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Photo courtesy of Brandpoint

Cold and flu season typically runs from October to May, but with summer colds, COVID outbreaks, RSV and allergies, it’s a pretty safe bet that you and your family may be dealing with a variety of symptoms of one kind or another, no matter the season.

Given this year-round battle against illness, the ever-rising costs of medications can put a strain on your wallet and cause confusion as to how best to guard against all of those various bugs out there.

“It’s vital for families to get reliable information on how to prevent illnesses, especially during cold and flu season when many bugs are at their worst, and what to do if they do come down with something,” said Preeti Parikh, Executive Medical Director at GoodRx, the leading prescription savings platform in the U.S. “This includes information about how to get the best price on any medications they need.”

That’s where GoodRx comes in. It is an online platform that does double duty. GoodRx can save you up to 80% off retail prices of medications, plus it offers trusted information on the myriad health conditions that families deal with. GoodRx’s articles, written by a team of doctors, pharmacists, health economists and public health experts, provide you with authoritative and trustworthy answers to your most pressing health questions so you can make better decisions for your family’s health.

When it comes to navigating cold and flu season, Dr. Parikh offers the following tips to prevent illness and manage treatment if you do become sick.

* Get vaccinated. Everyone should get their flu shot and COVID booster by the end of October, and these shots can be done at the same time. It’s the most important thing you can do to prevent illness, not only for yourself, but for vulnerable people in your community, such as children, the elderly and people with chronic conditions.

* Older Americans should investigate the RSV vaccine. All Americans aged 75 and older should receive one dose of the RSV vaccine. Adults aged 60 to 74 with serious chronic conditions, pregnant women, and young babies may also need to get vaccinated. Work with your healthcare provider to determine if the vaccine is best for you.

* Wash your hands. Everyone should practice good disease prevention! Wash your hands, avoid touching your face, and sneeze or cough into your elbow.

* Protect others. If you’re sick, stay home. Don’t go to the office or out shopping or dining. If you must go out, wear a mask to help avoid passing those bugs around.

* If you do become sick, GoodRx can help you save on treatments, including antibiotics that can treat your infection, cold medications to help with symptoms, and antivirals, which can shorten the duration or alleviate the symptoms of your illness. On average, GoodRx users save $34 on cold and flu treatment medications.

So, how do the savings work? It’s actually very easy. Just go to GoodRx.com or the mobile app and type in the name of the medications you have been prescribed. You’ll get a listing of local pharmacies and their prices. Choose the lowest one, and a coupon will pop up. Bring your phone with you to the pharmacy and show the coupon to your pharmacist to get the lowest possible price on your medications.

To arm yourself with information about how to battle the bugs, and ways to save at the pharmacy, visit GoodRx.com/go/fluseason. (BPT)

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Lowering inflammation and expanding lung capacity are keys

By David Dunaief, M.D.

Welcome to autumn! It’s the time of year when we revel in the beauty of changing foliage, the joy of Halloween decorations and costumes, and the prevalence “pumpkin spice” everything.

Unfortunately, it’s also the time of year when we are most alert to influenza (the flu), respiratory syncytial virus (RSV), and COVID-19 variants circulating in our communities.

If you have a lung disease, such as chronic obstructive pulmonary disease (COPD) or asthma, or if you smoke or vape, the consequences of these viruses are especially concerning.

The good news is that you can do a lot to improve your lung function by exercising, eating a plant-based diet with a focus on fruits and vegetables, expanding your lung capacity with an incentive spirometer, and quitting smoking or vaping (1). 

Does diet improve lung function?

It’s no surprise that your dietary choices can help or hinder your health. What is surprising is diet’s impact on your lung health. Let’s review some of the studies.

In a randomized controlled trial (RCT), results show that asthma patients who ate a high-antioxidant diet had greater lung function after 14 days than those who ate a low-antioxidant diet (2). They also had lower inflammation at 14 weeks, which was measured using a c-reactive protein (CRP) biomarker. Participants in the low-antioxidant group were over two times more likely to have an asthma exacerbation.

The high-antioxidant group had a modest five servings of vegetables and two servings of fruit daily, while the low-antioxidant group ate no more than two servings of vegetables and one serving of fruit daily. Using carotenoid supplementation in place of antioxidant foods did not affect inflammation. The authors concluded that an increase in carotenoids from diet has a clinically significant impact on asthma in a very short period.

In a longer-term analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, researchers assessed and stratified diets into three tiers to identify the impacts of diet quality on long-term lung health (3). Researchers found that a nutritionally-rich plant-centered diet was associated with significantly less decline in lung function over 20 years, even after adjusting for demographic and lifestyle factors influencing lung health.

What is the impact of fiber on COPD risk?

Several studies demonstrate that higher consumption of fiber from plants decreases the risk of COPD in smokers and ex-smokers.

In one study of men, results showed that higher fiber intake was associated with significant 48 percent reductions in COPD incidence in smokers and 38 percent incidence reductions in ex-smokers (4). The high-fiber group ate at least 36.8 grams per day, compared to the low-fiber group, which ate less than 23.7 grams per day. Fiber sources were fruits, vegetables and whole grain. The “high-fiber” group was still below the American Dietetic Association’s recommended intake of 14 grams per 1,000 calories each day.

In another study, this time with women, participants who consumed at least 2.5 serving of fruit per day, compared to those who consumed less than 0.8 servings per day, experienced a highly significant 37 percent decreased risk of COPD (5).

Both studies used apples, bananas, and pears to reduce COPD risk.

What exercise helps improve lung function?

In a study involving healthy women aged 65 years and older, results showed that 20 minutes of high-intensity exercise three times a day improved FEV1 and FVC, both indicators of lung function, in just 12 weeks (7). Participants began with a 15-minute warm-up, then 20 minutes of high-intensity exercise on a treadmill, followed by 15 minutes of stretching.

You do not need special equipment. You can walk up steps or hills in your neighborhood, do jumping jacks, or even dance around your home. It’s most important to increase your heart rate and expand your lungs. If this is new for you, consult a physician and start slowly. Your stamina will improve quickly when you do it consistently.

What is incentive spirometry?

An incentive spirometer (IS) is a device that helps expand the lungs when you inhale through a tube and cause one or more balls to rise. This inhalation expands the lung’s alveoli.

Incentive spirometry has been used for patients with pneumonia, those who have had chest or abdominal surgery and those with asthma or COPD, but it has also been useful for healthy participants (8). A small study showed that those who trained with an incentive spirometer for two weeks increased their lung function and respiratory motion. Participants were 10 non-smoking healthy adults who took five sets of five deep breaths twice a day, totaling 50 deep breaths per day. 

In recent years, some small studies examined the impact of IS on patient COVID-19 outcomes. One study of 48 patients in an outpatient setting found that study participants using an IS three times a day experienced a 16 percent increase in maximal inspiratory volume over a span of 30 days (9).

Another pilot study followed 10 patients diagnosed with moderate COVID-19 to determine whether IS use prevented development of Acute Respiratory Distress Syndrome (ARDS) (10). IS users had improved PaO2/FiO2 ratio, improved chest X-ray findings, shorter hospital stays, and sooner improvement of symptoms than non-users.

We all should be working to strengthen our lungs. Using a three-pronged approach including diet, aerobic exercise, and incentive spirometer can make a tremendous difference.

References:

(1) Public Health Rep. 2011 Mar-Apr; 126(2): 158-159. (2) Am J Clin Nutr. 2012 Sep;96(3):534-43. (3) Res Sq  [Preprint]. 2023 Apr 26:rs.3.rs-2845326. [Version 1] (4) Epidemiology Mar 2018;29(2):254-260. (5) Int J Epidemiol Dec 1 2018;47(6);1897-1909. (6) J Phys Ther Sci. Aug 2017;29(8):1454-1457. (8) Ann Rehabil Med. Jun 2015;39(3):360-365. (9) Cureus. 2021 Oct 4;13(10):e18483. (10) Eur Resp J 2022 60: 268.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Photo courtesy of StatePoint

Foot ulcers develop in about 15% of the 25 million Americans living with diabetes and are a top cause of hospitalization. These ulcers can lead to serious complications, such as infection and amputation. According to foot and ankle surgeons, there are steps you can take to prevent complications and keep your feet healthy, as well as breakthrough treatments that are saving limbs, restoring mobility and improving lives.

“The majority of lower-extremity amputations are preceded by a reoccurring foot sore or an ulcer that won’t heal,” says John S. Steinberg, DPM, FACFAS, a board-certified foot and ankle surgeon and a Fellow Member and Past President of the American College of Foot and Ankle Surgeons (ACFAS). “Patients do best when they take charge of their foot health with the help of a foot and ankle surgeon.”

The surgeon members of ACFAS are sharing some important insights into preventing foot ulcers associated with diabetes and treating them if they do occur.

Make these precautions part of your foot care routine:

• Inspect feet daily using a flashlight and mirror to see the bottoms of your feet.

• Moisturize dry, cracking feet to prevent sores. Use powder to control moisture that can result in blisters.

• To prevent injury, wear protective, well-fitting shoes and socks at all times, even in the house. Change socks daily and more often if your feet get wet or sweaty. Avoid socks with holes or seams. Sometimes diabetic shoes are prescribed to avoid pressure and rubbing on the feet.

• Get regular foot exams from a foot and ankle surgeon, which can reduce amputation risk by 45-85%. The surgeon can also screen feet for loss of protective sensation.

• Manage your diabetes. Out-of-control blood sugar levels can lead to nerve cell damage, making it harder to detect foot problems.

Look for telltale signs that an ulcer may be developing:

• Swelling. The foot or ankle may look puffy or engorged and larger than the other.

• Temperature. Cold feet might mean a circulatory issue, whereas hot feet might mean infection.

• Color changes. Redness and even other colors might appear before an ulcer forms.

• Calluses. If a callus changes colors or develops dark, “dried blood” colored spots, it may be time to have a foot and ankle surgeon offer a proper diagnosis.

Ask your foot and ankle surgeon about innovative treatments:

If you do experience a non-healing ulcer, talk to your foot and ankle surgeon right away about innovative technologies that stimulate healing.

Groundbreaking approaches include stem cell therapy, the use of bioengineered skin substitutes to accelerate growth of healthy skin, and negative pressure wound therapy (NPWT) to promote healing and enable healthy, new tissue to grow. Today, foot and ankle surgeons rarely do a skin graft without NPWT. Skin grafting for foot ulcers has also advanced. Surgeons now use advanced reconstructive surgery and grafting techniques to promote wound healing and decrease wound recurrence.

The success rate of these advanced therapies is high, providing substantial improvement over treatments of the not-too-distant past, when doctors would clean and bandage the wound and hope for the best.

“Thanks to the many advances in diabetic foot care, patients today are having simpler surgeries, avoiding amputations, and getting back to everyday life sooner than ever before,” says Dr. Steinberg.

For more information or to find a foot and ankle surgeon near you, visit FootHealthFacts.org, the patient education website of the American College of Foot and Ankle Surgeons. (StatePoint)

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Photo from Brandpoint

College student Jamie Schanbaum was studying at the University of Texas at Austin, just 19 years old, when she was rushed to the hospital with severe symptoms that seemed related to asthma or the flu.

Jamie Schanbaum

Two days later, Jamie and her family were stunned to learn she had contracted meningococcal disease, a serious, life-threatening illness. Meningococcal bacteria can infiltrate the brain and spinal cord, known as meningitis, or the blood, causing septicemia. People can carry the bacteria in their nose or throat without being aware of it and spread it to others. Jamie ‘caught’ the bacteria and developed septicemia.

While Jamie fortunately survived, her life would not be the same. Her legs and fingers needed to be amputated due to the infection. But her strength and determination have caused her to become an effective advocate for meningitis awareness, and after two years of walking on prosthetics, Jamie joined the USA Paralympic Cycling team in 2011.

“Jamie is making a difference for others every day,” said her mother, Patsy Schanbaum, “including inspiring the founding of the J.A.M.I.E. Group, a nonprofit organization that raises meningitis awareness and educates people about the importance of prevention through vaccination. We work with many other meningitis groups, often started by families impacted by this horrible disease, to help save lives.”

The J.A.M.I.E. Group has also worked to pass legislation requiring meningitis vaccination for college students, who are at higher risk for meningitis.

What is meningitis?

Meningitis is a devastating and debilitating infection that can affect anyone, anywhere, at any time. Those at higher risk of meningococcal infection include young children, adolescents, older adults, people living with chronic and immunocompromising conditions (such as HIV) and those living in close quarters – including college students and military recruits.

Bacterial meningitis is the most common type of meningitis. Even with prompt diagnosis and treatment, death and brain damage in survivors are common outcomes. Most cases of bacterial meningitis are caused by three different bacteria: Haemophilus influenzae type b (Hib), Pneumococcus (Pnc) and Meningococcus.

Meningococcal disease is transmitted person-to-person, through droplets of secretions from people who are carriers. Carriers are healthy people who have meningococcus in their nose and throat. Transmission is also through contact with contaminated items such as utensils and living in close quarters with a carrier.

Symptoms of meningococcal disease may begin like influenza (the flu), but can worsen rapidly to include fever, severe headache, stiff neck and a skin rash.

Approximately 10-20 percent of people with bacterial meningitis will die within 24-48 hours after onset of symptoms, and 10-30 percent of people will sustain permanent damage and disability, leading to life-changing events including brain injury, depression, hearing loss and/or limb loss.

The good news: Meningitis is preventable

Vaccination has been shown to be highly effective in reducing the risk of illness and disease transmission, which is especially crucial during the winter months when more people are spending time together indoors and many different viruses are spreading.

Routine use of vaccines in infants and children against Hib, Pnc and the common groups of meningococcus that cause the majority of illness have been very successful in preventing disease. The CDC Advisory Committee on Immunization Practices (ACIP) recommends routine administration of a single dose of quadrivalent meningococcal conjugate vaccine against serogroups A, C, Y and W to children 11 or 12 years of age, with a booster dose at age 16. Meningococcal B vaccination is available to all adolescents and young adults (ages 16-23).

Vaccine protection can decrease within five years following vaccination, so getting vaccinated at the recommended times maintains your protection and reduces the risk of illness and disease transmission.

Prevention is power. Talk to your doctor about vaccination against meningococcal disease for you and your family members, especially those who may be at higher risk. Visit MeningitisAwareness.org to learn more. (BPT)

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Photo from Brandpoint

As many in the type 1 diabetes community can attest, it can be difficult at first to understand the purpose of screening or the subsequent tests before and following a type 1 diabetes diagnosis, and what the results can mean for you or a loved one.

To help alleviate any uncertainties around which screening or test to take (and why), it’s time to bring it back to basics. Below are the “ABCs” of some of the screenings and tests (e.g., Autoantibody Screening, Blood Glucose Test, and A1C Test) that are currently available for type 1 diabetes, with the goal of empowering people of all ages with the tools and information necessary to advocate for their health when they are speaking to their doctor. It’s important to note that while a blood glucose test and an A1C test are crucial to the diagnosis, monitoring, and management of type 1 diabetes, an autoantibody test is the only test that can confirm your risk of developing the disease.

Autoantibody Screening

Autoantibody screening is a blood test that can detect whether someone is at risk for developing type 1 diabetes. The blood test looks for type 1 diabetes-related autoantibodies, which are proteins that appear in the blood in the early stages of the disease before there are noticeable symptoms, which tend to occur when type 1 diabetes has already progressed to a later stage after weeks, months, or even years.

When it comes to detecting type 1 diabetes early, knowledge is power. As a nurse who lives with type 1 diabetes herself, Grace Cochran could not agree more: “Having insights into whether you are at risk of developing type 1 diabetes is incredibly important. Early information can give you more time to educate yourself and your family about the disease and prepare for what will eventually come,” Cochran shared.

“People may think ‘ignorance is bliss’ when it comes to a future type 1 diabetes diagnosis, but as someone who not only received an unexpected diagnosis that required a hospital stay myself but also as a nurse who cares for people who might be in a similar situation, I can tell you that it’s 100% worth it to get screened,” Cochran continued.

The1Pledge.com has useful information about the importance of early screening and detection and how to start a conversation with your doctor. By the time someone is in the later stage of disease, complications of untreated type 1 diabetes can lead to an emergency room visit and hospital stay, as they did for Cochran, and lifelong insulin dependence begins – which brings up the “B” of the ABCs.

Blood Glucose Test

A blood glucose test not only confirms a type 1 diabetes diagnosis, but also helps people living with type 1 diabetes regularly monitor their disease. Doing so is important, as it gives a person insights into whether their blood glucose or sugar levels are within a normal range. Many factors can impact blood glucose levels, such as food, activity level, stress, illness, and certain medications and dehydration.

“There are a lot of tools these days that can help make routinely monitoring blood glucose levels easier and more convenient,” Cochran said. “For example, a doctor can test a person’s blood glucose levels, and many people living with type 1 diabetes also use devices to self-monitor their blood glucose levels throughout each day because this condition requires 24/7 care and attention. In addition to working with my care team, I’ve learned tips and tricks since I was first diagnosed 17 years ago to manage my glucose levels – but I, of course, still monitor my blood glucose levels multiple times a day, every day.”

Indeed, finding the right care team is incredibly important for people living with type 1 diabetes. For instance, an endocrinologist, a specialist who cares for people with diabetes, can work with someone living with type 1 diabetes and help them maintain normal blood glucose levels. Not only that, but they can also measure how someone is managing their disease over time, leading to the “C.”

A1C Test

An A1C test, which is also referred to as an “estimated average glucose,” can be used to show average blood sugar levels over two to three months. For people with type 1 diabetes, an A1C test can provide an overview of blood glucose management over a set period of time and help them, along with their endocrinologist, understand if any adjustments need to be made in the way they are managing their disease.

ABC Recap

It’s important to understand the role of screening before a type 1 diabetes diagnosis and the tests that are used following a diagnosis to monitor the disease and guide appropriate management. You can learn more about how to get screened early for type 1 diabetes and what to expect after screening by talking to your doctor. (BPT)

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Bariatric surgeons at Mather Hospital were on hand to celebrate the occasion. Photo from Northwell Health

Mather Hospital in Port Jefferson recently marked a new milestone: surgeons performing the hospital’s 10,000th bariatric surgery. The hospital offers gastric bypass, revisional surgery, gastric band and sleeve gastrectomy for weight loss.

The 10,000th surgery, a sleeve gastrectomy, was performed by Arif Ahmad, MD, Director of the Center of Excellence in Metabolic and Bariatric Surgery™. The procedure involves removing part of the stomach to help reduce food intake. The Center of Excellence provides support for patients before and after weight loss surgery. In addition to Dr. Ahmad, the team includes nurses and registered dietitians. A support group allows patients to share experiences and help keep them on track to achieve their weight loss goals.

Dr. Arif Ahmad – Bariatric Surgeon at Northwell Health

 

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Photo from Brandpoint

The Medicare Annual Enrollment Period (AEP) which runs from October 15 to December 7 is here, and with it comes a wave of changes that could make this year one of the most challenging yet for beneficiaries. But navigating AEP doesn’t have to be stressful. Here’s how you can prepare and make the most of this crucial time:

Review Your Current Plan

Start by reviewing your Annual Notice of Change letter, which arrives in September. It will outline key changes to your current plan, including costs, doctor, pharmacy networks and other additional benefits. Knowing these changes can help you decide whether your current plan still meets your needs.2. Compare Your Options

Medicare Advantage and Part D prescription drug plans can vary significantly. Use this time to compare plans and assess how they meet your prescription needs, preferred doctor networks, medical facilities and budget. Doing so could save you money and ensure you’re getting the coverage that best fits your health and financial situation.

Use Available Resources

If comparing plans feels overwhelming, there are resources available to help. Platforms like eHealth provide easy-to-use tools that allow you to compare a wide range of plans from top insurance companies, both online and over the phone. According to a recent study of 67,884 user sessions nationwide, eHealth found that Medicare Advantage enrollees who compared their current Medicare Advantage plan with available 2024 plans using eHealth’s platform could be saving an average of $1,100 per year on medical bills and prescription drugs with a lower cost plan.

Get Help from a Professional – For Free

Licensed insurance agents can provide personalized assistance at no cost to you. They’re knowledgeable about different plans and can help match you with one that suits your needs. An eHealth survey of more than 2,100 Medicare Advantage enrollees conducted in March found that beneficiaries who work with an agent feel more confident in their choice, with 66% feeling “very confident” in their plan selection. And remember, agents are paid the same for similar plan types and there is no obligation to enroll. Their goal is to help you find the best fit for you.

Don’t Procrastinate

It’s tempting to delay deciding, but waiting until the last minute can lead to rushed choices that may not be in your best interest. Schedule time early in the AEP period to review your options, consult with an agent if needed, and make a confident decision.

This year, tackle your insurance plan coverage with confidence. To learn more, compare plans and find help from a professional licensed insurance agent and benefits advisor please visit eHealth at www.ehealth.com or call 844-373-9751, TTY 711. (BPT)

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Photo from Brandpoint

Do you find that your health and fitness take a back seat during the fall and winter months? As the temperatures drop and the days grow shorter, it can be difficult to motivate yourself to make healthy choices that support your well-being.

Instead of throwing in the towel, get ahead of the sluggishness of the colder months by taking proactive steps to prioritize wellness. Check out these five expert tips that can help you thrive this fall and winter with ease.

Set a smart routine

One of the best ways to set yourself up for health and fitness success during fall and winter is by establishing and maintaining a routine. For example, waking up and going to sleep at the same time each day can help ensure you’re getting enough rest every day.

That said, new routines can be hard to get into at the beginning. To help you toward your goal, set alarms and reminders on your phone or other devices to remind you when to go to bed and wake up. You can do the same to remind you to get some exercise and any other health and fitness goals you may have.

Caffeinate (wisely)

Caffeine can provide a needed boost of energy to start your morning on the right foot or help you stay focused during the afternoon. However, be careful how much caffeine you ingest. Too much caffeine can make you jittery and can disrupt your sleep patterns, leading to tiredness, stress and anxiety.

Instead of reaching for a cup of Joe or an energy drink, consider an exact or more controlled delivery and vitamin packed option like AdvoCare’s Spark powdered energy supplement. Each sugar-free stick pack offers 120 milligrams of caffeine, b vitamins and minerals that enhance mental focus and elevate energy levels. Available online or at CVS in 12 delicious flavors, Spark is your convenient and flavorful solution for sustained energy at home or on the go. To learn more, visit advocare.com/BrandptSpark.

Get moving

Even during the colder months, it’s important to move your body every day. The weather may prevent you from going on a walk or jogging outside, but you can still engage in an indoor workout for daily exercise.

Any activity will do. If you’re a social butterfly, a dance or group fitness class can make working out more fun, which may make it easier to do more consistently. If you want to pair exercise with mindfulness and meditation, yoga may be more your speed. Don’t worry if you can’t fit in an hour of exercise every day. Any amount of physical activity is better than none and help you feel better.

Double down on nutrition and immune support

Eating a balanced diet with a variety of nutrient-rich foods is key to maintaining your health and wellness. A well-rounded diet is especially important during fall and winter to boost your immunity during flu season. However, even the most balanced diets have nutritional gaps, so consider adding a nutritional supplement to your daily routine.

You could take pill supplements, but a convenient and tasty way to support your nutrition and immune system is with Spark. In addition to a moderate dose of caffeine, each dose contains vitamins A, B, C and E, zinc, copper, chromium and other vitamins that support a healthy immune system.

Manage stress

Stress is an inevitable part of life. Some stress can even be positive when managed properly to help motivate you to achieve your goals or meet a deadline. However, prolonged periods of stress can negatively affect your physical and mental health. For example, you may find that when you’re stressed you adopt poor eating and sleeping habits.

Try out different stress management strategies to keep your stress in check. Mindfulness techniques like meditation, deep breathing exercises or journaling can help ground you after a long day at work or before a big event. Incorporating self-care moments throughout the day, like taking a bath or reading in a quiet and cozy space, can also help you manage your stress.

Good health and fitness don’t happen by accident. Using these five tips, and with the support of your healthcare provider, you can invest in well-being and stay healthy and active all fall and winter long.

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Addressing sleep apnea can avert serious health consequences

By David Dunaief, M.D.

Dr. David Dunaief

Quality sleep feels like it can be elusive these days. Yet, our physical and mental wellbeing depends on getting restful sleep. For those with obstructive sleep apnea (OSA), it can be particularly challenging.

Sleep apnea is defined as an abnormal breathing pause that occurs at least five times an hour while sleeping. While there are many potential causes, the most common is airway obstruction. Some estimates suggest that about 39 million people suffer from sleep apnea in the United States (1).

OSA diagnoses are classified in tiers from mild to severe. The American Academy of Sleep Medicine (AASM) estimates that roughly 80 percent of moderate and severe OSA sufferers are undiagnosed.

Most risk factors for OSA are modifiable. They include excess weight or obesity, alcohol use, smoking, hypertension, type 2 diabetes, and hyperlipidemia (high cholesterol) (2). 

How do you know what to look for?

OSA symptoms include daytime fatigue, loud snoring, breathing cessation observed by another, impaired concentration, and morning headaches. While these are significant quality of life issues, OSA is also associated with an array of more serious health consequences, such as cardiovascular disease, high blood pressure and depression.

Fortunately, there is an array of treatment options, including continuous positive airway pressure (CPAP) devices, oral appliances, positional sleep therapy, and lifestyle modifications.

Sleep apnea and cardiovascular disease risk

In a study of 1,116 women over a six-year duration, cardiovascular mortality risk increased in a linear fashion with the severity of OSA (3). For those with mild-to-moderate untreated sleep apnea, there was a 60 percent increased risk of death; for those in the severe group, this risk jumped to 250 percent. However, the good news is that treating patients with CPAP decreased their risk by 81 percent for mild-to-moderate patients and 45 percent for severe OSA patients.

Another study of 1,500 men with a 10-year follow-up showed similar risks of cardiovascular disease with sleep apnea and benefits from CPAP treatment (4). The authors concluded that severe sleep apnea increases the risk of nonfatal and fatal cardiovascular events, and CPAP was effective in curbing these occurrences.

In a third study, this time involving the elderly, OSA increased the risk of cardiovascular death in mild-to-moderate patients and in those with severe OSA by 38 and 125 percent, respectively (5). But, as in the previous studies, CPAP decreased the risk in both groups significantly. In the elderly, an increased risk of falls, cognitive decline and difficult-to-control high blood pressure may be signs of OSA.

OSA and cancer risk

There have been conflicting study results about the associations between OSA and cancer risk. To reconcile these, a 2023 study of over 62,000 patients in Sweden were followed. Researchers found that OSA was associated with cancer prevalence, independent of other confounding factors (6). 

In a previous study of sleep apnea patients under age 65, researchers also showed an increased risk of cancer (7). The greater the percentage of time patients spend in hypoxia (low oxygen) at night, the greater the risk. The authors believe that intermittent low levels of oxygen, caused by the many frequent short bouts of breathing cessation, may be responsible for the development of tumors and their subsequent growth.

OSA and male sexual function

Erectile dysfunction (ED) may also be associated with OSA and, like other outcomes, CPAP may decrease this incidence. This was demonstrated in a small study involving 92 men with ED (8). The surprising aspects of this study were that, at baseline, the participants were overweight, not obese, on average and were only 45 years old. In those with mild OSA, CPAP had a beneficial effect in more than 50 percent of the men. For those with moderate and severe OSA, the effect was still significant, though not as robust, at 29 and 27 percent, respectively.

Other studies have varying results, depending on the age and existing health challenges of study participants. Researchers have suggested that other underlying health problems may be the cause in some patient populations.

Can diet help with OSA?

For some of my patients, their goal is to discontinue their CPAP. Diet may be an alternative to CPAP, or it may be used in combination with CPAP to improve results.

In a small study of those with moderate-to-severe OSA, a low-energy diet showed positive results. A low-energy diet implies a low-calorie approach, such as a diet that is plant-based and nutrient-rich. In the study, almost 50 percent of those who followed this type of diet were able to discontinue CPAP (9). The results endured for at least one year.

If you think you are suffering from sleep apnea, you should be evaluated at a sleep lab and follow up with your physician.

References:

(1) ncoa.org. (2) Diseases. 2021 Dec; 9(4): 88. (3) Ann Intern Med. 2012 Jan 17;156(2):115-122. (4) Lancet. 2005 Mar 19-25;365(9464):1046-1053. (5) Am J Respir Crit Care Med. 2012;186(9):909-916. (6) BMJ Open. 2023; 13(3): e064501. (7) Am J Respir Crit Care Med. 2012 Nov. 15. (8) Sleep. 2012;35:A0574. (9) BMJ. 2011;342:d3017.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Janice. Photo courtesy of Brandpoint

For Janice, health and fitness were always priorities. Growing up in Jamaica, she’d been a sprinter for her high school track team. After moving to the U.S. in her mid-20s, she built a successful career in sales while raising two young children. Although she was busy, she maintained a healthy and active lifestyle. In fact, other than having slightly elevated blood pressure, she was the picture of good health.

Yet things changed dramatically for Janice when she reached her mid-40s. Her blood pressure escalated significantly and no longer responded to medication. Her menstrual cycles became unpredictable. Most unsettling of all were the alarming changes in her appearance. Her face swelled and she gained a significant amount of weight around the center of her body. “People asked me if I was on steroids,” Janice recalls. Her legs became emaciated and weak. She developed a fatty hump between the shoulders (buffalo hump) and grew so much facial hair she had to start shaving it. She fought constant lethargy during the day, but then would be unable to sleep during the night.

Looking back, she remembers, “I was constantly stressed out. I didn’t look well, and I didn’t feel well.”

“My blood sugar would just skyrocket.”

Things came to a head one afternoon. Feeling unwell, Janice experienced a dizzy spell and fell while getting out of the shower. Unable to move or see clearly, she was rushed to the emergency room, where her blood sugar was measured at 1,000 mg/dL – a level so high it could trigger a diabetic coma. She was diagnosed with type 2 diabetes and discharged with a new regimen of medications and lifestyle modifications.

Despite following her doctor’s instructions, Janice’s problems persisted. “Even when eating healthy and taking all my meds, my blood sugar would just skyrocket after meals.” She soon learned her kidneys and heart were also being impacted.

“Nobody had bothered to put it all together.”

Janice was on up to 25 different medications, but her symptoms continued, and her frustration grew. “I saw so many doctors – nearly every kind of -ologist you can think of,” she recounts.

One day, a chance conversation with someone else’s healthcare provider led to a breakthrough. After mentioning her health struggles in passing, the doctor suggested she might have Cushing’s syndrome. Janice began to research Cushing’s syndrome (also known as hypercortisolism) and was struck by how similar the symptoms seemed to her own. She found a local endocrinologist, shared her suspicions about Cushing’s syndrome, and a combination of blood tests confirmed her theory: Her cortisol levels were highly elevated. Further testing revealed a growth on her pituitary gland was causing the excess cortisol.

“For so long,” she recalls, “nobody had bothered to put it all together.”

“Finally, I look and feel normal again.”

With her Cushing’s syndrome properly diagnosed, Janice underwent surgery to remove her pituitary growth. Her recovery was difficult, but since receiving treatment she has grown stronger, and her Cushing’s symptoms are better. She remembers feeling that “at last, there was light at the end of the tunnel.”

While Janice’s journey has not been easy, today she is much healthier. She has lost 50 pounds, her hypertension is under control, her blood sugar has returned to normal levels, her kidney function is stable, and she has resumed her active lifestyle.

When speaking with other patients who face similar symptoms, she urges them to be proactive in their care. “A lot of people are walking around with Cushing’s and don’t know it. It’s everyone’s responsibility to educate doctors so they can help new patients.” She cites her own experience as living proof, adding: “Finally, I look and feel normal again. And I’m so grateful.”

If you suspect you may have hypercortisolism or Cushing’s syndrome, talk to your doctor.

This article is the experience of one person and is not medical advice. Consult a medical professional for medical advice, diagnoses or treatment. (BPT)

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