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 If people with obstructive sleep apnea don't use machines at night
to help keep the airway open, measures of their heart health and
blood sugar worsen, researchers found.
"One of the longstanding debates in our field" is whether sleep
apnea actually causes heart issues and problems with blood sugar,
"or if they’re just associated," said senior author Dr. Jonathan
Jun, of Johns Hopkins University in Baltimore.
In obstructive sleep apnea, the airway intermittently collapses or
becomes blocked during sleep. The blocked airway causes pauses in
breathing.
In the past, researchers have tried to find a direct link between
sleep apnea, heart health and blood sugar by comparing patients
instructed to use CPAP machines at night to keep the airway open
with patients who were instructed to sleep without using these
machines. But one of the major issues with those studies is that
people may not actually use the CPAP machine, Jun told Reuters
Health by phone.
For the new study, the researchers recruited 31 people with moderate
to severe obstructive sleep apnea who were known to regularly use
their CPAP machines.
The participants slept two nights in the lab, using their CPAP on
only one of the nights. The researchers obtained blood samples while
participants slept.
"We are looking at real time changes," said Jun. "We’re getting
blood every 20 minutes."
As reported in The Journal of Clinical Endocrinology and Metabolism,
on the night without CPAP, patients' obstructive sleep apnea
returned. On those nights, patients had low levels of oxygen in
their blood, poor sleep and an increased heart rate.
Additionally, their blood samples showed increases in fatty acids,
sugar and a stress hormone known as cortisol.
The researchers also saw increases in blood pressure and in arterial
stiffness, which has been linked with a risk for heart problems.
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"These were obese patients and patients with relatively severe sleep
apnea. They also had other medical problems," Jun pointed out.
People who fit that description may be experiencing the same changes
during the night if they sleep without their CPAP machine, he said.
Glucose and fatty acids rose in the overall group without the CPAP
machines, but participants with diabetes may be more vulnerable to
the glucose elevation, Jun warned.
He said the study can't say what would happen to people with milder
sleep apnea.
Because obesity has been tied to an increased risk of sleep apnea,
it's been difficult to know if it’s the sleep apnea or the obesity
itself that’s causing those problems, Jun noted.
The new study, he said, "advances that idea that other conditions
and not obesity itself are driver of those levels."
SOURCE: http://bit.ly/2sXLJaU The Journal of Clinical Endocrinology
and Metabolism, online June 8, 2017.
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