Just thought I would pass this along since we had a discussion a while
back about people with sleep apnea not seeking treatment.

Dana

Sleep apnea linked to night deathsBy ANDR� PICARD 

Thursday, March 24, 2005 Page A17

PUBLIC HEALTH REPORTER
 
 Many people long to die peacefully in their sleep, their heart
stopping while they dream and snore. But reality is different: Heart
attack deaths actually hit their nadir at night, and peak between
sunrise and noon.

The exception is people who suffer from sleep apnea. New research
shows that they are far more likely to die in their sleep. The irony
is that their sleep is, at the best of times, anything but peaceful.

Sleep apnea is a condition in which the throat closes repeatedly and
people stop breathing for several seconds. When this occurs, oxygen
levels plummet, and carbon-dioxide levels soar, which can trigger
cardiac arrest.

For a long time, sleep apnea has been dismissed as nothing more than
bothersome snoring but, increasingly, it is being seen as a serious
health risk. "It's one more piece of evidence linking heart disease
and sleep apnea, and why we need to take sleep apnea more seriously,"
said Dr. Virend Somers, a cardiologist at the Mayo Clinic in
Rochester, Minn.

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 Research has shown that people with congestive heart failure and
those who have had a stroke are far more likely to develop sleep
apnea. The condition is also common among the obese.

Dr. Somers stressed that the new research does not necessarily
demonstrate that people with sleep apnea are more likely to die of
heart disease, though there is evidence from other studies that
suggests this is the case.

But the time of death should raise some red flags, he said, because
sleep is normally a passive time, when the stresses that can trigger
heart attacks are absent.

The new research, published in today's edition of the New England
Journal of Medicine, involved 112 Minnesota residents, diagnosed with
sleep apnea, who died suddenly of heart-related causes. Their outcomes
were compared to people of similar backgrounds in the general
population who did not have sleep apnea.

Researchers found that more than half the sleep apnea sufferers died
between 10 p.m. and 6 a.m. In the general population, this was the
time people were least likely to die of cardiac-related problems. By
contrast, however, the number of deaths among sleep apnea sufferers
was significantly lower between 6 a.m. and noon than among members of
the general population.

What the study suggests is that people are dying at night because they
have sleep apnea, and that means the condition should be treated far
more aggressively, said Douglas Bradley, director of the Sleep
Research Laboratory at the Toronto Rehabilitation Institute.

"If sleep apnea is causing these deaths in the middle of the night,
then treating it may be able to prevent those deaths," Dr. Bradley
said.

The most effective treatment is known as continuous positive airway
pressure. Patients use the CPAP device and a breathing mask; the air
pumped into their mouth and nose prevents the involuntary lapses in
breathing that mark sleep apnea.

Problem is, the vast majority of people with sleep apnea are not being
treated because their condition has not been diagnosed. "The
literature suggests up to 80 per cent of people with sleep apnea don't
have a clue what's going on, said Jeffrey Lipsitz, medical director of
the Sleep Disorders Centre of Metropolitan Toronto. "They are just
walking around tired."

He said a diagnosis of sleep apnea requires a sleep study and, in some
parts of the country, the wait list stretches up to four years for the
test.

"You may die on a waiting list," Dr. Lipsitz said.

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