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Sleep Apnea Dangers—More than Just a Bad Night’s Sleep

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Common Sleep Disorder Linked to Heart Disease, Diabetes, Stroke and Even Brain Injury

A good night’s sleep is but a dream for the 12 million Americans who suffer with obstructive sleep apnea (OSA), a breathing disturbance that causes frequent awakening (often partial and not even remembered) and loud snoring at night, along with a host of daytime symptoms, including morning headaches, difficulty concentrating, depression, memory problems and daytime sleepiness and fatigue. The real nightmare, however, is that researchers have uncovered evidence that OSA may be life-threatening. Untreated OSA can lead to such problems as hypertension, heart disease, stroke and even brain injury. The good news, according to Ralph Downey, III, PhD, chief, Sleep Medicine, at Loma Linda University Medical Center in Loma Linda, California, is that OSA treatment is effective and may help to reduce the risk for and even lead to improvement in these conditions.

WHY IS OBSTRUCTIVE
SLEEP APNEA DANGEROUS?

OSA, caused by an obstructed airway, is a form of sleep apnea, diagnosed when there are between five to 15 apnea episodes per hour of sleep, each lasting 10 seconds or longer. According to Dr. Downey, 80% of men and 93% of women with moderate to severe sleep apnea remain undiagnosed. Those most at risk for OSA are males between the ages of 30 and 60 who are obese. Women are less likely than men to have OSA, but they may have different, often more subtle symptoms, said Dr. Downey. After menopause, women are as likely as men to have OSA, but again, symptoms are not usually as dramatic as in men, he added. This results in women often being diagnosed later in the disease process than men and therefore experiencing higher mortality.

New studies that link OSA to major illnesses and early death continue to emerge. Among those recently published:

  • Earlier death after stroke. Swedish researchers found that stroke victims with OSA were 76% more likely to die “sooner” than those with a different form of sleep apnea. They also found that OSA patients are at increased risk for stroke relative to normal breathing patients.
  • Brain injury from breathless episodes. UCLA researchers found evidence of brain injury, likely linked to the apnea episodes, in OSA patients. In the study, patients underwent MRI scans, which showed tissue loss in brain regions responsible for memory and thinking, possibly due to oxygen deprivation during sleep.
  • Complications with anesthesia. Undiagnosed OSA increases the risk of anesthesia-related complications during and after surgery, such as difficult intubation, longer hospital stays, increased intensive care unit admission and post-operative complications.

For additional information on sleep apnea and anesthesia, visit the American Society of Anesthesiologists Web site at http://www.asahq.org.

DO YOU HAVE OSA?

A simple four-question self-screening tool helps identify people with OSA, especially important prior to surgery, so special precautions can be taken. Known as the STOP test, affirmative answers to four questions indicate high risk for OSA:

  • S: Do you snore loudly?
  • T: Do you often feel tired, fatigued or sleepy during daytime?
  • O: Has anyone observed you stop breathing during your sleep?
  • P: Do you have or are you being treated for high blood pressure?

If you have two of the four symptoms, see your doctor or a sleep specialist for an examination.

For those who are diagnosed with OSA, there are several treatment options.

However, since the most significant risk factor for OSA is obesity, it’s worth emphasizing that the single most effective treatment is the simplest, healthiest and most likely to improve your quality of life overall — lose weight.” There is exceptional data that shows losing just 10% of your body weight may reduce the number of apneas per hour by 25%,” noted Dr. Downey. “That’s a great start. ”

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Source: Ralph Downey III, PhD, is chief, Sleep Medicine, Loma Linda University Medical Center, and associate professor of medicine, pediatrics and neurology, Loma Linda University.

Date: August 25, 2008 Publication: Bottom Line Health
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