This Week in Sleep Medicine: June 28, 2016
While You Were Sleeping: What Sleep Technologists Need to Know This Week
Your media watchdog for headlines and trends relevant to sleep technology and patient education.
“Law bringing changes to truck driver sleep requirements”
May 19, 2016
From the article: “Amy Joe Snider was killed in 2013 by a truck driver who police say fell asleep at the wheel. … ‘[He] didn't even slow down going about 70 MPH,’ Snider’s father Roger Hampshire Sr. said. ‘They said he hit the back end of my daughter's car and drove over the top of her.’ … The concern over tired truck drivers has Congress looking at ways to make sure they have enough sleep after they finish their 11-hour daily shifts. … Hampshire, who is a former truck driver, said even he drove tired more than 100 times.’
Takeaway: There are dozens of discussions out there right now about truck drivers, sleep deprivation, and road safety. Read this one (and watch the video), and then read the comments. We have patients who are drivers of all kinds, and these are the discussions they are having. We need to find thoughtful ways to educate them on the risks without making them feel their jobs are threatened. Knowing their thoughts and arguments—and developing solid rebuttals—is one place to start.
MEDICAL NEWS TODAY
May 21, 2016
From the article: “The researchers found that people who were currently working shifts—or who had worked shifts in the previous 5 years—performed worse on the test than non-shift workers. … They found this after taking into account other factors that could influence the results—such as age, education, and sleep duration.”
Takeaway: We never want to hear about the occupational hazards that come with shift work, but at least this study shows that cognitive problems caused by working nights are reversible.
“New study shows that CPAP and oral appliance therapy come out even par, when used equal amount of time”
May 23, 2016
From the article: “The OA [oral appliances] are now widely prescribed for the treatment of OSAS, either as a primary or as an alternative measure to those patients unwilling or unable to tolerate CPAP therapy. Although CPAP has been shown to be more effective than OA and highly cost-effective, there are increasing evidences that OA improve drowsiness, blood pressure, and indices of sleep-disordered breathing. Moreover, many patients who respond to both treatments generally prefer to use OA.”
Takeaway: Sleep technologists still have limited exposure to this alternative technology. It might be due to limited access to board-certified sleep dentists, biases from doctors, or a general lack of training among sleep technologists in the titration of oral devices. It’s in any sleep technologist’s best interests to learn how these appliances work, who may be best suited for using them, and how to titrate them in the lab environment.
“AASM updates ASV recommendations for central sleep apnea associated with heart failure” ~ AMERICAN ACADEMY OF SLEEP MEDICINE
May 19, 2016
From the article: “Based on a systematic review and meta-analyses, the AASM update comprises a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in adult patients with an LVEF of less than or equal to 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment of CHF-associated CSAS in adult patients with an LVEF greater than 45% or mild CHF-related CSAS.”
Takeaway: Time to update the P & P and make sure everyone gets the memo.
“Melatonin signaling is a risk factor for type 2 diabetes.”
May 12, 2016
From the article: “A sleeping pancreas releases less insulin, but how much insulin drops each night may differ from person to person, suggests a new study. Up to 30 percent of the population may be predisposed to have a pancreas that's more sensitive to the insulin-inhibiting effects of melatonin. People with this increased sensitivity carry a slightly altered melatonin receptor gene that is a known risk factor for type 2 diabetes.”
Takeaway: Here’s one way to connect the dots between endogenous melatonin (what we make ourselves), insulin resistance, shift work, and an eventual pathway to type II diabetes, a concern for nearly every person who works nights.
HEALTH LITERACY WATCH
“CDC unveils new campaign to improve hand-hygiene compliance”
May 6, 2016
From the article: “Doctors and nurses, on average, clean their hands less than half the number of times they should throughout the day, according to the announcement. More than 722,000 healthcare-associated infections occur in hospitals annually, the CDC said, and approximately 75,000 patients with these infections die during their hospital stays. The first step in preventing these illnesses is proper hand washing.”
Takeaway: It seems obvious, but clearly it’s not, if medical professionals are only following protocol half the time. Yes, as sleep technologists, we need to wash our hands and use protective gloves and other measures to prevent spread of infection, just as much as an ER nurse or a surgeon or any other healthcare professional should.
“American Academy of Sleep Medicine urges Oklahoma to reinstate coverage for sleep medicine services for Medicaid patients”
AMERICAN ACADEMY OF SLEEP MEDICINE
May 23, 2016
From the article: “The American Academy of Sleep Medicine (AASM) urges the Oklahoma Health Care Authority to reinstate coverage for diagnostic sleep studies and continuous positive airway pressure therapy, known as CPAP, for adult Medicaid patients. … The OHCA board has indicated that it recognizes the potential medical benefits of these sleep medicine services. However, the state’s severe budget crisis led to the recent decision to eliminate coverage of sleep studies and CPAP therapy, which the state considers to be ‘optional’ services.”
Takeaway: Sleep technologists and educators need to mobilize on this topic, lest other state agencies drop coverage under the aegis of “economics.” Patient outcomes—the key metric the ACA has hinged the future of patient care upon—will drop dramatically for those in OK who need, but will not receive, sleep studies or CPAP. They can only expect to see rises in healthcare costs and hospitalizations as a result.
About the author
Tamara Kaye Sellman RPSGT, CCSH curates the sleep health information clearinghouse, SleepyHeadCENTRAL, where she follows sleep health news headlines daily. She generates content for inboundMed and SomnoSure and contributes as a freelance writer to AAST’s magazine, A2Zzz, and MultipleSclerosis.net, and among other places.