Sleep-Disordered Breathing Might Kill You

Interruptions reduce sleep quality

Poor sleep quality harms your health

Sleep-disordered breathing (obstructive sleep apnea is one common example) occurs widely among American adults. This condition predicts increased risk of cardiovascular disease, including stroke. Most people with this malady don’t know they have it and don’t receive medical treatment. Yet, medical treatment can improve sleep quality. Data from the Wisconsin Sleep Cohort suggest that severe sleep-disordered breathing increases risk of death. The cohort included a random sample of 1,522 civil service employees in Wisconsin with a mean follow-up of 13.8 years. Researchers analyzed sleep disordered breathing during one-night sessions in a sleep research laboratory. The categories of sleep-disordered breathing included none (less than 5 apnea-hypopea events per hour of sleep) mild (5-14.9 events per hour), moderate (15 to 29.9 events per hour), and severe (30 or more events per hour).

After adjusting for age, sex, and body-mass index, participants with severe sleep-disordered breathing had three times the risk of dying during the follow-up period compared to participants with no sleep-disordered breathing. Further adjustment for chronic health conditions modestly reduced the risk to 2.7 times. When participants who used a continuous positive airway pressure machine were excluded from the analysis, the risk of dying increased to 3.8 times. Interestingly, daytime sleepiness did not predict severe sleep-disordered breathing. Obesity predicts significantly greater risk of poor sleep quality. Given the alarming rise in obesity in the US, the incidence of sleep-disordered breathing may also rise, along with higher risk of premature death.

Sleep-disordered breathing is also linked to hypertension and cardiovascular disease. A team of researchers used data from 6,441 participants with an average age of 63 years in the Sleep Heart Health Study to determine if sleep-disordered breathing predicted increased risk of mortality. Sleep-disordered breathing was measured using the apnea-hypopnea index (AHI) based on an in-home polysomnogram device. Categories of sleep-disordered breathing included 0-4.9 (none), 5-14.9 (mild), 15-29.9 (moderate), and 30 (severe) sleep interruptions per hour.

Compared to men participants with no sleep-disordered breathing, men in the severe category had a 54 percent significantly higher risk of dying over an average of 8.2 years of follow-up. Sleep disordered breathing did not predict increased risk of dying for women. These results accounted for confounding factors such as age, sex, smoking, and existing medical conditions. Men under age 70 with severe sleep-disordered breathing had a 109 percent increased risk of dying compared to men over age 70 without sleep-disordered breathing. Men with moderate to severe sleep-disordered breathing had a 69 percent increased risk of dying of cardiovascular disease compared to men with mild or no sleep-disordered breathing.

Possible reasons why poor sleep might increase increased risk of dying include greater risk of cardiovascular disease, stroke, hypertension, type 2 diabetes, and motor vehicle accidents. If think you might have sleep disordered breathing, consider consulting a sleep specialist. You might live longer as a consequence.

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