Thursday, May 24, 2012

Another Reason: Oxygen Depletion from OSA Linked to Higher Rate of Cancer

Every month, I take time to write these blogs to help educate people about the negative health effects associated with obstructive sleep apnea (OSA), and the importance of getting it properly diagnosed and treated. I hope my point is getting across out there.

If you or someone you love regularly experiences OSA symptoms, such as snoring and disordered (interrupted) breathing, here’s another reason to get it checked out: Two new studies claim that OSA sufferers are more likely to die from cancer.

Their findings are significant because it marks the first time that cancer growth has been associated with sleep apnea in people. In a previous study about a year ago, Spanish researchers had already linked the intermittent lack of oxygen caused by OSA—known as hypoxia—with increased tumor growth in mice. That study also found that the mice had more dead cells, which indicates a more aggressive type of cancer.

In one of the new studies, researchers at the University of Wisconsin School of Medicine and Public Health studied data on about 1,500 state workers who have been taking part in overnight sleep studies every four years since 1989.

The researchers found that people with severe sleep apnea who had the most intermittent disordered breathing problems were almost five times more likely to die from cancer than those without OSA. They also found that people considered to have moderate cases of OSA died of cancer at double the rate than those without OSA at all.

This is consistent with the hypoxemia theory—that an increase of interrupted/disordered breathing is actually contributing to cancer cell growth … because the body is being depleted of oxygen.

What the researchers also discovered—and what I found particularly notable—was that when OSA patients who were being treated with continuous positive airway pressure (CPAP) therapy were removed from the Wisconsin study, the OSA/cancer association increased.  In other words, OSA patients who undergo CPAP treatment—who lower their interrupted/disordered breathing episodes—may likely reduce their risk of dying from cancer due to OSA-related oxygen depletion.

In the second related study, researchers at the Spanish Sleep Network used the hypoxemia index, which measures the amount of time the level of oxygen in a person’s blood drops below 90 percent at night.

The researchers followed more than 5,000 OSA patients for seven years. None of them had any cancer diagnosis when the study began, but they found that those with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind. In other words, the greater the extent of oxygen depletion during sleep, the more likely a person was to be diagnosed with cancer during the study.

It should be noted that, in both the Wisconsin and Spanish studies, the researchers only looked at cancer diagnoses and deaths in general, not the specific type of cancer.

The takeaway for all of is that this is one more study … one more reason … for you or someone you love with OSA-related paused/intermittent breathing issues to take sleep apnea seriously and get diagnosed asap.

Monday, May 7, 2012

New Study: Health Effects of Sleep Apnea Evident After One Month

It’s an interesting time in the world of sleep apnea research, a disorder in which a person has periods of slow or paused breathing during sleep. It seems that every month there is a new study showing yet another link between sleep apnea and sleep-disordered breathing (snoring, paused breathing, etc.), and its negative effects on health.

Recent studies have linked obstructive sleep apnea (OSA) to depression, silent strokes and small brain lesions, abnormalities in the blood vessels, high blood pressure, heart disease and strokes, even sudden hearing loss. And women take note: Sleep apnea has been linked to dementia in older women, and another study found that women with untreated severe OSA are three and a half times more likely to die from cardiovascular disease than women without OSA!

Clearly, the link between OSA and an increased risk of stroke has been medically established. But what effect does OSA have on the brain vessels and cerebral circulation? Researchers at the   Baylor College of Medicine in Houston, Texas developed a way to find out.

In late April, a study entitled, “Cerebrovascular Consequences of Obstructive Sleep Apnea” was presented and discussed at the Experimental Biology 2012 meeting at the San Diego Convention Center. The researchers described how they developed a new way to induce the effects of obstructive sleep apnea in mice—specifically, the closure of the airway that results in paused breathing and the physiological side effects of OSA. The new testing model enabled the researchers to mimic the symptoms and effects of OSA in humans, and thus study the results in a controlled environment.

For the study, the researchers induced sleep apnea in the mice while they slept. Surprisingly, they found that—after just one month of induced repeated apneas—the mice’s “cerebral vessel dilatory function” was reduced by as much as 22 percent, and the mice’s cerebrovascular function did not function as normal, or before the apneas.

In other words, after just one month of repeated apneas, after a month of repeated apneas, the blood vessels in the mice’s brains did not work as well as they did.

What are the implications of this study? According to the researchers, one is that the new method of testing provides researchers with a more accurate and complete way to study the effects of sleep apnea on people. The other, which I find compelling, is that only one month of moderate, repeated sleep apnea caused a change in cerebrovascular function which could result in a stroke. It is important to note that the results of the study correlates with other studies that show similar cell dysfunction in arteries, which has caused an increased risk of stroke in OSA patients.

This just reinforces the speed in which sleep apnea can damage the body, and the importance of getting diagnosed and treated as quickly as possible.  The results are also a wake-up call to both sleep and medical doctors that damage to the vascular wall in brain arteries could be a factor predisposing an individual with OSA to stroke. Sleep and medical doctors should be working more in tandem to treat patients.

Again, it is in interesting time for sleep apnea research. And I hope and encourage researchers to continue studying and publishing their results so we can all better understand the symptoms and treatments of this disorder. I believe the need for treatment will only increase with time. As obesity, hypertension and other related conditions continues to plague this country, and as the general population ages, we will see an increase in OSA cases. It is no longer a male condition—women, non-obese people and even children can have OSA.

An estimated 18 million Americans have sleep apnea, including one in four women over 65, according to the National Sleep Foundation. While apnea is more common in men, it increases in women after age 50. And some researchers estimate that up to 85 percent of people with clinically significant sleep apnea have not even been diagnosed yet.

Sleep apnea and other sleep-related disorders are prevalent in our society, and people need to wake up to the symptoms and risks associated with them. (I am on a personal mission to educate people about this, and my blog is one of the ways in which I do so.)

So how do you know if you have sleep apnea? The first step is to become aware of some common symptoms, including trouble falling asleep at night, waking throughout the night, chronic snoring, morning headaches, poor memory, daytime sleepiness/falling asleep during the day, bad moods and irritability, increased depression and trouble concentrating/driving/making decisions.

If you have any of the symptoms mentioned above, and suspect that you may have sleep apnea, please get checked out by a doctor who specializes in sleep disorders. Be specific about the symptoms you are experiencing. Many times, sleep apnea can be misdiagnosed as chronic fatigue, insomnia, depression, or some other non-specific condition. Also, some doctors are too quick to prescribe a medication, rather than do a full sleep disorder work up. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don’t wait—it could save your life, not to mention help your bedmate keep his or her sanity.