RIP Tim Russert

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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roster
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Post by roster » Thu Jul 03, 2008 2:23 pm

Tim Russert's recent tragic death shook the political world. He died despite being on medications for high blood pressure and elevated cholesterol, and had no symptoms of heart disease. He even exercised every day, as part of a regimen to lose some weight. His autopsy report ultimately revealed that he had advanced blocked arteries in his heart. There's been much speculation in the media about the circumstances surrounding his untimely death, but in retrospect, all the data and his medical history strongly suggests that he may have had untreated OSA. One of the great myths perpetuated in the medical community (and the media) is that only men who are older, heavy-set, loud snorers, and have big necks can have obstructive sleep apnea (OSA). OSA is a common condition where one stops breathing repeatedly at night during sleep, with poor sleep quality and lowered oxygen levels, which stresses the heart. This perception started decades ago as sleep apnea was first described only in these type of men. Recent studies have shown, however, that even young, thin women who don't snore can have significant OSA.

There are dozens, if not hundreds of studies that show that having OSA can lead to high blood pressure, elevated cholesterol, increased CRP, weight gain, as well as heart disease. In fact, having OSA increases one's chances of having a heart attack is about 40%. Snoring alone significantly increased ones chances of having a stroke. Despite all the tomes of evidence, it's estimated that 80-90% of people with OSA in this country are not diagnosed.

We in the medical community will always tend to focus on the latest trendy test result or measurement. Years ago, cholesterol level was the hot topic, a few years ago it was CRP, and now it's waist measurement. Next year, it will be something else. But what every one of these past, current and future measurements reveal is the end result of OSA. Sleep apnea not only can cause weight gain, but causes generalized systemic inflammation, thus leading to elevated markers of inflammation, such as CRP. Every day in my practice, I see patients with medical histories very similar to Mr. Russert's. They are usually on high blood pressure and cholesterol medications, mildly to moderately overweight, and have very intense and stressful occupations. Nine out of ten times, a sleep study will reveal significant OSA. In fact, almost everyone with a history of heart disease or high blood pressure, if investigated carefully, will have some degree of a sleep-breathing disorder.
Another problem with our health care system is that a condition like OSA (and high blood pressure or diabetes) is something that you either have or don't have, based on a numerical test value. These threshold-based diagnostic tests tend to pick up only the severe or extreme cases of a medical condition. OSA, as we know it, is the extreme end of a sleep-breathing continuum. Even normal people can have mild levels of breathing stoppages, to various degrees: a completely normal person can have temporary OSA if he or she has a stuffy nose. This is why you don't sleep well when you have a cold.

One major reason that all of us are susceptible to sleep-breathing disorders is that our oral cavity anatomy is uniquely predisposed to breathing problems at night. The position of our voice boxes lower down in the neck, underneath our tongue, predisposes our tongues to fall back easily, especially when we are in deep sleep due to muscle relaxation. Interestingly, this lower position of the voice box is thought to allow complex speech and articulation. If you already have a potentially narrowed airway and you add any degree of narrowing due to either inflammation or throat fat enlargement, then slight degrees of obstruction and breathing pauses can set in. The good news is that OSA is a treatable condition. Treating OSA can also prevent onset or progression of high blood pressure, diabetes, weight gain, heart disease, heart attack or stroke. My greatest frustration is that even in men who fit the typical profile for someone with OSA, many doctors are too focused on lowering blood pressure or cholesterol levels. Perhaps if Mr. Russert's doctors had only considered the possibility of sleep apnea, he may still be with us today.

Steven Y. Park, M.D.

Author of forthcoming book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.

http://www.sleepinterrupted.com

Article Source: http://EzineArticles.com/?expert=Steven_Park

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Snoredog
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Post by Snoredog » Thu Jul 03, 2008 2:46 pm

rooster wrote:
Tim Russert's recent tragic death shook the political world. He died despite being on medications for high blood pressure and elevated cholesterol, and had no symptoms of heart disease. He even exercised every day, as part of a regimen to lose some weight. His autopsy report ultimately revealed that he had advanced blocked arteries in his heart. There's been much speculation in the media about the circumstances surrounding his untimely death, but in retrospect, all the data and his medical history strongly suggests that he may have had untreated OSA. One of the great myths perpetuated in the medical community (and the media) is that only men who are older, heavy-set, loud snorers, and have big necks can have obstructive sleep apnea (OSA). OSA is a common condition where one stops breathing repeatedly at night during sleep, with poor sleep quality and lowered oxygen levels, which stresses the heart. This perception started decades ago as sleep apnea was first described only in these type of men. Recent studies have shown, however, that even young, thin women who don't snore can have significant OSA.

There are dozens, if not hundreds of studies that show that having OSA can lead to high blood pressure, elevated cholesterol, increased CRP, weight gain, as well as heart disease. In fact, having OSA increases one's chances of having a heart attack is about 40%. Snoring alone significantly increased ones chances of having a stroke. Despite all the tomes of evidence, it's estimated that 80-90% of people with OSA in this country are not diagnosed.

We in the medical community will always tend to focus on the latest trendy test result or measurement. Years ago, cholesterol level was the hot topic, a few years ago it was CRP, and now it's waist measurement. Next year, it will be something else. But what every one of these past, current and future measurements reveal is the end result of OSA. Sleep apnea not only can cause weight gain, but causes generalized systemic inflammation, thus leading to elevated markers of inflammation, such as CRP. Every day in my practice, I see patients with medical histories very similar to Mr. Russert's. They are usually on high blood pressure and cholesterol medications, mildly to moderately overweight, and have very intense and stressful occupations. Nine out of ten times, a sleep study will reveal significant OSA. In fact, almost everyone with a history of heart disease or high blood pressure, if investigated carefully, will have some degree of a sleep-breathing disorder.
Another problem with our health care system is that a condition like OSA (and high blood pressure or diabetes) is something that you either have or don't have, based on a numerical test value. These threshold-based diagnostic tests tend to pick up only the severe or extreme cases of a medical condition. OSA, as we know it, is the extreme end of a sleep-breathing continuum. Even normal people can have mild levels of breathing stoppages, to various degrees: a completely normal person can have temporary OSA if he or she has a stuffy nose. This is why you don't sleep well when you have a cold.

One major reason that all of us are susceptible to sleep-breathing disorders is that our oral cavity anatomy is uniquely predisposed to breathing problems at night. The position of our voice boxes lower down in the neck, underneath our tongue, predisposes our tongues to fall back easily, especially when we are in deep sleep due to muscle relaxation. Interestingly, this lower position of the voice box is thought to allow complex speech and articulation. If you already have a potentially narrowed airway and you add any degree of narrowing due to either inflammation or throat fat enlargement, then slight degrees of obstruction and breathing pauses can set in. The good news is that OSA is a treatable condition. Treating OSA can also prevent onset or progression of high blood pressure, diabetes, weight gain, heart disease, heart attack or stroke. My greatest frustration is that even in men who fit the typical profile for someone with OSA, many doctors are too focused on lowering blood pressure or cholesterol levels. Perhaps if Mr. Russert's doctors had only considered the possibility of sleep apnea, he may still be with us today.

Steven Y. Park, M.D.

Author of forthcoming book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired.

http://www.sleepinterrupted.com

Article Source: http://EzineArticles.com/?expert=Steven_Park
someday science will catch up to what I'm saying...

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Post by roster » Thu Jul 03, 2008 2:50 pm

Snoredog wrote: didn't I say that?
Yes, but he is going to get his book published before you.

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Post by Snoredog » Thu Jul 03, 2008 2:56 pm

rooster wrote:
Snoredog wrote: didn't I say that?
Yes, but he is going to get his book published before you.
he had to get his material from some place
someday science will catch up to what I'm saying...

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Post by jrfoster » Fri Jul 04, 2008 3:50 pm

Snoredog wrote:
rooster wrote:
Snoredog wrote: didn't I say that?
Yes, but he is going to get his book published before you.
he had to get his material from some place

Maybe he will dedicate the book to you! After all, you are his inspiration.

Jeff

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More on causes of Tim Russert's death

Post by Auricula » Tue Jul 08, 2008 9:01 am

http://www.nytimes.com/2008/06/24/healt ... ?th&emc=th
"From a Prominent Death, Some Painful Truths"

I just found this article and these are the points that struck me:

1. The rupture of the plaque led to "a second catastrophe." It was the abnormal heart rhythm that the rupture triggered that led to cardiac arrest and sudden death. Use of a nearby defibrillator was delayed. Successful and timely use of this device has resulted in survival of the victim in up to 80% of cases; see this link: http://well.blogs.nytimes.com/2008/06/1 ... m-russert/ and look at the excellent comments in the appended section.

2. There is a good discussion on whether he should have had an angiogram and bypass surgery, based on what was known of his heart and arteries. The autopsy revealed extensive disease in the coronary arteries, "enough to surprise his doctors."

3. Scientists are trying to identify biomarkers that will show the presence of dangerous plaques.

4. A commonly used calculator of risk of heart attack, based on what his doctors knew of his cardiac profile, estimated his risk of a heart attack in the next 10 years at only 5%.

5. Some doctors believe that testing for the substance apoB in the blood is a better assesor of risk than LDL.

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Post by Guest » Tue Jul 08, 2008 9:23 am

why is this stupid thread still active?

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echo
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Post by echo » Tue Jul 08, 2008 9:38 am

auurgh! This reminds me of a new public service annoucement in the Netherlands : "Don't fall asleep at the wheel: stop by the side of the road and rest when you are tired." OK so some people fall asleep because they've been driving for 12 hours without stopping, but MANY people who fall asleep at the wheel actually have OSA!!! When will they wake up and smell the coffee? If you're gonna spend money on a public service ad campaign, at least give useful info, like "see your doctor about sleep apnea" or something!

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Post by Wulfman » Tue Jul 08, 2008 10:18 am

Anonymous wrote:why is this stupid thread still active?
Calm down.

Over on the ADA (diabetes T2) website, they discussed for a lengthy period whether he was diabetic.

Who knows......there may be other health-related websites where they included his conditions into their discussions, too.


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Post by wlo2008 » Tue Jul 08, 2008 10:22 am

untreated SA can cause many complications like we all know. It is very sad. I have had two uncles die. One from untreated SA and the other from complications from SA. Caught to late.

Just runs in my family big time. Almost everyone in my family is a Cpaper
Wendy

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Post by roster » Tue Jul 08, 2008 1:45 pm

Wulfman wrote:...........
Over on the ADA (diabetes T2) website, they discussed for a lengthy period whether he was diabetic.

.....
Yeah, he probably had T2 diabetes and I am sure it was caused by untreated sleep apnea!