Rising prevalence of sleep apnea in U.S. threatens public health
Public health and safety are threatened by the increasing prevalence of obstructive sleep apnea, which now afflicts at least 25 million adults in the U.S., according to the National Healthy Sleep Awareness Project. Several new studies highlight the destructive nature of obstructive sleep apnea, a chronic disease that increases the risk of high blood pressure, heart disease, Type 2 diabetes, stroke and depression.
“Obstructive sleep apnea is destroying the health of millions of Americans, and the problem has only gotten worse over the last two decades,” said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. “The effective treatment of sleep apnea is one of the keys to success as our nation attempts to reduce health care spending and improve chronic disease management.”
Data previously published in the American Journal of Epidemiology show that the estimated prevalence rates of obstructive sleep apnea have increased substantially over the last two decades, most likely due to the obesity epidemic. It is now estimated that 26 percent of adults between the ages of 30 and 70 years have sleep apnea.
Findings from new studies emphasize the negative effects of sleep apnea on brain and heart health; however, these health risks can be reduced through the effective treatment of sleep apnea with continuous positive airway pressure therapy:
A neuroimaging study in the September issue of the journal Sleep found that participants with severe, untreated sleep apnea had a significant reduction in white matter fiber integrity in multiple brain areas, which was accompanied by impairments to cognition, mood and daytime alertness. One year of CPAP therapy led to an almost complete reversal of this brain damage.
A neuroimaging study in the September issue of the journal Sleep found that participants with severe, untreated sleep apnea had a significant reduction in white matter fiber integrity in multiple brain areas, which was accompanied by impairments to cognition, mood and daytime alertness. One year of CPAP therapy led to an almost complete reversal of this brain damage.
A neuroimaging study in the September issue of the journal Sleep found that participants with severe, untreated sleep apnea had a significant reduction in white matter fiber integrity in multiple brain areas, which was accompanied by impairments to cognition, mood and daytime alertness. One year of CPAP therapy led to an almost complete reversal of this brain damage.
A study published online ahead of print Sept. 21 in the journal NeuroImage found functional and anatomical changes in brainstem regions of people with sleep apnea.
A study in the October issue of Anesthesiology shows that diagnosing sleep apnea and prescribing CPAP therapy prior to surgery significantly reduced postoperative cardiovascular complications - specifically cardiac arrest and shock - by more than half.
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A study published online ahead of print Sept. 19 in the Journal of Hypertension found a favorable reduction of blood pressure with CPAP treatment in patients with resistant hypertension and sleep apnea.
A Brazilian population study published online ahead of print Sept. 23 found that nocturnal cardiac arrhythmias occurred in 92 percent of patients with severe sleep apnea, compared with 53 percent of people without sleep apnea. The prevalence of rhythm disturbance also increased with sleep apnea severity.
Common warning signs for sleep apnea include snoring and choking, gasping, or silent breathing pauses during sleep. The American Academy of Sleep Medicine, Centers for Disease Control and Prevention, Sleep Research Society and other partners in the National Healthy Sleep Awareness Project urge anyone with signs or symptoms of sleep apnea to visit http://www.stopsnoringpledge.org to pledge to “Stop the Snore” and talk to a doctor about sleep apnea.
Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times. This means the brain - and the rest of the body - may not get enough oxygen.
There are two types of sleep apnea:
Obstructive sleep apnea (OSA): The more common of the two forms of apnea, it is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
Central sleep apnea: Unlike OSA, the airway is not blocked, but the brain fails to signal the muscles to breathe, due to instability in the respiratory control center.
References
Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol 2013 May 1;177(9):1006-14. Epub 2013 Apr 14.
Castronovo V, Scifo P, Castellano A, et al. White matter integrity in obstructive sleep apnea before and after treatment. SLEEP 2014;37(9):1465-1475.
Lundblad LC, Fatouleh RH, Hammam E, et al. Brainstem changes associated with increased muscle sympathetic drive in obstructive sleep apnea. Neuroimage 2014 Sep 21 [Epub ahead of print].
Mutter TC, Chateau D, Moffatt M, et al. A matched cohort study of postoperative outcomes in obstructive sleep apnea: could preoperative diagnosis and treatment prevent complications? Anesthesiology. 2014 Oct;121(4):707-18.
Iftikhar IH, Valentine CW, Bittencourt LR, et al. Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a meta-analysis. J Hypertens 2014 Sep 19 [Epub ahead of print].
Cintra FD, Leite RP, Storti LJ, et al. Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study. Arq Bras Cardiol 2014 Sep 23 [Epub ahead of print].
Obstructive sleep apnea is a common and serious sleep disorder that causes you to stop breathing during sleep. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or making choking noises as you try to breathe. Your brain and body becomes oxygen deprived and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.
In many cases, an apnea, or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in back of the throat vibrate as you breathe.
Sleep apnea can make you wake up in the morning feeling tired or unrefreshed even though you have had a full night of sleep. During the day, you may feel fatigued, have difficulty concentrating or you may even unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, even though you might not be conscious of each awakening.
The lack of oxygen your body receives can have negative long-term consequences for your health. This includes:
High blood pressure
Heart disease
Stroke
Pre-diabetes and diabetes
Depression
About the National Healthy Sleep Awareness Project
The Healthy Sleep Project addresses the sleep health focus area of Healthy People 2020, which provides science-based, 10-year national objectives for improving the health of all Americans. The sleep health objectives are to increase the medical evaluation of people with symptoms of obstructive sleep apnea, reduce vehicular crashes due to drowsy driving and ensure more Americans get sufficient sleep.
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