Sleep Apnea And Liver Disease

December 22, 2009

Here’s another "dot" that connects to the central concept of my sleep-breathing paradigm: That poor breathing and frequent obstructions and arousals can negatively affect EVERY organ or system in your body, and that all modern humans are susceptible to various degrees of breathing problems while sleeping.

We’ve known for a long time that untreated obstructive sleep apnea can lead to hypertension, diabetes, obesity, heart disease, heart attack, or stroke. Recently there are even studies suggesting a link to inflammatory bowel diseases such as Chron’s disease and ulcerative colitis. I’ve written numerous blogs about the link between Alzheimer’s and sleep apnea. One study showed that creating hypoxic states in mice similar to what occurs in sleep apnea creates amyloid plaques in brain tissue. Now, there’s a study linking oxygen deprivation to chronic liver disease in mice.

Researchers showed that keeping mice in low oxygen levels for a week resulted in increased levels of fat and inflammation in the liver. Nonalcoholic steatohepatitis (NASH) is a common, often silent liver disease that occurs in up to 40% of the population. It’s like alcoholic liver disease (alcoholic steatohepatitis, or ASH), but occurs in people who drink little to no alcohol. NASH can be severe and lead to cirrhosis.

Interestingly, we know that obesity predisposes to both fatty liver and obstructive sleep apnea. Alcohol also predisposes to obstructive sleep apnea by relaxing throat muscles, leading to more frequent obstructions and low oxygen states. In this particular study, the mice exposed to low oxygen were also less sensitive to insulin.

This study brings up an interesting question: are NASH and ASH the same condition, where alcohol aggravates more hypoxia by causing more frequent obstructions? If you’re obese, the chances that you’ll have obstructive sleep apnea are much higher, and if you add alcohol, it’ll add further to your risk of developing chronic liver disease.

If you have any type of chronic liver disease, do you snore, or suspect that you may have a sleep-breathing problem? Please enter your responses below in the comments box.

Written by Steven Park · Filed Under Blog | 4 Comments

Q: Can Sleep Apnea Cause Birth Defects?

July 3, 2009

Q:
Dear Dr. Park,

I was wondering if you are aware of any link to birth defects or other issues in babies of mothers with undiagnosed sleep apnea? I have only been diagnosed lately at the age of 47, but my first child who’s 22 was born with a cleft lip, has asthma + is waiting for an operation for a deviated septum. My son, who’s 13, is waiting to see a specialist as his hearing is very bad in one ear, he has a permanent stuffy nose and also has learning problems (border-line dyslexia). When my daughter was born with the cleft lip her orthodontist asked me several times if I could think of any occasion during my pregnancy where there could have been a lack of oxygen to the placenta. At the time I couldn’t, but I didn’t know then that I had sleep apnea.

Many thanks for your time.
Kath (UK)

A: It’s interesting that you ask that question, as a recent study reported that women with OSA had a much higher incidence of children with neural tube defects. There are a number of other studies linking sleep-breathing problems with perinatal complications. One study revealed that snoring alone during pregnancy was associated with much lower Apgar scores at birth. I’m not aware of any association between sleep apnea during pregnancy and cleft lip or palate problems, but I wouldn’t be surprised if there is a link. We also know that sleep apnea is most likely a major aggravator for pre-eclampsia during pregnancy.

I think your family history is a combination of hereditary risk factors as well an pregnancy-related sleep apnea complications. Unfortunately, there’s no easy way of proving cause and effect. The various problems that your children suffer from could be related to hereditary factors, since you already know that you sleep apnea. There are also external environmental factors that may contribute as well, such as bottle-feeding and the child’s diet. Needless to say, oxygen deprivation during pregnancy is not good for the developing baby.

Written by Steven Park · Filed Under QnA | Leave a Comment