Sleep apnea natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-In-Chief: Kashish Goel, M.D.

Overview

Complications

Prognosis

Although it takes some trial and error, most patients find a combination of treatments which reduce apnea events and improve their overall health, energy, and well-being. Without treatment, the sleep deprivation and lack of oxygen caused by sleep apnea increases health risks such as cardiovascular disease, high blood pressure, stroke, diabetes, clinical depression,[1] weight gain and obesity.

The most serious consequence of untreated obstructive sleep apnea is to the heart. In severe and prolonged cases, there are increases in pulmonary pressures that are transmitted to the right side of the heart. This can result in a severe form of congestive heart failure (cor pulmonale).

Elevated arterial pressure (commonly called high blood pressure) can be a consequence of obstructive sleep apnea syndrome.[2] When high blood pressure is caused by OSA, it is distinctive in that, unlike most cases of high blood pressure (so-called essential hypertension), the readings do not drop significantly when the individual is sleeping.[3] Stroke is associated with obstructive sleep apnea.[4] Sleep apnea sufferers also have a 30% higher risk of heart attack or death than those unaffected.[5]

Many studies indicate that it is the effect of the "fight or flight" response on the body that happens with each apneic event that increases these risks. The fight or flight response causes many hormonal changes in the body; those changes, coupled with the low oxygen saturation level of the blood, cause damage to the body over time.[6][7][8][9]


References

  1. Schröder CM, O'Hara R (2005). "Depression and Obstructive Sleep Apnea (OSA)". Ann Gen Psychiatry. 4: 13. doi:10.1186/1744-859X-4-13. PMID 15982424.
  2. Silverberg DS, Iaina A and Oksenberg A (2002). "Treating Obstructive Sleep Apnea Improves Essential Hypertension and Quality of Life". American Family Physicians. 65 (2): 229–36. PMID 11820487. Unknown parameter |month= ignored (help)
  3. Grigg-Damberger M. (2006-02). "Why a polysomnogram should become part of the diagnostic evaluation of stroke and transient ischemic attack". Journal of Clinical Neurophysiology. 23 (1): 21–38. PMID 16514349. Check date values in: |date= (help)
  4. H. Klar Yaggi, M.D., M.P.H. (November 10, 2005). "Obstructive Sleep Apnea as a Risk Factor for Stroke and Death". The New England Journal of Medicine. 353 (Number 19): 2034–2041. PMID 16282178. Unknown parameter |coauthors= ignored (help); |access-date= requires |url= (help)
  5. N.A. Shah, M.D., N.A. Botros, M.D., H.K. Yaggi, M.D., M., V. Mohsenin, M.D., New Haven, CT (May 20, 2007). "Sleep Apnea Increases Risk of Heart Attack or Death by 30%". American Thoracic Society.
  6. [1]
  7. [2]
  8. http://www.schlaflabor-breisgau.de/Bild_gif/Peppard.pdf
  9. [3]



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