Chanwell Clinic Institute for Heart & Sleep Disorders

The Guidelines in Stroke Prevention in Women are outdated and quite inaccurate or incomplete. When one deals with HYPERTENSION, PRE-ECLAMPSIA, ECLAMPSIA and or ...DIABETES in women (and men); one must consider the strong possibility of OBSTRUCTIVE SLEEP APNEA (OSA) as the mitigating cause or co-existing illness. OSA increases the risk for STROKE, HEART ATTACK & SUDDEN CARDIAC DEATH by 300%-400% depending on severity of OSA. OSA also raises the risk of CANCER DEATHS, and 700% increase in vehicular accidents. The Guidelines were written for and by Primary Care MDs and OB/GYNE. It misses the important and yet widely prevalent cause of women mortality and morbidity. References: NEJM March 2005 Mayo Clinic, NEJM November 2005 Yale New Haven Hospitals. See more

Clin Sleep Med. 2010 Apr 15; 6(2): 196204. Comorbid Insomnia and Obstructive Sleep Apnea: Challenges for Clinical Practice and Research Faith S. Luyster, Ph.D.,1 Daniel J. Buysse, M.D.,1 and Patrick J. Strollo, Jr, M.D. Study Objectives:... To review studies examining the cooccurrence of insomnia and obstructive sleep apnea (OSA), explore evidence for the effect of OSA therapy on insomnia symptoms and the effect of insomnia treatments on breathing and sleep in patients with OSA, and discuss challenges in the evaluation and treatment of comorbid insomnia and OSA. Methods/Results: Seven pertinent studies were identified that assessed the prevalence of comorbid insomnia and OSA or sleep disordered breathing. Four studies were identified that examined the effects of OSA treatment in patients with insomnia, and 8 studies were found that examined hypnotic use in patients with OSA or sleep disordered breathing. A high prevalence (39%-58%) of insomnia symptoms have been reported in patients with OSA, and between 29% and 67% of patients with insomnia have an apnea-hypopnea index of greater than 5. Combination therapy, including both cognitive behavior therapy and OSA treatment, resulted in greater improvements in insomnia than did either cognitive behavior therapy or OSA treatment alone. The use of GABAergic nonbenzodiazepine agents has been associated with improvements in sleep and has little to no effect on the apnea-hypopnea index in patients with OSA. Conclusions: Insomnia and OSA frequently cooccur. The optimal strategy for adequately treating comorbid insomnia and OSA remains unclear. Future research examining the impact of insomnia on continuous positive airway pressure therapy is needed. Given the substantial overlap in symptoms between insomnia and OSA, evaluation and treatment of these 2 conditions can be challenging and will require multidisciplinary collaboration among sleep specialists. See more

From Dr. Cesar Candari, Henderson, Nevada I wish to share a true story with our readers. This has cropped up last month as a result of Pilipino-American physicians engaged in the Internet, discussing varieties of subjects and our experiences - our paradigm blog. Antonio Q. Chan, MD (UST) of Chanwell Clinic of California wrote of treating an 82-year-old patient from Dongguan, China. His doctors in China gave up on him with intractable worsening heart failure. Patient ...Continue reading

Dr. Antonio Q. Chan invited to hold a lecture workshop at the World Congress on Sleep Medicine (WASM), Seoul, Korea March 2015. Dr. Antonio Q. Chan, a leading specialists in Cardiology and Sleep Medicine in Henderson and Las Vegas, Nevada is invited to hold a lecture workshop at the World Congress on Sleep Medicine (WASM), Seoul, Korea March 2015. At the same gathering of world’s experts in Sleep Medicine and Cardiology, Dr. Chan is presenting a scientific abstracts titled:...Continue reading

Asthma Sleep Apnea Connection Probable According to New Study The two distinct conditions of asthma and sleep apnea may indeed have a connection. A new study entitled Association Between Asthma and Risk of Developing Obstructive Sleep Apnea recently published in JAMA, suggests that adults who struggle with asthma face an increased risk for also developing sleep apnea. The finding stems from the long-term tracking of about 550 men and women, about 15% of whom had asthma. The... Wisconsin Sleep Cohort Study began in 1988, with all enrollees between the ages of 30 and 60. Every four years since that time, each completed general health questionnaires, while also completing an overnight, in-laboratory sleep test. According to HealthDay reporter Alan Mozes, the first four-year follow-up concluded that more than a quarter of the asthma patients (27%) also had newly developed sleep apnea. This compared with just 16% of the non-asthmatic patients. Over the full study period, the team concluded that asthma patients faced an almost 40 percent greater risk for sleep apnea than asthma-free participants, wrote Mozes. What’s more, the longer an individual had asthma, the greater their increased risk for developing OSA, investigators found. However, researchers concluded that while the study could point to an association between asthma and sleep apnea, it couldn’t prove a cause-and-effect relationship. The study was led by Dr. Mihaela Teodorescu, of the William S. Middleton Memorial Veteran’s Hospital and the University of Wisconsin School of Medicine and Public Health, both in Madison, Wisc. They published the findings in the Jan. 13 issue of Journal of the American Medical Association.