Sleep apnea doubles the prospect of sudden demise

By Steven Reinberg
Health Day Reporter

TUESDAY, August 3, 2021 (HealthDay News) — With apologies to William Shakespeare, this is the stuff bad dreams are made of: sleep apnea can double your risk of sudden death.

The condition — in which a person’s airway becomes repeatedly blocked during sleep, leading to pauses in breathing — may also increase the risk of high blood pressure, coronary artery disease and congestive heart failure, new research shows.

“This [study] adds to the growing body of evidence highlighting the importance of screening, diagnosing and treating sleep apnea,” said Dr. Kannan Ramar, past president of the American Academy of Sleep Medicine (AASM).

Ramar, who reviewed the findings, said they underscore the importance of detecting a common and often underdiagnosed condition that has become a growing public health concern.

For the study, a team from Penn State University reviewed 22 studies involving more than 42,000 patients worldwide. Their review found that people with obstructive sleep apnea had a higher risk of dying suddenly and that the risk increased as patients got older.

“Our research shows that this condition can be life-threatening,” lead researcher Anna Ssentongo said in a university press release. She is an assistant professor and epidemiologist at Penn State University.

The repeated pauses in breathing associated with sleep apnea disrupt the supply of oxygen to cells, which can lead to an imbalance of antioxidants in the body. This imbalance damages cells and can accelerate the aging process, leading to many health problems, the researchers said.

The study authors said the results underscore the urgency of treating sleep apnea.

Continuous positive airway pressure (CPAP) is the standard of care for moderate to severe apnea, according to the AASM. CPAP delivers a steady stream of pressurized air through a mask worn while you sleep. The airflow keeps the airways open, preventing pauses in breathing and restoring normal oxygen levels.

Other options include oral devices designed to keep the airway open and, in some cases, surgery to remove tissue from the soft palate, uvula, tonsils, adenoids, or tongue.

Losing weight also benefits many people with sleep apnea, as does on your side. In general, over-the-counter nasal strips, internal nasal dilators, and lube sprays reduce snoring, but according to the AASM, there’s no evidence they help treat sleep apnea.

dr Tetyana Kendzerska, assistant professor of medicine in the Department of Respirology at the University of Ottawa in Canada, noted that this is not the first study to find a link between sleep apnea and early death.

She found that apnea can increase the risk of sudden death in a number of ways, including a temporary lack of tissue oxygenation; sleep fragmentation; Inflammation; and chronic activation of the nervous system.

Kendzerska, who was not involved in the study, said it could be assumed that treating apnea would reduce the risk of sudden death, but that may not be the case.

She pointed out that a preliminary report by the US Agency for Research and Quality in Health Care suggests there is little evidence that CPAP reduces the risk of death, stroke, heart attack or other heart problems.

“This means we need more and better-quality studies to show the effect of CPAP on all-cause mortality and cardiovascular outcomes,” she said.

The findings were recently published online in the journal BMJ Open Respiratory Research.

More information

To learn more about sleep apnea, visit the American Academy of Sleep Medicine.

SOURCES: Kannan Ramar, MD, past president of the American Academy of Sleep Medicine, Darien, Illinois; Tetyana Kendzerska, MD, PhD, Assistant Professor, Medicine, University of Ottawa, Ontario, Canada; BMJ Open Respiratory Research, June 9, 2021, online

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