Sleep Apnea: Danger Zone for Men

According to a recent study funded by the National Heart, Lung and Blood Institute (an arm of the National Institutes of Health) men with sleep apnea, a sleep disorder, have a 58 percent higher risk of developing heart failure than those without it.

The Study

The study followed 4,000 subjects for a nine year period and also found that men (ages 40 to 70) with severe sleep apnea had a 68 percent higher risk of developing coronary heart disease than those without it.

Sleep apnea is a disorder in which breathing actually stops in intervals that can last from 10 seconds to a minute or longer. An unpleasant snoring noise can be heard when the body responds by sending air forcefully through it as breathing resumes. More common in adult men than women (24 percent compared with 9 percent), sleep apnea is a highly treatable condition.

 Sleep Apnea

When breathing stops during sleep, the lack of oxygen sends the body into a type of panic raising blood pressure, stressing the heart, and pouring sugar into the blood. This S.O.S reaction gets the breathing going again but often causes an unnoticeable arousal from sleep.

Another problem caused by the condition is the body doesn't experience the deeper stages of sleep and the sufferer feels tired the next day. He may also have morning headaches caused by the decreased oxygen.

If your spouse complains that you snore or snort frequently; if you fall asleep often during the day or nod off while driving, you may have the condition and should be evaluated by a physician board certified in sleep medicine. It could save your life.

Who Is Most Prone to Sleep Apnea?

About 70 percent of sleep apnea patients are obese. Added fat in the upper airway is the likely culprit. Sleep apnea is also more common in those with diabetes and high blood pressure. Here, other risk factors.

  • Being overweight or over the age of 40
  • Having a large neck size (17 inches or greater in men and 16 inches or more in women)
  • Having large tonsils
  • Having gastroesophageal reflux
  • Nasal obstruction due to a deviated septum, allergies, or sinus problems
  • Recessed chin
  • Family history of sleep apnea

Treatment Options Are Effective

Sleep apnea is a very treatable condition, according to Daniel J. Gottlieb, M.D., M.P.H., "and it appears that treatment may prevent the adverse health consequences of the condition including heart disease, heart attack, stroke and congestive heart failure."

CPAP

The most common treatment, called continuous positive airway pressure (CPAP), uses a machine that forces air through a breathing mask and into the airways to prevent breathing interruptions. According to New York City-based sleep specialist Gerald Suh, MD, "weight loss may be recommended as well as an oral appliance or surgery -either a nasal or throat-procedure," Suh explains. "A visit to a sleep clinic may not be necessary but having a physician trained in sleep medicine to treat and manage the sleep apnea is highly recommended."

Of all the treatment options, Suh says CPAP has an almost 100 percent success rate but only a 50 to 60 percent compliance rate. (Patients complain that the mask which resembles an oxygen mask and has straps to keep it in place is uncomfortable and the sensation of constant air flow is difficult to adjust to).

To properly diagnose the problem, Suh recommends an over-night polysomnogram performed in a sleep center or lab. "It is the gold standard." But sleep clinics are pricey with overnight stays starting at $2,000.

Home Sleep Tests

Home sleep tests are available but practitioners and advocacy groups don't agree on their reliability.

Regardless of how you proceed, Gottleib says OSA is a serious condition that warrants medical treatment.  "Many patients don't experience symptoms of OSA such as daytime sleepiness, or if they do, 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."

Sources:

Interview with Gerlad Suh, MD
Board certified in the specialties of ENT (ear, nose and throat) and sleep medicine and a sleep specialist with ENT and Allergy Associates, LLP

American Heart Association
http://www.newsroom.heart.org/index.php?s=43&item=1077

National Sleep Foundation
http://www.sleepfoundation.org/article/sleep-topics/sleep-studies

American Sleep Apnea Association (more cost info and info on in-home sleep diagnostic testing)
http://www.sleepapnea.org/about/archive/newsletters2008.pdf