Thursday, March 28, 2013

Sleep Apnea

      

(HealthDay News) -- Treatment at primary care centers is as effective as at specialist sleep centers in reducing daytime sleepiness caused by obstructive sleep apnea, a new study from Australia finds. People with obstructive sleep apnea experience repeated breathing interruptions while they sleep, resulting in poor sleep and daytime drowsiness. Left untreated, sleep apnea may lead to serious health problems, such as high blood pressure, stroke, heart failure, diabetes and depression.




Increasing rates of obstructive sleep apnea have led to long wait lists at specialist sleep centers. In order to improve that situation, the researchers suggested it might be a good idea for appropriately trained primary care doctors and nurses to become more involved in the diagnosis and management of obstructive sleep apnea. In their study, they compared outcomes among 81 patients treated at primary care practices and 74 patients treated at a university hospital sleep medicine center in Adelaide, South Australia. At six months follow-up, both groups of patients showed significant improvements in daytime sleepiness.



The study appears in the March 13 issue of the Journal of the American Medical Association. Treatment was about 40 percent cheaper at the primary care centers than at the sleep medicine center. The average per-patient cost was $1,819 (U.S. dollars) in the primary care group and $3,068 in the specialist care group, according to a journal news release. Sleep study costs, sleep physician consultations and travel expenses appeared to be the main reasons for the higher total price for patients in the specialist group, noted study author Ching Li Chai-Coetzer, of the Adelaide Institute for Sleep Health at the Repatriation General Hospital, and colleagues.



The authors said the fact that primary care centers can provide effective treatment for obstructive sleep apnea could be particularly beneficial for patients in rural areas and those in developing nations, where they may not have access to sleep specialists.

Vitamin D & Pregnancy

      

(HealthDay News) -- Women's vitamin D levels during pregnancy do not affect their children's bone health later in life, a new study shows. British researchers measured vitamin D levels in nearly 4,000 women during pregnancy and assessed the bone mineral density of their children when they were about 12. Bone mineral density is a measure of bone health. A lower mineral content is associated with poorer bone health and a higher risk of diseases such as rickets.


There was no significant association between a mother's vitamin D levels during pregnancy and her child's bone mineral density, according to the study published online March 18 in The Lancet. The University of Bristol researchers also found that mothers' vitamin D levels tended to be lowest during the first trimester of pregnancy, and then increased as the pregnancy progressed. As expected, vitamin D levels tended to be lower during the winter and higher during the summer. The skin produces vitamin D in response to sunlight and there are fewer daylight hours in winter than in summer.



The study also said that nonwhite mothers and those who smoked during pregnancy tended to have lower vitamin D levels, but this did not appear to have any affect on their children's bone health. The researchers said their findings suggest that U.K. health guidelines may be overstating the importance of vitamin D supplementation during pregnancy. Those guidelines recommend that all pregnant and breast-feeding women should take a 10 microgram vitamin D supplement every day.

Vitamin D helps keep bones and teeth healthy. Previous studies into the effects of pregnant women's vitamin D levels on children's bone health have been inconclusive, but this new study is more than 10 times larger than previous studies combined, according to a journal news release. "Suggesting to pregnant women that their child's future bone health depends on their pregnancy vitamin D status or that by taking supplements they will improve [their child's future bone health], ... I think our study challenges that [suggestion]," study leader Debbie Lawlor said in the news release.



In an accompanying editorial, Philip Steer, of Imperial College London, wrote: "In view of the inconsistency in results [of previous studies], it might seem unclear why vitamin D supplementation is officially recommended for all pregnant and breast-feeding women."



He added: "The safest approach is probably routinely to supplement pregnant women at greatest risk, as defined by the (U.K.) guidelines." These include women of South Asian, black African, black Caribbean or Middle Eastern origin, as well as women with little exposure to sunlight or who were obese before pregnancy, he noted. Steer added that pregnant women whose diets included few sources of vitamin D, such as oily fish, eggs, meat or fortified margarine or breakfast cereal, might also benefit from supplementation.



Other research has suggested a connection between vitamin D levels in pregnancy and infants' birth weight.