Sleep disorders cost Australia over $5 billion per year and cause deaths

A study of the economic impact of sleep disorders demonstrates financial costs to Australia of $5.1 billion per year. This comprises $270 million for health care costs for the conditions themselves, $540 million for care of associated medical conditions attributable to sleep disorders, and about $4.3 billion largely attributable to associated productivity losses and non-medical costs resulting from sleep loss-related accidents. Loss of life quality added a substantial further non-financial cost.

Snoring and Apnoea

Poor sleep is known to impart a significant personal and societal burden, and as a result it is important to have accurate estimates of its causes, prevalence, and the resultant costs, so as to better inform those who are creating the future health policy.

A recent evaluation of the sleep habits of Australians demonstrates that frequent sleep difficulties (initiating and maintaining sleep, and experiencing inadequate sleep), daytime fatigue, sleepiness and irritability are highly prevalent and range from 20%–35%. Frequent was defined as ‘daily or near daily’. These difficulties were found to be generally more prevalent among females, with the exception of snoring and similarly related difficulties. While about half of these problems are likely to be attributable to specific types of sleep disorder such as snoring and sleep apnea, the balance appears attributable to poor sleep habits or choices that limit sleep opportunity.

While large, these costs were assessed for those with sleep disorders alone.

Additional costs relating to inadequate sleep from poor sleep habits in people without sleep disorders were not considered. Based on the high prevalence of such problems and the known impacts of sleep loss in all its forms on health, productivity and safety, it is likely that these poor sleep habits would add substantially to these costs and probably double it.

Sleep is a basic and necessary biological process that demands to be satisfied but it is only recently that we have begun to understand the scale of the health and social consequences of insufficient sleep and associated sleep disorders such as snoring and OSA.

Sleep loss from these problems is associated with disturbances in cognitive and psychomotor function including mood, thinking, concentration, memory, learning, vigilance and reaction times. These disturbances have adverse effects on wellbeing, productivity, and safety. Insufficient sleep is also known to be a direct contributor to injury and death from motor vehicle and workplace accidents.

In addition, strong connections have been demonstrated between shortened sleep and a range of health problems including hypertension, type 2 diabetes, obesity, cardiovascular disease and total mortality risk.

The Australian Sleep Health Foundation commissioned this extensive work and the results illustrate that a considerable proportion of Australians report frequent sleeping difficulties:

  • 20% of respondents had frequent difficulty falling asleep, which was more prevalent among females and younger age groups.
  • Frequent waking during the night was reported by 35% overall, again more commonly among females but increasing with age.
  • Thirty-five per cent reported waking unrefreshed in the mornings
  • 24% reported inadequate sleep at any time
  • 22% complained of daytime sleepiness, fatigue and irritability

Snoring was widely reported by almost half those interviewed as a reason for disturbed nights, with poor quality sleep and daytime tiredness resulting for those disturbed. And in its worst most dangerous form many cases of sleep apnoea were recognized. Prevalence of sleep apnoea was derived by determining the proportion of respondents who snored loudly at least a few times a week and had observed breathing pauses during sleep at least a few times a month. An overall prevalence of 4.9% was noted, but in this case, prevalence was higher among males (6.4%) than females (3.6%).

The costs are massive whichever way examined, and individuals can do much on their own to reduce and even prevent the problem. As well as lifestyle solutions it is easy to acquire oral appliances and chin straps that not only stop snoring but also prevent the development of sleep apnoea, not just resulting in refreshing sleep, but improved health, and a longer life.

John Redfern


What is the real cost to you of sleep apnoea – treated or untreated?

There are several ways in which this question can be interpreted but the answer is always the same one if you’re considering the possible health repercussions, and that answer is high, but if it’s a financial question then the cost can vary incredibly.

Apnea the true cost

There are estimated to be over 100 million OSA sufferers throughout the world where data is recorded, but the real number is likely to be much, much higher than this. Because so many cases of sleep apnoea go untreated – an estimated 90% – accurate figures aren’t really known.

The most recent official figures that have been published give the figures of known OSA patients as follows. The USA has 18 million apnoea patients, Australia has just about two million, and the UK approximately three million. However in all these countries the figures are increasing rapidly and this is mostly due to increasing obesity problems. They are also an understatement of the real number as many cases simply aren’t reported and go untreated.

The figures for snoring are of course much higher, and on the increase for both sexes, creating similar heath dangers if left to develop and deteriorate.

An overnight Sleep Test in one form or another is available at a price in order to fully evaluate the severity of the condition, but the starting point for most people is their partner, who through close observation will soon notice whether or not the key symptoms exist.

As a partner’s sleep is often disturbed this is rarely a problem, but they often need to convince their partner that the problem really exists, as it’s common for them to be in denial. Tests can be paid for, mostly in a specialist Sleep Clinic, but more Home Testing equipment is now becoming available, and some in app form for your Smartphone. However it’s a good start for you to start by recording their disturbed sleep and show it to them as a first step.

OSA occurs when the tongue and other soft tissues relax or narrow for one reason or another during sleep and block the airway. The brain senses a problem and wakes the body up just long enough to take a breath. This can happen hundreds of times in the night resulting in poor unprofitable sleep. The ‘choking’ awakenings are accompanied by gasping for breath, and then followed by a return to snoring, and these are clear to observe.

Scores of medical reports now clearly state that early recognition and treatment of sleep apnoea is important, as it may be associated with:

  • Irregular heartbeat
  • High blood pressure
  • Heart attack
  • Stroke
  • Daytime sleepiness
  • Increased risk of motor vehicle accidents

Historically, treatment has been the use of a pump-driven breathing device that forced air through a face mask, called CPAP, but this is now most often reserved for very severe cases only, as both the cost and the rejection rates are extremely high due to the many perceived disadvantages. New style, more expensive, oral appliances have taken its place, and these are ones that are laboratory made to fit the shape of the person’s dental profile.

They have been thoroughly tested by the UK’s leading NHS Sleep Clinic at the world-renowned Papworth Hospital and are now proposed by them in published documentation as the first recommendation for the prevention of both snoring and sleep apnoea, particularly the UK made SleepPro Custom, that clearly headed the league of all the appliances that were tested.

The cost of the SleepPro Custom was also found to be one that was equally beneficial as it was affordable to all – and this was deemed very important due to the widespread nature of OSA.

A similar Dentally recommended oral appliance in the USA could eventually cost well in excess of USD $3,000 including the sleep testing, and even new products that have recently been launched into the North American market from Australia state all-inclusive prices from USD $1.390 to USD $1,790.

The SleepPro Custom will be tailored to your own dental profile and made in a UK Dental laboratory for a price of £154.99 or USD $220. This is a very small price to pay for a medically proven solution that can not only improve your life but also extend it considerably.

John Redfern


Sleep – and the lack of it in Australia – plus the growing obesity problem

In the modern age, where people are constantly online, work hours are increasing and there are ever rising demands on your time, proper rest is seriously endangered. And being sleep deprived is a major cost to the economy, public safety and personal health.

Cancer girl

In Australia the cost of sleep disorders including healthcare, absenteeism, loss of productivity, plus car and workplace accidents is estimated to be $5.1 billion a year, according to the Co-operative Research Centre for Alertness, Safety and Productivity, and the Sleep Health Foundation.

And the cost of lost sleep is not just lost productivity and poor health outcomes. The latest figures from NSW roads show that more people are killed in road accidents because of fatigue than alcohol, and yet there are no laws that relate to driving when tired.

Fatigue was a factor in 16 per cent of all fatal crashes in NSW in 2014, according to the NSW Centre for Road Safety. In 2013, the percentage of road accidents where fatigue was a factor, at 8%, was nearly twice as high as the figure for alcohol at 4.7%.

Sleep deprivation is a particular problem for young people, due to increased school demands and the ever-present social media. To quote Amanda Huffington, a leading media crusader for better sleep; “Nearly 5000 apps come up when you search “sleep” in the Apple App Store, more than 15 million photos under #sleep on Instagram, another 14 million under #sleepy, and more than 24 million under #tired. A quick search for “sleep” on Google will bring up more than 800 million results. Computers are however not the only, or even the key reason, for poor slumber.

For a long time, experts were guessing Australia’s obesity rate. Now, a groundbreaking, international study has put an actual number on the nations’ girth, with serious implications for the growth of health problems, the way the food industry operates, and the complications of an increasing and ageing population. The study was published in the leading medical Journal, The Lancet, in March of this year, and was based on body mass index data collected from 200 countries from 1975 to 2014.

The results show that more than one in four Australians is now obese.

The number of obese people in the world increased from 105 million in 1975 to 641 million in 2014. Australia had most recently estimated the rate to be 27%, but this is the first real proof.

The study showed the proportion of obese men more than tripled from 3.2% to 10.8% globally, and the proportion of obese women more than doubled from 6.4% to 14.9% and the rate was predicted to keep increasing.

Cancer Council Western Australia education and research director Terry Slevin said obesity increased cancer risk and this study forecast a cancer epidemic. “This is an extraordinary and frightening report which must prompt action,” Slevin said. “With the success in driving smoking rates down, obesity is the most important cancer risk factor for non smokers. On average the population is getting older, and fatter and that inevitably will increase the cancer burden.” Professor Margaret Allman-Farinelli is a Professor of Dietetics in the Charles Perkins Centre at the University of Sydney said it also had implications for Australia’s young generations.

“In Australia we anticipate an aging population to be supported by a younger population, who have become overweight and obese sooner than their parents and are more likely to experience the unwanted associated chronic diseases of obesity sooner,” Allman-Farinelli said. “As an example from 1995 until 2012 the percentage of obese 18 to 24 year old women more than tripled from 6% to 20%.”

The study also showed that while the most obese regions were Polynesia and Micronesia, almost a fifth of the world’s obese adults lived in six of the high-income English-speaking countries — Australia, Canada, Ireland, New Zealand, the U.K., and the U.S.A.

Obesity causes the neck to narrow, and the sound of snoring indicates the oxygen deprivation that is happening – resulting in massive health problems for those concerned. The key is to lose weight but in the meantime a simple oral appliance or chin support strap will open the airway and the snoring will be gone. The result will be better sleep and improved future health.

If you snore, the cost of doing this will be just a few dollars, but the cost of not doing it is simply too frightening to think about.

John Redfern


The fittest amongst us suffer from a variety of sleep disorders and leading sports professionals are not excluded

Many of us play active sport or focus on our fitness so perhaps we think that as a result our health is in better shape, but at the same time, getting good restful sleep can still be a major problem even for those who are professional sportsmen or women and make a career out of their skills.

snoring and apnea

Sleep disorders are so painfully common among the general population, but there’s one demographic that suffers significantly more than the rest of us: athletes. A new study from Finland has some good news for this group, though, because researchers now say that for the first time ever, they’ve shown just how treatable sleep disorders among athletes really are.

The survey revealed that one in four of the athletes involved in the study suffered from significant sleep problems, including having trouble falling asleep, snoring, and unbelievably, having serious issues with their breathing, such as sleep apnoea. Most of the athletes surveyed admitted to sleeping too few hours and one in six of them even used sleeping pills.

Although many of the athlete’s sleep troubles were classified as “significant” the study showed that general sleep-related guidance and personalized treatment plans greatly improved their sleep. Simple ‘Stop snoring mouthpieces’ and more customised versions can restrict or even eliminate the problem and greatly improve their performance and fitness as a result. Lack of sleep can reduce performance quality, though, and as many as one in four athletes involved in the study reported that sleep-related guidance helped to improve their athletic performance.

Aside from affecting how good someone is at sport, lack of sleep can also have serious health consequences and also lead to weight gain.

Sleep disorders among many groups of professional sportsmen and sportswomen are a widely reported problem, and researchers have suggested a variety of issues that might cause them. Intense training, rigorous schedules, and frequent traveling, sometimes across world time zones, are only some of the factors that may disrupt sleep patterns.

Professional athletes travel a great deal, often flying overnight before waking up to an early-morning practice or next-day game, and share risks for sleep problems with other high-frequency travellers and people who work non-traditional schedules. People in these jobs are at higher risk for sleep disorders such as insomnia and obstructive sleep apnoea. They also can be at elevated risk for health problems associated with poor sleep, including obesity, Type 2 diabetes, and cardiovascular disease.

The professional sports world appears to be continuing to turn a great deal of attention to what has previously been a much-overlooked issue: sleep.

In the USA, it’s the National Hockey League that is leading the way and that is addressing sleep problems on several fronts. Last year, teams like the New York Jets decided to hire sleep specialists to work with players on improving their sleep habits, and the sleep-friendly adjustments made to the team’s practice schedule improved their overall performance considerably.

At the same time numerous players of American football have recently headlined with major sleep apnoea problems but after watching a football game, it’s hard to believe that any of these big, tough men might be seriously ill. Injured, maybe. But sick? It seems very unlikely.

However, according to a recent study by New England Journal of Medicine, this might well be the case. Sleep apnoea affects about 4% of the general population, but when football players participated in sleep studies, the percentage rose to 14% of all players. Offensive and defensive linemen had an even higher prevalence of apnoea with 34% of them affected, probably due to their higher weight.

All sports are affected – even Sumo wrestlers in Japan – and many of them have serious problems with sleep apnoea caused by extra weight, which in that particular arena is an obvious advantage. Or is it? New investigations conducted by the Douai Hospital in Tokyo have determined that if the wrestler suffers from obstructive sleep apnoea, he lacks the concentration needed for the sport. This may be causing injuries and is also causing those wrestlers to lose more matches than is normal or to even miss tournaments.

The problem is easily solved for all these sportsmen and women – just as it is for the rest of us. If you suffer from sleep disorders or obstructive sleep apnoea you must deal with it. It’s easy and inexpensive to do so and can have a major effect on your life whether you’re a sports professional or not.

John Redfern

 


Sleep apnoea is a more dangerous condition for women than men

We now all know that sleep apnoea, which stops your breathing frequently during the night, is linked with serious health conditions, but it may be even more dangerous for women’s hearts than for men’s, according to a major new study in the journal Circulation.

snoring and sleep apnoea more dangerous for women

Obstructive sleep apnoea, or OSA, is characterized by frequent stopping of breathing during sleep and often followed by choking and gasping to recover. It is linked to cardiovascular disease, diabetes, depression, osteoporosis, increased mortality, and possibly earlier onset of cognitive decline and dementia.

Some of the leading experts in this field have spoken out further on this matter as they want to stress that both men and women can have this condition, and snoring is not necessarily a symptom, although it often is.

Dr. John Swartzberg of UC Berkeley said: “Don’t think sleep apnoea is just a man’s problem because men tend to snore loudly and more often. Snoring is a warning sign, but you can have sleep apnoea without snoring or very little snoring.” Swartzberg says this was a large and well-done study.

“These were women who tended to be older, their average age was 63,” he explained. “What they found was that women with sleep apnoea had high rates of complications, such as high blood pressure, heart failure, heart enlargement, and even premature death.” Recently it has been further linked with Breast Cancer and aggressive melanoma when left untreated.

The study followed more than 1,500 initially healthy people (average age 63) for 14 years and found that in women, but not in men, the condition was independently associated with a marker for heart damage in the blood called troponin T, as well as with heart failure, heart enlargement (ventricular hypertrophy), and premature death.

Snoring and Sleep apnoea is often regarded as a man’s problem, but women also have high rates, especially those who are obese. The new findings highlight the importance of screening women and getting early treatment for them as well as men.

Snoring by itself is usually a less critical matter, though it can be a source of strife between bed partners or roommates, but when associated with OSA it is a different matter altogether.

Estimates vary widely, but it’s likely that sleep apnoea affects about 10 per cent of all adults. Rates have been rising steadily over the past 20 years, largely because of the obesity epidemic. The biggest worry is that the great majority of people with sleep apnoea do not know they have it and continue without treatment whilst their health steadily worsens as a result.

OSA is certainly more common in men, especially black and Asian men, but this recent research has found it is surprisingly prevalent among women, too, especially after menopause. Being overweight greatly increases the risk, as a result of excess soft tissue in the throat. Though not everyone who snores has sleep apnoea, loud snorers are most likely to have it.

Increasing age, family history and certain anatomical abnormalities also increase the risk. In addition, heavy drinking, smoking and sedatives can promote the development and danger of OSA.

If you think that you have sleep apnoea, doing the following may help.

  • If you’re overweight, lose weight.
  • Limit or avoid alcohol, especially in the evening.
  • Avoid sedating medications.
  • Avoid heavy meals in the evening.
  • If you smoke, stop.
  • Try sleeping on your side, not on your back. This helps keep your tongue from falling back and obstructing the airway.
  • Elevate the head of your bed about six inches using a foam wedge.

In the meantime you can prevent the development of OSA by obtaining a custom-made mandibular advancement device made by a specialist NHS Approved company, such as SleepPro. The Custom fitted mouthpiece is easy to wear and much less expensive than any Dentist made product, and it keeps the airway open while you sleep by pulling the tongue and jaw (mandible) forward.

John Redfern


High fat diets cause weight gain and snoring – resulting in obstructive sleep apnoea and heart problems

Recent research conducted as totally separate studies in both Australia and the USA throws new light on the relationship between sleep and weight gain. Experts suggest sufficient undisturbed slumber every night is required to life a healthy life and snoring is a key factor that needs to be eliminated.

High fat diets cause weight gain and snoring – resulting in obstructive sleep apnoea and heart problems

The first report, from the University of Adelaide, tracked 1,800 Australian men aged between 35 to 80 and looked at their eating habits during a one year period. It concluded that men who consumed the highest amounts of fat were more likely to experience ‘excessive daytime sleepiness’ and that a high-fat content to a diet was strongly linked to sleep apnoea.

The data was taken from a larger study into Australian lifestyles called the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study.

Data extracted from this, with a focus on diet and sleep apnoea has found a strong correlation between higher fat content and sleep disorders.

The scope of the study included 1,800 Australian men who were aged between 35-80 years. The men were surveyed over a 12-month period and they recorded information about what they eat, when they felt sleepy and the quality and quantity of sleep they achieved each night. A high fat diet was linked to sleep apnoea and even more interestingly, the sleepiness was not linked to a person’s obesity – meaning smaller males were just as affected as larger-sized ones.

Almost half – 47% – with a high fat diet said they slept poorly at night and 42% admitted feeling lethargic and tired during the day. Meanwhile 54% suffered ‘mild-to-moderate’ sleep apnoea and 25% categorised as having ‘moderate-to-severe’ sleep apnoea. None of the men had previously been diagnosed with the condition.

The data was adjusted for the age groups and for lifestyle factors and note was also taken of any chronic diseases that the men were suffering from. With these factors accounted for, the results remained unchanged.

Comments from the participants suggested many of the men were locked into a vicious circle. Because they felt tired during the day they tended towards a high fat diet; and because they eat a high fat diet they were more likely to feel sleepy during the day. It’s long been suspected that a diet rich in carbohydrates and fat can adversely affect sleeping patterns and has significant implications for alertness and concentration, which would be of particular concern to workers.

Separate reports from the Universities of Delaware and Columbia in the USA independently supported this, and said that in a simpler study, one of them using nearly half a million individuals, that there’s a clear link between insufficient or disturbed sleep and obesity.

But getting fat is not the only problem caused by poor sleeping habits. Other research said that not getting enough sleep affects the cholesterol level. Thus there’s a link between heart diseases and lack of sleep. It has become evident that poor or lack of sleep may lead to a slowing of the metabolism and is linked to getting fat and worse – even causing obesity – and is also linked to cardiovascular diseases.

According to The European Society of Cardiology “Sleep disorders are very closely related to the presence of cardiovascular diseases. However, until now there has not been a major population based study examining the impact of sleep disorders on the development of a heart attack or stroke.”

Leading UK nutritionist and neuroscientist Victoria Wills has welcomed the news, saying it could even help save countless lives.

She said: “We’ve all experienced that feeling of eating a large, unhealthy meal and then being completely zapped of energy. Now this study shows that a long-term diet of fatty foods can have a fatiguing effect on your day-to-day life, even bringing about sleep apnoea – a common cause of night terrors – which is worrying in the extreme”.

“If you are eating too much fat then you may not be physically able to exercise properly because you haven’t been able to rest properly and your energy levels are depleted. It’s then a vicious circle. Meanwhile those who work in jobs where it’s vital that they stay alert and awake should also take note, or risk accidentally day-dreaming into a serious accident.”

You should improve your sleep initially by stopping snoring while you work on the lengthy task of reducing the fat from your diet to lower your weight.

John Redfern


Lack of sleep and regular snoring linked to poorer breast cancer survival

 

A new study from the USA reports that short sleep duration combined with frequent snoring reported prior to cancer diagnosis may influence subsequent breast cancer survival.

Breast cancer and sleep problems

Results show that women who typically slept less than the recommended 7 hours of sleep per night and were frequent snorers in the years before their cancer diagnosis experienced a poorer cancer prognosis.

The findings were especially robust for women who were diagnosed with breast cancer. Breast cancer patients who reported sleeping 6 hours or less per night and snoring 5 or more nights per week before their diagnosis were 2 times more likely to die from breast cancer (hazard ratio = 2.14) than patients who reported sleeping 7 to 8 hours per night and rarely snored.

The study results are published in the April 15 issue of the Journal of Clinical Sleep Medicine.

In a week where scientists have revealed extensive data on the world’s sleeping patterns, leading researchers have told the BBC that society has become “supremely arrogant” in ignoring the importance of sleep. They say people and governments really need to take the problem seriously.

The body clock drives huge changes in the human body. Cancer, heart disease, type-2 diabetes, infections and obesity have all been linked to reduced sleep. It alters alertness, mood, physical strength and even the risk of a heart attack in a daily rhythm.

Sleep experts worldwide, including many who are based in the UK, endorse these statements. They include Dr Akhilesh Reddy, from the University of Cambridge, who said that the body clock influences every biological process in the human body and the health consequences of living against the clock were “pretty clear cut”, particularly in the case of breast cancer.

But the pressures of work and social lives mean many people cut their sleep during the week and catch up at the weekend. Researchers are investigating whether there is a health impact.

The study, by a team at the University of Bristol in the UK and Weill Cornell Medical College in Qatar, assessed “sleep debt” – a measure of the difference in the nightly hours asleep on weekdays and at the weekend.

“We found that as little as 30 minutes a day sleep debt can have significant effects on obesity and insulin resistance,” said Prof Shahrad Taheri from Weill Cornell. He added: “Sleep loss is widespread in modern society, but only in the last decade have we realised its metabolic consequences.

“Our findings suggest that avoiding sleep debt could have positive benefits for waistlines and metabolism and that incorporating sleep into lifestyle interventions for weight loss and diabetes might improve their success.”

The study was funded by the UK’s Department of Health, where 10% of healthcare budgets are already spent on treating diabetes. Perhaps they’ll act on it accordingly.

Information on global sleep habits has been equally informative and it was clearly evident that there was a conflict between our desire to stay up late and our bodies urging us to get up in the morning.

Prof Daniel Forger, one of the researchers, said “Society is pushing us to stay up late, our body clocks are trying to get us up earlier, and in the middle the amount of sleep that we have is being sacrificed; that’s what we think is going on in global sleep crisis.

The study found people in Japan and Singapore had an average of seven hours and 24 minutes sleep while the people in the Netherlands had eight hours and 12 minutes. People in the UK averaged just under eight hours – a little less than the French. The study also showed women had about 30 minutes more per night in bed than men, particularly between the ages of 30 and 60.

The message to everyone is very evident.
Sleep enough – Stop Snoring – and don’t ignore the opinions of the experts.

John Redfern


The dangers of driving with sleep apnoea – and the legal situation

The most common symptom of obstructive sleep apnoea, and the most dangerous by far, is daytime drowsiness. This is accompanied when you sleep by heavy snoring, and choking sounds or gasping for breath on numerous occasions throughout the night. It’s a deadly problem to have.

OSA and drivong

Drowsy driving may result and this is defined as operating a motor vehicle while being cognitively impaired by lack of sleep. Leading Motoring Associations in the UK and USA state that drivers with untreated sleep apnoea pay less attention to the road, react more slowly when braking suddenly, and make bad driving decisions that may lead to an accident.

Obstructive Sleep Apnoea is very common among middle-aged men, especially if they are overweight. Studies show that drivers with untreated OSA are five times more likely to be involved in road accidents with 25% of motorway or expressway accidents can be attributed to drowsiness. Most countries have had numerous examples in the headlines recently where this has caused tragedy both on the roads and on the rail systems.

In December 2014 a bin lorry careered out of control in a busy shopping street in Glasgow leading to the tragic death of six people. The accident inquiry into the incident has led to increased concern among doctors about their responsibility to disclose information about their patients to the DVLA.

A Doctor’s responsibility is to explain to the patient that they have a medical condition that may affect their ability to drive and that they have a legal obligation to inform the DVLA or DVA, and to stop driving if they are not having treatment for the problem. It is the driver’s legal responsibility to inform the authorities and it is a criminal offence for the driver to fail to do so.  The decision on whether the patient’s licence will be withdrawn rests with the DVLA or DVA and not the doctor.

Doctors in the UK have said they are anxious about disclosing information to the DVLA or DVA but have now been issued with a step-by-step approach by the General Medical Council approach that will allow them to deal with these difficult discussions more confidently. It runs as follows:

  1. Tell the patient to inform the Licensing Authority (DVLA)
  2. Assess the patient’s medical condition against required standards
  3. Try to persuade the patient to stop driving
  4. Only disclose the minimum information
  5. Keep detailed records

In Australia, NSW will soon have instant health checks for the 400,000 motorists who need to prove they are capable of driving. The checks are for elderly drivers who need to prove they can drive safely, heavy ­vehicle drivers, and motorists with epilepsy, sleep disorders and diabetes.

Doctors assess elderly drivers aged 75 or over each year to determine if their eyesight, motor function and attention is at a level where it is safe to drive. For holders of a class MC licence drivers have to be assessed at age 21 and then every 10 years, and after then at age 40 and then every five years

The state government will automate fitness-to-drive medical assessments, so GPs can send them to Roads and Maritime Services instantly. Roads Minister Duncan Gay said it meant doctors could instantly send applications to the RMS licence ­review unit, and elderly drivers would not be forced to queue at service centres or post offices to send application forms.

Although drinking while driving is a very serious problem, the deadliest habit is proving to be even more widespread: drowsy driving. In 2014, over 33 per cent of all U.S. drivers fell asleep behind the wheel of a car.

There are 42 drowsy drivers for every drunk driver on the road today.

In the USA however the greatest focus has been on commercial drivers, who are required to pass a health screening in order to drive. Regulators overhauled the system in 2014 and have disqualified roughly 70,000 truckers since then, out of some 8.5 million.

Treatment for OSA, bringing high restorative sleep, has been proved in research to overcome the problem. Oral appliances are approved and available for a very small cost and without any form of prescription so the solution is seen to be in the hands of those who wish to continue driving.

It brings a whole new meaning to the old phrase ‘Keep Death off the road’.

John Redfern


A good night’s sleep keeps you healthy – but snoring prevents it happening

Of late you must have noticed how doctors and healthcare professionals have given extra attention to the importance of undisturbed quality sleep. Increasing number of studies have linked sleep deprivation to serious health issues, ranging from high blood pressure, stroke, heart attacks, obesity, mood disorders, attention deficit disorder, foetal and childhood growth retardation, besides making one accident-prone in the car and at work.

stop snoring week

There’s much more than that however, so whether you are up until the early hours of the morning watching the shows on Netflix, or simply staying up late because there’s too much work to do, one thing’s for sure – your body’s taking the brunt of your actions. But why is sleep so important? Not getting enough shut-eye can lead to other bad results as well as health and here are just some of the problems with comments from the experts in each case.

You gain weight

If you’re looking to shave off those stubborn extra pounds then lack of sleep certainly doesn’t help. In fact, it does the very opposite says nutritionist Dr Marilyn Glenville, author of the Natural Health Bible for Women.

“People who are sleep-deprived have an increased appetite. Inadequate sleep lowers the levels of leptin, a hormone that suppresses appetite. At the same time it increases leels of grehlin – a hormone that increases food intake and plays a role in long-term regulation of body weight. Sleep deprivation makes weight loss harder because it causes your body to work against you.”

Your immune system is compromised

Lack of sleep is known to lower the body’s immune response. A recent study found reducing the amount of sleep time every night lowered the number of “natural killer cells” which are responsible for fighting off invaders such as bacteria and viruses. Nutritional therapist Geeta Sidhu-Robb, who is the founder of Nosh Detox, says “A lack of sleep can impair the body’s ability to fend off diseases and inflammation, which in turn, can cause us to catch more colds or slow down the processes of recovery. No sleep means your body doesn’t have time to build up its defence system – the antibodies and cells that attack viruses and unfriendly bacteria.”

Your stress levels rocket

Inadequate sleep can also affect your cortisol levels – the hormone that help us manage stress, and Sidhu-Robb adds “Lack of sleep increases stress which produces the hormone cortisol, and it can also reduce collagen in the skin, which is what keeps it looking young and provides elasticity.”

Stress and ageing skin is not a combination worth losing your sleep for.

Your heart weakens

During sleep, the heart powers down significantly – reducing both your blood pressure and the heart rate, which is important for the health of the organ. By not getting enough sleep, your heart might not have enough time to lower your blood pressure to necessary levels.

“Research shows that those who sleep five hours or less a night are twice as likely to suffer from hypertension (high blood pressure) and heart disease as those who sleep for seven hours or more,” says Dr Marilyn Glenville.

A study conducted by a team from Mount Sinai Hospital showed having less than five hours of sleep each night had an 83% increased risk of stroke compared to sleepers who got seven to eight hours of shut-eye.

Your brain becomes foggy

Sleep deprivation affects our ability to learn and retain new information and can lead to poor long and short-term memory, as well as poor decision-making. “When we sleep our body and brain don’t actually shut off – we have light sleep phases and deeper ones,” says Neil Robinson, Sealy UK‘s resident sleep expert. “While we sleep in the deeper phases, our brain stays busy, overseeing an internal maintenance schedule that keeps us running in top condition. This helps the body repair itself and build energy for the day ahead – our muscles and tissues recover, our immune system gets a boost and all the information we have absorbed during the day gets consolidated in our memory. Without enough hours of this type of restorative sleep, we won’t function, work, learn, create, and communicate at effective levels.”

Your skin starts to age

Sleep deprivation leads to inflammation that can lead to poor skin conditions such as dullness, dryness, spots and dark circles under the eyes, and It can also age your skin.

“We all know that we look and feel worse after a bad night’s sleep,” says Georgie Cleeve, founder of skincare company OSKIA. “There is a real biological reason why a bad night’s sleep can play havoc with your skin.

“When we sleep the brain produces a brilliant chemical called Adenosine Triphosphate, or ATP for short. It’s essentially our cell battery power and runs all our cellular processes throughout the day. So less sleep equals less ATP. And that means less collagen production.”

It’s Stop Snoring Week – Be sensible and act on it.

John Redfern


The dangers of snoring and sleep apnoea during pregnancy

The period of time between conception and birth is a critically important one for the lifetime health of the easily influenced growing human baby. During this 35-40 week pregnancy span an expectant mother must be in optimal health so that she can adequately supply her unborn child with the nutrients needed for healthy development, including oxygen.

Snoring during  pregnancy

Oxygen is a primary resource necessary to make a healthy baby possible and if oxygen is cut off from the baby, they are at risk for any number of health complications.

Snoring and sleep apnoea a common problem in pregnancy, and nearly 30% of all pregnant women experience a worsening of OSA during their pregnancy. However, OSA is not commonly assessed during routine prenatal care. In one study, although 32% of patients reported snoring, less than 3% of physicians and nurses asked about snoring during a prenatal visit.

According to findings presented by researchers to the Australian Sleep Association, 50% of pregnant women will develop snoring by their final trimester – bringing dangerous health problems for both mother and baby.

The 2 main factors causing this are related to Hormones and Weight gain.

Changes in hormone levels dilate blood vessels, and cause the mucous membrane to swell in the nose, causing congestion and a narrowing of your nasal passages that results in forcing you to breathe through your mouth as you sleep, with the outcomes being snoring.

“As you gain weight in pregnancy, your lungs have less space and also a build-up of fat in the neck tissues narrows your airways which can cause more throat breathing – in other words, snoring,” says Professor Advisor of Education for the Royal College of UK Midwives, Michelle Lyne. She adds, “If snoring began during pregnancy, then it will almost definitely stop soon after you’ve had the baby. Your hormones settle down and you lose the excess weight and fluid you’ve been carrying for 9 months – which are the main causes for starting to snore when you’re expecting”.

According to US scientists, chronic snoring may be a sign of breathing problems that could possibly affect your oxygen supply to the baby. However, chronic snoring refers to women who snore regularly and badly both before they get pregnant as well as during their pregnancy.

The study showed that a chronic snorer might be up to two thirds more likely to have a low birth-weight baby, and twice as likely to need a C-section. Chronic snoring can easily be treated,” says lead researcher, Dr Louise O’Brien, from the University of Michigan’s Sleep Disorders Centre.

Sleep apnoea is at epidemic proportions in many countries and has become increasingly common among pregnant women. Oxygen restriction places the intrauterine baby at risk for: growth restriction (IUGR), diabetes or a stillbirth. Sleep apnoea and pregnancy share a few similar symptoms, blurring the line between healthy and unhealthy body changes.

Obstructive sleep apnoea (OSA) during pregnancy presents significant potential risks to both the mother and her foetus.  Symptoms of OSA in pregnant women should not be ignored.

There are four things that make OSA during pregnancy unique:

  • It affects not just one but two patients – the mother and the foetus.
  •  Pregnancy itself is often associated with symptoms that might mimic OSA, including sleep disturbance and daytime fatigue
  •  Sleep apnoea can worsen as pregnancy progresses and changes in the condition can occur rapidly. OSA should always be diagnosed and treated promptly.
  •  OSA may be temporary, and in those cases it should end after the birth. Women diagnosed with OSA during pregnancy should be checked again following the birth as the problem with all its associated health dangers may continue undiagnosed otherwise.

Approximately 85% of adults who have sleep apnoea are undiagnosed but Sleep apnoea during pregnancy is something that can be treated and the harmful effects to the baby from lack of oxygen can most certainly be prevented. There is no reason for a mother or her baby to have insufficient access to oxygen. Instead of worrying if her baby is getting the nutrients needed for healthy development, an expectant mother can prepare for an exciting future.

John Redfern