Saturday, September 7, 2019

CPAP , A Medical Aesthetic?


Coronary artery disease, cerebrovascular events, cardiac arrhythmias... What about fine lines and wrinkles?  Looks like we have the whole sleep apnea marketing approach wrong.

Patients With OSA Are Perceived as Younger Following Treatment With CPAP.



The aim of this study was to compare the effects of CPAP treatment and placebo intervention on the facial appearance of patients with OSA.


Patients with severe OSA were randomized to receive either CPAP treatment or nasal dilator (placebo) intervention for 1 month. The sequence was interposed by 15 days of washout with no treatment. Patients were evaluated by using questionnaires, polysomnography, and facial photographs at baseline and at the end of both interventions. In an electronic survey, the photographs were presented in a randomized order to 704 observers who rated the perceived age, health, attractiveness, and tiredness of the patients. Observers were unaware of the patients' conditions.


Thirty patients (age, 46 ± 9 years; 21 men; apnea-hypopnea index, 61.8 ± 26.2) were evaluated. During each intervention period, patients used CPAP 6.0 ± 1.7 h per night on 94% of the nights and the placebo intervention on 98% of the nights. After CPAP treatment, patients were rated younger (47.9 ± 3.5 years) than they appeared at baseline (53.9 ± 4.0 years) and following the placebo treatment (49.8 ± 3.7 years) (P < .001). Linear regression analysis identified that CPAP adherence, total sleep time, and percentage of total sleep time with oxyhemoglobin saturation < 90% were predictors of a decreased age rating following CPAP treatment.


Patients with severe OSA had a younger appearance following 1 month of CPAP treatment. This benefit can serve as an additional source of motivation for patients with OSA to comply with CPAP treatment and may facilitate OSA management.

Read abstract here.

Monday, February 18, 2019

Good Sleep Hygiene in Adolescents With Asthma Linked to Improved Attention

A real world comparison of this study seems to fit what we know.  Child and adolescent sleep patterns are woefully bad.  It's no surprise then that attentiveness and other quality of life factors can improve immensely when we "clean up" our sleep habits. Dr. Susarla
Adolescents with asthma who practice good sleep hygiene may experience improvements in sleep and attention span, better quality of life in school, and lower rates of dysfunction during the daytime, according to a study published in the Journal of Asthma
This study included 41 participants with persistent asthma (mean age, 14.83±1.28 years; 51.2% male adolescents). Measures included demographic information (sex, age, race/ethnicity, education, caregiver marital status, and family income), information on asthma, sleep hygiene via the adolescent sleep hygiene scale (ASHS), quality of sleep via the Adolescent Sleep Wake Scale (ASWS), quality of life via the Pediatric Quality of Life Index (PedsQL), and attention span via the psychomotor vigilance task (PVT).
To investigate associations among variables related to asthma, as well as between demographic features and dependent variables, Pearson product-moment correlations were used. The predictive power of sleep hygiene on sleep quality, quality of life (school-related or otherwise), and attention span was calculated using linear regressions. Because the sample size was smaller than the recommended 73 participants, effect sizes were used to interpret results. Cohen's f² effect sizes were categorized as large (0.35), medium (0.15), or small (0.02).

Friday, February 1, 2019

Can We Predict Childhood Asthma Earlier?

Predicting and appropriately diagnosing early childhood asthma is still a challenge, particularly with some "conventional wisdom" that diagnosing under 5 is too early. Can we arrive at a set of criteria where treatment is indicated? Health care providers needs tools to help direct us when early intervention is needed.  Predictive scores like the Pediatric Asthma Risk Score may bring us closer to the mark. Dr. Susarla

A new quantitative personalized tool to predict asthma development in young children predicted asthma development reliably according to results of a study published in the Journal of Allergy and Clinical Immunology.
Data from the Cincinnati Childhood Allergy and Air Pollution Study, a birth cohort of infants born to atopic parents between 2001 and 2003 in Cincinnati, Ohio, and Northern Kentucky was used to develop a quantitative personalized tool called The Pediatric Asthma Risk Score to predict asthma development in young children. The sensitivity and specificity of the Pediatric Asthma Risk Score were compared with those of the Asthma Predictive Index in the Isle of Wight study, which was a United Kingdom whole population birth cohort study.
Read article here.

Wednesday, January 16, 2019

Antibiotics in Childhood Asthma

Most experts agree that there is little role in use of antibiotics in chronic or acute treatment of asthma.  In addition, antibiotic overuse may delay diagnosis and management of a chronic condition and undermine medical provider recommendations. 
After all, if an inflammatory lung condition is repeatedly conflated with an infectious process, families may lose faith in medical care and seek treatment options elsewhere.
Dr. Susarla
Children with asthma are prescribed antibiotics at a higher rate than those without asthma, according to a study published in BMJ Open. Furthermore, the diseases for which they are prescribed typically do not call for antibiotics.
This underscores the importance of measured distribution of antibiotics among physicians to avoid overprescribing and its consequences, which include further infection and microbial resistance.
This population-based retrospective cohort study included data from 26,750 participants with asthma and 330,916 without asthma, all of whom were aged 5 to 18 years old. Asthma was defined by ≥2 respiratory drug prescriptions within 1 year after receiving an asthma code. Data were collected from The Health Improvement Network (THIN) in the UK and Integrated Primary Care Information Database (IPCI) in the Netherlands. Rates of antibiotic prescriptions were compared using a Poisson regression model, and use indications were compared between individuals with and without asthma using Fisher's exact or chi-square tests.