Aussie innovation curbing sleep-related risks

More than 1-in-20 Australian adults who stop breathing during the night1 are at increased risk of heart disease and a shorter life span, new research reveals.[2]

From today, these people may sleep better and live longer, with the launch of an Australian innovation.

New findings from a decade-long study show people living with obstructive sleep apnea (OSA) with less than 90 per cent oxygen in their blood for long periods during sleep face a 50 per cent increased risk of having a heart attack, stroke or early mortality.[2]

According to Professor David Hillman, Chair, Sleep Health Foundation and Director of the West Australian Sleep Disorders Research Institute, Perth, people living with OSA can reduce associated health risks with correct treatment.[3]

“People with OSA – one of the most common and costly sleep disorders4 – face an increased risk of early mortality and major health complications and the more severe the sleep apnea, the greater their risk.[3]

“It is now established that if you do not to treat your sleep apnea, you are at greater risk of developing diabetes or heart disease,” Prof Hillman said.

“However this risk can be reduced if you remain on appropriate treatment.”

People with OSA may from today sleep soundly with the launch of a new generation, Australian-designed, continuous positive airway pressure (CPAP) system mask. The new mask system works together with all CPAP devices, delivering a constant flow of air pressure to help keep the upper airway open.

“The innovations of the AirFit P10 nasal pillows mask make it extremely comfortable and easy to use, which is a great step forward in improving adherence to CPAP therapy,” said Sahisha Ketheeswaran, Biomedical Scientist and Clinical Researcher, ResMed.

CPAP is the preferred treatment for OSA due to its proven effectiveness in delivering a fixed, constant amount of pressure throughout the breathing cycle[5].

“Adherence to CPAP is one of the major obstacles in treating OSA,” Prof Hillman said.

“CPAP therapy is highly effective when used regularly and has been shown to reduce serious outcomes of OSA including heart disease, stroke and lower the risk of motor vehicle accidents.[6]

“Some of the reasons cited by patients for not continuing with CPAP treatment, such as pressure sores, mask leakage and airflow-generated noise, are significantly overcome with this new mask. So those who are currently not using CPAP therapy for these reasons should consider trying this new mask,”[7,8] said Ms Ketheeswaran.

According to the new mask’s mechanical engineer, Alicia Wells, the mask’s nasal pillows allow direct flow of air into the nose to prevent leaking, and minimise contact with the skin, and also feature an extremely soft venting system.[9]

“The new mask is designed for anyone over 30 kilograms. It is lightweight – only 43 grams, or the equivalent of two Caramello Koalas – quiet, and doesn’t disturb people with OSA or their bed partners during sleep, making it a more acceptable CPAP mask alternative.

“In addition, our clinical study has found patients using the AirFit P10 nasal pillows mask were sleeping for an average of 40 minutes longer per night than they were previously,[9]” Ms Wells said.

According to Prof Hillman, sleep deficiency has a serious impact on overall health and wellbeing in both the short and long-term.[10]

“OSA is caused by repeated obstructions to the throat during sleep, involving a narrowing of the throat, relaxation of the tongue and airway muscles[11], leading to reduced oxygen levels and sleep disruption,” Prof Hillman said.

“Many people with OSA are unaware they have the condition and therefore a significant proportion of people with the disorder remain undiagnosed.[2]

“Sleep deficiency is serious and can result in reduced cognition, memory and ability to solve problems, as well as mood disorders, depression and a poor quality of life,”[10,12] said Prof Hillman.

IT analyst, avid golfer and father-of-three, Bryan, 53, Sydney, who was diagnosed with severe OSA in 2012, says his quality of life has improved significantly since using the new nasal pillows mask.

“I was waking up a lot during the night, and in the mornings I always had a really dry, parched mouth.

“I would wake up feeling tired and in the afternoon I would be completely overwhelmed with tiredness, to the extent that I would zone in and out mid-conversation,” Bryan said.

“My OSA was so severe, I was waking up more than 30 times an hour, or at least once every two minutes.

“I’m told that sort of pressure on my body is equivalent to running a marathon and then trying to survive the next day,” said Bryan.

Bryan commenced CPAP therapy following his diagnosis to effectively manage his sleeping disorder. His apnea hypopnea index (AHI) score – the numeric measure for the number of occasions a sleep apnea patient wakes up each hour throughout the night – is now 0.7 with the new nasal pillows mask, as opposed to 31 pre-treatment.

“I’m getting the best sleep I’ve had in a long time. I wake up only about once a night now and can now get through the day much more happily and healthily than before,” Bryan said.

Signs of OSA include snoring, choking or gasping while asleep, daytime sleepiness, dry mouth and throat, poor concentration, and memory loss3. While obesity is the most common and most important risk factor for the development of OSA, followed by sex (men are twice at risk of developing of OSA than women) and age, OSA can affect anyone.[3]

Mild OSA is defined as between 5-to-15 apnea episodes per hour; moderate OSA involves between 15-to-30 apnea episodes an hour; while severe OSA involves more than 30 apnea episodes per hour.[3]

Representing a new generation in OSA mask technology, the AirFit P10 nasal pillows mask has a simple, three-part body with a single piece QuickFit™ headgear, nasal frame and key clip pillows that allows the user to slip it on and off quickly and easily.[9] It can be used with a patient’s existing CPAP flow generator.

Clinical trial results with the new nasal pillows mask show statistically significant reduction in noisiness and better air diffusion,9 offering less sleep disruption for patients and their bed partners. Reinforced ease of use, increased breathing comfort and headgear are also listed as major advantages of the new nasal pillows mask.[9]

“If you have been diagnosed with, or suspect you may be living with OSA, talk to your GP,” said Prof Hillman.

For more information about the new AirFit P10 nasal pillows mask, visit www.resmed.com/airfitp10.

References

1. Position Paper: Best Practice Guidelines for Provision of CPAP Therapy Australasia, Guideline for CPAP Provision V2.2 14 January 2009.

2. Tetyana, K. et al. Obstructive Sleep Apnea and Risk of Cardiovascular Events and All-Cause Mortality: A Decade-Long Historical Cohort Study, PLOS Medicine, Vol 11, Issue 2, February 2014.

3. Palnitkar, G. et al. Obstructive sleep apnea in adults: Identifying risk factors and tailoring therapy. Medicine Today 2012;13(8):14-23.

4. Hillman, D. et al. Public health implications of sleep loss: the community burden, MJA 199 (8) 21 October 2013.

5. Robert C, Basner MD. Continuous positive airway pressure for obstructive sleep apnea. N Engl J Med. 2007; 356:1751-1758.

6. Tregear S et al. Obstructive sleep apnea and risk of motor vehicle crash: Systemic review and meta-anlysis. J Clin Sleep Med. 2009; 5(6):573-581.

7. Pepin JL et al. Side effects of nasal continuous positive airway pressure in sleep panea syndrome. Chest. 1995; 107(02):375-381.

8. Kribbs NB et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993:147(4): 887-895.

9. Pham, A. et al. Assessment of a new nasal pillows mask in patients receiving CPAP. Sydney: ResMed Science Center, 2013. p. 1.

10. Colten, HR. et al. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Institute of Medicine (US) Committee on Sleep Medicine and Research. Washington (DC): The National Academies Press; 2006.

11.SLEEP. Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research. SLEEP. Vol 22, No 5. 1999.

12. National Heart, Lung and Blood Institute. Why is Sleep Important? February 22, 2012. [Online] 2012. [Cited 2,24,2014].