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Sleep Apnea: Death and Heart Disease Risk
Sleep apnea increases the risk of heart disease or death by two-thirds
Thomas H. Maugh II, Los Angeles Times
2:59 PM PDT, July 12, 2010
Moderate to severe obstructive sleep apnea increases the risk of coronary heart disease or death by 68% in men under the age of 70, but does not increase the risk for men over 70 or for women, researchers reported Monday. Previous studies have also found an increased risk of death linked to the night-time breathing disorder, but the studies have generally involved only small groups of patients, often those who are hospitalized, and most included few or no women. The new study, reported in Circulation: Journal of the American Heart Assn., is by far the largest study to date.
Obstructive sleep apnea is marked by the frequent collapse of the airway during sleep, making it difficult for victims to breathe for periods lasting as long as 10 seconds. Those with a severe form of the disorder have at least 30 disruptions per hour. These disruptions not only interfere with sleep, leaving the victim unusually tired the next day, but also reduce the amount of oxygen in the blood, which can impair the function of internal organs. An estimated 24% of adult men and 9% of adult women suffer from it. The most common treatment is continuous positive airway pressure, or CPAP, in which a small device forces air through a mask into the airway, preventing apnea. Many patients do not like to wear the devices, however.
Dr. Daniel J. Gottlieb of the Boston University School of Medicine and his colleagues studied 1,927 men and 2,495 women who were 40 or older at the beginning of the study and who had no cardiovascular problems. All were already enrolled in other studies examining problems that affect the heart. In this group, 24% of men and 11% of the women suffered from sleep apnea, as diagnosed by standard sleep studies. None received treatment for it.
The researchers found that, when they eliminated all other risk factors, men between the ages of 40 and 70 who suffered 30 or more apnea episodes per hour were 68% more likely either to suffer a heart attack, to need a coronary artery opened, or to die of heart disease during the median of 8.7 years of follow-up. The men were 58% more likely to suffer heart failure. The researchers were at a loss to explain why women did not suffer such cardiovascular problems, but speculated that the study was simply not large enough to detect it because of the low incidence of apnea in that sex.
"The take-away from our study is that obstructive sleep apnea is a serious condition that warrants medical treatment," Gottlieb said in a statement. "Many patients don't experience symptoms of obstructive sleep apnea, such as daytime sleepiness, or if they do, they don't mention it during routine medical exams. It's important for anyone who suspects they have obstructive sleep apnea to discuss it with their primary care physician."
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Replies to This Discussion
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Permalink Reply by Darlene Hitch on
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WOW Sheila, thank you for writing this though I know it was probably very painful. It was a wake up call for me. I was diagnosed with Sleep Apnea about 4 years ago. I hardly ever used the CPAP because I couldn't get used to it. I left it behind when I moved to the UK. I now am scheduled for another sleep study this week coming which I am very nervous about. I KNOW I am going to be put back on the machine again. This time I WILL USE IT! I have fallen asleep at the wheel driving several times. I had to quit driving school buses. Also Heart Disease runs in my family. My sister who is only 50 had a quadruple bypass surgery when she was only in her early 40's and my dad just had the surgery in December. It runs on BOTH sides of my family. Plus I am diabetic. So I just want to Thank You.
Sheila Knowles said:My son was born in 1973...and I think he always had sleep apnea to some degree..but we didn't know how to recognize it..and doctors didn't know anything about it either..By the time he was 22 yrs old.. it was horrible..He had sleep apnea and later reading for all information I could find on it...was a " swimmer" too. That is where he would sleep on his stomach..kick his feet..with his face down in his pillow..then raise his head to gasp for air and go down again I imagine this was RLS or lack of oxygen causing the kicking like a swimmer. I would send him to the ER and they would send him home with antibiotics..the last time I sent him to the ER all the nurses were saying.. " he has sleep apnea really BAD, doesn't he"..He couldn't even stay awake while he was in the ER....the nurses actually moved his bed out by their station while he was there to keep a closer eye on him and his breathing. NO ONE said.. this young man is in grave danger.. .. we are KEEPING him and putting him thru a sleep study and will try to start treatment from there.. EVERYTIME I sent him to the ER I would sit at home praying.. " please let some doctor see how bad he is doing and try and help him"..His wife would go with him. The last trip they set up a referral to a heart doctor and sent him home with antibiotics again. The next morning we awoke to screaming ...and he had died face down in his pillow. His weight DOUBLED in that final 6 months....they had to fit him in a special coffin and they never could ease him into it where he looked even remotely " natural". I had the coffin closed..instructed the funeral home NOT to open it again. The funeral home director told me that almost EVERY person that had died of sleep apnea had become morbidly obese in a very short period of time. I was told that his heart was 3 times the size it should be and that the heart attack was what killed him.. I think the Sleep Apnea killed him. Now days I just casually mention to a Dr in the clinic that I think I might have sleep apnea..and I am thrown into a sleep study within a day. Sleep Apnea CAN kill you.. and IF you do NOT get some kind of help WILL kill you. My son was only 22 yrs old..he left this world with an 18 month old daughter and his life had JUST BEGUN...and it was over. Don't EVEN ask me how I feel or what I think about every night when I put my CPAP mask on faithfully.........
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Permalink Reply by Kath Hope www.hope2Sleep.co.uk on
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Sheila, that was very brave of you to share this, as it must have been so painful for you. I am so sad for you, but pleased to hear how much you value your life by complying with your own treatment. My story is the other way around - it was my Mum who died suddenly at aged 49 of a heart attack, and she definitely had sleep apnea, although people didn't really know about it in those days in the UK. I always comply with my treatment because of this. Thank you for sharing your sad story, and so wonderful to hear that Darlene has already been moved by your story (along with countless others who have read/or will read it. God Bless You! Good Luck to Darlene too!
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Permalink Reply by Bob on
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Has anybody seen any newspaper or death certificates that says cause of death was due to Sleep Apnea?
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Yet another great answer jnk. What was it Mike called you the other day? He was right :)
j n k said:VERY good question, Bob.
I believe that it would be a rare thing indeed for "sleep apnea" to be written down as the cause of death. I believe there are several reasons for that. For one thing, the meaning of the word "apnea" is literally "breathing stopped." Everyone who dies stops breathing, so the word "apnea" would generally look pretty silly if it was listed as a cause of death, unless the person was literally suffocated by someone else, since it is obvious information, in a sense. It would be tantamount to writing on the death certificate that the cause of death was that the person ceased to continue being alive.
When sleep apnea causes the thing that causes a death, it is generally the things that sleep apnea caused that gets written on the death certificate as the cause of death instead of the sleep apnea that caused the condition that caused the death. Let's take one obvious example: If a person driving alone falls asleep at the wheel and dies in a terrible car crash, "sleep," alone, would not likely be listed as the cause of death (even if it is assumed that is what happened). And it is just as unlikely that "sleep apnea" would be written either, even if that was ultimately why the person was tired and sleepy enough to fall asleep behind the wheel. It is much the same with diseases that result from bad breathing during sleep.
Any human failing to get sufficient air, nutrition, water, or sleep is risking death from a multitude of "causes." That is why breathing, eating, drinking, and sleeping must be taken seriously by anyone who takes life seriously, regardless of what may or may not get written on a piece of paper when someone leaves us.
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