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American Heart Association Gives OSA Patients the Finger

I have personally approached the marketing/ communications director of the American Heart Association to work together with the NYC AWAKE group to spread OSA awareness, and she essentially told us to pound sand because the connection between OSA and heart disease was not sufficiently proven. Outrageous, huh?

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Mike said:
I'm pretty slim myself -- 6 feet tall, 180 lbs. and i have OSA. osa is largely due to how narrow your jaw is.

Exactly.

I am an old man with BMI 22, flat stomach, run trails and climb mountains, just ran two 10Ks, and have severe obstructive sleep apnea.

It is mostly about the jaw being too narrow. I know plenty of slim people with OSA. Very few overweight people are ever able to cure their OSA by losing weight.

Geronimo.
Neck size plays a huge factor. Muscle atonia is the major culprit.

Banyon said:
Mike said:
I'm pretty slim myself -- 6 feet tall, 180 lbs. and i have OSA. osa is largely due to how narrow your jaw is.

Exactly.

I am an old man with BMI 22, flat stomach, run trails and climb mountains, just ran two 10Ks, and have severe obstructive sleep apnea.

It is mostly about the jaw being too narrow. I know plenty of slim people with OSA. Very few overweight people are ever able to cure their OSA by losing weight.

Geronimo.
Using that logic, any number of conditions (besides cardiovascular ones) should not be treated because they are partially caused by obesity, such as Type II diabetes, joints with osteoarthritis, gall bladder removal, high blood pressure, and yes...even breast and colon cancers. However, while one may be advised by doctors to lose weight with any of these, they still require treatment...even if reducing weight is undertaken.

Brian Smith said:
For the record I've used CPAP for OSA for over 10 years. I'm 5' 9" tall and weigh 241lbs with a 17.5" collar size.

I am a typical OSA sufferer. I am overweight; significantly so. If there is a normal weight/slim sufferer out there, sorry if I've overlooked you.

How is anybody supposed to separate out the effects of obesity on the heart - which are documented - from those caused by OSA?

As a scientific body, the AHA are quite right to say that the research isn't there/hasn't been done, if that is the case.

We OSAers would be better off talking to WeightWatchers and leaving the AHA to their "proper" work. OSA isn't an illness or a disease, it's a lifestyle failing.

If we need help from the medical community it's in getting our weight under control.

We could, of course, just eat a little less and exercise a little more and leave the doctors to look after sick people. But then that's blaming ourselves...

Basically, I don't think it's helpful to see OSA as a medical condition. A personal trainer would be more relevant - and cheaper - than a physician, heart surgeon etc.
There is ample evidence that particulate air pollution/ultra fine particulates are a major contributor to heart disease, atherosclerosis, and blood clotting abnormalities. If one were to examine their in-line cpap filters, they would come to the quick realization that the standard inlet filtration misses a considerable amount of particulate matter. What is the answer to the question - does the dynamics of cpap therapy - the significant increase of the surface area of the lung and the deposition of these particles deep into the recesses of lung tissue increase the cpap patient's exposure to particulate air pollution. If the answer is yes, then there may be a connection between OSA and heart disease.
So if the answer to your question is no, then there is no connection?

Come spend some nocturnal hours with me. I will show you the connection. I get to see the effects of OSA on the heart 3-4 nights a week. Better yet I get to see the effects of PAP therapy as well.

greg said:
There is ample evidence that particulate air pollution/ultra fine particulates are a major contributor to heart disease, atherosclerosis, and blood clotting abnormalities. If one were to examine their in-line cpap filters, they would come to the quick realization that the standard inlet filtration misses a considerable amount of particulate matter. What is the answer to the question - does the dynamics of cpap therapy - the significant increase of the surface area of the lung and the deposition of these particles deep into the recesses of lung tissue increase the cpap patient's exposure to particulate air pollution. If the answer is yes, then there may be a connection between OSA and heart disease.
it is like saying that when a burgulary takes place the police are resposible because they are alway around when the burglary take place

usually very untrue very rarely true

greg said:
There is ample evidence that particulate air pollution/ultra fine particulates are a major contributor to heart disease, atherosclerosis, and blood clotting abnormalities. If one were to examine their in-line cpap filters, they would come to the quick realization that the standard inlet filtration misses a considerable amount of particulate matter. What is the answer to the question - does the dynamics of cpap therapy - the significant increase of the surface area of the lung and the deposition of these particles deep into the recesses of lung tissue increase the cpap patient's exposure to particulate air pollution. If the answer is yes, then there may be a connection between OSA and heart disease.
greg said, "the dynamics of cpap therapy - the significant increase of the surface area of the lung and the deposition of these particles deep into the recesses of lung tissue increase the cpap patient's exposure to particulate air pollution."

Where is the science for this? What does the strange and dramatic term "deep into the recesses" mean in terms of science?

In fact, where is the logic for this? Compared to normal air pressure and compared to the pressures in the lungs when breathing hard from exercise, CPAP pressure is small. There is no evidence it "increases the surface area of the lungs".

Fear mongering?
I should have clarified that OSA causes heart issues and particulate air pollution cause heart disease. Cpap is a means to mitigate the damage done by OSA. When attempting to craft a therapy, it would be best to eliminate any issues that would further contribute to the problem. Thus, very good filtration is necessary.
Louise said:
"...It seems to me that the AHA is in need of "clear direction" when it comes to the link between OSA and CVD. She needs to understand that those of us in the sleep profession have no need for additional research as we see the connection quite clearly and up close every night in every sleep center across the entire world. ..."

Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".

Per centage wise, the RPSGTs are the real heroes of sleep medicine, but they aren't "good enough" to tell us patients much 'cause they "ain't" no medical professional.

Of course, your sleep doctor (the medical professional) in all too many cases can't even be bothered consulting w/us, preferring to send their dictation to our referring doctor to let him/her "waste" their time consulting w/us, or if they do condescend to consult at all w/us, its an "in and out", 10 minute, yuo've got OSA, here's your script, bye. IF we are lucky enough to get a fully data capable PAP our "medical professional" isn't interested in really looking at the data and just glances at it at best w/o paying any real heed to it.
I volunteer to go sit in the AHA's office without my CPAP for as long as it takes for my legs to swell up like baloons and my systemic and pulmonary hypertension to return so that they can see just for their very own eyes, that yes Virginia, there is a direct connection between OSA and heart disease. I will be the scientific study that they need.
Louise I believe that Judy was being sarcastic. great speach though. Could I get you to direct at a few other people please.

Louise Dover said:
Just so you know, Judy, my medical director (a board-certified sleep physician) comes in every single morning and reviews every study that ran the night before, meets with the patient before they leave the lab, and dictates the report before he leaves. Our patients are extremely well cared for, considering I have over 15 years of sleep experience behind me. And on the rare occasion that my medical director is unable to appear in the sleep lab the following morning, he depends on me, yes - ME - the lowly sleep tech who ain't qualified for crap as far you are concerned, to review the study with the patient and make sure they leave the lab with their CPAP prescription in place, or a follow-up study appointment - if necessary. Apparently whatever lab you went to wasn't worth their salt, because I would never work in a place that treated their patients the way you described. So before you start belittling me and my profession, back the truck up and look at who you are speaking to before you speak - it makes you appear shallow and uneducated. If you are unhappy with your sleep lab experience, I would suggest you find a PROFESSIONAL lab.

Judy said:
Louise said:
"...It seems to me that the AHA is in need of "clear direction" when it comes to the link between OSA and CVD. She needs to understand that those of us in the sleep profession have no need for additional research as we see the connection quite clearly and up close every night in every sleep center across the entire world. ..."

Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".

Per centage wise, the RPSGTs are the real heroes of sleep medicine, but they aren't "good enough" to tell us patients much 'cause they "ain't" no medical professional.

Of course, your sleep doctor (the medical professional) in all too many cases can't even be bothered consulting w/us, preferring to send their dictation to our referring doctor to let him/her "waste" their time consulting w/us, or if they do condescend to consult at all w/us, its an "in and out", 10 minute, yuo've got OSA, here's your script, bye. IF we are lucky enough to get a fully data capable PAP our "medical professional" isn't interested in really looking at the data and just glances at it at best w/o paying any real heed to it.
I do not think that this came out quite the way you wanted Judy.

Judy said:
Louise said:
"...It seems to me that the AHA is in need of "clear direction" when it comes to the link between OSA and CVD. She needs to understand that those of us in the sleep profession have no need for additional research as we see the connection quite clearly and up close every night in every sleep center across the entire world. ..."

Yeah but, yeah, but, geeze, Louise!!!! You RPSGTs "ain't" medical professionals, most of you have no medical background whatsoever, shucks youse guys "ain't" even allowed to provide us much info at all about our PSG the next morning 'cause you "ain't" no medical "professional".

Per centage wise, the RPSGTs are the real heroes of sleep medicine, but they aren't "good enough" to tell us patients much 'cause they "ain't" no medical professional.

Of course, your sleep doctor (the medical professional) in all too many cases can't even be bothered consulting w/us, preferring to send their dictation to our referring doctor to let him/her "waste" their time consulting w/us, or if they do condescend to consult at all w/us, its an "in and out", 10 minute, yuo've got OSA, here's your script, bye. IF we are lucky enough to get a fully data capable PAP our "medical professional" isn't interested in really looking at the data and just glances at it at best w/o paying any real heed to it.

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