support research on sleep apnea

[bmd]

In modern, industrial societies the majority of people have some degree of malocclusion.

I have seen those case studies in rural Kentucky. They clearly traced a big increase in malocculusion to the opening of grocery stores.

I hope your project gets approved and I have voted for it earlier.

Thanks for your vote, Hang Fire.

[bmd]

Voting ends on May 15, 2015. To vote just click on the up-arrow in the box to the right of the title, and you will be asked to enter your name and email address.

Looks like the voting is not doing very well. -10 net votes at the moment.

That is true, unfortunately. I guess it is harder than I realized to gain support for a new idea. I was hoping this group would help with that. Here is the link again for anyone who wants to see this research happen. Please vote!
http://nhlbistrategicvisioning.ideascal ... 0728-32287

What or how would you envision incorporating the changes to the world population as a whole?
.

The way I see it, the benefit of further research on this topic is that it will generate new knowledge, and clarify existing knowledge, on the causes of the airway features that lead to the development of sleep apnea. When this new knowledge reaches the medical community, pediatricians and dentists will disseminate it to parents of kids at risk for sleep apnea. Also, parents and grandparents who have sleep apnea themselves would undoubtedly be quite motivated to prevent it in their kids, if they knew it was preventable.

"Knowledge is power" because it gives people the opportunity to make more informed choices. Some options parents would have for promoting healthy jaw and airway development in their kids include: 1) breastfeeding long and frequently, or using an orthodontically correct baby bottle, and 2) feeding older kids plenty of tough foods, like raw fruits and veggies, or having them do myofunctional therapy (mouth exercises) daily. Better understanding through research will help clarify which of these practices are most effective and exactly how much is needed, in which kids, at what ages. (Note that no prehistoric lifestyle is necessary to gain the benefits of this knowledge.)

It is understandable that this idea is quite novel for many on this forum, but I hope all will consider it with an open mind.

[Wulfman...]

Voting ends on May 15, 2015. To vote just click on the up-arrow in the box to the right of the title, and you will be asked to enter your name and email address.

Looks like the voting is not doing very well. -10 net votes at the moment.

Just to be clear........
I did NOT vote in that poll.
So, don't blame me for the way the voting is going.


Den

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[robysue]

Also, parents and grandparents who have sleep apnea themselves would undoubtedly be quite motivated to prevent it in their kids, if they knew it was preventable.

It sure hasn't worked out that way with HBP, Type II Diabetes, or obesity. All of which are "lifestyle illnesses" that are thought to be preventable by making changes in the diet and level of activity. And all of which strongly run in families.

[ChicagoGranny]

It sure hasn't worked out that way with HBP, Type II Diabetes, or obesity.

Is it safe to assume that you are not saying because it has yet* to be successful in these areas, we should remain ignorant in other areas?

*Note: The trend line in growth of obesity in the U.S. population has flattened indicating some success is being achieved, although there is more work to be done.

[robysue]

It sure hasn't worked out that way with HBP, Type II Diabetes, or obesity.

Is it safe to assume that you are not saying because it has yet* to be successful in these areas, we should remain ignorant in other areas?

No. What I'm saying, however, is that simply expecting people to simply change their behavior for very long term goals has a long history of failing.

In other words, if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues, we're not likely to succeed in getting people to rear their children differently on the expected chance that changing how we rear our children may help prevent OSA when they become middle-aged adults.

Fixing the problem of getting people to change long term behavior is an important issue, and we're NOT working on it in this culture. And, in my humble opinion, a big part of the problem is American culture in the first place: As Americans we have an expectation that problems can be fixed in a short span of time and we have a very difficult time planning for what might happen 10 or 20 years down the road, let alone what might happen 30 or 40 years down the road.

*Note: The trend line in growth of obesity in the U.S. population has flattened indicating some success is being achieved, although there is more work to be done.

Flattened out does NOT mean the US population has learned a damn thing about maintaining a healthy weight: Here are some statistics from National Institutes of Health

Fast Facts
Data from the National Health and Nutrition Examination Survey, 2009–2010

More than 2 in 3 adults are considered to be overweight or obese.
More than 1 in 3 adults are considered to be obese.
More than 1 in 20 adults are considered to have extreme obesity.
About one-third of children and adolescents ages 6 to 19 are considered to be overweight or obese.
More than 1 in 6 children and adolescents ages 6 to 19 are considered to be obese.

It could very well be that the 1/3 of the US population that is NOT overweight or obese is the 1/3 of the population that naturally is more active, more inclined to eat healthier, and simply more aware of the need to watch their weight----i.e. this 1/3 of the population may have been "easy" to educate. The remaining 2/3 of the population? There's no evidence that they've embraced the need to change their lifestyles.

There's also a new study that shows 95 percent of parents think their overweight children look ‘just right’. Parents who don't "see" the problem of their children's weight are highly unlikely to do anything about the problem of their children's weight.

[ChicagoGranny]

You make some good points, but I find it a bit spurious to make the point about obesity trends as you give the impression that this is a reason the research on jaw development should not be done.

if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues

I would still argue that changing the trend line is some indication that research and public education about the causes and dangers of obesity is starting to work.

if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues

Oh, but there are some things where good behavior change has been observed. Smoking would be a top example. Consumption of vegetable and fruits (It is up.) is another example.

the problem of getting people to change long term behavior is an important issue

As a matter of public policy, I am not in favor of "getting people to change". What I do support is doing the research and providing the education/information. The rest is up to the people.

[Julie]

I think part of the problem with parents unable (or unwilling) to see their children's weights is that they themselves are overweight and feel threatened by being asked to confront it in their kids... knowing they'll probably have to lose weight themselves... that and the fact they've lost sight of 'normal' or good because everyone else is big!

They should be sent to some 3rd world country to see what lack of obesity means in real life, what starvation really means (not having had to miss coffee break one day).

[Sheffey]

....

Thank you Granny. I have trouble understanding why people with OSA, of all people, would express any objection to this research.

I have come to the conclusion that they just don't understand the issues and I will try to drop out of this conversation as hard as it is for me to keep quiet.

Best of luck bmd.

(BTW, I don't expect to receive any benefit from this research. My hope is for future generations.)

[robysue]

....

Thank you Granny. I have trouble understanding why people with OSA, of all people, would express any objection to this research.

I have no particular problem with this research. But at the same time, I don't see how the proposed project will positively make much of a difference either now or for future generations.

In other words, I'd rather see research $$$ put towards projects that have a much better chance of making a positive difference both now and in the future. I would like to see more $$$ spent finding ways to help people with OSA overcome the current difficulties so many find with CPAP. It's a matter of priorities: I would rather focus $$$ on researching effective ways to fix the "50% failure rate" when it comes to becoming fully compliant with therapy. I'd also prefer $$$ to be spent on figuring out why some people's sleep becomes substantially worse once they start CPAP. And I'd also prefer to see $$$ spent on figuring out ways to screen OSA sufferers for potentially difficult adaption periods---if it were easy to identify who was at high risk of developing pressure induced central apneas; who was at high risk of severe aerophagia; and who was at high risk for developing CPAP-induced insomnia, then we might be able to proactive in making sure those new CPAPers get the kind of help they need instead of hoping that they find a forum like this one before they just give up because they're feeling much, much worse after starting CPAP than they did before starting CPAP.

I'd also like to see more research $$$ put towards long-range studies of the medical consequences of treating/not treating mild and moderate OSA, particularly when the person is asymptomatic before the diagnosis. While there is data that clearly indicates CPAP does reduce mortality for people with severe OSA, the data is much more muddy when it comes to whether CPAP really reduces mortality rates for people with mild or moderate OSA.

And yes, I understand that my own research priorities emphasize "short term" results over "fixing a long term problem". But with so many suffering now at the hands of the so-called "sleep medicine industry", I personally think the short term problems must be addressed.

[Wulfman...]

You make some good points, but I find it a bit spurious to make the point about obesity trends as you give the impression that this is a reason the research on jaw development should not be done.

if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues

I would still argue that changing the trend line is some indication that research and public education about the causes and dangers of obesity is starting to work.

if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues

Oh, but there are some things where good behavior change has been observed. Smoking would be a top example. Consumption of vegetable and fruits (It is up.) is another example.

the problem of getting people to change long term behavior is an important issue

As a matter of public policy, I am not in favor of "getting people to change". What I do support is doing the research and providing the education/information. The rest is up to the people.

REALLY???
Give me a break!
Those could be some of the most contradictory comments I've ever seen. (Especially after you attacked me on a previous page)
Who was it that mandated the "Warning" labels on smoking products about 50 years ago? Back in the 1960s when that started, the cost of a pack of cigarettes was about 30 cents a pack. Now, they're many dollars per pack, depending on where you live and the amount of taxes the "public policy" folks (government)......have imposed on them. They've tried to tax them out of existence (behavior change).......along with alcoholic beverages.
I'm not saying that smoking or drinking is "good", but are two of the things that the government is trying to force the people to change.......and suck as many tax dollars out of them as possible.
More currently, the healthcare debacle and the school lunch food "nanny state" are a couple more.


Den

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[ChicagoGranny]

Now, they're many dollars per pack, depending on where you live and the amount of taxes the "public policy" folks (government)......have imposed on them. They've tried to tax them out of existence (behavior change)

Have you lost your ability to read and understand? I said we should not do just what you are complaining about being done. I'd say we are in agreement on this one point, but your lack of reading and comprehension skills makes you think we are in disagreement. Please go back and read or drop out of the discussion -

As a matter of public policy, I am not in favor of "getting people to change".

the school lunch food "nanny state"

You don't have a clue. The government feeds kids in government schools. You don't have a clue what the shit they feed them is. I do. It's the nastiest looking pizza slices I have ever seen, french fries, grisly hamburgers, rubbery chicken nuggets. If you don't believe it, go to one of your local government schools and check it out.

That is what the nanny state brings to our kids - shitty food that you would not eat once a month, much less five times per week.

Now you are feeble enough in your thinking to say it is a nanny state if there is an attempt to change those shitty meals to something good?? So what the hell do you want the Republicans you elected to do? Continue to block any attempts to stop feeding this shitty food to kids? I also watch Fox News. I know what kind of people you vote for. Jezuus!

[Wulfman...]

Now, they're many dollars per pack, depending on where you live and the amount of taxes the "public policy" folks (government)......have imposed on them. They've tried to tax them out of existence (behavior change)

Have you lost your ability to read and understand? I said we should not do just what you are complaining about being done. I'd say we are in agreement on this one point, but your lack of reading and comprehension skills makes you think we are in disagreement. Please go back and read or drop out of the discussion -

As a matter of public policy, I am not in favor of "getting people to change".

the school lunch food "nanny state"

You don't have a clue. The government feeds kids in government schools. You don't have a clue what the shit they feed them is. I do. It's the nastiest looking pizza slices I have ever seen, french fries, grisly hamburgers, rubbery chicken nuggets. If you don't believe it, go to one of your local government schools and check it out.

That is what the nanny state brings to our kids - shitty food that you would not eat once a month, much less five times per week.

Now you are feeble enough in your thinking to say it is a nanny state if there is an attempt to change those shitty meals to something good?? So what the hell do you want the Republicans you elected to do? Continue to block any attempts to stop feeding this shitty food to kids? I also watch Fox News. I know what kind of people you vote for. Jezuus!

I think it's YOU who has no clue what you're talking about. I don't even know where to start with that one.
Regarding the school lunch breakfast programs, I DO know what I'm talking about because I had a close relationship with one for over 12 years. I helped supervise it and programmed the computerized menus.
Schools may participate in the lunch breakfast programs and receive government subsidized food at reduced prices. However, they have to adhere to certain requirements to keep receiving that stuff. Actually, much of the food I saw was quite good quality in those years. But, you could tell which companies were contributors to the presidential/congressional campaigns by reading the names of the suppliers on the packages (think of one chicken supplier in Arkansas as an example). Many of the schools are now opting out of the program because the menus have been changing and the kids aren't eating the "food" and are throwing it away. The one I worked with has also opted out in the last couple of years.

The "shitty" meals/programs have been imposed under the current administration. The better meals/food were available under the Clinton and Bush administrations (and probably before that). And, if a school doesn't have decent cooks, the food will be "shitty" regardless of what goes into it. Your Republican/Democrat argument is bogus, as is your Fox News innuendo.


Den

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[ChicagoGranny]

if a school doesn't have decent cook

You have cooks in government schools in Montana??? All the government schools I have been in have no cooks. Only workers who warm shitty food up.

[robysue]

if we've not been able to get the vast majority of the US population to change its behavior in regards to other long term life style issues

Oh, but there are some things where good behavior change has been observed. Smoking would be a top example.

It's taken 50+ years for us to reduce smoking to the current levels. And much of that change has been because of government sponsored education programs, increasingly expensive cigarette taxes, and local and state governments passing more and more restrictive laws on where people are allowed to smoke. In other words, the big bad government's rules, regulations, and laws have a lot to do with the reduction in smoking levels.

In particular, people tend to discount how much significant increases in cigarette taxes influence behavior, but The relation between tobacco taxes and youth and young adult smoking: What happened following the 2009 U.S. federal tax increase on cigarettes is a peer reviewed study that concludes that the huge 2009 increase in federal cigarette taxes did reduce both the numbers of new smokers among the youth and young adult populations AND a decrease in the cigarettes actually smoked by youth and young adult smokers.

the problem of getting people to change long term behavior is an important issue

As a matter of public policy, I am not in favor of "getting people to change". What I do support is doing the research and providing the education/information. The rest is up to the people.

If there is no effort to get people to change their behavior, there's no point of doing basic research that leads to just another long list of recommendations that boil down to: You need to change your behavior to minimize your (or your children's) risks of these diseases.

You know, there is a big difference between the government stepping in and passing laws that regulate behavior and tackling the problem of how to get people to voluntarily change their behavior. Public health campaigns are one way of trying to influence people into making significant changes to their risky behaviors; without public health campaigns, most people are NOT likely to read about, think about, or implement any changes to their day to day behavior. But public health campaigns designed to provide and educate people about risky behavior do cost money.

As a specific example: Government bans on supersized soft drinks (as was once proposed in NYC) are silly. They're not really going to stop anybody from drinking more soda than is good for them AND they represent the absolute worst of "nanny-state" politics. But multi-pronged public health campaigns that include things like teaching k-12 kids to make better choices, banning soft-drink and candy machines in public schools, and encouraging doctors and dieticians to have serious, substantial conversations with their patients who do consume too much sugar just might get some people to start making better beverage and dietary choices. And it's important to understand that when I say "teaching kids" I mean both encouraging parents to think about the family's diet and what they are teaching their kids every day by what they choose to put on the table as well as explicit instruction in public school Health courses that are typically mandated by the state as part of the state's control of K-12 education.

More to the point on a CPAP support forum: I do wish that research $$$ would be spent on figuring out what kinds of patient intervention and patient education programs really make a difference in getting new CPAPers to become fully compliant PAPers. It's a huge issue. And it certainly can't and won't be "solved" by governmental legislation or regulation. It could be solved with appropriate research into various models of patient information/education programs that do detailed follow-up of large numbers of patients and statistically analyzing which kinds of things lead to better long-term PAPing results. Once it was shown which kinds of things have the most bang for the buck (so to speak), the next challenge would be in getting the vast sleep medicine industry "machine" to adopt those practices. Part of convincing the sleep medicine industry to adopt whatever techniques can be shown to work would be in making sure the information is properly disseminated to the everyday sleep medicine folks and part of it would probably come from the big, bad insurance companies deciding to tighten up on when they would pay for a CPAP machine.