injuries and motor-vehicle accidents. Effective treatments promotes your safety at work on the roads.
  • Improved Quality of Life
    Sleep disorders can take a severe tool on your personal well-being. Taking care of yourself leads to improvements in your mood, attitude, energy, memory and overall outlook on life. Sleep disturbances can put strain on your relationships.

Mysleepapnea.com can help you with obtaining a Home Sleep Test.

The wise words of Wilse Webb, a prominent sleep researcher recently said.

  So, question of pose: How long can humans stay awake?

The experiemental answer to this question is 264 hours (about 11 days).  In 1965, Randy Garder, a 17 year-old high school student, set this apparent world-record for a science fair. Several other normal research subjects have remained awake for eight to 10 days in carefully monitored experiments. None of these individuals experienced serious medical, neurological, physoiological or psychiatric problems.

  On the other hand, all of them showed progressive and significant deficits in concentration, motivation, perception and other higher mental processes as the duration of sleep deprivation increased. Nevertheless, all experimental subjects recovered to relative normality within one or two nights of recovery sleep.  Other anecdotal reports describe soldiers staying awake for four days in battle, or un-medicated patients with mania going without sleep for three to four days.

  The more difficult answer to this question revolves around the definition of “awake.” As mentioned above, prolonged sleep deprivation in normal subjects induces altered stated of consciousness ( often described as “microsleep”), numerous brief episodes of overwhelming sleep, and loss of cognitive and motor functions. We all know the dangerous, drowsy driver, and have heard about drowsy flyers crashing planes because they fell asleep while flying. RandyGardner was “awake” but basically cognitively dysfunctional at the end of his ordeal.

 In certain rare human medical disorders, the question of how long people can remain awake raises other surprising answers, and more questions. Morvan’s fibrillary chorea or Morvan’s Syndrome is characterized by muscle twitchings, pain, excessive sweating, weight loss, periodic hallucinations, and severe loss of sleep ( agrypnia ). Michel Jouvet and his colleagues in Lyon, France, studies a 27 year-old man with this disorder and found he had virtually no sleep over a period of several months. During that time he did not feel sleepy or tried and did not show any disorders of mood, memory, or anxiety. Nevertheless, nearly everynight between 9:00 and 11:00 p.m., he experienced a 20 to 60-minute period of auditory, visual, olfactory and somesthetic (sense of touch ) hallucinations, as well as pain and vasoconstriction in his fingers and toes. In recent investigations, Morvan’s Syndrome has been attributed to serum antibodies directed again by specific potassium (K+) channels in cell and nerve membranes.

  So, to return to the orginal question, “How long can humans stay awake?” the ultimate remains unclear. Despite studies, there are no reports that sleep deprivation per se has killed any humab ( excluding accidents and so forth ). Indeed, the U.S. Departmend of Defense has offered research funding for the goal of sustaining a fully awake, fully functional “24/7” soldier, sailor, or airman. Future warriors will face intese, around the clock fighting for weeks at a time. Will bioengineering eventually produce genetically cloned soldiers and citizens with a variant of Morvan’s Syndrome who need no sleep but remain effective and happy? I hope not. A good nights sleep is one of life’s blessings.

As Coleridge wrote years ago, “Oh sleep! It is a  gentle thing, beloved from pole to pole.”

time

 

Updated information about the FMCSA proposed medical ruling for CDL requirements.

According to Trasport Topics, the Federal Motor Carrier Safety Administration last week issued a final rule requiring all interstate truck drivers to prove they have passed medical examinations and proposed a separate rule setting up a national registry of qualified examiners.

The rule would require proof of an exam to obtain and keep commercial driver license.

This  new rule, long sought by safety advocates, also will require states to merge commerical driver license records and truk drivers’ medical examination certificates into a singe electronic record that law enforcement officials could check at any time.

Current federal regulations require that commercial drivers pass medical exams every two years, but in most states, drivers are required only to prove evidence of their medical certifications to their employers or when asked by roadside inspectors or law enforcement officers.

Under the new rule, drivers will be required to keep their state licensing agencies informed each time they pass their mandated medical exams, which is every two years for drivers who don’t have special medical conditions. Some drivers with medical problems are required to pass medical exams as often as every three months!

The new driver medical requirements are intended to help prevent medically unqualified drivers from operating on the nation’s highways by providing state licensing agencies with a means of identifying interstate CDL holders who are unable to obtain a medical certificate.

FMCSA also said this rule would deter drivers from submitting falsified medical certificates because enforcement personnel would have electronic access to information about the medical certificate and the identity of the medical examiner.

After the new rule is implemented, drivers will no longer be required to carry a medical certification care in thier wallets.

*Did you know… During 2007, FMCSA and its state partners conducted more than 3.4 million roadside inspections, citing drivers with more than 145,000 violations for failing to have medical examination  certificated in their possession and issued 6,105 violations for physically unqualified drivers.

It is said that the propsed medical examiners rule would help prevent “doctor shopping” and fraud.

  On the heels of a report criticizing the federal governments efforts to ensure that truck drivers are medically qualified, the House transportation committee’s chair man blasted the top   truck safety agency for not living up to tis mission and for dragging its feet on the health issue.

Rep. James Oberstar (D-Minn.), chairman of the House Transportation and Infrastructure Committee, laid into the Federal Motor Carrier Safety Admin. for not moving fast enough to implement congressional mandates or recommendations from the National Transportation Safety Board.

“It shouldn’t take you eight years. It shouldn’t take you five years. Or three years,” Oberstar said during a July 24 hearing by the committee. “People’s lives are at stake, and they are depending on you and your colleagues. We’ve given you a half-billion dollar [annual] budget, practically, to do this. There is no excuse for foot-dragging.”

Oberstar’s comments were in response to a Government Accountability Office report that said hundreds of thousands of drivers have potentially serious medical conditions, some significant enough to prevent them from driving a truck.

During the hearing, Rose McMurray, FMCSA’s chief safety officer, defended the agency’s work on driver health issues, telling the committee the agency was committed to completing rules later this year that would address most of NTSB’s recommendations.

“Four of the NTSB’s eight most-wanted recommendations will addressed by the medical certification and national registry rules,” she said, adding that the remaining recommendations would be addressed by the agency’s medical review board.

The top Republican on the committee’s panel on highways, Rep. John Duncan Jr. (R-Tenn.) also questioned the GAO (Government Accountability Office) conclusions.

“I am concerned this report will be seen by some to imply a broader problem in the CDL population,” he said. “In fact, the report makes it clear that these 15 cases are not representative of the commercial driver population.”

Oberstar was unconvinced and pointed to a report by the transportation committee’s staff that also noted issues with the medical certification program.

“Staff got 600 medical card from drivers at truck weigh stations, and thy tried to verify them with the medical examiners who issued the card, or allegedly issued the card,” he said. “The report documents 30 cases -5%- where the medical examiner didn’t exist, or the medical examiner indicated that the signature of that person had been forged or changed.”

Oberstar, as well as, Rep Peter DeFazio, the chairman of the highways sub-committee, pressed McMurrayto explain why the agency has taken so long with its medical rules, which she said have been “difficult to develop.”

DeFazio asked McMurray if the agency had the resources to complete the rules, but she answered that it wasn’t a “matter of resources, as much as it is a problem of expertise.”

McMurray also said that “other rule-makings” have taken priority over the medical rules, but without specifying which ones.

The rules are also complicated by cost issues, she said, telling Oberstar they are “a significant burden on states.”

That burden, McMurray said, comes in costs to upgrade information technology to handle new databases, and new training requirements for enforcement officers and medical examiners.

“The sheer size of the driver population will require thousands of certified medical examiners to evaluate drivers,” McMurray also added.

Oberstar, however, said the agency lacked “a safety mindset,” and, if it had one, “you would have done this in the last eight years.”

“What we need is will -and willpower- at the highest levels, he said. “And it is apparent there isn’t that will at the level of the secretary of Transportation and permeates all the way down through the Federal Motor Carrier Safety Administration.”

 

 


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