Morbidity and Complications of Sleep Apnea

The incidence of sleep apnea is as high as 4% of women and 9 % of men in developed countries. Long term effects and complications associated with this condition:

1)      poor sleep during the night with fatigue during daytime hours

2)      effects on the cardiovascular system

3)      effects on nervous system

4)      effects on behavior

5)      sleeping while driving and resultant accidents

6)      possibility of stroke

7)      diabetes

Daytime sleepiness is described as an entirely new entity and is labeled as EDS (excessive daytime sleepiness) in modern medical literature. The biggest and most debilitating effect of sleep apnea is daytime sleepiness. Lack of sleep during night results in stress and produces adverse behavioral effects on these patients. One of the earliest effects of EDS is lack of concentration at work or in the case of children, inability to adequately perform in school. Despite all efforts at treatment of EDS and the causative factor, namely sleep apnea, even with CPAP (continuous positive airway pressure), daytime sleepiness may not be fully eliminated. Many patients resist the use of CPAP or use it inconsistently.

Falling Asleep While Driving

It has been found that many motor vehicle accidents today are related to drivers sleeping behind the wheel. At least a part of this group are victims of sleep apnea causing daytime sleepiness. Patients of sleep apnea should be monitored before being allowed to drive vehicles for their own safety and safety of others.

Effects on Behavior

Studies show that patients of sleep apnea have impaired daytime alertness and concentration. Many have impaired intellectual capacity and serious memory loss. Motor coordination (movement of limbs) is also found to be adversely affected.

Cardiovascular Effects

Perhaps the widest spectrum of effects in sleep apnea is on the cardiovascular system. The long term effects of sleep deprivation and hypoxia (insufficient oxygen intake) and hypoxemia (low oxygen in blood) in patients of sleep apnea can result in a number of illnesses. Among these diseases are dangers of cardiac arrhythmias (or irregular heart beats) and myocardial infarction (heart attack). Other conditions like stroke (bleeding or clotting within the brain) can also result from sleep apnea. Hypertension (high blood pressure) and renal failure (non-functioning of kidneys) as well as more ominously, sudden death during sleep, are also known complications of sleep apnea. In fact, in sleep apnea patients, both the diastolic and systolic blood pressures were found to be significantly higher. But there is good news; the use of continuous positive airway pressure (CPAP) machines was found to bring down both these components of high blood pressure. Many patients do not like to use CPAP for a long time during sleep. These patients will not benefit much in correcting their hypertension. More serious conditions like myocardial infarction (heart attack), cardiac arrest (heart failure and cessation of heart beats) are now increasingly linked to sleep apnea, especially as long term complications. In fact, recent studies show that the incidence of coronary artery disease (narrowing of arteries of the heart), in sleep apnea patients, is double that of those who do not suffer from sleep apnea.

Sleep apnea signs, risk factors and treatments.

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