CPAP Therapy Improves Heart Function, Study Says
New research points to obstructive sleep apnea (OSA) as a contributor to heart failure, but fortunately, the use of continuous positive airway pressure (CPAP) devices can help.
The randomized clinical trial, funded in part by Respironics Inc, Murrysville, Pa, showed that patients who have obstructive sleep apnea and heart failure and are treated for sleep apnea with a CPAP portable device show improvements in heart function beyond that due to drug therapy.
“Prior to this study, it had not been considered that heart failure might be adversely affected by something that goes on during sleep,” says Douglas Bradley, MD, lead investigator of the study; head of the Sleep Research Laboratories at Toronto General Hospital (TGH), Mount Sinai Hospital, and Toronto Rehabilitation Institute; and director of the University of Toronto Centre for Sleep Medicine and Circadian Biology. “We have demonstrated that obstructive sleep apnea is a previously unrecognized contributor to heart failure, and that a simple and specific therapy targeting sleep apnea can improve heart failure.”
Patients in the study receiving CPAP treatment in addition to medication experienced decreases in sleep apnea episodes, heart size, blood pressure, and heart rate while heart function improved.
What happens, Bradley says, is that when OSA causes asphyxiation, the sympathetic nervous system turns on, causing blood pressure and heart rate to rise at a time when the heart is supposed to be resting. Compounding that is the heart oxygen starvation during sleep apnea episodes that impairs its ability to pump at a time when the load on it is being increased.
“You’re basically doing the same thing as if you had hypertension, which is the commonest cause of heart failure,” Bradley says.
Using CPAP to treat sleep apnea reverses the negative consequences.
“The effects at night carry over into the day. That is very exciting because it means that the sleep apnea must have been responsible for part of the heart failure,” Bradley says. “Otherwise, why would the heart get better?”
Bradley says that treating OSA sufferers with CPAP, which he calls relatively inexpensive compared to drugs and other devices used to treat heart conditions, could improve quality of life, reduce hospital stays, and save money.
The study was conducted at TGH, University Health Network (UHN), Mount Sinai Hospital, and the Toronto Rehabilitation Institute. Researchers tested 24 patients with heart failure who also had obstructive sleep apnea. Titled “Cardiovascular Effects of Continuous Positive Airway Pressure in Patients with Heart Failure and Obstructive Sleep Apnea,” the study appeared in the March 27 issue of The New England Journal of Medicine.
| HME Insider  Dennis Santoli
In the article “Insurance Shakeup” in the September 2002 issue of Dealer/Provider, Dennis Santoli, JD, CRM, CEO of Campania Management Co Inc, Vienna, Va, said that the insurance industry was in a “state of collapse.” Campania, a full-service provider of specialty insurance for the subacute sector of the health care industry, was one of the few remaining companies still writing liability policies for HME enterprises. In April, Dealer/Provider spoke with Santoli again to see how he thought the market was doing. Q What is the current state of the insurance industry?
A The property and casualty insurance market is still consolidating. There are even fewer companies writing coverages for home care providers today than there were 6 months ago. Prices continue to escalate. Availability continues to diminish. A number of the larger companies have had their financial security rating reduced. The few specialty niche providers who have historically written home care liability are still doing so. Q How was Campania able to stay afloat while other companies went out of business?
A Campania has always charged the appropriate premiums for the risks it is underwriting. In soft market periods we lost business as clients went to lower priced coverages. While our volume of premiums declined during that period, so did our exposure to risk. In addition, Campania has adopted the Medicare investment guidelines for related insurance entities. This means that our investment portfolio has not been impacted as negatively as might be the case for others because we are invested primarily in government bonds. We continue to limit our underwriting activity to only those health care risks that we believe we have the expertise to evaluate. Q What are the two most important services/qualities providers should look for when choosing a reliable insurance company?
A Home care providers should look for an insurance carrier and/or agent who knows the home care business. They also need to look for a company that knows how to handle the types of claims that are particular to the home care industry. If you can get a rated, admitted carrier who has the necessary knowledge and who charges an appropriate premium, you should give them preference when selecting coverage. Price, product knowledge, and financial security are all equally important components when purchasing insurance. |
Invacare Graces Small Screen
During coverage of Arnold Palmer’s Bay Hill Invitational Golf Tournament on March 22–23, NBC aired four commercials for Invacare Corp—an associate sponsor of the tournament.
The 30-second spots represented the Elyria, Ohio-based corporation’s first direct advertising on national television. The advertisements featured Palmer—a spokesperson for the company—and Invacare’s power wheelchairs.
The commercials offered viewers the opportunity to call in and receive a free information kit, including a letter from the company providing them with the name of an Invacare provider in their area, an Invacare power wheelchair information video, a product brochure, and a personal note from Palmer. Invacare has been forwarding all leads from the call-in offer to local providers participating in the company’s Marketing Advantage Partnership (MAP) program.
MedCath, ResMed Team to Address Cardiovascular Disease Link to SDB
MedCath Corp, Charlotte, NC, a national provider of cardiovascular services, will offer sleep-disordered breathing (SDB) screening, diagnosis, and treatment in conjunction with services now offered through the company’s cardiovascular diagnostic centers thanks to a deal with ResMed, San Diego.
The agreement comes as more studies appear on the connections between SDB and cardiovascular disease.
“We’re learning that cardiovascular disease and SDB are a dangerous combination,” says Tom Hearn, president of MedCath’s Diagnostics Division. “By combining the best cardiovascular care with increased knowledge, diagnosis, and treatment of sleep apnea and other sleep disorders, we believe we can increase our effectiveness on both fronts.”
Pikes Peak Cardiovascular Lab in Colorado Springs, Colo, the first cardiovascular sleep laboratory established under this alliance, began diagnosing patients in December 2002. MedCath and ResMed currently are seeking cardiology groups and specialist hospitals interested in working with them to establish cardiovascular sleep laboratories across the United States.
Neither MedCath nor ResMed expects this alliance to materially contribute revenue or profit in the short-term. However, they believe its long-term impact will be positive.
Bond-Holders Buy Graham-Field
After 3 years in bankruptcy, Graham-Field Health Products Inc, Atlanta, sold substantially all its assets at an April 9 auction, says Mark Stead, Graham-Field’s chief restructuring officer.
Although Invacare Corp, Elyria, Ohio, issued a bid of $25 million—the minimum permitted—a group of bondholders beat the company out with a bid of $28 million, according to Irwin Selinger, a representative for the bondholders. The American Stock Transfer and Trust Co, New York, acting as trustee for the bondholders, say they expect a “seamless transition.”
“The purchaser will build on Graham-Field’s reputation for high-quality products and excellent customer service and will set about regaining market share,” Selinger says. “The purchaser remains committed to the development and implementation of customer-focused strategies. With fresh financing, I would expect product availability to improve over the next 90 to 120 days.”
Stead says that the purchasers assured him that during the transition period, prices will be unchanged, open orders will be shipped, and existing warranties will be honored.
The company expected the sale to close by April 30.
The Med Group Picks Pride for Mobility Products
The Lubbock, Tex-based MED Group has reached purchasing agreements with Pride Mobility Products Corp, Exeter, Pa, for power chairs, scooters, and lift chairs, and ResMed, Poway, Calif, for sleep therapy devices. The selection of the two companies resulted from The MED Group’s new request-for-proposal vendor contracts process.
| In Brief • In April, Medline Industries Inc, Mundelein, Ill, opened a manufacturing facility in Waukegan, Ill, to produce premoistened bathing and cleaning products. The opening, the sixth for the company, follows a period of growth in 2002 in which sales increased 17% to more than $1.45 billion. • Harmar Mobility’s new Web site, www.harmar.com, includes enhanced photographs, product information for all Harmar automobile lifts and safety ramps, information and forms for becoming an authorized Harmar dealer, and contact and dealer service information. The Sarasota, Fla-based company also invites dealers to use information and photographs from the site for their own sites and advertising. • In February, Innomed Technologies Inc, Boca Raton, Fla, appointed Ken Godish to its management team as director of sales and national accounts. Since 1992, he worked at ResMed Corp, Poway, Calif, where, as director of sales, Western region, he was responsible for building the western half of the US sales organization and increasing revenues to more than $30 million annually. • In April, Stephen D. Neese, vice president of eCommerce at Invacare Corp, Elyria, Ohio, received a Distinguished Sales and Marketing Award from the Sales and Marketing Executives of Cleveland for enhancing Invacare’s Web site. Neese was one of 21 executives to receive the award at the Business Executive of the Year/Distinguished Sales and Marketing Awards Program, held at the Renaissance Cleveland Hotel’s Grand Ballroom. Winners are nominated by their industry peers. The company also recently received an eVolution in Manufacturing Award for employing e-business solutions to achieve a mixture of cost savings, revenue enhancement, and productivity enhancements. |
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