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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."
Views: 102
Replies to This Discussion
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Permalink Reply by Claude on
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Years ago, I didn't think there was anything to this, but after I was diagnosed with it, and after starting treatment (which I had to work really hard at to get used to), I wouldn't dare, or even want, to go without my cpap each night. I feel so much better, not only sleepwise, but also knowing that I'm not as likely to die during the night. It might sound extreme, but I honestly feel that could happen during the night with this condition.
I am also very thankful for this forum, because I went for years using an uncomfortable 'nose only' mask, and with this forum, finally got the courage to try a different mask (full-face), and am doing so much better.
Anyone who doesn't think this is a serious condition needs to re-assess their priorities, and get the advice, treatment, and courage to follow through and live a better life.
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Permalink Reply by S Miller on
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I'm a nurse that's had 2 heart attacks and coronary bypass before being diagnosed with severe sleep apnea.
I use my BiPAP faithfully every time I nap and at night.
I can't tell you how many patients that I've talked to that have sleep apnea, but don't use their CPAP. I do a lot of educating on the importance of using this device. Sure, the CPAP and BiPAP are not sexy...but it sure isn't sexy to be dead either.
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Permalink Reply by Mike on
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Jeff -- I move to change your name from the "Chronic Oversimplifier" to the "Voice of Reason"
j n k said:My views may not be mainstream on such matters.
For me, the need for good sleep and the need for the ability to breathe well while asleep are no-brainers--they are obvious needs for all humans. So, for me personally, studies that document which organ systems are affected first or most profoundly are mostly a waste of time in the sense that they don't change my view on the importance of sleep and breathing. No one needs to convince me that bad sleep and bad breathing can hurt you and eventually kill you, one way or the other.
The flip side to studies such as this one, though, is this: People with serious disease are likely also to have sleep problems and are likely also to have breathing problems that show up first during sleep. Therefore, with this study, for example, it is just as likely that "bad health can cause bad breathing during sleep" as it is that "bad breathing during sleep can cause bad health." The association of any two conditions can work both ways, and causation is not the issue for me.
The issue for me is the need to spread the word among the humans who are so confused about things that they have lost sight of the fact that breathing while asleep is an important thing to do. People need to be alerted to the fact that if there are any indications that their sleep-breathing is bad enough to disturb their sleep or affect their oxygen, it needs to be tested/diagnosed/treated.
Jeff (the chronic oversimplifier)
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sure. i myself am not necessarily reasonable, so take that endorsement with a grain of salt !
j n k said:Thanks, Mike.
May I print your sentence out to show my wife that there is at least one person on the planet who considers me reasonable?
:-)
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It really upsets me to hear "sleep deprivation" of prisoners defended as really no big deal. People who do so obviously don't know what they are talking about.
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If you like oversimplification -- I contend that "bad breathing" during the day plays a role in creating feelings of anxiety and even "panic attacks". Anxious people often discover that they are habitually holding their breath or hyperventilating. Yoga and meditation emphasize the breath as a link between mind and body.
Mike said:Jeff -- I move to change your name from the "Chronic Oversimplifier" to the "Voice of Reason"
j n k said:My views may not be mainstream on such matters.
For me, the need for good sleep and the need for the ability to breathe well while asleep are no-brainers--they are obvious needs for all humans. So, for me personally, studies that document which organ systems are affected first or most profoundly are mostly a waste of time in the sense that they don't change my view on the importance of sleep and breathing. No one needs to convince me that bad sleep and bad breathing can hurt you and eventually kill you, one way or the other.
The flip side to studies such as this one, though, is this: People with serious disease are likely also to have sleep problems and are likely also to have breathing problems that show up first during sleep. Therefore, with this study, for example, it is just as likely that "bad health can cause bad breathing during sleep" as it is that "bad breathing during sleep can cause bad health." The association of any two conditions can work both ways, and causation is not the issue for me.
The issue for me is the need to spread the word among the humans who are so confused about things that they have lost sight of the fact that breathing while asleep is an important thing to do. People need to be alerted to the fact that if there are any indications that their sleep-breathing is bad enough to disturb their sleep or affect their oxygen, it needs to be tested/diagnosed/treated.
Jeff (the chronic oversimplifier)
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Jeff,
What you said is so incredibly obvious. I often wonder why so many medical professionals fail to see and/or understand the obvious. Basic, simple truth is so hard for some over-educated people to get! At times, medical professionals think so hard that they overlook simple, common sense. I was punished as a child for having such a difficult time waking up in the morning. As an adult, I finally was able to access health care on my own. Every doctor to whom I complained that I was tired all of the time tested my thyroid. When thyroid function was normal, they all said there was nothing wrong with me. My husband diagnosed my OSA when I was 54. I had to fight my PCP to get a sleep test to prove it. I had multiple congenital conditions and one hereditary condition that I ended up having to have surgery for. (I used CPAP after diagnosis up until I had undergone all of the sugeries.) That (female) PCP learned that OSA is not a male-only condition. As for the connection between overall health (especially cardiovascular health) and OSA, it seems to me that it is a no-brainer. Of course, the struggle to breathe is going to stress the body. Why wouldn't it? Medical professionals frequently put cause and effect in just one certain pattern without considering that with some people there might be a different pattern. Recently, my physiatrist told me that the particular way I was sitting caused my knees and my feet to want to turn in. I asked him if perhaps the reason it was so comfortable for me to sit that way was a muscle imbalance and that the same muscle imbalance was what caused my knees and feet to turn in. (He was forced to acknowledge that what I said made sense.) The EMG I had two weeks later supported my theory that a muscle imbalance caused the turning in and odd sitting postion (and supported my mother's account of my having had polio when I was young), not my physiatrist's assertation that the way I sat caused the knee and foot problem (even tho' he believed that I had polio when two neurologists didn't! One of the neurologists now believes I did have polio altho' I don't have post-polio syndrome - at least not yet, I don't.)
I hope that some day medical schools will finally teach their students that the patient has a certain insight on his/her personal experience and the medical professional must listen. Sometimes the strangest and/or seemingly most irrelevant remarks could be the the most significant.
People with OSA often have and/or develop other medical conditions, especially related to the cardiovascular system. People with cardiovascular problems may also have OSA. If OSA is diagnosed, treat it and investigate the possibility that cardiovascular issues may already be present. Treat if present; watch for their development if not yet present. Be proactive in preventation of any that can be prevented. If a person has any cardiovascular health issues or other health issues that might be associated with OSA, treat the known health issues and determine if the OSA may already be present. Take steps to treat if present; if not already present, take possible measures to prevent the development of OSA in the future. How simple is that? Likely, it is too obvious for doctors to figure out.
Jeff, you don't over simplify - you just have common sense!
PS - I thank God for leg braces as well as CPAP and Bi-PAP machines!
j n k said:My views may not be mainstream on such matters.
For me, the need for good sleep and the need for the ability to breathe well while asleep are no-brainers--they are obvious needs for all humans. So, for me personally, studies that document which organ systems are affected first or most profoundly are mostly a waste of time in the sense that they don't change my view on the importance of sleep and breathing. No one needs to convince me that bad sleep and bad breathing can hurt you and eventually kill you, one way or the other.
The flip side to studies such as this one, though, is this: People with serious disease are likely also to have sleep problems and are likely also to have breathing problems that show up first during sleep. Therefore, with this study, for example, it is just as likely that "bad health can cause bad breathing during sleep" as it is that "bad breathing during sleep can cause bad health." The association of any two conditions can work both ways, and causation is not the issue for me.
The issue for me is the need to spread the word among the humans who are so confused about things that they have lost sight of the fact that breathing while asleep is an important thing to do. People need to be alerted to the fact that if there are any indications that their sleep-breathing is bad enough to disturb their sleep or affect their oxygen, it needs to be tested/diagnosed/treated.
Jeff (the chronic oversimplifier)
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Permalink Reply by 99 on
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doctors are well trained for what they do, but when it comes to sleep apnea or thiroid, very few doctors excel in these areas.
i have just purchased a book on the thyroid and it mentions how doctors get it so wrong so often, and i am wondering whether this is a precursor to sleep apnea with the reading i am doing, but do not know how to progress that question and to whom i should address it to.
i see that the thyroid can cause an enlarge tongue and many other simular problem. where can definitive empirical answers be found
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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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I'm so very sorry for your loss Sheila.
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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to hear stories like this makes me very very sad
and very angry with the system, my heart goes out to all who suffer like yourself and to you also
i am looking at things at this moment and when you are ready to share i would like to say what i have found, shelia
tSheila 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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