Obstructive Sleep Apnea Prevalence

Natural Treatments for Sleep Apnea

Hey, guys. Axe, here, of naturalmedicine and founder of DrAxe . In this tutorial, I'm going to go through a sevenstepprocess on how to overcome sleep apnea. If you struggle with sleep apnea, snoring, insomnia,just trouble sleeping at night, these tips are going to help you big time. The number one thing you've got to start doingif you want to overcome sleep apnea is look at your diet. Now, sometimes sleep apnea canbe related to weight gain. It can be related to inflammation in different areas of yourbody. But if you can follow these dietary tips, it's going to help tremendously.

The first thing you want to do is you reallywant to focus on supporting your metabolism. You want to focus on getting three thingsevery single meal: good quality protein, healthy fat, and fiber, those three things. Most peoplewith sleep apnea, most people tend to consume too many carbohydrates and too much sugar,which can actually affect your insulin levels and your metabolism, which causes sleep apnea.So again, healthy protein, such as bone broth protein, organic chicken and turkey, wildcaughtfish, grassfed beef, getting good quality protein is important. Number two, fiber, getting more vegetablesand fruits in your diet and wholesprouted

grains, such as brown rice, that's where youwant to get your fiber. The healthy fats, things like coconut oil, olive oil, organicnuts and seeds, those are some ways to get some good healthy fat in your diet. So again,focus on a healthy diet, a diet that's antiinflammatory and that helps balance out insulin levelsis going to be big when it comes to beating sleep apnea. Number two, there are certain things you wantto avoid. If you have sleep apnea, you want to avoid intake of alcohol, caffeine, smoking,and also you need to be aware of sedatives. If you're taking sedatives on a regular basis,that can really cause sleep apnea. Stay away

from those things. If you're saying to yourself,quot;Well, I'm still going to do caffeine and alcohol,quot; then what I would do is not do coffee.I would just do a little bit of tea, like a green tea during the day. So again, just tone it down some. The otherthing I would do is, if you're drinking alcohol, limit it to one glass. When you start doingmore than one glass, more than one beer, more than one glass of alcohol, that's really goingto affect your sleep cycle. And no more than two days a week. Again, bring the alcoholdown, because that will absolutely cause sleep apnea.

The number three tip is to treat acid reflux.Many people with sleep apnea have heartburn, GERD, or acid reflux, or some type of digestiveissue that's causing their sleep apnea. Now, the way to overcome that is to follow thesedietary tips. You want to eat smaller meals, so you don't want to overeat, and get moreorganic meat, vegetables, and fruits. You've got to be careful overconsuming thegrains, the pastas, the breads, the chips. All of those things will really cause acidreflux and sleep apnea. Also, supplementing with digestive enzymes, probiotics, and applecider vinegar. So probiotics, enzymes, and apple cider vinegar, all of those can helpin the natural treatment of acid reflux and

reduce sleep apnea. The number four thing you want to considerdoing to beat sleep apnea is getting a humidifier in your bedroom. Oftentimes, it's the humidityor being too dry in the bedroom that actually causes sleep apnea. So look into getting ahumidifier and sometimes an air purifier. So a humidifier, an air purifier, those thingscan actually help support your body and you breathing better and overcoming sleep apnea. Number five is your sleeping position. Manypeople with sleep apnea sleep on their back. Some of them sleep on their stomach. You wantto sleep on your side. What you want to do

2015 Atrial Fibrillation Patient Conference Managing AF Risk Factors Panel

Wilber: Well thank you. This is really,I think, a topic that I look forward to talking to people about and I think more and moreit's assuming increasing importance in how we take care of patients. We're going to tryto do a broad overview. We're going to focus specifically on diabetes, sleep apnea andexercise as 00:00:30 potential risk factors and how they can be modified in our care ofpatients with atrial fibrillation, but we'll try to give your broad overview of some ofthe other topics as well. So although I'm going to mostly talk about obesity today andatrial fibrillation, we'll talk about a couple of other things as well.

There are a variety of risk factors for atrialfibrillation and this was initially, I think, mostly of interest to epidemiologists, peoplewho study how disease, what the prevalence of it is, and how it comes to pass. I thinknow we've really begun to understand that central role, not only in sort of understandingthe disease but really in treating it, and if we don't consider these as we treat patientsthen I think our outcomes are not nearly as good as they might be otherwise. This is the traditional list and I think thereare probably even a few more. I've starred a few of them where I think that the evidencenow is becoming very clear that these are

potentially modifiable and that's really whatI want you to take home today. These aren't static risk factors that cause something andthen there's nothing you can do about it but treat the consequences, but in fact by intervening,both early and late, you have a chance to modify the disease and improve outcomes. What that means for you as patients is thatyou have to participate in your care and that's really something I want to emphasize; andif you're not invited to do so, then you must insist on doing it. Because I think your outcomesfor atrial fibrillation really depend on how you address each of these risk factors asthey apply to you individually.

Just to briefly talk about hypertension; wewon't spend a lot of time. It's certainly important; it's one of the most common riskfactors associated with atrial fibrillation. Somewhere between 60% and 80% of patientswho have atrial fibrillation in large populations studies have at least hypertension as a riskfactor, and by itself may account for the 20% to 25% of the overall risk of new onsetatrial fibrillation. There's some evidence that systolic bloodpressure probably plays a more important role than diastolic blood pressure, but there'sno clear threshold value. When you look in large population studies, each increment insystolic blood pressure is associated with

the increasing risk of atrial fibrillation.There's no sort of magic number necessarily that if you get below, your risk of atrialfibrillation goes away. It's probably reasonable and what I like to use as a therapeutic targetis somewhere around below 13080. What that means is that that's even below the sort oftraditional guidelines for treatment of hypertension, but it's very clear that even mild elevationsof blood pressure within the range of what we would call normal can still confer afibrisk. There's no clear superiority of one drug overanother although the control of atrial fibrillation certainly can improve the symptoms and thefrequency with which you have atrial fibrillation.

It's not clear that any single drug is absolutelybetter. There's some evidence that ACE inhibitors and ARBs, which are drugs that many of youmay be on to treat your hypertension, may be particularly beneficial, particularly whenyou have relatively advanced hypertension with end organ involvement like thickeningof the heart muscle, the left ventricular hypertrophy, as we call it. But there's also evidence that uncontrolledhypertension as you start antiarrhythmic drug treatment and after catheter ablation, ifyou enter into that with poorly controlled blood pressure, in fact, you have much pooreroutcomes than if your blood pressure is controlled.

ESC TV 2015 Congress by Topic Heart Failure

The study is called SchlaHF XT, which means sleep and heart failure We were able to rule out sleep apnea in only 25 % of the patients so that is meaning that 75 % of the patients will have sleeplessness or breathing of one or other type or severity and about half of them are, let us sayroughly 45 %, will present with moderate to severe obstructive or central sleep apnea we see that with including now HFPAF patients into the registry, we see much more obstructive sleep apnea compared tocentral sleep apnea before sleep breathing disorder is very prevalent in heart failure either HFRAFand HFPAF

it is, all the data out say that it has a prognostic impact, you can treat it and I think my key messages is, screen your patients for prevalence of sleep disorder breathing and look for data out there iftreatment changes anything in prognostic prognosis of them or quality of life, and we have to clearly differentiate I think at that point, from obstructive andcentral sleep apnea In SERVEHF, 1 325 systolic heart failure patients presenting with central sleep apnea were randomised to receive either adaptive servoventilation or medicalmanagement alone, median followup was 31 months

We found actually there was no difference in outcome at all and surprisingly, which has taken both respiratory physicians and cardiologists completely by surprise we found an increase inmortality, and if you look at cardiovascular mortality it was up 34 %,so not only does it not make any difference to the patients with systolicheart failure but it actually increases the risk of them dying, so this is a realgamechanger trial, really important All of the available patients who wererandomised in trials, we put those patients together from individual patient dataand so we were able to do something that

has not been done before which is to lookat age as a continuous variable and look at the benefits of betablockerscompared to placebo across all ages and gender and what we found was that patients who were older got exactly the same benefit from beta blockers as youngerpatients, if they were in sinus rhythm with an absolute risk reduction ofaround 4 % whether you are 50 or whether you are 75, looking at the results for gender, women had less mortality as you would expect but actually again they got exactly the same benefit that men got from beta blockers, so this suggestsvery importantly that the practice that

seems to be out there that women andolder patients get less beta blockers is something that we should not do, andreinforces the need for all of these patients to get guidelines' recommendedtreatments The ESC heart failure longterm registry is a general registry under the European observational research programme of the ESC, and the aim is to know theepidemiology and management of adult patients with heart failure in ESC countries orMediterranean countries

this registry has started in 2011, so far we have enrolled more than 24 000 patients from 31 ESC countries and 320 active centres participating, according to KaplanMeier survival curves the mortality at one year is 23.6 % for acute heart failure patients and around 6 % for chronic heart failure patients mortality for acute heart failure is still high while mortality for chronic heart failure is lower and this might reflect that there have been no new therapies in the last years for the

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