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brain-damage

Studies show that obstructive sleep apnea (OSA) affects much more than just your sleep. It can even damage your brain.

A recent brain imaging study from France involved 16 adults. Each of them had just been diagnosed with sleep apnea.

In numerous brain regions the study found a loss of “gray matter.” This is brain tissue that contains fibers and nerve cell  bodies. There also was a decrease in brain metabolism.

The authors suggest that these changes may explain some of the impairments that often occur in people with sleep apnea. Examples include attention lapses and memory loss. The study was published in March 2009 issue of the Journal of Sleep Research.

The results are similar to those found by a research team from UCLA. Their study was published in Neuroscience Letters in June 2008. They reported that people with sleep apnea have tissue loss in the “mammillary bodies.” These are brain regions that help store memory.

In July 2008 the UCLA team published another brain imaging study in the journal Sleep.It involved 41 people with moderate to severe sleep apnea. It also included 69 control subjects matched by age.

Results show that people with sleep apnea have extensive alterations in “white matter.” This is nerve tissue in the brain. It contains fibers that are insulated with myelin -a white, fatty sheath. The structural changes appear in brain regions that help control mood and memory. These regions also play a role in adjusting your blood pressure. Damage also was found in fiber pathways that connect these brain regions.

What causes the brain damage? The authors suggest that oxygen, blood flow and blood pressure may be involved. Sleep apnea involves breathing pauses that can occur hundreds of times a night of sleep. These pauses can produce drastic changes in oxygen levels.

These breathing pauses also reduce blood flow in the brain. People with sleep apnea also are at risk for high blood pressure. Both of these conditions create a potential for brain tissue damage.

Dr. Ronald Harper of UCLA said that the studies show how important it is for sleep apnea to be treated. CPAP is the most common treatment for sleep apnea. The findings make it all the more imperative that OSA be treated as soon as possible to prevent further injury. The long-term effects of OSA are terribly damaging to memory and thinking processes.

Can treatment reverse the brain damage caused by sleep apnea? The authors are uncertain if the changes are permanent.

But studies show that CPAP does help your heart, it may even save your life.

  An independent link between sleep apnea and mortality was discovered by a group of Australian researchers, suggesting the prevention and treatment of this condition should be a higher priority for government bodies working to improve community health.

The study conducted by the Woolocock institute of Medical Research in Sydney found moderate to severe obstructive sleep apnea (OSA) was associated with 33% mortality over 14 years in people with no sleep apnea.

This is the first report to demonstrate an independent association between all-cause mortality and obstructive sleep apnea in a population-based cohort. The community based sample of 380 people comprised men and women from Western Australia who underwent investigation with a home sleep apnea monitoring device in 1990.

The study results confirm the pattern seen in clinic or hospital-based studies where people more severely afflicted by the disease may have potentially biased results.

Findings of the study have important implications for the direction of health policy in Australia.

Because sleep apnea is strongly associated with obesity, and its related diseases, it has been difficult in the past to produce clear evidence that increased mortality is a result of OSA and not because of other established causes.

The evidence is now available and shows the moderate to severe sleep apnea is associated with about five times the risk of dying after you control for the other factors that are already know to cause premature death.

The study results highlighted a need to increase research funding to investigate whether treatment of sleep apnea can decrease heart attacks, strokes and premature deaths.

Obstructive sleep apnea is a deadly disease and it is now time for public health and medical practitioners as well as the general public to take it seriously.

heart   Although effective medical treatment for sleep apnea exists, this information has not entered routine medical practice nor does the public recognize the dangers. Unfortunately, even when apnea is suspected, it may be difficult to obtain qualified care. As a result, 95 percent of the millions of people who suffer from sleep apnea have not and may never be diagnosed, let alone properly treated. Nevertheless, the informed person with sleep apnea can take the initiative to get appropriate diagnosis and treatment and take the steps necessary to assure recovery.

  • People with coronary artery disease whose blood oxygen is lowered by sleep-disordered breathing may be at risk of ventricular arrhythmia’s and nocturnal sudden death. CPAP treatment may reduce this risk.
  • Sleep disordered breathing, including apnea, may cause coronary artery disease and hypertension. Additional research is needed to determine if treatment of the sleep-disordered breathing can prevent these impacts.

With the support of the National Center for Sleep Disorders Research, scientist are now examining the relationship between heart disease and sleep apnea. Research data that justifies a major series of studies to determine if apnea is a cause of heart disease including congestive heart failure, high blood pressure and chest pain. Some of the research suggests that apnea may indeed be a cause of the heart disease.

  • Congestive hear failure affects 2.5 million Americans, about 10% of the population.
  • 10 percent of men and 5 percent of women are estimated to have sleep apnea.
  • In obstructive sleep apnea, often marked by snoring, the right side of the heart may suffer damage because it has to pump harder to support the extra effort of the lungs trying to overcome the obstruction of the airway. *When 42 patients with heart failure were tested in a sleep lab, almost half had a severe apnea, which had not been previously diagnosed.
  • Several obese patients with both obstructive sleep apnea and heart failure were treated with CPAP, the usual treatments for OSA. Marked improvement was seen with increased energy and lessened fatigue, lower blood pressure, and a more positive outlook as a result of this treatment.
  • Central apnea may cause high blood pressure, surges of adrenaline, and irregular heartbeats. (Centrally apnea occurs without snoring and is not caused by obstruction; rather it is caused by the failure of the brain to send signals for breathing.)

public-awarness.jpgObstructive sleep apnea is overdue for public attention; it is the second leading cause of daytime fatigue, after insomnia. Poor sleep caused by sleep apnea is a major public health problem. Each night millions of men and women wage a life and death struggle with this little-recognized illness, sleep apnea syndrome. Many deaths among people in their 40’s and older which are attributed to heart disease and transportation accidents may actually be related to an unseen epidemic of sleep apnea. People with sleep apnea syndrome have a higher risk of death than the normal population. The price they pay includes a potentially crippling deterioration in daily functioning, an increased risk of high blood pressure and stroke, depression, and death either in accidents or in their sleep. 

People with sleep apnea syndrome have a higher risk of death than the normal population. The price they pay includes a potentially crippling deterioration in daily functioning, and increased risk of high blood pressure and stroke, depression, and death either in accidents or in their sleep. There are terrible costs for the family of the person with sleep apnea syndrome, who may experience irritability, mood changes, lowered sexual drive and capacity, and a reduction of intellectual ability. In addition there are major business, insurance, health, and social costs including the loss of productivity, the impact of accidents caused by a driver or worker falling asleep, and the wasted health care dollars spent on alleviating symptoms like heart disease without treating their possible underlying cause.

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  Moderate to severe cases of OSA (obstructive sleep apnea) significantly increases the risk of suffering a stroke. The study of 1,475 people found that those with moderate to sever sleep apnea at beginning of the study were 3 to 4 times more likely to have a stroke than a comparable group of patients without sleep apnea during the next four years. The study did not find any significant increase in the odds of having a stroke for people with mild sleep apnea compared with people without sleep apnea. The stroke risk we found for people with moderate to severe sleep apnea is quite significant- double the risk of other well -known risk factors for stroke, such as hypertension or diabetes. It was even found that the risk of stroke was significant even after other risk factors for stroke, such as high blood pressure and obesity, were taken into account.

   The patients in the study were defined as having moderate to sever obstruction sleep apnea in their breathing stopped or slowed at least 20 times per hour of sleep. People whose breathing stopped or slowed between 5 and 20 times per hour of sleep were considered to have mild sleep apnea. One reason obstructive sleep apnea may increase stroke risk is that it has been shown to cause high blood pressure, with this, it is the most common risk factor for stroke. Another possible reason is that when a person stops breathing, the lack of oxygen kick in the body’s “fight or flight” response. Part of that reaction is to make the blood more clottable, and blood clots in the brain can cause a stroke.    

    This study provides yet another reason why it’s so important to treat sleep apnea with all caution as possible. It also raises the question of weather people with sleep apnea should be put on aspirin therapy or given other anti-clotting drugs/medications, which is what is done for other people with stroke risk, but this is an issue that needs further research.

Sleep apnea increases risk of heart attack and/or death up by 30%.

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