Sunday, December 04, 2005

More about Cardiovascular Disease and Sleep Apnea

On November 20th, I blogged about 2 recent articles in the New England Journal of Medicine. USNews and World Report has a pretty good discussion of these same 2 articles:
People with sleep apnea often don't realize they have it, since they don't remember waking up again and again, gasping for breath. Often, it's a bed partner who hears the choking and "industrial-strength snoring," says Klar Yaggi, a sleep specialist at Yale who led the study. He and his colleagues followed two groups of patients who were tested for sleep apnea (defined as stopping breathing five or more times per hour). Some had the condition; some didn't. During the 3½ years or so that they were studied, the people with sleep apnea were about twice as likely to have a stroke or die.
Another study in the same issue of the New England Journal looked at how well the continuous air treatment works for people with central sleep apnea, a different disorder altogether. In both forms of sleep apnea, you stop breathing periodically. But in central sleep apnea, the problem is not an obstructed airway but that the brain fails to send out the command to breathe. The disorder is usually caused by congestive heart failure, in which the heart doesn't pump as well as it should and fluid collects in the chest.
The treatment did help people with central sleep apnea in some ways: Their hearts worked better, they didn't stop breathing as often, they didn't have adrenaline surges, and they were able to exercise more.
"That's the good news," says Douglas Bradley, a pulmonologist at the University of Toronto and author of the article. "The bad news is that we didn't improve survival."

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