2017

A Current Affair

Oventus oral appliance - a Sleep Physicians perspective

Dr Desai, Sleep and Respiratory Physician, was filmed as an independent Sleep Physician expert for a TV segment on A Current Affair, which aired Friday 24 November 2017.

The segment discussed a new oral appliance available to treat obstructve sleep apnoea - Oventus O2Vent.

Although potentially promising as a new treatment for obstructive sleep apnoea, Dr Desai made the point that there is only one (industry funded) published study supporting the use of this device to date and far more research is required to know whether it will be effective to treat obstructive sleep apnoea and if so, which patients might benefit.

Sleep Forum 2017

Full day symposium on insomnia

Dr Desai, Sleep and Respiratory Physician, and Rosemary Clancy, Clinical Sleep Psychologist, participated in a large educational form for GP's at the Sheraton Hotel in Sydney on Saturday 18 November 2017. Associate Professor Goldin, Respiratory and Sleep Disorders Physician from Royal Melbourne Hospital, and Dr Nava Zisapel, Professor of Biochemistry at Tel Aviv University, Israel, both flew in to make the Forum the highlight of Sydney Sleep Centre's GP Educational activities for the year:

Dr Jeremy Goldin “Sleep Medicine – Wake up, it is not all about sleep apnoea”

Dr Anup Desai “Insomnia – Assessment and Management”

Dr Nava Zisapel “Current and future pharmacological management of sleep disorders”

Ms Rosemary Clancy The utilisation of Cognitive Behavioural Therapy (CBT) in Insomnia management – a case based discussion

Over 100 GP's attended and the Forum was oversubscribed. The Forum was generously sponsored by Aspen Pharmaceutical.

"Less is more when it comes to productive hours at work"

Sleep is important to productivity

An article in the Sydney Morining Herald in November 2017 sums up well the importance of good sleep. In the article, the BHP CEO, Andrew McKenzie, explains that working when not well rested is less efficient and less productive. He states, "A rested Andrew can do more in four hours than a tired Andrew can do in eight". He then adds, "It's not only diminishing returns, [not being rested] is like a scorpion's tail; it can undo things,".

 

The importance of adequate sleep hours and good sleep quality is consistent with sleep research on the importance of sleep for productivity in the workplace. These are important messages for everyone to be aware of and for key influencers, such as Senior Executives, to reinforce and propogate in their organisations.

 

"A recent study by Deloitte Access Economics found 39.8 per cent of Australians did not get enough sleep and that sleep deprivation cost the economy an estimated $66.3 billion in health bills, lost productivity and wellbeing in 2016-17. Lost productivity included "presenteeism", where workers were present at work but too tired to be productive."

 

Good sleep involves adequate sleep hours (often more than you think) and the treatment of any sleep disorders that may be fragmenting sleep. There are many sleep disorders that can fragment and limit sleep and these are discussed elsewhere in our website in the section on "Sleep Disorders". Many sleep disorders are unrecognised or unaddressed by patients and it is important to discuss possible symptoms of these conditions with your doctor to receive help sooner, rather than later. Important clinical clues to a sleep disorder include daytime fatigue, poor concentration, poor attention, daytime sleepiness, and night time symptoms of snoring, gasping in sleep or repeated awakenings overnight.

GP Education

As part of ongoing educational initiatives to local doctors, Dr Desai and Dr Lewis lectured to GP's at Claires Kitchen in Darlinghurst. The talks covered Respiratory and Sleep Medicine topics and were well received by around 30 local GP's.

How Lack of Sleep Can Cost You Money

Lack of sleep can influence your productivity at work, and to some extent, it can even end up costing you money. New research conducted on this topic has shown that sleep deprivation is costing the economy up to $66.3 billion in "health bills, lost productivity, and wellbeing". The survey conducted by Deloitte Access Economics shows that 39.8 per cent of Australians don't get enough sleep, which is incurring increased health system costs, productivity loss, and costs to overall wellbeing.

People with sleep disorders or sleep deprivation s generally seek help from our health systems. The costs incurred through these systems were broken down into separate categories: admitted patients, out of hospital medical, pharmaceuticals, and 'others' (which includes community services and research conditions). Most of the costs incurred were due to work place injuries, depression, and MVAs (motor vehicle accidents). These were all due to sleep deprivation and inadequate amounts of sleep. The overriding message here was that the less sleep you get, the more susceptible you are to possible health problems, which can incur substantial costs, an estimated $1.8 billion in 2016-2017 alone.

Productivity loss is a huge consequence of sleep deprivation. Inadequate sleep can have a huge impact on your ability to engage and attend work. If a person is too tired to attend work or actively participate in their job duties, it can impact their performance, which hinders the growth and operation of a business. This can cost a company and even the employee in the long run. If an employee is not fulfilling the duties of their employment, they are a risk to the company and they can potentially be terminated from employment. The effects of sleep deficit can include difficulty staying focused, taking longer to complete tasks, less motivation to learn, and finding it difficult to generate new ideas. It's a double-edged sword. By sleeping less, you are less productive at work during work hours, so you bring work home to complete, which affects your time spent sleeping. The easiest fix is to ensure you get up to 7-8 hours of sleep per night, which will give you a boost in productivity on a day-to-day basis.

Overall wellbeing is another consequence of sleep deficit. The loss of quality of life, loss of leisure, and physical pain are all outcomes of sleep deprivation. According to the Deloitte Access Economics  surveythrough the Sleep Health Foundation, congestive heart failure, coronary artery disease, strokes, type 2 diabetes, depression, and general difficulties with sleep were attributed to sleep deprivation. The estimated financial costs of sleep deprivation on a person's overall wellbeing amounted to $40.1 billion in 2016-2017. This is a huge concern that can be readily addressed . There are steps you can take to combat sleep deprivation:

1. Stick to a schedule of the same bed time and wake up times, regardless of the day. This can help to regulate your body clock, which helps set the rhythm for your body's sleeping schedule.

2. Exercise daily. Exercising has shown to help with sleep quality and duration, even if it's for a short 10-minute duration.

3. Have a bedtime ritual. Create a ritual for yourself right before you fall asleep that is relaxing.. Reduce exposure to bright lights and computer screens to help you settle for sleep.

4. If all else fails, consult a Sleep Physician, such as those at Sydney Sleep Centre, for a thorough assessment of your sleep problems and an expert management approach. Sydney Sleep Centre provides services and treatments on sleep disorders.

Royal Australasian College of Physicians Education

Dr Desai presented a lecture to the NSW Branch of the Royal Australasian Faculty of Occupational and Environmental Medicine on Obstructive Sleep apnea and Driving Assessment. This is a difficult topic for Occupational Doctors in particular given the risk of serious occupational accidents from untreated obstructive sleep apnea. Over 30 Doctors were in attendance at the Education Centre of the Royal Australasian College of Physicians on Saturday 5 August and there was good bi-directional discussion of the challenging clinical issues.

Dr Desai talks Sleep with Dr Ron Ehrlich of Sydney Holistic Dental Centre

Dr Ron Ehrlich is one of Australia’s leading holistic health practitioners, educators and a dentist. Dr Ehrlich has a strong interest in sleep and its impacts on dental health and general well being. Dr Desai discusses with Dr Ehrlich the importance of sleep and sleep disorders.

 

After a general discussion on why sleep is important, Dr Desai discusses common sleep disorders, including snoring and obstructive sleep apnoea (OSA). He explains what snoring and obstructive sleep apnoea is and gives some insights in to sleep studies. He explains “apnoeas” or pauses in breathing during sleep and the “apnoea hypopnoea index”, a medical term that describes the severity of obstructive sleep apnoea. The link between obstructive sleep apnoea and mental health is discussed, as well as common risk factors for obstructive sleep apnoea. Sleepiness on the road, the risk of car accidents from falling asleep at the wheel, and the medicolegal side of untreated sleep disorders are discussed. CPAP therapy, mandibular advancement splints, surgery and weight loss are outlined as treatments for OSA.

Insufficient Sleep Can Cause Obesity

A recent study from the University of Leeds

A recent study from the University of Leeds showed that people who were sleeping on average around six hours a night had a waist measurement that was 3cm greater than individuals who were getting nine hours of sleep a night. And shorter sleepers were heavier too. The results strengthen the evidence that insufficient sleep could contribute to the development of metabolic diseases such as diabetes.

Previous studies have shown that poor quality sleep and lack of sleep contributes to obesity through poor dietary choices - namely the types of food people consume and their portion sizes. In this study, the researchers found a new metabolic link relating to sleep - shorter sleep was linked to reduced levels of HDL cholesterol in the participants’ blood – another factor that can cause health problems. HDL cholesterol is ‘good’ cholesterol that helps remove ‘bad’ fat from the circulation. In doing so, high HDL cholesterol levels protect against conditions such as heart disease.

Dr Hardie said: “Because we found that adults who reported sleeping less than their peers were more likely to be overweight or obese, our findings highlight the importance of getting enough sleep.

"How much sleep we need differs between people, but the current consensus is that seven to nine hours is best for most adults.”

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0182195