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Re: seriousness of OSA

Posted by SGS on July 07, 2002 at 14:51:17:

In Reply to: seriousness of OSA posted by MikeD on July 07, 2002 at 13:06:57:

OK most of what Perry is saying is true. People with sleep apnoea have impaired quality of life, impaired cognitive skills, they crash their cars more often, etc etc. So, certainly, OSA can be a serious condition.

The jury is still out on some of the cardiovascular stuff. OSA is almost certainly associated with hypertension. Hypertension (consistantly high blood pressure) is a major risk factor for heart disease and stroke. But the association between hypertension and OSA is kind of weak. This is partially because being overweight is a risk factor for hypertension and a lot of overweight people also have OSA. Some of the problems with OSA might therefore have more to do with being too big than having OSA. But generally speaking the worse your OSA is the worse your chance of having hypertension gets- especially for some reasson if you are a younger man (say around 30-35). It's not necessarily certain that OSA itself CAUSES hypertension (as far as I know...). It is expected that it does though. I think a reasonably definative might be fairly close.

Another key point here is that the severity of your OSA does matter. If you have a Apnoea Hypopnoea index (AHI) or a respiratory disturbance index (RDI) that is high the chances of having hypertension get higher.

I havn't seen anything that indicates that people with mild OSA have more traffic accidents than others the same age and sex who don't have OSA. But the risk is severe OSA is well documented. The good news is that the excess risk totally goes away on effective treatment with CPAP.

The best current treatment for OSA is CPAP. Which has only really been shown to be effective in people with AHI/RDI of more than 30 per hour. . And then only when they also have significant daytime sleepiness. There is some evidence that CPAP will reduce your blood pressure from proper randomised control trials in people with AHI of more than 15. It has yet to be proven that BP can be lowered in those with mild OSA with CPAP or that CPAP, in general, is effective in people with mild OSA.

Losing weight is probably one of the most effective treatments for OSA and related problems- if a person is overweight. Weight loss reduces AHI/RDI- conversely weight gain increases AHI/RDI. Excess weight alone increases chances of death in almost all ways prominant in the western world.

Having said all that. If you do have severe OSA then CPAP is a very effective treatment. The more you use it the better. I'm convinced it should help you have a longer happier and more productive life.

Hope this info helps you.

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