OSA is an abnormal pause in breathing while sleeping that occurs at least five times an hour. Its prevalence may be as high as 20 percent of the U.S. population, and 26 percent are at high risk for the disorder.
Risk factors for OSA include chronic nasal congestion, large neck circumference, excess weight or obesity, alcohol use, smoking and a family history.
Not surprisingly, about two-thirds of OSA patients are overweight or obese. Smoking increases risk threefold, while nasal congestion increases risk twofold. Fortunately, many of the risk factors are modifiable.
Significant symptoms of OSA include daytime fatigue, loud snoring, breathing cessation observed by another, impaired concentration and morning headaches. In the elderly, an increased risk of falls, cognitive decline and difficult-to-control high blood pressure may be signs of OSA.
OSA is also associated with a list of serious complications, such as cardiovascular disease, high blood pressure and cancer.
Among treatments for OSA are continuous positive airway pressure (CPAP) devices; lifestyle modifications, including diet, exercise, smoking cessation and reduced alcohol intake; oral appliances; and some medications.
In a study of 1,116 women, the risk of cardiovascular mortality increased in a linear fashion to the severity of OSA. In other words, in those with mild-to-moderate untreated sleep apnea, there was a 60 percent increased risk of death; and in the severe group, this risk jumped considerably to 250 percent.
However, treating patients with CPAP considerably decreased their risk by 81 percent for mild-to-moderate patients and 45 percent for severe OSA patients.
Not to leave out men, another study of more than 1,500 men showed similar risks of cardiovascular disease with sleep apnea and benefits of CPAP treatment.
The authors concluded that severe sleep apnea increases the risk of nonfatal and fatal cardiovascular events, and CPAP was effective in stemming these occurrences.
In sleep apnea patients under 65 years old, a study showed an increased risk of cancer. The authors believe that intermittent low levels of oxygen, which are caused by the many frequent short bouts of breathing cessation during sleep, may be responsible for the development of tumors and their subsequent growth.
The greater the percentage of time patients spend in hypoxia (low oxygen) at night, the greater the risk of cancer.
Erectile dysfunction may also be associated with OSA. CPAP may decrease the incidence of ED in these men. This was demonstrated in a small study involving 92 men with ED. The surprising aspect of this study was that, at baseline, participants were overweight, not obese, on average and were young, at 45 years old.
Unfortunately, CPAP may not be well tolerated by everyone. In some of my patients, their goal is to discontinue CPAP. Diet may be an alternative to CPAP, or may be used in combination with CPAP.
In a small study, moderate-to-severe sleep apnea sufferers who followed a low-energy diet, also known as a low-calorie diet, showed positive results in treating OSA; almost 50 percent were able to discontinue CPAP.
A diet that is plant-based and nutrient-rich would fall into this category. Patients of mine who have suffered from numerous problems have been able to discontinue CPAP after following this type of diet.
The bottom line is that if you think you or someone else is suffering from sleep apnea, it is very important to go to a sleep lab to be evaluated, and then go to your doctor for a follow-up. Don’t let obstructive sleep apnea rob you of more than sleep.
For further information, visit medicalcompassmd.com or consult your personal physician.