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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Saturday, November 11, 2017

UNTREATED OBSTRUCTIVE SLEEP APNEA HAS IMMEDIATE & LONG-TERM HEALTH CONSEQUENCES

A recent study underscores the importance of consistently treating obstructive sleep apnea (OSA).  The research trial revealed that when individuals with sleep apnea do not use their continuous positive airway pressure (CPAP) devices, even for just a couple of days, they experience marked increases in blood sugar, stress hormones, and blood pressure.  Another recent study concluded that over time untreated sleep apnea increases the build-up of amyloid beta, the plaque-building peptides associated with Alzheimer's disease. 

An estimated 25% of adults and 45% of obese adults have obstructive sleep apnea in which one's airway momentarily closes multiple times per hour during sleep. Treatment typically entails wearing a mask that provides air pressure into the throat to keep the airway open during sleep but there are also other less intrusive treatment options that can work in some cases.

"This is one of the first studies to show real-time effects of sleep apnea on metabolism during the night," said study senior author Dr. Jonathan Jun.  In the study, researchers monitored 31 obese individuals as they slept. All the subjects had moderate to severe obstructive sleep apnea and were monitored either while using a CPAP device or after not using it for two nights.  During the night, researchers measured levels blood fatty acids, insulin, glucose and the stress hormone cortisol. They found that having not worn the CPAP for two previous nights resulted in elevated heart rate and reduced blood oxygen. CPAP withdrawal also increased levels of free fatty acids, glucose, cortisol and blood pressure during sleep. The more severe the OSA, the more these parameters increased.

Another recent report finds that OSA puts elderly at greater risk of developing Alzheimer's disease.  Researchers from this study report that biomarkers for amyloid beta, the plaque-building peptides associated with Alzheimer's disease, increase over time in elderly adults with OSA in proportion to OSA severity. Thus, individuals with more apneas per hour had greater accumulation of brain amyloid over time.

What to do:  These studies emphasize the importance of treating OSA to prevent its metabolic, cardiovascular, and neurological consequences.  Indications one is at increased risk for OSA include obesity, particularly in the upper body and neck, daytime sleepiness, snoring, and waking at night feeling like one cannot breath.  Maintain a healthy weight or work on weight loss to minimize your risk for OSA.  Screening with a sleep study can reliably diagnose OSA but  many diagnosed individuals find it difficult to tolerate wearing their CPAP device. In this case work with a sleep specialist with whom you can explore the various CPAP mask options and potential alternative OSA therapies including implanted devices, dental appliances, and positional therapy. 

Adapted from articles available at:
https://www.medlineplus.gov/news/fullstory_168254.html
https://www.sciencedaily.com/releases/2017/08/170831101454.htm
https://www.sciencedaily.com/releases/2017/11/171110084325.htm

Sources
Chopra S, Rathore A, Younas H et al. Obstructive sleep apnea dynamically increases nocturnal plasma free fatty acids, glucose, and cortisol during sleep. The Journal of Clinical Endocrinology & Metabolism, 2017; DOI: 10.1210/jc.2017-00619


Sharma RA, Varga AW, Bubu OM et alObstructive sleep apnea severity affects amyloid burden in cognitively normal elderly: A longitudinal study.  American Journal of Respiratory and Critical Care Medicine, 2017; DOI: 10.1164/rccm.201704-0704OC

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