The barbarism of managed care.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A J Block.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: We sought to find a combination of noninvasive treatments for snoring by adding weight loss to previously studied treatments, including the combination of sleeping on one's side and using a decongestant nasal spray. STUDY POPULATION: Twenty asymptomatic men who snore heavily were studied previously on a control night and on a night when they slept on their side and used a nasal spray. With these two treatments, minor improvements in apnea/hypopnea index (AHI) were seen, but no improvement occurred in snoring frequency. Nineteen of these subjects subsequently completed a 6-month weight loss program, and 12 lost weight. These 19 subjects comprise the study population of this report. STUDY DESIGN: At the conclusion of the weight loss program, a repeated sleep study was done from which the effect of adding weight loss to the two previously studied treatments could be assessed. RESULTS: Those 12 subjects who lost any amount of weight showed a very mild reduction in snores per hour from 328 using two modalities of treatment to 232 per hour with the addition of weight loss (p = 0.15). The nine subjects who lost > or = 3 kg reduced the number of snores per hour from 320 to 176 (p = 0.0496). Three subjects losing an average of only 7.6 kg showed virtual elimination of snoring after weight loss. Subjects who gained weight had no improvement in snoring. Weight loss added to the other two modalities of treatment had no effect on the AHI. CONCLUSION: In most cases, the combination of weight loss, sleeping on one's side, and the administration of a nasal decongestant significantly reduces the frequency of snoring in asymptomatic men who snore heavily. The major effect appears to be related to weight loss.
Explore the source record for details and available documents.
The benefits of using a nasal decongestant, sleeping on one's side and the combination thereof were studied in 20 asymptomatic male snorers. Both the apnea-hypopnea index (AHI) and snoring were evaluated. Four consecutive nocturnal polysomnographic studies were done. Night 1 was a control; the other 3 nights were randomly assigned to nasal decongestant, best sleeping position and a combination of the two. Results were calculated based on sleep period time. The mean control AHI +/- the standard error of the mean (SEM) was 17.5 +/- 6.5. AHI improved to 14.1 +/- 6.3 with sleep in the best position (p = 0.03). The AHI also improved to 13.2 +/- 6.04 with both nasal decongestant and position (p = 0.0012). Using nasal decongestant alone, the mean AHI was 18.1 +/- 6.3 (p = 0.765). During the control night, the mean number of snores/hour +/- SEM was 356 +/- 46.0. Using nasal decongestant alone, the mean number of snores was 381 +/- 50.4 (p = 0.50). With position alone, the mean number of snores was 356 +/- 46.0 (p = 0.8). Using the combination of nasal decongestant and position, mean snores were 352 +/- 48.9 (p = 0.91). In conclusion, a statistically significant improvement in AHI was produced using the general measures of altering the position of the body during sleep and by the combination of nasal decongestant and positional change. There was no significant change in snoring using any of these general measures.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.