January 13, 2014

Is Sleep Apnea Killing You?

sleep apneaTwo recent studies highlight the health risks associated with obstructive sleep apnea. First, sleep apnea is a medical condition characterized by a reduction or cessation of breathing during sleep. There are two main types of sleep apnea – central apnea and obstructive sleep apnea. Central sleep apnea occurs when there is a failure of the brain to stimulate the breathing muscles during sleep. Obstructive sleep apnea, which is more common and the focus of this discussion, occurs when there is collapse of the airway during sleep.

What is Sleep Apnea?

Apnea is defined as period where breathing stops either completely or less than 25% of a full breath for 10 seconds. Episodes of apnea lead to disrupted sleep due to poor oxygen delivery to the brain and tissues. Snoring and gasping are common in individuals suffering from sleep apnea.

Obesity, narrow oropharyngeal opening, or enlarged tongue are common among individuals with sleep apnea.

Health Risks Related to Sleep Apnea

Sleep apnea increases the risk for:

  • High blood pressure.
  • Heart disease.
  • Strokes.
  • Daytime sleepiness or fatigue.
  • Motor vehicle accidents.
  • Difficulty with memory and concentration.
  • Impaired glucose metabolism.
  • Depression.

Sleep Apnea and Death

Two recent studies show how sleep apnea is linked to death and accidents.

The first studied involved 2,240 adults from Asia and was published in the Journal of Clinical Sleep Medicine. It showed that all-cause mortality is 2.5 times higher and cardiovascular mortality 4 times higher in people suffering from severe obstructive sleep apnea.

The study was carried out from 2003 to 2009. During that time 1.81 percent of the people without sleep apnea died, 2.18 percent of those with mild apnea died, 3.54 percent of those with moderate apnea died, and 4.2 percent of those with severe apnea died. One third of the deaths were from heart disease and strokes

The second study was also published in the Journal of Clinical Sleep Medicine. That studied involved 2,673 participants from Australia and found that there is an increased risk of motor vehicle crashes in very sleepy men. There were also increased risk of near-misses in sleepy men and women. The study discovered that individuals with untreated sleep apnea are three times more likely to be involved in motor vehicle accidents as the general population.

In some studies driving while tired is more dangerous than driving tipsy from alcohol (not legally intoxicated while driving).

Treatment for Sleep Apnea

There are several treatments for obstructive sleep apnea. Treatment depends on the severity of sleep apnea. For overweight patients weight loss is critical and many times weight loss solves the problem entirely. Other nonsurgical treatments include dental appliances to keep the airway open, medications (to treat the drowsiness related to sleep apnea), continuous or bi-level positive airway pressure.

Surgical treatments exist to change the anatomy of improve airflow and include nasal surgery, uvulopalatophayngoplasty, tongue reduction surgery, maxilla-mandibular advancement, palate implants, and bariatric or weight loss surgery.

About 30% of the population gets inadequate sleep. Not all of them suffer from sleep apnea. But, if you snore or gasp for air at night while sleeping, and frequently wake up not well rested and suffer from daytime drowsiness then obstructive sleep apnea should be considered and can be diagnosed with a physical examination and a sleep study or polysomnography.

 

 

 

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

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