Sleep apnea occurs when breathing passages become obstructed during sleep and breathing is interrupted temporarily but frequently; it is often accompanied by snoring.

Sleep apnea affects more than 12 million Americans and is more common in people who are obese; it can lead to daytime drowsiness and other complications including high blood pressure, stroke, heart disease and diabetes.

Current treatments for obstructive sleep apnea include continuous positive airway pressure (CPAP) which uses a breathing machine which is cumbersome and intrusive.

Researchers at Johns Hopkins University in Baltimore have come up with a much simpler device which they believe will improve the treatment outcomes for patients with sleep apnea syndrome because it is minimally intrusive.

They used a thin, flexible tube with small prongs inserted into the nostrils, to deliver warm, humidified air at a high flow rate to raise nasal pressure; a heater and humidifier regulated the temperature and humidity of the air, which was delivered by a compressor to the nasal tube.

Dr. Hartmut Schneider and colleagues say while CPAP is the widely accepted treatment, low adherence impedes its therapeutic effectiveness leaving a vast number of patients untreated.

The researchers examined the effectiveness of the nasal tube in 11 patients with sleep apnea, ranging from mild to severe and they found with an air flow rate of 20 liters per minute, sleep and breathing patterns stabilized in all of the subjects and the average number of apnea events was reduced.

They believe the results show that oxygen therapy using a single nasal tube is a viable alternative to CPAP.

The research is published in the American Journal of Respiratory and Critical Care Medicine, July 15, 2007.

The reviewed studies measured considerably different health outcomes “ sometimes simply a return visit to the emergency room, sometimes admissions to the hospital. Six studies, involving 665 participants, found that education resulted in a significant reduction of repeat hospital stays after the emergency department visit. Seven studies involving 690 participants found no significant differences in subsequent visits to the emergency department between patients who received education and those who did not.

The differing educational programs and varying health measures made it difficult to draw conclusions from the studies.

"It tells us that we need to be very specific in outcome measurements and to specify at the beginning what intervention we are going to make, said William Calhoun, director of Allergy, Pulmonary, Immunology, Critical Care and Sleep at the University of Texas Medical Branch in Galveston, Texas.

"We need very clear, well-designed studies on asthma education and its effects, Calhoun said. He did not participate in the Cochrane review.

The review authors said the limitations of the current analysis reveal a strong need for further study into asthma education interventions. In the future, they would like to see better health outcome reporting and a review of socioeconomic and cultural factors that could effect asthma management and health.

Tapp S, et al. Education interventions for adults who attend the emergency room for acute asthma (Review). Cochrane Database of Systematic Reviews 2007, Issue 3.

The Cochrane Collaboration is an international non-profit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.

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