• Obstructive sleep apnea has become a worldwide health concern.
• Sleep apnea has associations with an increased risk of sudden and cardiovascular-related deaths.
• Future research should focus on decreasing and preventing this serious sleep condition.

Obstructive sleep apnea has become a globally prevalent health concern. Recent literature estimates that more than 1 billion individuals experience this chronic sleep disorder.

A study by Penn State College of Medicine in Hershey, which appears in BMJ Open Respiratory Research, found that those who receive a diagnosis of obstructive sleep apnea are at a significantly greater risk of dying suddenly than those who do not have the condition.

The word apnea means “without breath.” During obstructive sleep apnea, there is a reduction or complete blockage of airflow during sleep. This sleep disturbance manifests itself in various ways, including excessive daytime sleepiness, fatigue, heavy snoring, and non-refreshing sleep.

Serious consequences of sleep apnea

While these symptoms can potentially affect a person’s quality of life, they can also have even more serious consequences.

Researchers at Penn State performed a systematic review of the literature and identified 22 studies focusing on obstructive sleep apnea, cardiac death, and sudden death. The team analyzed the combined data of these studies by meta-analysis.

The quantitative analysis included a combined total of over 42,000 individuals across the world. The mean age of participants was 62 years old, and 64% were men.

The meta-analysis showed that individuals with obstructive sleep apnea were approximately twice as likely to experience sudden death than those who did not have the sleep condition. The study also identified that obstructive sleep apnea resulted in a nearly twofold risk of cardiovascular death that increased with age.

According to Dr. John S. Oh, assistant professor in the Department of Surgery at Penn State Health Milton S. Hershey Medical Center and one of the study authors, many patients do not realize the seriousness of an apnea diagnosis.

“Obstructive sleep apnea is a common condition that can have fatal consequences,” stresses Dr. Oh.

Timely diagnosis and treatment

In an interview with Medical News Today, Dr. Ryan Soose, director of the UPMC Sleep Division, said: “We’ve known for a long time that untreated sleep apnea patients are more likely to develop high blood pressure, heart disease, and a number of other health conditions. But the risk of sudden death reported in this study is eye-opening and makes a timely diagnosis and treatment even more pressing.”

The effects of the nervous system on the human sleep cycle may explain the association between sleep apnea and the increased rate of sudden death.

Because of the intermittent lack of oxygen that people with sleep apnea experience, the central nervous system may be over-aroused to increase airflow. In turn, this can cause increases in both the systolic and diastolic blood pressure of an individual.

In addition, someone with sleep apnea will experience oxidative stress, which can contribute to an imbalance of antioxidants in the body. This imbalance can damage cells and speed up the aging process, causing numerous health problems over time.

In a podcast, Dale Coller, DO, from Holland Hospital Pulmonary and Sleep Medicine in Michigan, OH, has commented on the serious stressors resulting from obstructive sleep apnea.

“Every time [the throat] closes off, it’s very similar to if someone is being choked,” Coller explains. “This can happen hundreds of times in one night, causing the person stress and fragmentation of their sleep.”

Additional research needed

“Providing accessible and affordable treatments for populations with [obstructive sleep apnea] may ultimately reduce adverse health outcomes for these individuals,” added co-author Emily Heilbrunn.

Dr. Soose agreed:

“Rather than the traditional cookie-cutter approach, I believe that cutting-edge sleep apnea management involves customizing a more holistic and combination treatment plan to each individual’s unique needs.”

The Penn State researchers noted some study limitations.

Because the research involved 22 separate studies, factors other than obstructive sleep apnea may have affected the data in each study.

Also, although the meta-analysis included studies from North America, Australia, Europe, Asia, and South America, there were no studies from Africa. The authors note that more research is needed to determine if the results from this study apply to African populations.

In addition, they stress the need for treatments and interventions related to decreasing and eventually preventing obstructive sleep apnea across the globe to optimize survival and increase a person’s quality of life.

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