What do frat parties, philly cheese steaks and paper cuts have in common?
This is neither a joke nor a rhetorical question. The common denominator linking nights of heavy drinking, high fat diets and work place injuries is obstructive sleep apnea.
Stereotypically thought of as a condition reserved for middle aged men with a tendency towards aggressive snoring, obstructive sleep apnea (OSA or simply, “sleep apnea”) is in the spotlight of many medical and dental researchers who are finding more and more evidence that it can affect all people across age and gender. More alarming, though, is the research that is coming out linking sleep apnea to a laundry list of seemingly disparate medical conditions like Parkinson’s and lifestyle behaviors like Vitamin D deficiency.
Sleep apnea is one of the most common forms of sleep disordered breathing (SDB). According to the American Academy of Dental Sleep Medicine, over 25 million US adults, and approximately 2-4% of children, suffer from this condition. It is characterized by shallow breathing or pauses in breath while sleeping, triggered by a collapse in the soft tissue of the back of the throat. This, in turn, causes the airway to become blocked, thereby limiting the quantity of oxygen to the lungs.
Often treated to address apparently short-term symptoms like snoring and day-time tiredness, it’s becoming increasingly clear that we ought to consider the other, less obvious risks when screening and treating sleep apnea.
To get an understanding of this, here are a few health conditions and behaviors that you may not have known had anything to do with OSA:
Sure, we’ve all felt a little drowsy in the aftermath of a fast food meal, but fluctuations in blood sugar may not be the only culprit. Research shows that a diet high in fat may be related to daytime sleepiness. A study published this year in the journal Nutrients surveyed 1,800 male participants and found that those who reported in the highest quarter of fat-intake were over 75 percent more likely to experience tiredness during the day and three times as likely to have OSA.
A regular night cap may seem like a great way into a restful sleep, however the most recent data is telling us otherwise. Though it is true that alcohol can help induce sleep, studies show that it is actually disruptive to sleep cycles that occur at later points in the night, reducing the overall quality of a night’s sleep. Research from the London Sleep Centre in the UK found that a big night of drinking before bed can actually compromise a person’s breathing while they sleep, which can trigger sleep apnea.
An occupational health study that was published this year in the journal of the British Thoracic Society found that the risk of being injured at work was twice as high for those with untreated sleep apnea, compared to people who do not have OSA. The study also produced the alarming finding that people with OSA were nearly three times more likely to incur an injury as a result of “reduced vigilance,” a measure that included such unfavorable outcomes as falls and car accidents resulting from drowsy driving.
It has been long documented that sleep apnea raises the risk of hypertension and heart disease, but, in addition to these, we’re realizing that sleep apnea has links to a whole host of cardiovascular conditions. For instance, more and more research shows that sleep apnea is a significant risk factor for stroke. A study done at the Mayo Clinic demonstrated that cardioembolic stroke – the type of stroke that occurs when a blood clot formed in the body breaks loose and lodges in the brain – was much more frequent in members of the study population who had OSA compared to those who did not have OSA. In addition to this, it was found that the frequency of stroke in study participants who have OSA increased with the severity of their OSA – those who had the most serious cases of sleep apnea tended to experience more strokes during the study period than study participants who had “mild” to “moderate” OSA.
Sleep apnea may also be a concern for people who use pacemakers. A study that was presented at this year’s Heart Rhythm Society annual meeting revealed that there is an increased risk of atrial fibrillation, a serious condition that complicates the rhythm of the heartbeat, for those who have both a pacemaker and sleep apnea.
Alarmingly, studies are finding that sleep apnea may take its toll on a person’s brain and central nervous system, potentially leading to serious neurological conditions like Parkinson’s disease in women and dementia in older men.
A recent retrospective study published in the Journal of Clinical Sleep Medicine found that female patients with sleep apnea had a significant risk of developing Parkinson’s during a five year follow up period. The study did not find an elevated risk of Parkinson’s for men with OSA. Although the reason for this disparity between genders is unknown, it is hypothesized that because sleep apnea is commonly under-diagnosed in women, their OSA symptoms are not detected until they get to a severe state, thereby elevating their risk for Parkinson’s disease.
A study published in the journal Neurology found that breathing difficulties during sleep, including snoring and sleep apnea, are associated with early onset cognitive decline such as Alzheimer’s disease and dementia. The researchers also found that untreated sleep disordered breathing may speed mild cognitive impairment by up to 10 years.
Another study, also published in the journal Neurology, found that older men who have breathing difficulties during sleep, including sleep apnea, may be at a greater risk of developing brain abnormalities that can precede dementia. Although this study identified a relationship between sleep disordered breathing and dementia-related changes to the brain, the nature of that relationship is still unclear.
And the list goes on.
The number of medical conditions that have ties to sleep apnea may seem daunting, but do not despair. Once sleep apnea is diagnosed and treated, you are better equipped to address the other conditions or behaviors that are related to OSA. If you snore, experience daytime tiredness or have members of your family who have any of the conditions that may be related to sleep apnea, make an appointment with your doctor or dentist to talk about being screened for OSA.
But for good measure, maybe think twice about living a lifestyle that involves martinis or heavy meals just before bed!