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 IIH and sleep apnea (OSA)

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Wylee
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Wylee


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PostSubject: IIH and sleep apnea (OSA)   IIH and sleep apnea (OSA) I_icon_minitimeSat Mar 02, 2013 7:03 pm

Interesting article in the Journal of Neurology, Feb. 15, 2013, on the association between IIH and sleep apnea. Their conclusion:
We conclude that the prevalence and severity of OSA in IIH patients is no greater than would be expected for their age, sex, race, BMI, and menopausal status. It remains unclear whether the presence or treatment of OSA influences the clinical course of IIH.
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Sophiasmom
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PostSubject: Re: IIH and sleep apnea (OSA)   IIH and sleep apnea (OSA) I_icon_minitimeMon Mar 04, 2013 6:03 am

since OSA is prevalent in all humans, I would not expect the prevalence to be different in those of us with IIH as compared to others. (there was the study last year showing that up to 50% of all women have sleep disordered breathing, so it's much more common than most realize) the issue, is that OSA in an IIH patient will surely raise their ICP and amplify their symptoms. just think about the number of people on this forum who complain that they wake up feeling like death. any sleep hypoventilation, even if not detected on a sleep study, will raise carbon dioxide levels which in turn increases cerebral blood flow and intracranial pressure. this basic tenet in medicine is used in ICUs all over the world on a daily basis, for head injury patients. there is nothing theoretical about this fact. therefore it seems obvious to anyone who understands the physiology, who actually thinks about it in relation to IIH, that to not treat sleep hypoventilation in an IIH patient, is like not doing the diet when you are diabetic. it's three steps forward, two steps back. therefore any IIH patient who has any sleep problems at all, whether or not they snore, really ought to have a sleep study. and a very sensitive one, given the fact that Stanford showed that the standard hypopnea criteria can miss up to 80% of a sample of patients with sleep disordered breathing. I have hundreds of scientific references I can share if anyone wants documentation of any of these facts or other information on SDB. I believe the primary reason that the medical community is not on board with the importance of SDB in IIH, is because the true prevalence of SDB is not recognized by anyone outside of Stanford or Brazil. Everyone else thinks it's really only 2% of women. Given the fact that Stanford is the birthplace of Sleep Medicine, I tend to value their assessment.
so, yes, other people have sleep apnea just as frequently as we do. it just makes US a whole lot sicker.
Deb
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Sophiasmom
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PostSubject: Re: IIH and sleep apnea (OSA)   IIH and sleep apnea (OSA) I_icon_minitimeMon Mar 04, 2013 7:46 am

I have located the full PDF of this paper if anyone is interested. reading the fine print, they DID find an increased prevalence of OSA in their male IIH patients, consistent with several prior studies. the hypopnea criteria they used to assess the patients in their study were slightly different from the recommended 2007 AASM criteria, but strict enough that they will clearly miss milder cases of OSA; I base this on multiple studies indicating that the AHI will be higher if less strict criteria are used. the AHI will be approximately 3 times that found using the 2007 criteria if the Chicago criteria are used. So it seems to me they did not fully assess the complete range of sleep disordered breathing in their sample. There was no part of their study designed to determine the effect of OSA treatment on IIH. they were simply referring to a review of the current data out there, saying that there have been no studies done that contained a control group, therefore better studies need to be done before any conclusions can be made about this. treatment of OSA is very problematic, especially for IIH patients due to problems with tolerating CPAP, therefore I can see so many confounding factors in any study that might be designed to assess this issue. it is a difficult, complex problem.
Deb
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Wylee
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PostSubject: Re: IIH and sleep apnea (OSA)   IIH and sleep apnea (OSA) I_icon_minitimeTue Mar 05, 2013 2:42 am

Deb, seems nothing about IIH is simple, let alone the associations with other illnesses. I hope this is one thing the ihrf will eventually be able to sort out. At least it is being talked about.
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PostSubject: Re: IIH and sleep apnea (OSA)   IIH and sleep apnea (OSA) I_icon_minitime

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