Breast Cancer and the Sleep Apnea–Alcohol Link
December 14, 2009
I’ve been accused in the past of of trying to link everything to sleep apnea. While not everything is caused by sleep apnea (taxes, the weather, etc.), I can make a good argument that not breathing properly during the day and while sleeping can directly or indirectly affect every aspect of our state of health and well-being. Obstructive sleep apnea is only a small fraction of what I describe in my sleep-breathing continuum. Due to the way we define sleep apnea, you can have major sleep-breathing problems and not have any sleep apnea.
Along these lines, here’s something interesting to think about: Can a sleep-breathing problem cause or aggravate breast cancer?
Drinking alcohol was found to increase a woman’s risk of not only developing breast cancer, but also increase the risk of developing recurrence in breast cancer survivors. In a recent study from Kaiser Permanente, women who drank 3-4 glasses of wine per week were 34% more likely to develop a recurrence compared with women who drank little to no alcohol.
The researchers speculated that alcohol can increase levels of estrogen, which increases metabolism. However, they didn’t have a clear explanation for these findings. What’s more relevant to this discussion is the fact that post-menopausal women and overweight women who drank were at higher risk for recurrence.
Like many other studies, researchers never commit themselves to state that one thing causes another—they can only state statistical likelihood of an association, but not causation.
Similar finding are being reported with prostate cancer—that heavy alcohol consumption and being overweight increases your risk of recurrence.
Here’s my interpretation of these findings: Alcohol is a strong muscle relaxant that’s usually taken with dinner or later in the evening. Muscle relaxation during deep sleep causes more frequent obstructions in your breathing, which can cause or aggravate existing sleep apnea. The resulting activation of the sympathetic nervous system leads to a relative hypoxic environment in preferential body parts and organs, such as the gastrointestinal system, the reproductive system, the skin, and the hands and feet.
Since the breast is a combination skin and reproductive structure, it’s more susceptible to various levels of hypoxia. Physiologic stress that develops in sleep apnea constricts blood vessels that feed blood into the breasts. This is also why many women with breast cancer also have cold hands and feet.
As I’ve described in my book, Sleep, Interrupted, hypoxia creates chemical mediators that tell the body to send more blood. One particular substance is vascular endothelial growth factor, or VGEF, which promotes new vessel formation and more aggressive tissue growth and regeneration.
Menopause is stage in life in a woman’s life where progesterone slowly diminishes, leading to more and more frequent obstructions and arousals (since progesterone promote tongue muscle tone). Furthermore, inefficient sleep can promote weight gain. Weight gain narrows the throat, leading to more frequent obstructions. Women’s rate of cardiovascular disease also increases significantly after menopause, along with a significant increase in obstructive sleep apnea. We know that sleep apnea can cause heart disease, but so far, these conditions are treated separately. It’s not surprising that breast cancer is treated independently, rather than looking at the bigger picture.
Granted, this is an unorthodox explanation for breast cancer, but as Einstein once said, "The significant problems we face cannot be solved at the same level of thinking we were at when we we created them." In other words, we must think outside the box.
What I’m proposing doesn’t contradict traditional explanations for breast cancer. Rather, it’s a different perspective that can only complement existing treatment options.
What you do think about this explanation? Please enter your responses in the box below.