Volume 7
Issue 1
In recent years, physicians and researchers have observed a growing percentage of the population afflicted
with “Metabolic Syndrome”. The condition, which currently affects roughly 25% of the US adult population,
refers to a group of risk factors that occur together and increase chances of coronary artery disease, stroke,
Type 2 Diabetes, kidney disease, and early mortality. As more attention is given to ailment, its connections to
sleep disorders are now being examined.
One of the greatest health risks to today’s population is obesity. Roughly one third of Americans are
considered obese (Body Mass Index > 30) and that percentage is predicted to double by 2030. Obesity is the
primary cause for development of metabolic syndrome and is also a primary risk factor for some sleep
disorders. Sleep quality and quantity can greatly impact the elements that make up metabolic syndrome.
Multiple studies have shown that Obstructive Sleep Apnea, a condition in which a sleeping person’s airway
collapses repeatedly and causes disrupted slumber, leads to increased insulin resistance, stroke, heart
attacks, and may contribute to weight gain.
Chronically shortened sleep duration may also wreck havoc with metabolism. Adults who sleep less than 6
hours per night have a 45% higher chance of having metabolic syndrome and for each hour less of sleep
there is a .35 increase in BMI. Those with shortened sleep also have increased levels of the hormone Ghrelin,
which stimulates appetite. Coupled with daytime fatigue and a sedentary lifestyle, these influences can lead
to obesity and increase the possibility of developing metabolic syndrome.
Fortunately, reversing metabolic syndrome is possible through lifestyle changes and medical intervention.
Weight loss and exercise can help curb its effects and medications can be used to control blood sugar levels
and heart disease. Properly treating sleep disorders can have dramatic effects on health in general and
correcting the sleep disruptions caused by OSA may help to lessen the risks that become categorized as
metabolic syndrome. If you are overweight, you may be at risk for this disorder. Talk to your doctor to learn
more about how to address the problem through a process of lifestyle changes and medical treatment.
Contact Oregon Sleep Associates to get screened for sleep disorders as part of this process.
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Obstructive sleep apnea has been shown to affect both physical and mental
functions in the body. OSA can cause excessive fatigue, memory loss, and hinder
cognition. CPAP therapy, the most commonly used treatment for OSA, may
reverse some of these problems.
CPAP works by providing the user with a constant flow of room air delivered via a
facial mask. The air splints open the wearer’s airway using positive pressure,
thereby eliminating nighttime airflow restrictions. In a recent 6-month long
multicenter study, over 1500 participants were randomly given either real or sham
CPAP to gauge the device’s effectiveness in reducing neurocognitive problems
caused by sleep apnea.
The participants in the study were tested using a variety of methods to assess three areas of cognition:
attention and psychomotor function, learning and memory, and executive and frontal-lobe function. The
results of the study showed “improvement in the most sensitive measures of executive and frontal-lobe
function for those with severe disease, which suggests the existence of a complex OSA-neurocognitive
relationship” The research also indicates that CPAP users benefit from “a significantly greater ability to remain
awake whether measured subjectively or objectively” than non-CPAP users who suffer from sleep apnea.
If you or a loved one has untreated sleep apnea, it could be affecting your memory, reasoning and daytime
energy levels. Seeking treatment using CPAP therapy could greatly improve the way you think and feel. To get
tested for sleep disorders, contact the sleep specialists at Oregon Sleep Associates at 503-288-5201 or visit
www.oregonsleepassociates.com.
As the levels of obesity in children in the US have continued to rise, so too have cases of increased insulin
resistance and Type II Diabetes. The connections between short sleep duration in children and adolescents and
obesity have been explored in multiple studies. Now researchers are examining how sleep duration may also
affect the ability of kids’ bodies to regulate blood glucose levels.
A study recently conducted by researchers from the University of Pittsburg and the University of California
addressed the topic. Their research, published in the December 2012 issue of the journal SLEEP, involved 245
urban high school students from varied ethnic backgrounds. The students each provided a fasting blood draw,
kept a written sleep log, and wore a device called an actigraph on their wrist for one week during the school
year. An actigraph is a small device that measures movement over an extended period of time. The actigraph
data shows activity levels and can be used to accurately determine sleep/wake durations using intensity of
movement. The participants’ blood glucose levels were evaluated using the homeostatic model assessment of
insulin resistance (HOMA-IR), a well-validated method of determining blood sugar levels.
The resulting findings indicate that adolescents who sleep less per night on average then their peers had higher
levels of glucose in their blood streams. This was also true for those participants that had fragmented sleep
during the week. These results are significant because they suggest that short sleep may impact otherwise
healthy individuals’ insulin resistance during adolescence. Restricted sleep might also lead to complications with
Type II Diabetes for these people later in life. The researchers point out that the study is not conclusive, as a
larger and more varied sample size is needed for further tests. They also caution that there is no direct indication
that the lack of sleep causes insulin resistance, just that there is a correlation between the two conditions.
Another point made by the researchers is that the results show just how little sleep high school students are
running on. The average time asleep as measured by the actigraph was 6.4 hours per night. That is far less than
the commonly recommended 9-10 hours for teenagers to feel rested.
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As described in the lead article, the obesity epidemic sweeping our nation has dramatic effects on health.
Exercising is a key component in losing weight, but it may also affect the severity of Obstructive Sleep Apnea
and help you sleep at night.
Researchers enrolled forty-three sedentary and overweight adults aged 18-55 years with at least moderate
untreated OSA in a 12-week study to evaluate the efficacy of exercise as a treatment for sleep apnea. The
participants were divided into two groups: One met 4 times per week and performed 150 minutes per week of
moderate-intensity aerobic activity, followed by resistance training twice a week. The other group was the
control and met twice weekly to perform low-intensity exercises designed to increase whole-body flexibility.
Both groups underwent sleep studies before and after the exercise trial to determine severity of apnea.
The results of the trial, published in the December 2011 issue of SLEEP, showed that the group that exercised
weekly experienced a moderate reduction in their Apnea-Hypopnea Index (AHI), the measurement of the
average number of breathing events per hour of sleep. The group that was limited to stretching did not
experience this reduction. Interestingly the exercise group members did not experience any weight loss as a
result of the exercise, suggesting the benefit of a reduced AHI was not in relation to losing weight. The
researchers point out that further studies need to be done on this subject but speculate that “possible
mechanisms of improvement in OSA following exercise training include a general strengthening and fatigue
resistance of the ventilatory and upper airway dilator muscles, attenuation of respiratory instability from reduced
sleep fragmentation, decreased nasal resistance, and prevention of lower-extremity fluid accumulation.”
Exercise is not a replacement for effective treatment such as CPAP or an oral appliance but a regular exercise
program may help reduce your apnea severity.
Continuous Positive Airway Pressure, or CPAP, is the gold standard of treatment for
Obstructive Sleep Apnea. There is no doubt that using CPAP can be a beneficial
life change, but the treatment is not without its challenges. One question often
asked by both new and experienced CPAP users is how to use the device when
traveling where there is no electricity.
In the past, CPAP machines were loud, bulky, and difficult to travel with. CPAP users
were forced to either bring additional luggage to accommodate the machines or
suffer through sleepless nights without treatment while on vacation. Fortunately,
newer generations of CPAP devices are very quiet, lightweight, and easy to pack.
But what about when someone wants to go camping or is traveling to an area
without reliable electrical service? That’s changed too, says Jason Cowlishaw,
CPAP Equipment Specialist at Oregon Sleep Associates. “People used to have to
rig up a deep -cycle marine battery to their machines if they wanted to go
camping,” he explains, “It was crazy, you’d attach the CPAP to the these big batteries with alligator clamps.
They were heavy, unreliable, and you’d only get maybe one night before the juice ran out.” However battery
technology has improved over the years, gaining power capacity and dropping in both weight and price.
“Now we carry Lithium-Ion battery packs that are specifically made for CPAP machines,” Cowlishaw says,
“They are about the size of a hard cover book, generally weigh between 1.5 to 3 pounds, and can provide
power for 25-30 hours on average before needing a recharge.” Depending on the model, the batteries usually
require an adapter to connect to the CPAP, and manufacturers recommend that users don’t power their
heated humidifiers with them to maximize the time before a recharge. “They’ve really turned the CPAP into a
portable device now,” he remarks, “I’ve got patients that take their CPAP and a little battery when they go
backpacking. That was unimaginable a few years back!”
To learn more about using battery power with CPAP, contact Jason Cowlishaw at 503-972-4692 or visit OSA.
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Dr. Daniel Root of Oregon Sleep Associates has been named as one of Portland
Monthly Magazine’s 2013 Top Doctors in Portland for Sleep Medicine. The annual
rankings are available in the January 2013 issue of Portland Monthly and cover
73 healthcare specialties in the metro area. Over 1100 local doctors and nurses
voted on the rankings utilizing the basic criteria given to them: “If you or a loved
one needed medical care, which doctor would you call?”
Dr. Root is Board Certified in Sleep Medicine and has been practicing in this field
for over 10 years. In 2005, he founded Oregon Sleep Associates in Northwest
Portland to provide patients with a quality resource for improving their health
and quality of life through better sleep. To date, OSA has helped thousands of
people achieve this goal.
Dr. Root and Dr. Jennifer Kim see patients in the AASM Accredited Sleep Center
for a wide range of sleep issues including snoring, insomnia, sleep apnea, restless
legs syndrome, and narcolepsy. OSA offers both in-lab overnight sleep testing at
our comfortable 5-bedroom sleep lab, and at-home sleep testing for sleep disordered breathing. We also
have an in-house Durable Medical Equipment office for all your sleep apnea treatment needs and a
Cognitive Behavioral Therapy treatment program for insomnia and other behavioral sleep medicine concerns.
If you live in the Northwest Oregon or Southwest Washington area and are having trouble sleeping, contact
OSA at 503-288-5201 to schedule a consultation with the physician voted by his peers as the right choice to
help put you on the path to better sleep.
2228 NW Pettygrove St, Suite 150
Portland, OR 97210
503-288-5201
Daniel Root, MD ~ Jennifer Kim, MD
Check us out online:
www.OregonSleepAssociates.com
www.OSABlog.com
/OSASleep
/OregonSleep