The Comorbidities of Sleep Apnea

Monday, October 2nd, 2017

Sleep apnea is fascinating because there are so many comorbidities associated with it. If that’s a new word to you, no worries: A “comorbidity” is a medical term; it means the presence of a second (or third or fourth) chronic disease or condition in a patient who already has one chronic condition. Sadly, a number of chronic conditions tend to cluster together. They seem to run in packs.

So if you have sleep apnea … what other conditions or disease are most likely to be present?

Number One: Hypertension

Chronically high blood pressure, or hypertension, is the most common comorbidity associated with sleep apnea. In fact, there is an actual cause-and-effect relationship, meaning that sleep apnea actually causes hypertension. There’s more than enough evidence to make that bold statement.

How does that happen? The mechanism is straightforward. When you go to sleep and you have a sleep apneic event – when your breathing is interrupted by an obstruction in your mouth or throat – your oxygen level drops. When your oxygen level drops, your body screams out and forces you to wake up enough to breathe. During that distress, there is damage being done, a little at a time, to all the blood vessels in your body. The endothelium—the layer of tissue inside your blood vessels, no thicker than one cell—responds to the lower oxygen levels and a cascade of events occur, including the development of plaque; plaque is what leads to high blood pressure.  Once that distress is relieved – when you start to breathe again – that plaque doesn’t go away. Even though the amount of damage that’s done with each apneic event, each interruption, is very small, it occurs every time you have an event. And the effect builds up.

Then there’s the rest of the hit parade:

There are many other comorbidities related to sleep apnea, though none with the same demonstrated level of cause and effect. Those include:

• • Insulin resistance
• • Glucose intolerance
• • Diabetes
• • Heart disease
• • Impotence in men
• • Some cancers
• • Stroke

… In fact, strokes are associated not only with sleep apnea, but simply with snoring alone. Any one (or more) of these comorbidities is serious, some even life-threatening, and the presence, or even the risk, of any one of them should be enough to get you to your medical caregivers, and into our office for an assessment and consultation concerning your sleep apnea.

There’s really no reason to wait –

Time really is an important factor. The longer your sleep apnea goes untreated, the more damage is being done, and the greater the risk to your health, or even your life. Please don’t wait for a medical emergency, like a stroke or a heart attack, before you deal with the management of your sleep apnea. It’s far better to treat it and even prevent it – and its comorbidities – in advance, rather than waiting until after the damage is done.