Obstructive Sleep Apnea: Fact or Fiction?

Lately, it seems that Obstructive Sleep Apnea (OSA) has been receiving more attention than ever before. It made the the list as a probable contributor to the death of Star War’s star Carrie Fisher. Recently, NFL Star Ryan Jensen spoke to the media about how his diagnosis of OSA saved his life and career.  So, what’s the fuss over OSA?  By now, most everyone has at least heard of OSA, but there are still many misconceptions about this condition.  Read below to see if you can tell fact from fiction.

Only middle-age, overweight men suffer from obstructive sleep apnea

Fiction:  While older and heavier men create the “classic” profile of an OSA patient, younger and healthy men can be diagnosed with OSA.  Besides Ryan Jensen, Tony Dorsett and Shaquille O’Neill are other athletes living obstructive sleep apnea.  Weight is only one risk factor for OSA.  People of normal weight and thin people can also suffer from OSA.  Tongue size or jaw, nose, and airway anatomy can also cause airflow to become blocked during sleep. There is also sometimes a heredity component to OSA.

Obstructive sleep apnea is often missed as a diagnosis in women

Fact: While OSA is more common in men, women are also susceptible. However, more women than men remain undiagnosed.   In some cases, obstructive sleep apnea is overlooked as a potential diagnosis for women because women don’t often fit the “classic” profile. Women also tend to complain of different symptoms.  A recent UCLA study explains that while men often report snoring and fatigue, women often complain of depression, anxiety or fatigue.  Actresses Amy Poehler and Roseanne Barr are two female celebrities who have OSA.

Obstructive sleep apnea can lead to other serious health conditions

Fact: Untreated OSA has been connected to many other very serious health conditions such as high blood pressure (hypertension), diabetes, stroke and heart disease. Some research shows that up to 1/3 of people who have high blood pressure also have obstructive sleep apnea.  High blood pressure and sleep apnea have both been linked to an increased risk of heart attack and stroke.  OSA has also been linked to diabetes and obesity.

A CPAP machine is the only treatment option for obstructive sleep apnea

Fiction: It is true that positive pressure therapy is the most effective treatment for severe obstructive sleep apnea, but oral devices are becoming a more common option for patients that cannot tolerate CPAP therapy.  Oral appliances work by either holding your tongue in position or sliding your jaw forward when you sleep. Surgical Interventions may also be an option, depending on the cause of your sleep apnea. Ultimately, you and your doctor need to work together to find the treatment option that works for you.

 

Help Students With Asthma Have a Successful School Year

At the start of each school year we are consumed with medical paperwork—physical forms, immunization forms, medication forms and emergency contact forms. They come in the mail or are sent home with the student. It’s easy to place them on a stack with great intentions to complete and send back, but then school starts and before you know it, they are forgotten. But they really are important, why?

Working directly with school nurses as an asthma educator I can’t tell you the countless times there is a need to treat a student with asthma but there are no forms and the proper medication has not been sent in. These students range from those who occasionally present at the nurse’s office with a mild asthma attack, as well as those who have constant breathing issues and spend a majority of the school year seeking help from the school nurse. Keep in mind however, that a mild attack can turn into a major one if the proper medication and action plan is not in place and followed.

The state of Pennsylvania law states (Act 187):

 In order to ensure that a child has his or her asthma medication immediately available when an asthma attack occurs, Pennsylvania schools are required to develop a written policy that allows school aged children to carry (possess) and use (self-administer) their asthma medication. 

It is important to talk with your school nurse about your child’s asthma management before school begins or shortly thereafter. Schools have written policy and procedure that includes asthma action plans that can be completed by both parent and physician. Practice with your child proper inhaler/spacer technique and talk about the purpose of each medication. There’s a good chance your school nurse will require your child to demonstrate they are ready and equipped to self-carry.

If you are not sure what the difference is between short-acting bronchodilators and controlling medication, then consider a conversation with your pharmacist and invite your student to be part of the meeting and ask questions. Short-acting medications reverse asthma symptoms in 3-5 minutes,   easily allowing the child to return back to class to finish the day. Not having access to the inhaler can turn an easy fix to a 911 call, causing the attack to worsen. Now the student is in an ambulance and looking at a possible hospital stay and you are being pulled away from work.

Asthma is one of the top reasons for absenteeism in school settings. A simple fix is to work with both your asthma doctor, school nurse, and student to create an asthma action plan that covers medication use and what to do if an attack occurs. To help you get started, contact Breathe Pennsylvania at 1-800-220-1990 or www.breathepa.org and talk with our Certified Asthma Educators.

Asthma Training Opportunity for Early Learning Practitioners

Breathe Pennsylvania would like to invite our Early Learning Practitioners to contact our Certified Asthma Educators, Jeannie and Jessica, to host or participate in a fun, interactive asthma training.

This 3-hour asthma training has been approved by the Southwest Regional Keys.

The interactive training provides education and case studies that will help practitioners better understand chronic asthma, prevent or respond appropriately to an asthma attack, deliver support utilizing recommended management tools, and be active partners in accessing community resources.

There is no prior asthma knowledge or experience required.

CBK Code: K7 C2- Breathe Pennsylvania will manage the event through PAKeys.

Cost: The center can register 3 staff members for free. All others:

  • 3 hours of instruction costs $14 per person
  • No classes available on Sunday

For more information, contact Jeannie Simms at 412-855-4594 or jsimms@breathepa.org for Allegheny, Armstrong, Fayette, Indiana and Westmoreland counties. Contact Jessica Schuman at 724-900-1115 or jschuman@breathepa.org for Beaver, Butler, Greene, Lawrence and Washington counties.

 

Halloween: Protecting your kids with asthma and allergies

In our house the excitement of the first day of school is quickly fading and Halloween costume ideas are beginning. Rainbow Kitty, Rainbow unicorn…Rainbow unicorn kitty! There are so many options!

Halloween is a really fun time of year for kids. Ghosts, goblins and spooky sounds are around every corner, but one of the spookiest things about Halloween is how asthma and allergies can creep up on us. Consider the following:

TREATS

The merriment and excitement of holidays can cause asthma and allergies to fall to the wayside. In school, the kids’ holiday parties are regulated by the school’s food policies to protect children with allergies, but the same kids who are protected behind a school’s doors are trick or treating in your neighborhood, too.

With the abundance of peanut/food allergies, Food Allergy Research and Education (FARE) created the Teal Pumpkin Project. This initiative is to raise awareness of food allergies and to promote inclusion of all Trick-or-Treaters during the Halloween season. Here’s how it works:

You look for homes that have a teal colored pumpkin or a teal colored sign on their doorstep. These homes offer non-food, allergy friendly choices for your child.

If you want your home to be a Teal home you can visit the FARE website at www.foodallergy.org/education-awareness/teal-pumpkin-project to print out signs and get ideas on allergy friendly treats like glow bracelets, pencils, bubbles and mini note pads. Just be aware, items like moldable clay still contain ingredients like wheat, which is a known allergen.

Still want to hand out candy, too?No problem! FARE’s website offers a printable teal sign that says CANDY or a PRIZE and the child can choose. Make sure that non-food items and candy are placed in different containers to reduce cross contamination.

COSTUMES

Some costumes, masks and makeup could contain latex, which is an asthma trigger. It is very important that you read the labels on these items. Area towns offer about a two-hour Trick or Treating time. A child with asthma could have a prolonged exposure to this latex during this time, causing an attack.

Sometimes we borrow costumes, and I know if you borrow one from me, it’s going to come out of a plastic container in my basement. Though I try my best to protect my costumes, they may have dust or mold on them. Be sure to inspect old costumes and give them a proper washing to remove dust or dust mites. If a costume is moldy, it is best to throw it away.

OUTINGS

Another thing to consider is popular October outings. As we gear up to Halloween night, we visit pumpkin patches, enjoy hay rides and creep through haunted houses.

These are elements that can trigger an asthma attack. Children with asthma need to prepared for mold or allergies on hay that they are sitting on during a ride. Running through haunted houses, being scared and fog machines can all be asthma triggers, too. Moments of anxiety or fear can trigger a physical change in the lungs initiating a need for an inhaler. It is important that a child carries their short acting inhaler with them during these fun Halloween moments.

Finally, here in Pennsylvania, we have the most unpredictable weather. I remember everything from warm October nights to it snowing while I was handing out candy. The change in weather can cause a child with asthma to have a difficult time breathing. Cold temperatures can cause the airways to react and trigger an attack. It is important to have your child cover their nose and mouth with a scarf if the weather becomes cold while trick-or-treating outside.

Halloween is fun, and should be fun for everyone. You can still be scared and hunt for the perfect pumpkin without putting your asthma and allergies at risk. Think ahead and be prepared to make your Halloween the spookiest—but not in a bad way. .

 

Does Your Child’s Snoring Keep you Up at Night?

When most of us picture the loud snorer, it’s likely the classic profile of an overweight, middle-age man sleeping soundly on his back, breathing through his mouth. This is also the image many people associate with obstructive sleep apnea. Now, imagine that same loud snoring coming from your adorable cherub-like child. Could this also be obstructive sleep apnea?

Although recent data indicates that as many as 1 in 5 adults may suffer from obstructive sleep apnea, it is estimated that this condition also affects about 3% of the pediatric population. While snoring and excess weight are universal risk factors for OSA, there are some risk factors and symptoms that are more common in children.

Tonsils and adenoids are made up of lymph tissue and are located in the upper airway (the back of the throat). Tonsils and Adenoids play a role in helping to fight infection, and in young children, they often become enlarged and interfere with breathing.

At night time, the combination of relaxed throat muscles and enlarged tonsils and adenoids may narrow the airway, making it difficult for the child to breathe air from the nose and mouth into the lungs. Air that does move through the narrowed airway causes snoring sounds. If the airway becomes completely blocked, the child may experience episodes of apneas (not breathing). The child’s brain will stop the apneas and the child may choke or gasp as breathing starts again. Each time this happens, the child partially awakens and sleep is disturbed. In addition, apneas cause oxygen levels to drop in the blood, which if untreated, may lead to other health conditions later in life.

Children who are experiencing obstructive sleep apnea may have the following symptoms:
• Hyperextension of the neck during sleep – this position makes it easier for the child to breathe when the airway is narrowed or blocked
• Mouth breathing – if enlarged adenoids are blocking the back of the nose, the child may be able to breathe only through their mouth
• Restless sleep
• Irritability during the day
• Difficulty awakening in the morning or from naps
• Daytime hyperactivity, from poor quality sleep

In addition to the immediate effects of poor quality sleep, research in the field of pediatric obstructive sleep apnea suggests untreated OSA may also be linked to slow growth, ADHD and bedwetting.

If you think your snoring child could be suffering from obstructive sleep apnea, you should talk to your doctor about having your child evaluated.

Emergency and Disaster Planning for those with Chronic Respiratory Conditions

Disasters and emergencies can happen to anyone at any time and sometimes without warning. It helps to have a plan in place if you have a chronic condition that requires the use of medical devices. Your local officials may or may not have prepared for your needs, so planning for an emergency before it happens is very important.

  • Ask your local officials if there is a plan for oxygen delivery, providing a power source for your equipment and where emergency shelters are located.
  • Contact your local power/utility companies and let them know that you have special needs and get on their priority list for restoring power.
  • If you are using ventilatory support, suction, a medical air compressor, CPAP or need to use your oxygen continuously consider purchasing a generator or portable batteries.
  • Have appropriate supplies (1-2 weeks) of medications, food and water.
  • Make sure you have a way to contact someone for help if your telephone or power is out of service. Purchase a battery that will charge your cell phone.
  • If using an oxygen concentrator make sure you have an oxygen cylinder as back up.
  • Know how to contact your medical supplier in an emergency.
  • Keep a list of all your medical equipment and the type, model and make and settings used.
  • For ventilator patients always have a bag/mask device available.
  • ALWAYS take the power cord for your machines, short trips or not.
  • Find out if there is an inhaler version of any medications you are taking with a nebulizer in case of a power outage.
  • If any medications require refrigeration have a plan for keeping them cold.
  • If you know a storm is coming and you may be forced to evacuate, be sure to have a full tank of gas in your car.

This list should help you devise a plan that will keep you and your loved ones safe during an emergency or disaster. Don’t wait for an emergency to happen, plan ahead.

Back to School with a “circle of care” for your Child with Asthma

Can it really be time to head back to school?

Preparing for another successful school year by supporting the management of your child’s asthma and anyone who interacts with him or her is at the top of your ‘must do’ list.

Who should be on that list? Maybe a few people you hadn’t considered or maybe you have but aren’t sure where to begin?

Start with the school nurse, teachers, the school bus driver and anyone who’s on the “need to know” list set by the school nurse and you. Establishing a good network of care will help to insure your child’s safety as well as encourage him or her to participate in all aspects of the new school year.

The whole process is much easier if roles and responsibilities can be defined for everyone.

You and your child should complete an Asthma Action Profile together to verify what you do and don’t know about your child’s asthma. It is important your child be included in establishing a current asthma record because you won’t always be there when they need help. Visit www.breathepa.org  or call 800-220-1990 and request an Asthma Action Profile. Make a copy of the one-page Asthma Record for the school nurse.

Next, meet with your physician, so your child and you can discuss and create an Asthma Action Plan. This plan should cover medications used both at home and at school. It should also include the purpose, and dosage of the medication, and what to do if your child has an asthma attack at school. Remember to provide current contact information and provide the needed medication for the school nurse office.

Meet with your school nurse and discuss what information should be shared with teachers and school bus driver. Your school nurse can determine the best way to share this information.

Making sure that everyone is on the same page will help support your efforts in keeping your child healthy, in school and ready to learn. For additional information or to find out how you can bring an asthma program to your school, contact Jeannie Simms at 800-220-1990.

 

 

Indoor Air Quality and Carpets

Did you know that you could control your allergies in the home if you control your Indoor Air Quality? You might be surprised to know that the biggest culprit is your carpet.

Switching to solid flooring and using washable area rugs is the best way to control severe allergy symptoms. Assuming those symptoms are directly related to carpet issues. Most people are not able to make this expensive modification to their home. It is also a personal preference that can change the overall look of a home.

According to the Asthma and Allergy Foundation of America, the rules listed below may help homeowners with carpet control allergens:

Rule #1: Select carpets with short tight weaves. They limit dirt and allergens from becoming imbedded, and consistent vacuuming will help keep such materials off of the top.

Rule #2: Look for newer vacuums with HEPA filtration.The Carpet and Rug Institute gives a seal of approval to vacuums that meet their standards, for more information visit www.carpet-rug.org. Keep in mind that the filters that will clog up over time. Periodic cleaning or replacement of the filters will keep them functional.

Rule #3: Try steam cleaning your home every six months. For DIY fans this can be a great project. Make sure any spills or stains are not only cleaned up quickly, but cleaned completely. A wet spot is an opportunity for mold growth.

Rule #4: This forth rule is my addition.Keep humidity levels low in a home. Please see previous blogs on basement wetness issues and mold.

Controlling Indoor Air Quality can be a chore, but easier breathing is a blessing for asthma sufferers.

E-Liquid Ingredients: You May Not Know What You’re Vaping

E-cigarettes do not contain actual tobacco or other harmful ingredients such as carbon monoxide and tar, which are found in traditional cigarettes. Instead, e-cigarettes use a liquid nicotine solution know as e-liquid or e-juice. What exactly is e-liquid? E-Liquid is made up of four basic ingredients; water, nicotine, flavorings, and a propylene glycol or vegetable glycerin base (or sometimes a mixture of PG and VG).

Nicotine – The addictive ingredient found in e-cigarettes and traditional cigarettes. Nicotine stimulates the central nervous system and raises blood pressure, respiration and heart rate. When nicotine enters the brain, it releases a feeling of pleasure as dopamine levels increase. Makers tend to offer their products in varying ranges of nicotine content, ranging from none to 36 milligrams per milliliter. Nicotine, while not considered a carcinogen, is still addictive and may “prime the brain to become addicted to other substances,” according to the National Institute on Drug Abuse.

Flavorings – Over seven thousand flavors exist including cherry, coconut, berry blast, fresh apple, sweet tarts, cinnamon and even tobacco. It would be impossible to list all of the chemicals that create the flavors here, but one chemical that stands out is diacetyl. Diacetyl is commonly used to create a buttery flavor to popcorn. While this chemical is believed to be perfectly safe to ingest, there is mounting evidence that inhaling diacetyl can trigger an incurable disease called Obliterative bronchiolitis (OB), also known as “Popcorn Lung.”

Propylene Glycol (PG) – This is a lab-made liquid that the FDA generally views as safe in food, drugs and cosmetics. It’s also used to make artificial smoke or fog for performances. It can irritate the lungs and eyes and may be more harmful for people with chronic lung diseases like asthma and emphysema.

Glycerin – Odorless and colorless, liquid glycerin has a slightly sweet taste. Like PG, the FDA generally views it as safe. It’s found in many products, including food and drugs, both prescription and over the counter medications.

While some of the ingredients listed above are known to be generally safe in food and drugs, what remains unclear are the health risks that come from inhaling large amounts of the chemicals over time. Long-term effects are almost guaranteed. What they are exactly cannot be defined just yet. One thing is for sure: they won’t be good.

 

A Look At How Flu Vaccines Are Made

Flu season is coming up soon, but have you ever thought about how the vaccines are made? Currently there are three influenza vaccine production technologies that are utilized in the United States.  All meet U.S. Food and Drug Administration (FDA) approval. They are:

  • Egg-based flu vaccine
  • Cell-based flu vaccine
  • Recombinant flu vaccine

Egg-based flu vaccine

The egg- based process has been used for some 70 years. When the current year’s flu virus strains have been identified by the World Health Organization (WHO) Influenza Surveillance System and approved for use in the United States by the FDA, these candidate vaccine viruses (CVVs) are injected into fertilized hen eggs and incubated for several days to allow the viruses to replicate. For flu shots, the influenza viruses are then inactivated (killed), and the virus antigen is purified. This method requires large numbers of chicken eggs and usually takes longer than other methods to produce a vaccine.

Cell-based flu vaccine

The cell-based production process for flu vaccines was approved by the FDA in 2012. However, until recently, this production process also began with egg-grown candidate vaccine viruses (CVVs). In August of 2016, the FDA issued an approval for Seqirus, the sole FDA approved cell-based flu vaccine manufacturer in the U.S. to use cell grown CVVs. Cell-based flu vaccine production does not require chicken eggs because the vaccine viruses used to make the vaccine are grown in animal cells. Cell culture technology has the potential for a faster start-up of the vaccine manufacturing process.

Recombinant flu vaccine

The recombinant method of producing flu vaccine was approved by the FDA for use in the U.S. market in 2013. This production method does not require an egg grown vaccine virus and does not use chicken eggs at all in the manufacturing process. It uses an influenza virus protein that is made by genetically modifying a virus that infects insect cells to produce the flu vaccine protein. The protein, as in other flu vaccines, then triggers the immune system of the person receiving the vaccine to make protective antibodies. Currently, recombinant flu vaccine is the only 100% egg free vaccine on the U.S. market.

As with all health related issues, it is best to have a discussion with your physician in making the determination as to which flu vaccine formulation is best for you.

For further information: www.cdc.gov/flu/protect/vaccine/how-fluvaccine-made.htm