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Snore Centre now offers online video consultaitons - Lockdown caused sharp increase in insomnia - Is OSA a risk factor for COVID-19? - No evidence CPAP use increases coronavirus risk - BBC Stories - Try the Snore Centre Mobile App - Michael Oko explains cardiac anatomy
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Snore Centre eNewsletter September 2020

Snore Centre now offers online video consultations via Doctify

Given the current crisis with many people's movements severely restricted The Snore Centre has set up an online consultation service in partnership with Doctify



Patients can now access our first class sleep service from their own homes without having to risk travel or attending a clinic in person.

Doctify is revolutionising the global healthcare market, enabling patients to search, book and review clinics and hospitals online. They strongly believe in the benefit of patient reviews and how they strengthen the patient-specialist relationship: empowering people to make informed decisions, as well as recognising the exceptional dedication of clinics and hospitals.

Lockdown caused sharp increase in insomnia

The Guardian reported that lockdown triggered a sharp increase in anxiety-related sleeping problems, with mothers, key workers and people from minority ethnic backgrounds the worst affected, a study shows.

The number of Britons suffering sleep loss caused by worrying rose from one in six to one in four as a direct result of the huge disruption to people’s social and working lives after the restrictions began on 23 March. Social isolation, loss of employment, financial problems, illness, fear of getting infected with coronavirus and the pressures of juggling work and home-schooling all contributed to the trend.

Prof Jane Falkingham, from the Economic and Social Research Council-funded Centre for Population Change at Southampton University, which undertook the research, said: “Sleep loss affected more people during the first four weeks of the Covid-19 related lockdown than it did before. We observed a large increase in the number of Britons, both men and women, suffering anxiety-induced sleep problems.

“This reflects stress levels due to anxieties about health, financial consequences, changes in social life and the daily routine, all of which may affect sleep.”

She and her colleagues looked at how many people aged 16 and above from a 15,360-strong sample of the population had trouble sleeping both before the pandemic struck in March and then in April.

The overall incidence of worry-related sleep loss rose from 15.7% to 24.7%. But that 9% increase nationally masked much bigger spikes in certain groups, particularly mothers of young children. For example, while the number of men experiencing poor sleep rose from 11.9% to 16.5%, the increase among women was much more pronounced – it shot up from 18.9% to 31.8%.

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Is Obstructive Sleep Apnoea a risk factor for COVID-19?
 


In an expert interview in Pulmonology Advisor this month Toni Rodriguez investigates whtere sleep apnoea is a potential risk factor for COVID-19.

In the context of coronavirus disease 2019 (COVID-19), underlying health conditions such as lung disease, diabetes, hypertension, and cardiovascular disease confer an increased risk of infection and associated adverse outcomes including admission to the intensive care unit (ICU) and death. Additionally, the authors of several recently published papers have proposed that obstructive sleep apnea (OSA) may represent another important variable contributing to increased risk related to COVID-19.1,2

In 2 small studies of individuals admitted to the ICU with confirmed COVID-19, researchers reported that OSA was present in 21.0% and 28.6% of patients, respectively.3,4 Such findings suggest that OSA “could potentially contribute to worsening hypoxemia and the cytokine storm that occurs in COVID patients,” wrote the authors of an article published in the Journal of Clinical Sleep Medicine (JCSM).2

However, the mechanisms potentially linking to OSA to worse outcomes in COVID-19 remain to be identified, according to coauthor Atul Malhotra, MD, a board-certified pulmonologist, intensivist, professor of medicine, and research chief of pulmonary, critical care, and sleep medicine at the University of California, San Diego School of Medicine. “Some studies have suggested that sleep apnea is a risk factor for pneumonia, and sleep deprivation — even without sleep apnea — has been associated with risk of developing pneumonia and with impaired response to vaccinations,” Dr Malhotra noted.5,6

One area that warrants special attention in future research is the role of the immune system in OSA, and there is a need for additional investigation regarding the benefits of OSA treatment from the standpoint of respiratory infection, noted Dr Malhotra. “Trying to separate the effects of obesity, diabetes, and sleep apnea will likely require interventional studies — these can be difficult to differentiate since they are all correlated.”

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No evidence CPAP use increases coronavirus risk

There is no current evidence that CPAP use increases the risk for getting or developing complications of coronavirus (COVID-19). However, many patients with OSA may also have other long term health problems that may increase their risk. Please ensure that if you are affected by any other conditions that you check if they are relevant for COVID-19.

OSA Alliance advice for CPAP users:

  • People with OSA should continue to use their CPAP at home as normal.
  • There is no evidence that using CPAP makes you more likely to catch COVID-19, and nothing to suggest that CPAP will make you more unwell if you do catch it.
  • If a CPAP user becomes unwell with symptoms suggestive of COVID-19 (new cough and fever > 37.8 C), please follow government guidance regarding self and household isolation.
  • We do not know whether CPAP makes virus spread worse within a household. This will be something you will need to consider when deciding whether or not to continue using CPAP if you are self-isolating with symptoms of COVID-19. You may wish to distance yourself from vulnerable household members by changing bedrooms or stopping CPAP for a short time.
  • Any respiratory infection, particularly with a blocked nose, can make it more difficult to use CPAP. Try and persist, but if wearing CPAP makes you feel worse (e.g. by increasing coughing and disturbing sleep), then stop using it until your respiratory symptoms improve. Sleeping more upright, avoiding alcohol and using a mandibular advancement spilt if you have one, may help as alternatives to CPAP in reducing OSA a little in this period. Your OSA symptoms are likely to worsen over the week, but will resolve when you restart CPAP.
  • Routine hygiene is adequate for infection control: changing machine filters routinely, cleaning surfaces, cleaning mask and tubing with hand-hot soapy water (washing up liquid) and washing hands regularly.
  • Masks and machines should not be shared.
  • Please use the telephone number/email address provided by your sleep centre for urgent issues with your equipment or sleep/OSA related symptoms. Do not attend in person unless instructed to do so. Please be aware the team may not be able to respond quickly, as staff may have been moved to Emergency Services.
  • Please look after masks and tubing carefully as there may be a temporary shortage in the future.
  • A reminder that DVLA says anyone with excessive sleepiness having or likely to have an adverse effect on driving must not drive.

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BBC Stories: Are you holding your breath in your sleep?




Watch the video on the BBC
 
 

Have You Tried Our Mobile App?

 

 
Keep up with all the latest news and research on sleep apnoea from the Sleeping Disorders Centre with this nifty free app. Here you can find all our social media channels (YouTube/Facebook/Twitter/Blog) all in one place, right on your phone.

Be sure to let us know what you think of our app by leaving a review on iTunes or the Google Play Store. All your feedback is valuable to us.

 

Download the app for Android devices

Download the app for iOS devices


Michael Oko explains cardiac anatomy using virtual reality  ​


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