Dangers of Sleep Apnea Shouldn't be Dismissed
Posted on Wed, Aug 24, 2011 @ 11:55 AM
Effective therapeutic solutions to serious medical conditions should not be withheld for the sake of studying the health consequences of a particular disease. That was the message Elizabeth Rowe, PHD, MBA delivered in a blog article Sleep Apnea: Disturbing Study Highlighted in JAMA. A quick synopsis: In a recent study, elderly women that were diagnosed with obstructive sleep apnea (OSA) were not treated with CPAP (Continuous Positive Airway Pressure) so that their cognitive decline could be compared to a similar group that received CPAP.
One could dismiss this ethical lapse as a misfortunate oversight by well-meaning researchers that would not likely occur again anytime soon. However, in the same week that this posted, and was picked up by one of the most widely read medical blogs, KevinMD, another study was released with an equally disturbing protocol. Ironically, it too dealt (too lightly) with the sleep disorder, sleep apnea. As the study title suggests, Withdrawal of CPAP Therapy Results in Rapid Recurrence of OSA, sleep apnea patients that were effectively managing their breathing disorder with CPAP, were taken off CPAP therapy for 2 weeks and then analyzed for sleepiness, psychomotor performance, blood pressure and heart rate, vascular function and nervous systemic activity. And guess what?!?!? There was a negative change in all of these areas.
So let me raise this question: If the medical community has known that OSA negatively affects blood pressure, heart rate, heart rhythms, insulin resistance, cognition and more… why would these investigators, and the
Institutional Review Board (IRB) that approves clinical study protocols, continue to allow control groups with potentially harmful health consequences? The answer must be that far too many in the medical community do not consider sleep apnea as a serious and/or treatable condition, even when all the evidence is to the contrary.
To prove I’m not making mountains of mole hills – try this exercise. Imagine a clinical trial in which a new seizure medication is being tested for epilepsy and the control group is taken off of their current seizure medicine so they can study the decrease of grand mal seizures compared to the study medication group. Or a new heart pacemaker in which a control group gets the device implanted but the unit is not functional. No investigator would dream up such a protocol and the IRB would never approve it if submitted.
Changing the apathetic attitude among health care providers about OSA may require a grass-roots effort from the general public.
THE CHALLENGE
To begin this grass-roots campaign I am challenging anyone who snores, is overweight, has migraines, struggles to make it through the day without a nap or lots of caffeinated beverages or any of the diseases or symptoms associated with OSA to watch the video below. You don’t have to view the entire 6 minutes to be moved by this mans struggle to breathe as his airway is blocked during sleep. Pay attention (with the sound on) to 0:33 to 1:00 as his mouth gapes and chest expands in vain attempts to inhale air with a blocked airway. It happens again at 1:13 to 1:40 and 1:52 to 2:17. The only breaths he accomplishes are when he slightly awakens between apneic events. How rested do you imagine he feels in the morning?
On a personal note: It was this video that scared me into recognizing my own “snoring problem” was much more than just an inconvenience for my wife but a potential serious health problem. 3 PM Starbucks runs, angry late-night elbows from my wife and a dry, sore throat each morning couldn’t convince me to talk to my doctor about having a sleep study. Even blogging for my employer, a neurology clinic and sleep lab, about all the dangers of sleep disordered breathing didn't cause me to take action – but this video did and I hope it might cause you to consider what health consequences you are risking by ignoring your own excessive fatigue, snoring, or other sleep issues. Stay tuned to this blog for updates.
-Aaron Seacat, MBA
Web Marketing & Physician Liaison at MidAmerica Neuroscience Institute