Loud Snoring May Trigger A Heart Attack


People who snore loudly in their sleep not only run the risk of irritating their spouse, but also be an indication of sleep apnea (a momentary deferral of breathing while asleep). Such people are actually deprived of sufficient sleep and this may produce a car crash, or even worse, result in a heart attack.

Interestingly enough, scientists are now commencing a test to find out whether implanting a device akin to a pacemaker would help specific people suffering from sleep apnea. They expect this device to keep the airways of the sufferers open by zapping the tongue of the patient while he/ she is sleeping.

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All this may seem incredible and many may be wondering how the tongue intervenes in having sound night sleep.

Well, the answer to this is simple. A major reason for disruptive sleep apnea is that the muscles of the tongue and throat loosen up excessively when one is asleep - sufficient to provisionally collapse as well as obstruct breathing for approximately 30 seconds at one time. In effect, when this happens, people jerk and become wakeful and struggle for breath - a sequence that may recur 30 times or even more in an hour. This, in turn, leaves the patients without the essential sound sleep.

The concept that has led to the trial implant is to excite the nerve that regulates the base of the tongue with a gentle electric current while the patient is sleeping and it is likely that the tongue will remain toned and in its position as it is during the day time when the patient is awake. In other words, the implant is expected to keep the tongue from becoming flaccid when the patient is sleeping at night.

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It has been learnt that Inspire Medical Systems based in Minneapolis intends to start registering 100 sleep apnea patients by the end of this month to undertake a crucial research in the United States and Europe with a view to find out if the purported hypoglossal nerve (the twelfth cranial nerve that provides the muscles of the tongue) spur would actually be effective. In fact, two rival firms are developing comparable implant devices for patients of sleep apnea. While ImThera Medical, based in San Diego, has announced that it expects to commence the research in the United States early this year, another organization, Apnex Medical from St. Paul in Minnesota, has said that it will undertake a small-scale trial in this regard.

According to Dr. Meir Kryger who is an authority on sleep medicine and associated with Gaylord Hospital based in Connecticut, and is assisting in guiding the research by Inspire, they are not seeking small changes in this type of research. He added that they were actually looking for a cure to this bothersome and, possibly hazardous, health condition.

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It may be noted that as per the statistics made available by the National Institute of Health, presently over 12 million Americans suffer from disruptive sleep apnea. In fact, this health condition is especially common in people who are obese and middle-aged men. Nevertheless, the scientists say that any person can develop this health problem.

Presently, the undoubted therapy for this disorder is known as CPAP or the continuous positive airway pressure. As per the CPAP therapy, unique masks are used at bedtime to blow air gently through the nose in order to keep the airways clear. However, researches have hinted that no less than 30 per cent of people who have been diagnosed of having sleep apnea will not or cannot use CPAP. Such patients either complain that the masks have loose fittings and leak or they report that they have a strange fear of being enclosed. Some others have complained that the masks are not in their desired position when they toss or turn while asleep at night.

However, not taking any treatment to cure this health disorder may prove to be even more hazardous compared to simply feeling tired or exhausted owing to lack of adequate sleep at night. In fact, people suffering from sleep apnea experience that their body is stressed in several ways and these may result in high blood pressure or hypertension, diabetes, heart attack and stroke. Even if one does not develop these ailments immediately, people enduring sleep apnea are seven times more prone to car crashes compared to those who do not suffer from this disorder. The National Transport Safety Board had advised pilots, truck drivers and others who operate commercial transport vehicles last year to begin screening for apnea, because it found that sleep apnea has been a major factor in accidents involving all modes of transit.

Occasionally, surgeons try to cure the patients suffering from sleep apnea by removing a portion of the roof of the mouth or any other soft tissues so that the airways are broadened. However, it is actually difficult to foretell when such complicated operations would be really helpful. Hence, such difficult surgeries are undertaken only when the cases are extremely acute.

According to 67-year-old Rik Krohn of suburban Minneapolis who is suffering from sleep apnea, there comes a time when he is really afraid of going to bed. Several studies undertaken on sleep have demonstrated that Krohn's apnea was awaking him for an average of 35 times an hour. It is interesting to note that though Krohn has tried five different types of CPAP masks, none of them were able to deliver the desired results. This actually made him frustrated. However, before he gave up hopes of being cured of this unusual disorder, Krohn sought the help of surgeons who turned him away.

Entrance of hypoglossal nerve stimulation

The implant device marketed by Inspire enables the doctors to embed a small generator, which is akin to a pacemaker, beneath the patient's skin in the region of the collarbone and bend a wire up below the jaw to the nerve that controls the tongue. A sensory device placed at the diaphragm identifies the point when a patient is taking breath, indicating the implant to zap the nerve. Meanwhile, the researchers regulate the power of the device in such a manner that the nerve is stimulated only enough to keep the tongue from falling backward while the patient is sleeping and not to stick out of the mouth. The patients are required to switch on the gadget at bedtime using a remote control, which is fitted with a timer that can be set by the patients enabling them to fall asleep prior to the pulses beginning to work.

Krohn, the sleep apnea patient from Minnesota who had quit the treatment for the disorder until he volunteered for an initial study undertaken by Inspire last year, said that while he is asleep he doesn't have any idea that the device is on. At the same time, he confirmed that since he has been using the device, he has been getting a good sleep every night. According to Krohn, the device has proved to be a game-changer for him.

The prospective subjects of the up-coming Inspire study would be required to go through a special examination wherein a tube bent down the airway keeps record of whether a tongue collapse or any problem with any other factor is the actual cause of the sleep apnea in the patient, emphasized Kryger from Connecticut.

Echoing Kryger's views, Dr. Rick Odland, who is Rik Krohn's surgeon at a medical center in Minneapolis, say that it is extremely imperative to find out the actual place of obstruction and tailor the treatment accordingly. In fact, Dr. Odland had turned away another prospective candidate during a previous examination when the test displayed zapping the tongue would actually have focused on the wrong spot.

Thus far, not much emphasis was laid on finding ways to effectively treat sleep apnea and the present trials are only the start of an exercise to find ways and means to cure this disorder. So far, only a few implants have been tested and although this is a very exciting perception, Dr. Amy Atkeson of Columbia University Medical Center located in New York, warns that patients who are frustrated with their problems ought to first try some proven measure.

According to Dr. Amy Atkeson, even if the CPAP masks don't work perfectly, one should consult a knowledgeable sleep technician before giving up hope. It is possible that the sleep technician will amend humidity levels of the CPAP mask or undertake some other measure which not all CPAP prescribers may know how to try. Moreover, it is important to note that in case you happen to be obese or overweight, sleep apnea may be cured to a great extent if you lose some extra flab from the body.


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