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Heart Disease, Dementia and Sleep Apnea

Here’s an interesting study showing that the presence of heart disease may predict dementia better than cognitive tests. This finding is not surprising since we know that untreated obstructive sleep apnea can cause major injury to multiple areas of the brain. We also know that the older you get, the more likely you’ll develop sleep apnea. In fact, based on some recent population studies, more than half of people over 50 had some degrees of sleep apnea. 

 

Rates of Strokes in Younger People Rising

Here’s an article about increasing rates of strokes in younger people. Rates of stroke in people ages 20 to 55 increased from 12.9 to 18.6% from 1994 to 2005. Researchers site the usual reasons for stroke, including bad diets, lack of exercise, and obesity. Nowhere does it mention anything about obstructive sleep apnea, which is always something to think about for anyone who suffers from a stroke. In a recent study from Sweden, 50% of women aged 20 to 70 were found to have obstructive sleep apnea. In the US, with increased rates of obesity, this figure is likely to be much higher. There are many different reasons for obstructive sleep apnea raising your risk of stroke, but one important thing to remember is that blood is much thicker in people with sleep apnea. This makes blood more susceptible to clot in various parts of your body, including your brain.

If you had a stroke at a young age, do you have sleep problems?

Why Does Having Sinusitis Raise Your Risk of Stroke?

I’ve written before about my observation that almost 80% of patients with recurrent sinus symptoms after nasal or sinus surgery have obstructive sleep apnea. Here’s another study showing similar findings: Researchers in Taiwan found that people with acute sinusitis have a higher chance of having a stroke (hazards ratio of 1.39), whereas if you have chronic sinusitis, the HR is 1.34. Theses figures were adjusted for other potential stroke confounders and were statistically significant.

This is no surprise, since if you have obstructive sleep apnea, your risk of stroke increases about 2-3 times normal levels. This also explains the high incidence of nasal and sinus symptoms in people with obstructive sleep apnea.

If you’re  sleep apnea sufferer, do you also suffer from sinusitis?

If You Had Cancer, Would You Put Off Treatment Until It’s Convenient For You?

Once or twice a month, I have patients that are diagnosed with severe obstructive sleep apnea (50 to 90 apneas per hour) and when told that it’s important to treat it, they are reluctant, saying that they’ll take care of it once school ends, or when they get vacation time. I even go as far as to tell them that insurance actuaries rank sleep apnea at the same level as cancer. In fact, a recent study showed that for untreated obstructive sleep apnea, your relative risk of dying from cancer is much higher than that for heart attack or stroke. Another study showed that your life expectancy is about 20 years shorter, and still another study showed that your risk of getting into a car accident is 15 time higher than normal.

There’s a lot of psychology involved when you’re dealing with obstructive sleep apnea. What are your stories that involve friends or family members? Is there a lot of denial or refusal to act when told they have severe obstructive sleep apnea?

Short Sleep Ups Your Risk of Stroke

Here’s a surprising finding that was presented at the SLEEP meeting: Sleeping less than 6 hours increases your risk of stroke by over 4 times. These people did not have obstructive sleep apnea or were not obese. It just goes to show that length of sleep is just as important as quality sleep.

High Blood Pressure In Pregnancy Raises Child’s Heart Risk

Having high blood pressure during pregnancy (also called preeclampsia) was found to increase the offspring’s risk of having high blood pressure in childhood and young adulthood. This study published in Pediatrics analyzed 18 studies and looked at cardiovascular risk factors in people exposed to high blood pressure during pregnancy. Those that were exposed had a systolic blood pressure that was 2.39 mm Hg higher compared to those whose mothers had healthy pregnancies. The diastolic pressure was 1.35 mm Hg higher. They calculated  that over time, these figures would increase one’s risk for dying from heart disease by 8% and from stroke by 12%.

What’s my take on this study? It’s not surprising, since many women with preeclampsia have sleep-breathing problems such as obstructive sleep apnea and upper airway resistance syndrome. It’s been shown that treating with CPAP can lower blood pressure in women with preeclampsia. Despite this knowledge , sleep apnea is almost never considered when treating preeclamptic women in the US. Having hypoxia and physiologic stress from the mother’s poor sleep quality can be detrimental to the developing fetus. Since the offspring will also inherit the mother’s upper airway anatomy, it’s not surprising that the child will be predisposed to the consequences of obstructive sleep apnea, such as high blood pressure, diabetes, heart attack and stroke. It’s also likely that environmental and dietary factors during pregnancy  may carry over into the household which can also affect the child’s diet.

Did Lenin Die of Sleep Apnea?

In my periodic quest to find famous people and celebrities who might have obstructive sleep apnea, I came across someone who died over 88 years ago:  Vladimir Lenin.

In a recent article in the New York Times, various experts describe his medical ailments that lead up to his massive stroke and death at the age of 53. His cerebral arteries were found to be almost completely clogged. He supposedly had major sleep problems and had chronic headaches. He also had a strong family history of cardiovascular diseases, with his father dying of a cerebral hemorrhage at age 54, and siblings dying of a heart attack and stroke.

Lastly, notice that he had a mustache and a goatee. Many men with weak chins grow facial hair to make their chins more prominent. It’s not surprising that he also had narrow, triangular facial features. Take a look at his picture in the New York Times. It seems like he had a fat neck as well. 

What do you think about my theory?

Why Hypertension Is More Lethal For African Americans

Blacks with high blood pressure were found to be twice as likely to suffer sudden cardiac death compared to other racial groups. A study published in HeartRhythm found that this was the case regardless of other other factors such as age, gender, family history, weight, diabetes or previous history of heart disease. What they don’t mention is that blacks are also at significantly increased risk for having obstructive sleep apnea, which more than doubles one’s chances of having a heart attack or stroke. I wish more studies like this would also control for the presence of obstructive sleep apnea. 

High Blood Pressure In Children Predicts Heart Disease In Parents

You may be thinking that I mixed up the words in the title. Yes, I did mean to say that children who have high blood pressure or high cholesterol have higher chances that their parents have diabetes or heart disease later on in life. Researchers found that 26 years after screening these children for health problems, 47% of parents of these same kids had suffered a heart attack, stroke, or underwent a procedure to unclog blocked arteries. Thirty-seven percent of parents developed diabetes.

Again, there’s not one mention of the likelihood that there’s any chance of obstructive sleep apnea. 

 

Searching for a drug rehab Florida program? 

8 Glasses of Water Per Day: Is it Really Healthy?

In his “Really?” column in the New York Times, Anahad O’Connor brings up recent research which suggests that drinking 8 glasses of water every day can be beneficial, especially for your kidneys. The authors found that those who had the highest urine volume had lower rates of kidney disease.

On the other hand, another recent study showed that renal hyper-filtration can significantly increase your chances of stroke. They also noted that kidneys tend to overwork in people with the metabolic syndrome, and type 2 diabetes. Notice how obstructive sleep apnea by itself has been linked to increased risk of hypertension, obesity, high cholesterol, and insulin resistance (the metabolic syndrome, or Syndrome X)). In fact, Syndrome Z describes metabolic syndrome plus obstructive sleep apnea.

Knowing that untreated obstructive sleep apnea can also increase urine production by increased levels of atrial naturietic peptide/hormone, it’s not surprising that increased urine production can be linked to higher rates of stroke. Many people who go to the bathroom often at night are found to have untreated obstructive sleep apnea (which increases your risk of stroke). It’s actually been shown that people wake up due to breathing pauses, and not from too much urine production. But the overall levels of urine to go up significantly.

I think that you have to use common sense when it comes to recommending certain volumes for water intake. People have different metabolic needs, and there’s additional water in the normal food that you eat throughout the day. Drinking too much water before bedtime can also increase urine production, leading to more frequent awakenings and poor sleep quality.

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