Sunday, May 10, 2009

Sleeping Disorders - Sleep disordered breathing.

Sleep disorders can be a killer.

A recently publish study based on the Wisconsin Sleep Cohort investigated the effects of sleep disordered breathing on sufferers compared with the general population.

Of particular concern is the effect apnea (or apnoea) has on the body. Apnea is generally defined an upset in the regular breathing pattern, so that one or more breath is missed with a gap between breaths of 10 seconds. Hypopnea is similar, but no breaths are missed. A series of shallow inefficient breaths are undertaken but breathing does not stop.

Sleep disordered breathing.
Sleep disordered breathing (SDB) is defined by the Apnea-Hypopnea Index (apneas or hypopneas per hour)– an AHI greater than 5 is considered a mild disorder, above 15 is considered moderate and above 30, is a severe case. Previous studies have shown a link between these issues and an increased mortality, but because they were based on people diagnosed as having sleeping disorders to begin with the results were incomplete.

The Wisconsin Sleep Cohort is a random sample of the total population. Over 1500 people aged 30-60 agreed to have their sleep patterns examined and regularly updated their health outcomes. It is important to emphasize that these were not just clinical patients, or those who had sought treatment for a sleep disorder or other ill health. The survey began in 1988, and the follow up study was investigated in 2006, 18 years later.

The alarming result of the study for those people with a severe sleep disorder is that there was a three-fold increase in the risk of mortality compared with the general population. For cases that were undetected or untreated there was a four-to-five fold increase.

This was taking into account other factors such as age, sex, BMI and smoking.

It was hypothesized that sleep disordered breathing was contributory to all causes of the increased mortality, from coronary heart disease, stroke and hypotension through to behavioural issues including suicide, accidents, violence and car accidents.

Previous studies have proved a conclusive link between apnea and other sleeping disorders and obesity. With the rate of obesity increasing in modern society, there appears to be a linked increase in the rates of sleep disordered breathing with worrying implication for the nations health care systems.

The study did find that patients who had access to continuous positive air pressure (CPAP) which is the preferred current treatment did have better outcomes than those who remained untreated. And patients who did not report an increase in day time sleepiness, which is not always a linked symptom, had the same negative outcomes as for those sufferers who did report the symptom.

Which makes the conclusion clear, if you suspect you may be suffering from a sleeping disorder liked to apnea or hypopnea or have been diagnosed, then obtaining treatment through a competent health care professional is essential for your long term health.

Young T et al. Sleep disordered breathing and mortality. SLEEP 2008 31(8):1071:1078


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