Thursday, April 11, 2013

Sleep apnea causes systemic inflammation: CPAP can help

By Dr. David O. Volpi

If you, or someone you know, have been diagnosed with obstructive sleep apnea (OSA), you’re probably familiar with a treatment called CPAP, or Continuous Positive Airway Pressure.

While some people find the mask worn for CPAP treatment uncomfortable—more on that later—it has been proven to be a highly effective way to keep the airways open that become obstructed in sleep apnea patients, and reduce or prevent snoring and paused breathing.

There’s a new study that found that CPAP treatment also reduces the systemic inflammation caused by sleep apnea, usually in the bronchial and nasal passages.

Systemic inflammation is the chronic biological response, or inflammation, of blood vessel tissues due to dangerous or foreign elements, such as pathogens or damaged cells. It is increasingly being recognized that systemic inflammation is a risk factor for a number of health complications, including atherosclerosis, and is a well-established factor in the development of cardiovascular disease.

The new study published March 22 in the Journal of Inflammation found that treating OSA with a CPAP machine helps to lower systemic inflammation, which might prevent some of the other problems associated with OSA. The source of the research was the PubMed, Embase and Cochrane library.

Here’s a refresher on how CPAP machines help OSA patients: When you fall asleep, your muscles relax, and the soft palate at the back of the throat may sag. When this happens, the upper airway can become obstructed, causing the soft palate and uvula to vibrate, causing snoring.

When the airway is completely obstructed, breathing stops for a period of time, until the body is jerked awake in reaction. This is known as obstructive sleep apnea. OSA can cause interrupted breathing hundreds of times a night, usually around 20 seconds per pause. This paused breathing causes waking through the night, preventing deep, restorative sleep. This often leads to a host of problems, from daytime sleepiness and reduced job performance to hypertension, heart disease, mood, and memory problems.

A CPAP machine helps this condition by pumping a continuous flow of air into the nasal passages—via a mask worn at night—keeping the airway open—and preventing or greatly reducing snoring and paused breathing.

To find out if CPAP treatment reduces inflammatory symptoms or “markers” in OSA patients, the researchers pooled data from 24 trials involving more than 1,000 patients. The resulting data suggested that treating OSA with CPAP significantly reduces levels of two proteins associated with systemic inflammation: tumor necrosis factor and C-reactive protein (CRP).

While more study is needed, the researchers believe that reducing systemic inflammation in OSA patients with CPAP treatment may be one way to reverse some of the long-term health disorders associated with OSA.

If you or someone you know is considering Continuous Positive Airway Pressure (CPAP) treatment, you'll need a sleep study to diagnosis whether or not you have sleep apnea, and a sleep specialist will recommend the correct CPAP machine, or treatment, for you.