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Why You Should Be Concerned About Untreated Sleep Apnea

When sleep is disrupted night after night by the frequent awakenings caused by sleep apnea, you feel tired all day and are less able to function.


Daytime sleepiness is not the only consequence of Obstructive Sleep Apnea (OSA) or other sleep breathing disorders. If left untreated, OSA prevents you from taking in the amount of oxygen you need while sleeping. As one can imagine, this makes the whole body work harder! The decreased flow of oxygen to the brain and other tissues can lead to many serious health conditions.


A study of sleep problems in the general population shows some alarming findings: over an 18-year period, people with severe, untreated sleep apnea died at a rate more than three times that of those without apnea.


Excessive Daytime Sleepiness Due to Lack of Sleep

Excessive daytime sleepiness is a significant cost on the economy. The National Sleep Foundation found that people with mild to moderate untreated sleep apnea performed worse than those with a 0.06% blood alcohol level and 37% of adults say they are so tired during the day it interferes with daily activities. The sleepiness effect of untreated sleep apnea can lead to:


Car accidents:

  • Almost 20 percent of all serious car crash injuries are associated with driver sleepiness.
  • With untreated sleep apnea, you are 6 times more likely to cause a car crash (1)
  • The NHTSA estimates the cost of drowsy driving is $12.4B per year (2)
  • Treating all US drivers suffering from apnea would save $11.1B in collision costs and save 980 lives annually (2)

Poor job/school performance:

A National Sleep Foundation 2008 poll found that sleepy people report difficulties with:

  • Concentration - 68%
  • Handling stress - 65%
  • Relating to others - 38%
  • Solving problems - 57%
  • Listening - 57%
  • Decision making - 56%


Productivity loss:

  • Sleep-related fatigue costs for US businesses have been estimated at $150 billion per year due to absenteeism, workplace accidents and lost productivity.
  • Research shows that work performance can be decreased by 30 percent due to sleep fragmentation and repetitive hypoxia, which are characteristics of OSA.
  • Untreated OSA results in job performance deficiencies such as excessive sleepiness, cognitive dysfunction, irritability and reduced vitality.
  • Highly fatigued workers are 70% more likely to be involved in on the job accidents.

Suffering personal relationships:

Take this quiz to find your sleepiness score.


Cardiovascular Problems

The lack of oxygen during sleep makes the whole body work harder, especially your heart, causing:


Heart Disease:

  • People with untreated sleep apnea are 3 times more likely to have heart disease.
  • Up to 70% of patients admitted to the hospital because of coronary artery disease were found to have sleep apnea.
  • 23% of the morbidity of certain heart diseases are associated with sleep apnea and could possibly be eliminated if the sleep apnea were eliminated.

Irregular heartbeat:

  • A study found that the odds of experiencing a heartbeat abnormality were 18 times higher immediately after an episode of sleep apnea.
  • Sleep apnea has been linked to both atrial fibrillation (a major risk factor for stroke) and ventricular tachycardia (a cause of sudden death).
  • One study indicated abnormal heart rhythms were not linked to the severity of sleep apnea. In fact, most arrhythmias occurred in people with mild-to-moderate sleep apnea.
  • The likelihood of sleep apnea patients seeking treatment for a recurrence of atrial fibrillation decreases from 80% to 40%, with treatment of sleep apnea. (5)

Hypertension (high blood pressure):

  • 30-40% of Americans with high blood pressure also have sleep apnea.
  • The increase in blood pressure is caused by falling oxygen levels alerting the brain to sends signals through the nervous system telling the blood vessels to "tighten up" in order to increase the flow of oxygen to the heart and the brain.
  • Approximately 80% of patients that do not respond to hypertensive medications have sleep apnea.

Increased risk of sudden cardiac death:

  • In a study of 10,000 adults who participated in a sleep study, the risk of sudden cardiac death was almost twice as high in patients who stopped breathing more than 20 times an hour during sleep. (4)
  • In people with obstructive sleep apnea, sudden cardiac death is more likely to occur between the hours of 10pm and 6am.
  • Sudden cardiac death accounts for 450,000 deaths annually.

Sexual Dysfunction

Snoring sounds aren’t the only reason sleep apnea could be impacting your relationship. Sex hormones, like testosterone, rise with sleep and fall when there is a lack of it. Because sleep apnea causes intermittent waking and chronic sleep deprivation, it is a common cause of sexual dysfunction in both men and women. Getting treated for sleep apnea could improve your bedroom life and bring sexy back if you are experiencing:


Erectile dysfunction:

  • Erectile dysfunction is twice as common in patients diagnosed with sleep apnea, likely caused by both lack of sleep and reduced oxygen levels.
  • Healthy young men found a decrease in testosterone when there were several nights of short sleep times.
  • In one study, erectile dysfunction vanished in 40% of patients treated for sleep apnea.

Loss of libido:

  • Obstructive sleep apnea has been shown to negatively impact sexual function in women, independent of age and associated co-morbid diseases.
  • Severity of sleep apnea has not been shown to be an indicator of sexual dysfunction in women.

Other Consequences of Untreated Obstructive Sleep Apnea

Depression and Other Mood Disorders

  • People with depression were found to be five times more likely to suffer from sleep-disordered breathing
  • People with insomnia have a ten-fold risk of developing depression compared with those who sleep well.
  • Men and women who said they snorted or stopped breathing at least five nights per week were three times more likely to show signs of major depression.
  • OSA patients who were treated by CPAP for one year showed that improvements in symptoms of depression were significant and lasting.

Diabetes:

  • 70% of type 2 diabetics also have obstructive sleep apnea.
  • Studies show early-morning increase in blood sugar in people who have Type 2 diabetes and sleep apnea could be reduced by up to 45% as a result of OSA treatment.
  • Sleep duration and quality have emerged as predictors of levels of Hemoglobin A1c, an important marker of blood sugar control.

Insomnia:

  • As many as 50% of obstructive sleep apnea patients have insomnia, and many of these patients also report fatigue, non-restorative sleep and difficulty in concentrating. (3)
  • It’s estimated that of insomniacs with middle of the night awakenings, 90-100% have a sleep breathing disorder.

Cancer:

  • Sleep apnea is more common among cancer patients.
  • It’s estimated that 30% to 88% of cancer patients are affected by sleep disorders.
  • Moderate to severe obstructive sleep apnea is associated with a 2.5 times higher risk of cancer and a 3.4 times higher risk of dying from cancer.
  • Cancer patients are twice as likely to experience insomnia.

Stroke:

  • Obstructive sleep apnea doubles the risk of stroke in men.
  • Men with moderate to severe sleep apnea were about three times more likely to have a stroke than men with mild or no sleep apnea.
  • Sleep apnea is common in people with silent strokes and small lesions in the brain.
  • An estimated 70% of acute ischemic stroke patients may have sleep apnea.
  • Sleep apnea may negatively affect the short- and long-term outcome in acute ischemic stroke patients.
  • Early treatment of sleep apnea may help reduce risk of silent strokes in these patients.

Obesity:

  • Short sleep duration leads to metabolic changes, likely linked to obesity.
  • Insufficient sleep during childhood may adversely affect the function of a region of the brain known as the hypothalamus, which regulates appetite and the expenditure of energy.

Snoring and sleep apnea should not be taken lightly! If you believe that you or your loved one may have sleep apnea, contact your physician or sleep apnea dentist today.



Source 1: Teran-Santos J et al, NEJM 1999


Source 2: Sassanai, et al. Sleep


Source 3: Dr Barry Krakow’s findings on the relationship between insomnia and sleep-disordered breathing


Source 4: Gami AS, Olson EJ, Shen WK, et al. Obstructive sleep apnea and the risk of sudden cardiac death: A longitudinal study. JACC 2013; available at: http://content.onlinejacc.org


Source 5: Susan Redline, M.D., professor, medicine, Case Western Reserve University, Cleveland; Ken Monahan, M.D., assistant professor, medicine, Vanderbilt University, Nashville; Nov. 3, 2009, Journal of the American College of Cardiology





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