A recent study reveals that people with Type 2 diabetes and people with Obstructive Sleep Apnea (OSA) share the same early signs of cardiovascular damage. This study was presented the week of December 5th at the annual meeting of the European Association of Cardiovascular Imaging in Athens, Greece.
The most common type of sleep apnea is Obstructive Sleep Apnea (OSA). OSA occurs when the airway collapses or becomes blocked during sleep, usually by the tongue or the soft palate. We are all familiar with partial obstruction or, more commonly, snoring! To be an apnea, the breathing has to be totally obstructed for at least 10 seconds and the oxygen (O2) in your blood has to drop by 4%. These apneas end when the brain, sensing suffocation, partially arouses us just enough to “consciously” open the airway. This is usually heard by the bed partner as a snort, gasp, or choke, after which the cycle repeats itself. When sleeping, obstructive breathing stops can last anywhere from mere seconds to tens of seconds, and can occur from 5 to over 100 times or more an hour! The number of apneas per hour are scored as your AHI (apnea-hypopnea index), whereas your RDI (Respiratory Disturbance Index) scores total breathing disruptions per hour, even those less than 10 seconds duration.
OSA is a deadly condition that moves people repeatedly from a deep sleep into a light sleep, never allowing the deepest levels of sleep to occur and as a result disrupts the sleep cycle. People suffering from sleep apnea often feel tired or sleepy throughout the day, have memory or work performance issues, may not be alert while driving or doing similar functions requiring paying attention, and often have emotional and mood disorders such as depression. It is also responsible for a number of other cardiac disorders such as increased blood pressure, heart rhythm disorders, heart attack, stroke, sudden cardiac death and heart failure, in addition to GERD (reflux) and diabetes.
The study’s focus compared early cardiovascular dysfunction in sleep apnea patients and patients with diabetes. Diabetes is a typical risk factor for cardiovascular disease. Study subjects included 20 patients with moderate to severe obstructive sleep apnea, 20 healthy people and 20 people with Type 2 diabetes. Each subject underwent test to assess the condition of their arteries.
According to the study author Dr. Raluca Mincu of Bucharest, Romania, subjects with moderate to severe obstructive sleep apnea had a significant increase in arterial stiffness and malfunction of the inner lining of the blood vessels (endothelial dysfunction) than the group of healthy people. The study also revealed that those patients with chronic sleep apnea had similar results to patients with diabetes, suggesting that obstructive sleep apnea is directly linked with a high risk for cardiovascular disease. Dr. Mincu sees this as a signal to other cardiovascular specialists and general physicians to work together to actively diagnose obstructive sleep apnea in the hopes of assessing arterial function and administering the appropriate treatment more efficiently.
Most people who have sleep apnea do not realize they even have it until it’s noticed or observed by family members or bed partners. Unlike the stereotype of the overweight, middle aged male, this type of sleep apnea occurs in both sexes and people of all ages and weights. OSA is usually diagnosed by a sleep doctor, usually a pulmonologist, after an examination and an overnight sleep study, most commonly a PSG or Polysomnogram which is performed at a sleep center. Traditionally, the most common treatment for OSA was a CPAP (Continuous Positive Air Pressure) which is basically a mask which blows air into your airway.
4-5 years ago the American Academy of Sleep Medicine issued guidelines specifying certain oral appliances fabricated by a trained dentist are also primary treatment choices for patients with mild to moderate OSA (AHI score 30 or less) or for those patients with severe apnea who cannot tolerate a CPAP. At our practice, Mark W Langberg, DDS, MAGD, I have had extensive training and experience working with OSA patients making and monitoring these appliances and coordinating treatment with sleep doctors. I am available to answer all your questions and concerns at 248-356-8790. For more information, see my web page on OSA at https://drlangberg.com/sleep-apnea.html .
Until next time,
Dr. Mark W. Langberg, DDS, MAGD
26206 West 12 Mile Road, Suite 303
Southfield, MI 48034