The largest study to date on mortality from sleep apnea reveals: Sleep apnea is more dangerous in young people
Avi Blizovsky
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The risk of death in sleep apnea patients compared to the general population is 10 times higher among young men aged 20-29. This was revealed by a study conducted at the Technion and published in the March issue of the European Respiratory Journal.
The study's editor, Technion Vice President and sleep researcher Professor Peretz Lavi, said that the surprising results raise significant doubts about the effectiveness of the existing diagnostic methods for sleep apnea syndrome.
"This is a common and well-known phenomenon that exists among more than ten percent of the population, and is manifested in breathing pauses that last ten seconds or more, at least five times an hour," he explains. "Many of those breathing pauses are not felt at all by those who suffer from them, even though they lower the oxygen levels in the blood. However, even if they are not felt when they occur - the breathing pauses are manifested in sleepiness during the day, chronic fatigue at work or loud snoring. Sleep apnea sufferers are At an increased risk of suffering from cardiovascular diseases - especially high blood pressure."
The study, the largest that has been done so far on the topic of sleep apnea mortality, was done at the Lloyd Rigler Sleep Apnea Research Laboratory at the Technion, and involved 15,000 people aged 20 and over who were examined in the years 1991-2000. It was found that obesity, and the severity of the breathing disorder, are significant factors independent of the risk of mortality. The average mortality rate in the test group was 5.5/1000 person-years, but it jumped at a double rate and even more - 11.47/1000 person-years - among extremely obese people, with more than forty breathing pauses per hour during sleep.
"Problems with the heart and blood system are the common cause of death in these patients," explains Professor Lavie. "Sometimes patients die from myocardial infarction, cerebrovascular events or heart failure."
An analysis of the death rate according to the age group, among men suffering from sleep apnea with a severity of over thirty pauses in breathing per hour, revealed that men aged 20-29 had a significantly higher death rate than men in the general population of the same age.
Among patients suffering from fifty (or more) pauses in breathing per hour the mortality rate was 9.8 times higher than in the same age group (29-20) in the general population; in the 30-39 age group it was 3.12 times higher; In the 40-49 age group - 1.89 times higher. Men over the age of fifty suffer from a mortality rate similar to that of the general population of their age.
"This research is both fascinating and surprising," said Professor Lavie. "Older patients suffer from a greater number of risk factors, especially those related to the heart and the circulatory system, so it could be expected that the relative mortality would increase with age. In practice, the mortality rate actually decreases with age. From this it can be assumed that patients with apnea develop some mechanism, which is still Its consumption, which protects the cardiovascular system, is not quite clear."
It is no coincidence that the said study focused on men, those who are at a relatively high risk. While 4 to 10 percent of men suffer from sleep apnea (depending on the definition of symptoms for the disease), only 2 to 4 percent of women suffer from the syndrome.
"Nobody knows what is the reason for this difference between the sexes," says Professor Lavie. "Certain theories point to hormonal differences, differences in the distribution of fats in the body or differences in breathing control."
"The meaning of the results is that a drastic change in the approach to diagnosis is needed," concludes Professor Lavi, "because patients usually go to the doctor only when the symptoms related to apnea appear (sleepiness, exhaustion, snoring), usually around the age of fifty. Now we know that it is too late, that We miss the people with the highest risk. It would be more correct to take proactive tests for apnea among high-risk groups, that is, men under the age of thirty who are Especially obese, suffer from high blood pressure, or have a family history that justifies it."
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