OBSTRUCTIVE SLEEP APNEA

Might losing weight improve the disturbed breathing known as obstructive sleep apnea?

The question: This study involved 264 obese people, all with diabetes, who were randomly assigned to an intensive weight-loss program or a diabetes education and management program. About three-quarters of them had mild or moderate sleep apnea, and the rest had more severe cases. The weight-loss group followed a strictly regulated diet and exercised moderately for about three hours a week; the others attended three informational sessions on diet, physical activity and social support.

Who may be affected? Obese people with obstructive sleep apnea, which occurs when breathing temporarily stops or becomes very shallow, severely disrupting sleep. In the United States, about 12 million people -- men more than women -- have the disorder, and about half of them are overweight.

Caveats: Participants ranged from 45 to 75 years old; whether the findings would apply to younger people remains unclear. They also might not apply to people without diabetes.

Find this study: Sept. 28 issue of Archives of Internal Medicine.

Learn more about obstructive sleep apnea at www.nhlbi.nih.gov/health and www.sleepeducation.com (click ``sleep disorders'').

CARPAL TUNNEL SYNDROME

Even in moderate cases, surgery may be worthwhile.

The question: When nerve damage in the hand is severe, surgery is the generally accepted treatment for those with carpal tunnel syndrome, but it's not recommended for mild cases. What about those in between?

This study randomly assigned 166 people with moderate carpal tunnel syndrome but no severe nerve damage to have surgery to relieve pressure on the nerve or to be given hand therapy, with therapeutic ultrasound treatments and ibuprofen for pain relief if needed. Hand therapy, once a week for six weeks, included ligament stretching exercises, splinting and recommended modifications for work and other activities; those who did not improve could have ultrasound. A year later, both groups had improved, but those who had had surgery had fewer symptoms and better use of their hand than the others. About 46 percent of the surgery group, compared with 27 percent of the others, improved to the point of having only minimal interference in daily life.

Who may be affected? People with carpal tunnel syndrome, characterized by tingling or numbness in a hand with periodically sharp pain that shoots up the wrist and arm. Irritation or swelling can narrow the passageway (the tunnel) that contains nerves and tendons, causing the pain and leading to difficulty grasping objects or simply moving the hand.

Caveats: Various surgical procedures were used, including open and endoscopic surgery.

Find this study: Sept. 26 issue of The Lancet.

Learn more about carpal tunnel syndrome at www.ninds.nih.gov/disorders and www.mayoclinic.com.

-- LINDA SEARING

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