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Medscape
6 days ago
- Health
- Medscape
Stay Alert to Sleep Apnea Burden in the Military
Obstructive sleep apnea (OSA) was associated with a significantly increased risk for adverse health outcomes and healthcare resource use among military personnel in the US, according to data from approximately 120,000 active-duty service members. OSA and other clinical sleep disorders are common among military personnel, driven in part by demanding, nontraditional work schedules that can exacerbate sleep problems, but OSA's impact in this population has not been well-studied, Emerson M. Wickwire, PhD, of the University of Maryland School of Medicine, Baltimore, and colleagues wrote in a new paper published in Chest . In the current health economic climate of increasing costs and limited resources, the economic aspects of sleep disorders have never been more important, Wickwire said in an interview. The data in this study are the first to quantify the heath and utilization burden of OSA in the US military and can support military decision-makers regarding allocation of scarce resources, he said. To assess the burden of OSA in the military, they reviewed fully de-identified data from 59,203 active-duty military personnel with diagnoses of OSA and compared them with 59,203 active-duty military personnel without OSA. The participants ranged in age from 18 to 64 years; 7.4% were women and 64.5% were white individuals. Study outcomes included new diagnoses of physical and psychological health conditions, as well as healthcare resource use in the first year after the index date. Approximately one third of the participants were in the Army (38.7%), 25.6% were in the Air Force, 23.5% were in the Navy, 5.8% were in the Marines, 5.7% were in the Coast Guard, and 0.7% were in the Public Health Service. Over the 1-year study period, military personnel with OSA diagnoses were significantly more likely to experience new physical and psychological adverse events than control individuals without OSA, based on proportional hazards models. The physical conditions with the greatest increased risk in the OSA group were traumatic brain injury and cardiovascular disease (which included acute myocardial infarction, atrial fibrillation, ischemic heart disease, and peripheral procedures), with hazard ratios (HRs) 3.27 and 2.32, respectively. The psychological conditions with the greatest increased risk in the OSA group vs control individuals were posttraumatic stress disorder (PTSD) and anxiety (HR, 4.41, and HR, 3.35, respectively). Individuals with OSA also showed increased use of healthcare resources compared with control individuals without OSA, with an additional 170,511 outpatient visits, 66 inpatient visits, and 1,852 emergency department visits. Don't Discount OSA in Military Personnel 'From a clinical perspective, these findings underscore the importance of recognizing OSA as a critical risk factor for a wide array of physical and psychological health outcomes,' the researchers wrote in their discussion. The results highlight the need for more clinical attention to patient screening, triage, and delivery of care, but efforts are limited by the documented shortage of sleep specialists in the military health system, they noted. Key limitations of the study include the use of an administrative claims data source, which did not include clinical information such as disease severity or daytime symptoms, and the nonrandomized, observational study design, Wickwire told Medscape Medical News . Looking ahead, the researchers at the University of Maryland School of Medicine and the Uniformed Services University, Bethesda, Maryland, are launching a new trial to assess the clinical effectiveness and cost-effectiveness of telehealth visits for military beneficiaries diagnosed with OSA as a way to manage the shortage of sleep specialists in the military health system, according to a press release from the University of Maryland. 'Although the association between poor sleep and traumatic stress is well-known, present results highlight striking associations between sleep apnea and posttraumatic stress disorder, traumatic brain injury, and musculoskeletal injuries, which are key outcomes from the military perspective,' Wickwire told Medscape Medical News . 'Our most important clinical recommendation is for healthcare providers to be on alert for signs and symptoms of OSA, including snoring, daytime sleepiness, and morning dry mouth,' said Wickwire. 'Primary care and mental health providers should be especially attuned,' he added. Results Not Surprising, but Research Gaps Remain 'The sleep health of active-duty military personnel is not only vital for optimal military performance but also impacts the health of Veterans after separation from the military,' said Q. Afifa Shamim-Uzzaman, MD, an associate professor and a sleep medicine specialist at the University of Michigan, Ann Arbor, Michigan, in an interview. The current study identifies increased utilization of healthcare resources by active-duty personnel with sleep apnea, and outcomes were not surprising, said Shamim-Uzzaman, who is employed by the Veterans' Health Administration, but was not involved in the current study. The association between untreated OSA and medical and psychological comorbidities such as cardiovascular disease, diabetes, and mood disorders such as depression and anxiety is well-known, Shamim-Uzzaman said. 'Patients with depression who also have sleep disturbances are at higher risk for suicide — the strength of this association is such that it led the Veterans' Health Administration to mandate suicide screening for Veterans seen in its sleep clinics,' he added. 'We also know that untreated OSA is associated with excessive daytime sleepiness, slowed reaction times, and increased risk of motor vehicle accidents, all of which can contribute to sustaining injuries such as traumatic brain injury,' said Shamim-Uzzaman. 'Emerging evidence also suggests that sleep disruption prior to exposure to trauma increases the risk of developing PTSD. Therefore, it is not surprising that patients with sleep apnea would have higher healthcare utilization for non-OSA conditions than those without sleep apnea,' he noted. In clinical practice, the study underscores the importance of identifying and managing sleep health in military personnel, who frequently work nontraditional schedules with long, sustained shifts in grueling conditions not conducive to healthy sleep, Shamim-Uzzaman told Medscape Medical News . 'Although the harsh work environments that our active-duty military endure come part and parcel with the job, clinicians caring for these individuals should ask specifically about their sleep and working schedules to optimize sleep as best as possible; this should include, but not be limited to, screening and testing for sleep disordered breathing and insomnia,' he said. The current study has several limitations, including the inability to control for smoking or alcohol use, which are common in military personnel and associated with increased morbidity, said Shamim-Uzzaman. The study also did not assess the impact of other confounding factors, such as sleep duration and daytime sleepiness, that could impact the results, especially the association of OSA and traumatic brain injury, he noted. 'More research is needed to assess the impact of these factors as well as the effect of treatment of OSA on comorbidities and healthcare utilization,' he said. This study was supported by the Military Health Services Research Program. Wickwire's institution had received research funding from the American Academy of Sleep Medicine Foundation, Department of Defense, Merck, National Institutes of Health/National Institute on Aging, ResMed, the ResMed Foundation, and the SRS Foundation. Wickwire disclosed serving as a scientific consultant to Axsome Therapeutics, Dayzz, Eisai, EnsoData, Idorsia, Merck, Nox Health, Primasun, Purdue, and ResMed and is an equity shareholder in Well Tap.
Time of India
18-06-2025
- Entertainment
- Time of India
Chainsaw Man chapter 206: Denji battles the Falling Devil, Fakesaw Man's identity revealed
Chainsaw Man chapter 206: Chapter 206 of Chainsaw Man throws readers into the thick of the action as Denji confronts the terrifying Falling Devil. Blending intense combat with deep psychological themes, the chapter keeps the tension high from start to finish. With rising stakes and unexpected turns, the manga continues to grip fans. Here's everything we know about the latest installment. (Spoilers ahead) Who is the Fakesaw Man? Chainsaw Man chapter 206 begins right after the intense showdown between Denji and Fakesaw Man reaches its climax. The Fire Devil emerges from within Fakesaw, unveiling that Fakesaw is actually the twin of the boy Denji failed to rescue from the Cockroach Devil earlier in Part 2 of the series. Chainsaw Man chapter 206 Chainsaw Man chapter 206, titled Chest, Woman, Apology, begins with Denji getting sidetracked by the Falling Devil's appearance. However, War Devil Yoru quickly alerts him that the figure before him is an incredibly powerful devil known as the Falling Devil. Denji questioned whether the Falling Devil would permit his actions, but to his surprise, she had no objections as long as he and Yoru kept their distance. The townspeople were horrified by the unfolding events when Denji chose to attack the Falling Devil. Denji's plan ultimately failed, leading him to become ensnared by the Falling Devil's Thought Manipulation. She also made it clear that his chainsaws didn't intimidate her. Shortly after, a man came out of the Falling Devil's mouth. Where to read the Chainsaw Man manga? You can read the Chainsaw Man manga online through the official Shonen Jump app or website, both operated by Viz Media, which offers authorized English translations. Another official option is MANGA Plus by SHUEISHA, where the series is also available.
Glasgow Times
14-06-2025
- Business
- Glasgow Times
Paisley law firm named finalist for top industry award
MJC Law has been shortlisted for Small Firm of the Year at the Scottish Legal Awards 2025, which recognise excellence, innovation and dedication across the legal sector in Scotland. The firm is known for its community-focused approach and expanding outreach work. Matthew Coffield, founder of MJC Law, said: "I am delighted MJC Law has been shortlisted as a finalist for this award. Read more: Bus operator 'cannot' run services across new bridge Plans for new bike hub and toilet block at popular country park approved Here's how much is set to be spent on iconic B-listed building in Renfrew "It means the world to know that our good work is being seen and appreciated." Founded in 2016 with the aim of protecting people in debt from homelessness, the firm has since broadened its mission. In 2024, it adopted the belief that "a strong community starts with a secure home." The firm now offers a range of services including eviction prevention, support for first-time buyers, will writing, and tailored legal advice. MJC Law's solicitors have more than 38 years of combined experience. The firm has recently launched monthly pro bono legal clinics in partnership with East Renfrewshire Citizens Advice Bureau. It also provides free weekly legal advice on to help reach more people across Renfrewshire. In addition, the firm has partnered with Chest, Heart & Stroke Scotland to support fundraising and raise public awareness as part of its community engagement.
Daily Record
23-05-2025
- Sport
- Daily Record
Fundraisers club together to remember Stirling author and sports fan
Bridge of Allan Sports Club hosted a remembrance fundraiser event in honour of dedicated member Bert Mitchell, who sadly died of a stroke last April. His wife Arlene and daughter Ava put on a day to celebrate their beloved Bert and to ensure his legacy lives on at his club. The day boasted everything Mitchell enjoyed: sport, food and socialising. Ava said: 'With excellent cuisine thanks to the Secret Chef, everyone was kept happy with the vast selection of food options. 'A thanks needs to go to Louise from Chest, Heart and Stroke Scotland who said a couple of words on the day on the impact of strokes and how many people in the UK are affected. 'Approximately 100,000 people have a stroke each year in the UK. 'Stats like that put into perspective how important it is to raise money for causes like CHSS, to help ensure no-one is alone when going through a stroke.' The first exhibition of the afternoon was tennis, featuring Jonny O' Mara [Andy Murray's coach for his last year on court] and some of Stirling University's best players: Scott MacAulay, Matthew Earnshaw and Robert Cawley. Ava added: 'The match was a smashing success with people oohing and aahing at every shot. 'Everyone loved the raffle and it came to a point where tickets had to be created as they ran out. 'A huge thank you has to go to all the companies and brands who donated to us. 'These include: Whyler Photography, Adam Brown Tennis Academy, Paper Kisses, Malmaison, Hotel Du Vin, Game4Padel, Head Squash, Arran Sense of Scotland, Stirling Gin, Birds and the Bees and Graham's Dairy's, among others. 'The day was non-stop with a squash exhibition match starting at 5pm featuring John Meehan and Andrew Glen who are both Senior International players. 'This was a gripping match with both players dripping of sweat and it went to a fourth set. 'The level was high and points were long, with viewers turning their heads at each stroke. 'They certainly put on a good show.' The day fittingly concluded at the squash courts with the unveiling of a memorial plaque in honour of Bert Mitchell. It has been positioned between court 3 and 4. Court four is memorable for being 'Bert's court' - the one he loved to play on and booked regularly. Ava said: 'It felt right to conclude the day where my dad spent much of his time training on court. ' It was great to see so many people who knew my dad, supporting us on the day. 'I want to thank the local community for their help in advertising our event. 'A special thanks needs to go to Forrester Pyke, the local organist at Bridge of Allan Parish Church who put posters up in the church. 'It was great to have the support from so many.' Arlene and Ava have so far raised nearly £1500 on Justgiving - with further funds raised on the day seeing the total so far sitting at around £3500. The pair are hoping with further advertisement and encouragement they could get to £5000. Arlene said: 'It was a great day and everyone was so generous - but we are still keen to keep pushing. 'We want to reach £5000 for the charity. 'Any donations would mean a lot to us. 'Even £10 could make a difference to someone struggling with a stroke just now. 'Please help us reach our target to a well deserving cause which is close to many of our hearts.'
BBC News
29-04-2025
- Entertainment
- BBC News
'We're honoured to play Latitude,' say Suffolk and Norfolk acts
Independent artists from Suffolk and Norfolk have spoken of their excitement and disbelief after being selected to perform at this year's Latitude annual arts event, first hosted in 2006, will take place at Henham Park, near Southwold, Suffolk, from 24 to 27 line-up includes big-name headliners Sting, Fatboy Slim and Snow Patrol, as well as laugh-out-loud comedians like Bridget Christie, Greg Davies and Reggie artists Lottie Gray, Pozzy, Arthur Black and Chest will also take to the Alcove Stage, and Jazmine Banks and The Wild Hearts will play The Sunrise Arena, all having been selected to perform by either BBC Introducing and First Light Festival. Lottie Gray from Gorleston, Norfolk, started writing songs aged eight and considers Latitude her local festival. "I am so excited to be at Latitude because I have always wanted to play at Latitude and I am lucky enough to have been given the opportunity," the 21-year-old told the BBC."My whole family is going to come and watch. It's amazing and a big milestone for me. I can't wait."Expect upbeat, fun pop songs mixed with moody folky stuff, good songwriting and a great band." Singer Arthur Black, who is from Lowestoft, Suffolk, but based in Norwich, said she was "honoured" to be performing at the festival. "It is so exciting and there will be lots of emotion," she said."Our performances are quite open and raw and we are a bit rocky at times, too, so you can get your boogie on."It is super-special and quite surreal and I am really looking forward to it. It's such a great community [at Latitude] and going back to reality is strange." 'It's so important' Chest, a '90s grunge-inspired band from Norwich, thanked BBC Introducing for the impact it has had on the group's success so far."If it wasn't for BBC Introducing I don't think we would have got half the opportunities we have," said the group's guitarist, Stan. "It's so nice to come to a festival that is on such beautiful grounds and there's so much nice water around here."So, I am looking forward to getting in that when we get here - a pre-show dip." Grime and hip-hop artist Pozzy, from Bury St Edmunds, Suffolk, said he was shocked when he was asked to take his blend of "raw, relatable lyricism and energy" to the event. Describing his reaction, he previously told BBC Introducing it was: "'"No way? Thank you so much."'That'll be sick; that'll be amazing. Let's do it.'"This year's event, run by Festival Republic, is expected to attract as many as 45,000 music fans. Follow Suffolk news on BBC Sounds, Facebook, Instagram and X.
