• Nalaka de Silva

Why Treat Sleep Apnoea

Updated: Oct 15, 2021


While the initial reasons for presentation with sleep apnoea are partner-related social concerns, daytime sleepiness, a sleep study revealing a high apnoea index, there are many other reasons why sleep apnoea MUST be managed.




Unmanaged sleep apnoea affects mental wellbeing, physical wellbeing, social wellbeing and financial wellbeing. A basic outline is as follows.



Economic Consequences

It is estimated the loss of workplace productivity account for 77.4% of the total cost burden of OSA in the United States. This translates to an estimated economic loss of $86.9 billion in 2015. A recent survey of 506 employed US patients with treated OSA found a 40% decline in workplace absences and 17.3% decrease in work productivity. For more details, please read the post on economic consequences.


General wellbeing

It affects the mental and physical well being. Sleep apnoea leads to depression and other mental health concerns. Social concerns, partner-related concerns add to this. A study has shown OSA impaired all domains of quality of life, including emotional functioning, mental health functioning, vitality, and physical health.


Loss of work

Sleep apnoea patients are more likely to be unemployed.


Hyper Coagulation:

Sleep Apnoea is associated with increased clotting or coagulation. This is due to increased inflammatory markers leading to platelet aggregation and increased clotting and coagulation. A study in Taiwan had shown over nine-fold increase in clotting in severe sleep apnoea patients.


Myocardial Infarcts

Over 65% of patients admitted due to heart attacks have sleep apnoea. This is likely due to increases in other risks such as blood pressure, clotting, obesity and low oxygen levels during sleep.


High Blood Pressure

Pressure is regulated by the sympathetic system, Kidney function, cardiac function and endothelial function. Sleep apnoea leads to increased sympathetic drive, blood vessel constriction and fluid retention. This leads to increased blood pressure. Moderate sleep apnoea is likely to have three times the risk of high blood pressure, leading to other health concerns.


Arrhythmia

Changes in respiration again affect the sympathetic drive and body electrolyte balance. This can lead to arrhythmia. Atrial fibrillation is five times more likely in a sleep apnoea patient.


Heart Failure

50% of the patients with severe sleep apnoea has been found to have heart failure. This is partly related to increased pressures in the lung circulation, also known as pulmonary hypertension.


Chronic Kidney Disease

Increased sympathetic drive leads to chronic vessel damage in the kidneys and damage to the filtration system called glomeruli.


Strokes/ CVA

Stroke risk can be 3.3 times higher in severe sleep apnoea patients. Some risk is due to the above-listed risks. Even when adjusted for those risks, sleep apnoea patients have shown a higher risk of stroke.



Neurocognitive

Due to sleepiness as well as a general reduction in neurocognitive function, patients with sleep apnoea would score lesser in IQ tests.


Car Accidents

The most significant mortality risk of sleep apnoea is due to car accidents.


Metabolic Syndromes

Sleep apnoea leads to an increase in insulin resistance and diabetes. Also, there is an increase in inflammatory markers, cholesterol and triglycerides (fat in the blood). These put patients at increased health risks.



Pregnancy

Sleep apnoea gets worse during pregnancy. In a pregnant patient, sleep apnoea leads to increased complications such as preeclampsia, cesarian section, newborn needing neonatal ICU, and possibly miscarriage.


Management of sleep apnoea is complex. Due to the unique collaboration between surgeon and physician, CSSC has delivered outstanding results to sleep apnoea patients in Melbourne.


Disclaimer: The material and information contained in this website is is for general general purpose or in addition to what was provided for patients during their consultation. You should not rely upon the material in this website as basis for decision making









52 views0 comments