Health Risks & Apnea

Two new studies have found that people with sleep apnea, a common disorder that causes snoring, fatigue and dangerous pauses in breathing at night, have a higher risk of cancer. The new research marks the first time that sleep apnea has been linked to cancer in humans.

About 28 million Americans have some form of sleep apnea, though many cases go undiagnosed. For sleep doctors, the condition is a top concern because it deprives the body of oxygen at night and often coincides with cardiovascular disease, obesity and diabetes.

“This is really big news,” said Dr. Joseph Golish, a professor of sleep medicine with the MetroHealth System in Cleveland who was not involved in the research. “It’s the first time this has been shown, and it looks like a very solid association,” he said.

Dr. Golish, the former chief of sleep medicine at the Cleveland Clinic, said that the cancer link may not prove to be as strong as the well-documented relationship between sleep apnea and cardiovascular disease, “but until disproven, it would be one more reason to get your apnea treated or to get it diagnosed if you think you might have it.”

In one of the new studies, researchers in Spain followed thousands of patients at sleep clinics and found that those with the most severe forms of sleep apnea had a 65 percent greater risk of developing cancer of any kind. The second study, of about 1,500 government workers in Wisconsin, showed that those with the most breathing abnormalities at night had five times the rate of dying from cancer as people without the sleep disorder. Both research teams only looked at cancer diagnoses and outcomes in general, without focusing on any specific type of cancer.

In both studies, being presented in San Francisco this week at an international conference organized by the American Thoracic Society, the researchers ruled out the possibility that the usual risk factors for cancer, like age, smoking, alcohol use, physical activity and weight, could have played a role. The association between cancer and disordered breathing at night remained even after they adjusted these and other variables.

Dr. Mitesh Borad, a cancer researcher and assistant professor of medicine at the Mayo Clinic who was not involved with the studies, called the findings “provocative” but said more research was needed to confirm the association. The studies were observational, and other, unknown factors may account for the correlation between sleep apnea and cancer.

Recent animal studies have suggested that sleep apnea might play a role in cancer. When mice with tumors were placed in low-oxygen environments that simulate the effects of sleep apnea, their cancers progressed more rapidly. Scientist speculate that depriving mice of oxygen may cause their bodies to develop more blood vessels to compensate, an effect that could act as a kind of fertilizer for cancer tissue and cause tumors to grow and spread more quickly.

The researchers wondered whether a similar relationship might exist in people with sleep apnea, in whom throat muscles collapse during sleep, choking off the airway and causing gasping and snoring as the body fights for air. Severe sleep apnea can produce hundreds of such episodes each night, depleting the body of oxygen.

In one study, a team at the University of Wisconsin School of Medicine and Public Health examined data on state workers taking part in the long-running Wisconsin Sleep Cohort, who since 1989 have undergone extensive overnight sleep studies and other measures of health about every four years. The landmark project was one of the first to reveal the widespread occurrence of sleep apnea in the general population.

The researchers found that the more severe a person’s breathing problems at night, the greater the likelihood of dying from cancer. People with moderate apnea were found to die of cancer at a rate double that of people without disordered breathing at night, while those in the severe category died at a rate 4.8 times that of those without the sleep disorder.

“That is really striking,” said Dr. F. Javier Nieto, one of the study’s authors and chairman of the department of population health sciences at the University of Wisconsin. “It could be something else, but it’s hard to imagine that something we didn’t control for is causing this.”

In the second study, researchers with the Spanish Sleep Network took a slightly different approach, looking not at cancer mortality among apnea patients, but at the incidence of cancer. They used a measure called the hypoxemia index, which looks at the amount of time the level of oxygen in a person’s blood drops below 90 percent at night.

About 5,200 people were followed for seven years, none of whom had a cancer diagnosis when the study began. The researchers found that the greater the extent of hypoxemia, or oxygen depletion, during sleep, the more likely a person would receive a cancer diagnosis during the study period.

People whose oxygen levels dropped below 90 percent for up to 12 percent of the total time they were asleep, for example, had a 68 percent greater likelihood of developing cancer than people whose oxygen levels did not plummet at night, said study author Dr. Miguel Angel Martinez-Garcia of La Fe University and Polytechnic Hospital in Spain. As time spent without oxygen increased, so, too, did cancer risk.

Although the study did not look for it, Dr. Martinez-Garcia speculated that treatments for sleep apnea like continuous positive airway pressure, or CPAP, which keeps the airways open at night, might reduce the association.

The Wisconsin study also did not specifically look at the impact of treatment for apnea on survival, either, but when people who were being treated with CPAP were removed from the analysis, the cancer association became stronger, “which is consistent with the hypoxemia theory,” Dr. Nieto said.

“I would say that this is one more instance that shows that sleep apnea can have profound impacts for people’s health,” he added. “Not breathing while you’re sleeping is a serious problem.”

If you are an adult male, the odds are about 50/50 that your breathing is not normal when you are sleeping. It is imperative that anyone who might have this problem, is predisposed, or knows someone they care about who has the problem, should have the clearest possible understanding about it.

Sleep apnea occurs when a person’s airway becomes blocked while they are sleeping. It is usually caused by the collapse of soft tissue in the back of the throat during sleep. Between snores, breathing stops for a period of 10 seconds or longer, and this pattern may repeat itself multiple times over the course of a night.

During an episode of obstructive apnea, the person’s effort to inhale air creates suction that collapses the windpipe. This blockage stops air flow for 10 seconds to a minute while the sleeping person struggles to breathe.

When the person’s blood oxygen level falls, the brain responds by awakening the person enough to tighten the upper airway muscles and open the windpipe. The person may snort or gasp, then resume snoring. This cycle may be repeated hundreds of times a night.

Truth be told, sleep apnea may well be the most significant, costly, easily treated, and least understood public health issue we face.

The most recent studies show that between 50 and 65 million Americans are at “high risk” for having sleep apnea, and very few of them have the slightest idea what sleep apnea is, much less the fact that it may be affecting their lives in profound ways.

Repetitive sleep fragmentation can trigger many changes in a person’s personality. Some of the effects include increased irritability and lack of concentration, effecting a person’s work and relationships. Concentration loss also increases the likelihood of automobile and other types of accidents.

Sleeplessness is nothing to mess around with. A good night’s sleep is mandatory for a person to fully-function in their lives. If you are think you are suffering from sleep apnea, watch for signs of:

• Tiredness
• Weight Gain
• Depression
• Trouble Concentrating
• Elevated Blood Pressure

These signs could be the on-set of sleep apnea. If you are experiencing any of these signs, take it seriously, find a professional, and have an over-night study performed. It could change your life, and potentially save it.

Wellness begins with a good night’s sleep. PV Sleep Well specializes in testing for sleep apnea. We are also a supplier of CPAP equipment and accessories, available for sale or rent. For additional information or to schedule a screening contact info@pvsleepwell.com.

Puerto Vallarta, Mexico - Sleep apnea and its main symptom – loud snoring – have long been viewed as an annoyance. Just ask someone who has to share a room with a loud snorer if sleep apnea is a problem. But there’s growing evidence that sleep apnea isn’t just annoying; it can be bad for your heart, too.

Untreated sleep apnea is one risk factor for heart disease. Heart disease is the leading cause of death in America. Sleep apnea increases the risk of irregular heart rate, coronary heart disease, heart attacks and congestive heart disease. Sleep apnea affects even one’s heart shape. Sleep apnea causes the heart to swell and thicken the walls reducing the hearts ability to pump.

Sleep apnea may be linked to heart disease because of the drop in oxygen that occurs during sleep apnea. When the oxygen level drops, carbon dioxide level increases. Your brain senses trouble and tells your body to release adrenaline-like substances into the bloodstream which increases blood pressure, thus the link to sleep apnea and high blood pressure.

Because of low oxygen, your body also releases other substances that can eventually damage the endothelium (inner lining of your body’s blood vessels), and it is this damage that might eventually cause or worsen high blood pressure and other forms of cardiovascular disease or heart problems.

According to a recent study, “While previous studies have shown an association between sleep apnea and heart disease, ours is a large study that allowed us to not only follow patients for five years and look at the association between sleep apnea and the combined outcome of heart attack and death, but also adjust for other traditional risk factors for heart disease,” says researcher Neomi Shah, M.D., of Yale University.

“We recommend that patients who experience symptoms of obstructive sleep apnea – excessive daytime sleepiness, or snoring along with breathing pauses – consult their physician or sleep specialist,” Dr. Shah says. “There is some evidence to make us believe that when sleep apnea is appropriately treated, the risk of heart disease can be lowered.”

Diagnosing and treating sleep apnea is critical to successfully managing a person’s health so if you are experiencing daytimes sleepiness, load snoring or think that you may have sleep apnea, find a professional and have an over-night study performed. It could change your life, and potentially save it.

Wellness begins with a good night sleep.

PV Sleep Well specializes in testing for sleep apnea. We are also a supplier of CPAP equipment, available for sale or rent, and accessories.

At the 2011 American Urological Association’s annual meeting in Washington, DC, a study was done of 870 men with an average age of 47.3 years. Health screening revealed 63% of men had sleep apnea. After adjusting for their age and other health conditions (like diabetes, obesity, and smoking status), researchers found that those men with erectile dysfunction were more than twice as likely to have sleep apnea than those without erectile dysfunction. The more severe the erectile dysfunction, the greater the likelihood of having sleep apnea.

Most people with sleep apnea do not know they have the disorder, that it can cause erectile dysfunction, or other health effects.

Characterized by a strong and irregular snore, apnea is marked by several cessations of breathing in at least ten seconds during sleep. In one night, dozens of events can occur. With the interruption of breathing, brief awakening occurs. The person goes from a deeper stage of sleep to a lighter and less refreshing one. In addition to being naturally more tired and lethargic, those who have the disorder end up with more chance of developing not only erectile dysfunction, but cardiovascular disease and other illness. Impotence is just one more item in this package.

According to Monica Andersen, a professor at UNIFESP (Federal University of São Paulo, Brazil) and researcher at the Sleep Institute, the relationship between sleep apnea and erectile dysfunction is evident, but the specific factors that contribute to it are not yet well understood. “As a hemodynamic phenomenon [connected to the circulation of blood in the vessels] erection depends on the integrity of the tissues, as well as psychological factors. Any change In these components, further altered by sleep apnea, can lead to erectile dysfunction,” she says.

Moreover, there are studies that link sex to impotence reduced levels of male hormones caused by sleep apnea. This level reduction may be in testosterone due to age, excess weight, beside other factors like hypoxia [lower rates of oxygen in arterial blood or tissues] and sleep fragmentation.

Researchers have also noted that people with sleep apnea normally have other risk factors – such as obesity, hypertension and diabetes – that can cause erectile dysfunction, actually the combination of many factors.

Diagnosing and treating sleep apnea is critical to successfully managing a person’s health so if you are experiencing erectile dysfunction, find a professional and have an over-night study performed. It could change your life, and potentially save it.

Wellness begins with a good night sleep.

PV Sleep Well specializes in testing for sleep apnea. We are also a supplier of CPAP equipment, available for sale or rent, and accessories.

Sleep apnea and hypertension requires medical help and a committed life-style change. The combination of pulmonary hypertension and sleep apnea can be an even great health risk.

Studies have shown that there is strong evidence for a link between sleep apnea and hypertension. Your snoring could be putting a great strain on your cardiovascular system.

The prevalence of snoring and sleep apnea among individuals with high blood pressure is close to 40% and jumps to over 80% among individuals with drug-resistant hypertension (requiring two or more anti-hypertensive medications).

Researchers have shown a strong relationship between the severity of sleep apnea and the incidence of new hypertension that cannot be explained by other risk factors, such as age, gender, or Body Mass Index (BMI). This indicates that individuals with a history of habitual snoring with frequent pauses in their breathing, and waking up gasping for air throughout the night, are at a significantly greater risk of developing hypertension.

The following is an all too common account of how easily the seriousness of sleep apnea and hypertension and its diagnosis can be missed:

“Before I discovered that hypertension and sleep apnea could be significant I fought with an overwhelming tiredness that kept me from enjoying the normal functions in my life. All I wanted to do was sleep but when I would lie down, either sleep would not come or I would take a small nap and wake up feeling more drained. This went on for a period of almost two years before I discovered the reason. Since I live alone, no one ever told me that my snoring was atrocious until a relative spent the night and mentioned that my snoring kept him awake in another room. I decided to read up on how snoring might affect my tiredness and was surprised to find sleep apnea could very well be the cause.”

Hypertension is high blood pressure that may occur without any change on your part but can shorten your life by forcing your heart to work harder to keep your organs functioning. Pulmonary hypertension is when the right side of the heart has trouble pumping blood through the lungs that it is connected to. Left undiagnosed and untreated, the affected blood vessels thicken and become stiff, a process known as fibrosis. Lungs are constricted and cut off precious air supply, making every movement a chore. With the additional sleep apnea, heart and lungs have to work beyond normal capacity.

Hypertension is nothing to mess around with and the mixture of sleep apnea and hypertension can make for a deadly combination. If you are suffering from sleep apnea, heart conditions could be a leading contributor. Watch for signs of:

• Tiredness
• Weight Gain
• Depression
• Trouble Concentrating
• Elevated blood pressure

These signs could be the onset of sleep apnea and hypertension so if you are experiencing any of these signs, take it seriously and find a professional and have an over-night study performed. It could change your life, and potentially save it.

Here is a wake-up call to the millions of men and women with type 2 diabetes: Snoring at night or nodding off during the day may be symptoms of sleep apnea. Sleep apnea is a potentially life-threatening problem affecting one out of three people with diabetes.

Based on evidence linking the two disorders, health experts are encouraging physicians to assess their diabetic patients for sleep apnea symptoms and to screen sleep apnea sufferers for metabolic disease.

“It is probably too early to see any concrete evidence of changes in practice, but there is little doubt that awareness of the importance of screening people with diabetes and people with sleep apnea for the other condition is rising,” says Dr. Jonathan Shaw, lead author of the IDF task force and associate professor at the International Diabetes Institute in Melbourne, Australia.

Sleep apnea occurs when a person’s airway becomes blocked during sleep. It is usually caused by the collapse of soft tissue in the back of the throat during sleep. Between snores, breathing stops for a period of 10 seconds or longer, and this pattern may repeat itself multiple times over the course of a night. Not only does it deprive the person of a good night’s sleep, but it may increase the risk for high blood pressure and heart disease.

Obstructive sleep apnea affects just 2 percent of women and 4 percent of men in the general population, the International Diabetes Institute notes. But, it is much more prevalent among people with diabetes.

In a recent report in the journal Endocrine Practice, researchers examined data from 279 men and woman with type-2 diabetes. Overall, 36 percent had obstructive sleep apnea. Men with diabetes were particularly vulnerable. Men younger than age 45 had more than a one-third increased chance of developing sleep apnea. After age 65, the risk doubled. For women younger than 45, the chances of having sleep apnea were slim: between 5 percent and 8 percent. Females 65 and older, however, had a one-third increased chance of having the sleep disorder, the study found. The study suggests that once you’re diabetic, there’s such a powerful disposition to obstructive sleep apnea that the other contributing variables are simply less important. Diagnosing and treating sleep apnea is critical to successfully managing a person’s diabetes so if you are diabetic, find a professional and have an over-night study performed. It could change your life, and potentially save it.

Remember the last time you forgot something? Did you forget about the last time this happened? Chances are you were probably sleep deprived. Patients with sleep apnea may blame their daytime difficulties on simple sleepiness, but new research suggests that their brains may be to blame. Specifically, their cognitive challenges may be caused by structural deficits in gray matter, brought on by the intermittent oxygen deprivation that comes with sleep apnea. The good news is that these deficits may be partially or fully reversible with early detection and treatment. “Gray matter” refers to the cerebral cortex, where most information processing in the brain takes place. It is a layer of tissue that coats the surface of the cerebrum and the cerebellum and is gray in appearance, lacking the myelin insulation that makes most other parts of the brain appear to be white.

Characterized by a strong and irregular snore, apnea is marked by several cessations of breathing in at least ten seconds during sleep. In one night, dozens of events can occur. With the interruption of breathing, brief awakening occurs. The person goes from a deeper stage of sleep to a lighter and less refreshing one. In addition to being naturally more tired and lethargic, those who have the disorder end up with more chance of developing multiple health problems including loss of gray matter.

UCLA scientists have discovered that patients suffering from obstructive sleep apnea show gray matter loss in brain areas that regulate breathing and speech. Nearly 40 percent of these patients also stuttered as children, suggesting that the nighttime breathing disorder may arise from faulty brain wiring early in life. There are tons of studies showing that even mild sleep deprivation can have detrimental effects on memory and every-day functioning. Now there’s new research from Stanford University showing that sleep fragmentation can be just as detrimental as sleep deprivation. Their conclusion was that “regardless of the total amount of sleep, a minimal unit of uninterrupted sleep is crucial for memory consolidation.”

Remarkably, however, treatment with continuous positive airway pressure (CPAP), seemed to reverse these damages. In a recent CPAP sleep study, after three months of treatment, the subjects were evaluated again. There was a gray mater volume increase in the left anterior parahippocampal gyrus, which was associated with improved performance on tests of short-term memory and executive function. Subjects who had undergone treatment also had gains in the right cornu-ammonis and the enthorinal-cortex bilaterally, both of which were associated with improvements in executive function. Indeed, the researchers observed significant cognitive improvement in all parts of the brain.

Diagnosing and treating sleep apnea is critical to successfully managing a person’s health so if you are experiencing daytimes sleepiness, load snoring or think that you may have sleep apnea, find a professional and have an over-night study performed. It could change your life, and potentially save it.

Sleep apnea patients who are successfully treated have lower blood fat levels and a reduced risk of heart attack than people who are left untreated, University of Sydney researchers have found.

Sleep apnea, a condition in which people stop breathing momentarily while sleeping, affects up to 20 percent of the population. The researchers found treatment with a continuous positive airway pressure (CPAP) device reduced post-meal blood fat (triglyceride) levels.

The study was conducted at the University of Sydney's NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS) and published this week in the American Journal of Respiratory and Critical Care Medicine.

The researchers investigated blood fat levels across a 24-hour period after standard meals in 38 patients with sleep apnea. Patients were studied both before and after two months of CPAP and two months with a placebo CPAP device.

"We know that blood fat levels after meals are an important predictor of future cardiovascular disease. This research provides a possible reason why patients with sleep apnea are at increased risk of heart attacks and strokes," said lead author Dr. Craig Phillips, who holds joint appointments with CIRUS and Royal North Shore Hospital.

"Although the results need to be confirmed in larger studies, we estimate that the extent of the improvement in triglycerides with CPAP could reduce the risk for heart attack in these patients by as much as 25 percent."

Study senior author, Professor Ron Grunstein from CIRUS, commented: "Another interesting aspect of the study was that triglyceride levels were particularly high in the middle of the night during sleep, almost seven hours after the evening meal.

"There may be an influence of the body clock that pushes up blood fat levels at these times," he said. "If this is the case, the higher rates of cardiovascular disease in night shift workers may be caused by eating high fat meals at a time when the body can't properly control blood fat levels."

The researchers are currently studying this possibility using special shiftwork simulation facilities located at the University of Sydney's Woolcock Institute.

The current study was conducted by CIRUS researchers from Royal North Shore and Royal Prince Alfred Hospitals and the Woolcock Institute of Medical Research at the University of Sydney.

Sleepless impact

“In a society of 24/7 access, there aren’t enough hours in a day to do everything,” says Dr. Rahul Shetty, a Toronto physician researching the relationship between cardiovascular health and sleep.

“Historically, we’re sleeping much less than our ancestors,” he says. “Jobs are changing, people are working longer, and it means we aren’t sleeping as much as we should.”

He states that a lack of sleep affects judgment, the ability to retain information, and could increase the risk of serious accidents and injury. Studies reveal that sleep deprivation alters the immune system, making us more susceptible to respiratory tract infections and diseases. It may also cause weight gain by impacting how we process and store carbohydrates as well as altering hormone levels affecting appetite.

Serious sleep disorders are linked to diabetes, hypertension, stroke, irregular heartbeat, increased stress hormone levels and

depression. “Lack of sleep has a huge societal impact: pick any bodily system and it is

affected by fragmented sleep,” says Dr. Glen Sullivan, Deputy Director of the Atlantic Health Sciences Sleep Centre in Saint John, New Brunswick.

The Threat of Death

Steven Boticki, a 38-year-old from Burlington, Ontario, was hospitalized for two weeks in winter 2012 with a case of sleep apnea so severe it almost killed him.

Five years ago, Boticki noticed ‘something was off.’ He’d awaken several times a night and felt perpetually tired. He recalls getting up to wash his face and passing out on the bathroom floor. He chalked it up to a strenuous job and being overweight, but dieting and exercise didn’t help.

“After work, I’d grab a pop just to make it home without falling asleep,” he recalls. Then, one afternoon, he drifted off at the wheel and hit the curb. Luckily, the only injury was a smashed tire.

Turning point

Unable to walk up to the second floor at work, he called his wife, who insisted they go to the walk-in clinic. “They took my blood pressure and called 911 immediately,” he recalls.

Not getting enough oxygen during the night, his heart was working overtime to compensate, resulting in an enlarged heart valve and a blood pressure reading of 210/140 (healthy BP is 120/80). “I was spiraling out of control,” he says. Today, Boticki sleeps soundly with the help of a Continuous Positive Airway Pressure (CPAP) machine, a small device beside his bed that pushes air through a mask connected to his nose. “I’m finally sleeping deeply and I have so much energy now,” he states. “I am one of the fortunate ones.”

Taking Control

Dr. Ruchi Shetty, a Toronto-based naturopath, suggests meditation or certain supplements before bed to relax muscles and help the body wind down.

SLEEP strategies

DO

• Exercise regularly for better and deeper sleep (exercise outside if possible to get adequate daily sun exposure).
• Follow a regular sleep schedule: go to bed and get up at the same time daily, even on weekends.
• Finish dinner three to four hours before bed; snack on easy-to-digest yogourt, cereal and milk or applesauce.
• Take herbal remedies or supplements proven to treat insomnia (valerian, melatonin, magnesium, calcium and passion flower).
• Create a sleep sanctuary: ban all electronics; keep it cool, dark and quiet (block out sound with earplugs, a fan or a device that produces ‘white noise’) and make sure you have a comfortable mattress (not too hard or soft).
• Establish relaxing bedtime routines: a warm bath; a light novel. Calm the mind and relax the muscles with deep breathing exercises or meditations like Yoga Nidra to achieve deep relaxation and a sleep-like state. Take classes or learn from books/DVDs.
• Tossing and turning after 20 minutes in bed? Get up, do something relaxing as suggested and try again. Clock-watching increases anxiety.

DO NOT

• Drink alcohol before bed, it can interfere with deep sleep. Limit alcohol to one drink a day and stop at least two hours before bedtime.
• Exercise a few hours prior to bedtime. It can be a stimulant.
• Stimulants like coffee, chocolate, caffeinated teas and soft drinks ingested after 2pm block the brain chemical adenosine, which promotes sleep.
• Daytime naps can impede nighttime sleep. If it’s necessary, 20 minutes max before 4pm.
• Laptops and TV in the bedroom interfere with sleep.

If sleep issues persist for several weeks after trying these strategies, or it begins to impact productivity during the day, talk to your doctor. They can determine if you have sleep apnea or an underlying medical condition, such as high blood pressure, that should be treated.

A successful night can lead to a successful day. If you aren’t waking up feeling rejuvenated, you might not be getting the necessary sleep at night. Fatigue can refer to mental or physical tiredness, or both. Feeling tired throughout the day is inconvenient and can affect your life in many aspects. There are numerous reasons why someone might be feeling tired throughout the day. Sleep apnea is one of the leading causes of fatigue.

If you are struggling with fatigue during the day, this might be a sign of restless sleep at night. When you have sleep apnea, you wake up throughout the night (even though you may not be aware of it), every time you stop breathing. Although you may have slept a full night, you are feeling exhausted throughout the day.

If you suffer from fatigue, then you know how difficult it can be to live with. It makes it harder to concentrate on work and be productive. As I mentioned before, your memory can be compromised, affecting your ability to work. It also takes a toll on your personal life. When you should be enjoying your time with family and friends, you may feel an overwhelming sense of tiredness. Lack of proper sleep can also result in depression and irritability.

If you think that your fatigue could be the result of sleep apnea, then you might want to look at the other signs of sleep apnea. Some of the more obvious signs may include waking up with a dry mouth or sore throat, loud snoring, or even headaches. You can even sometimes wake up choking, snorting, or gasping.

There are a lot of things you can do to treat your sleep apnea, and ultimately eliminate your fatigue. If you are overweight, losing those extra pounds takes pressure off of your airways when you’re sleeping. You should also quit smoking, if you do so. A continuous positive airway pressure (CPAP) is the most essential treatment for sleep apnea. This device delivers a stream of air into your airways through your mouth and nose keeping those passages open when you are asleep.

Fatigue is uncomfortable and difficult to deal with. It’s important to decipher why you have fatigue so you can figure out the best treatment for your problem. Sleep apnea is one of the leading causes of fatigue and should be taken into consideration. If you want to have successful days, first understand how to have a successful night.

Sleep apnea is a chronic condition that interrupts breathing during sleep. In obstructive sleep apnea, the airway becomes blocked, causing breathing to stop for up to 2 minutes. This condition affects more than 12 million Americans. Its symptoms include loud snoring, gasping or choking while asleep, morning headache and daytime sleepiness.

Sleep apnea adversely affects the delicate and fragile vessels in the eye, particularly the retina, by sudden fluctuations of blood pressure and oxygen levels. During undisturbed sleep, the systemic blood pressure decreases slowly. Retinal vessels dilate to match blood flow based upon oxygen and metabolic demands.

In obstructive sleep apnea, oxygen levels drop rapidly and dramatically. Retinal vessels respond by dilating maximally to prevent retinal damage from oxygen deprivation or ischemia. The brain, however, responds to a lack of oxygen in the blood by releasing epinephrine and norepinephrine hormones that cause blood pressure spikes. These repeated hypertensive episodes throughout the night result in nests of micro-infarcts or mini-strokes and damage the retinal tissue.

Sleep apnea accelerates and compounds the abnormalities associated with diabetic damage to the retina. Diabetic patients can develop signs of impaired retinal blood flow and retinal micro-infarcts despite having a healthy blood sugar level. Decrease blood oxygen level in retinal capillaries and eye tissues triggers a release of chemicals that, in turn, could cause macular edema — excessive fluid in the macula — the center of the retina where perception of precise, sharp details of images occurs.

Ischemic optic neuropathy has also been associated with sleep apnea. This condition describes a mini-stroke of the optic nerve, the eye's direct connection to the brain. Optic nerve swelling from raised intracranial pressure is recognized in obstructive sleep apnea patients who often complain of headache upon waking.

More recently, sleep apnea has been identified as an independent risk factor for open-angle glaucoma — elevated pressure inside the eye to a level that damages the optic nerve causing a gradual loss of vision. Sleep apnea patients are nearly two times more likely to have open-angle glaucoma. Individuals who experience sleep apnea are encouraged to be screened for glaucoma.

Floppy eyelid syndrome is one of the most common ocular disorders associated with obstructive sleep apnea. Ninety percent of patients with floppy eyelid syndrome have obstructive sleep apnea. Apnea events prompt a sleeping position shift. The large, elastic upper eyelids become easily distorted and everted when they come into contact with pillow cases. These patients complain of chronic tearing, eye irritation and blurred vision; worse upon waking.

Additionally, apnea interferes with REM sleep — a stage of deep sleep when muscles are maximally relaxed and body systems are at maximum rest. Sleep apnea interrupts this overnight system reset, a condition that adversely affects an individual's physical and mental health.

Obstructive sleep apnea is more common in men than women. Typical apnea patients are middle-aged with a thick neck or narrow pharynx and have a body mass index of more than 28. Sleep apnea suspects also include children with enlarged tonsils, youngsters experiencing daytime sleepiness and adults whose partners report loud snoring. Following sleep lab evaluations, successful treatments can be implemented to protect patients from the ocular and systemic ravages of obstructive sleep apnea.

More than 25 million Americans suffer from asthma. They use steroids, inhalers, and pills to help control their symptoms. But, soon there may be a new option: doctors are using a sleep disorder device to help asthma patients breathe easier.

College professor Kurt Stoecker spends many late nights grading papers, but some nights his asthma gets the best of him."You can't sleep, that kind of thing. It's a tightness in your chest, and then you cough," Stoecker said. He was diagnosed with asthma at age 16. He's taken steroids and inhalers, but now he's trying something new.

As part of a clinical trial, doctors are testing whether treatment with a CPAP machine will improve symptoms in asthma patients by making their airways less reactive.

"At nighttime, their muscles that are around their windpipes are not being allowed to relax. In essence, they're working almost 24 hours a day," Mario Castro, MD, MPH, Professor of Medicine and Pediatrics, Washington University School of Medicine said.

The CPAP pushes gentle air down the windpipe, forcing the muscles to relax. It's typically used for patients with sleep apnea, but doctors say it could be the first drug-free option for asthma patients. In the 12-week study, patients used the device for at least four hours a day and there were no serious side effects.

"The most exciting thing is that it's not a drug. This is a device," Dr. Castro said.

Stoecker watches TV while his CPAP goes to work.

"I don't even notice it, honestly," Stoecker said. He hopes the simple mask could one day be all he needs to keep his asthma under control. Doctors say the hope is patients will only need to use the CPAP for a short period of time, and not indefinitely, to see results.

Researchers at 19 sites across the country are still recruiting patients for this clinical trial, which is sponsored by the American Lung Association.

Breathing problems during sleep may be linked to early mental decline and Alzheimer’s disease, a new study suggests. But treating apnea with a continuous positive airway pressure machine can significantly delay the onset of cognitive problems.

In a group of 2,470 people, average age 73, researchers gathered information on the incidence of sleep apnea, a breathing disorder marked by interrupted breathing and snoring, and the incidence of mild cognitive impairment and Alzheimer’s disease.

After adjusting for a range of variables, they found that people with disordered breathing during sleep became cognitively impaired an average of about 10 years sooner than those without the disorder.

But compared with those whose sleep disorder was untreated, those using C.P.A.P. machines delayed the appearance of cognitive impairment by an average of 10 years — making their age of onset almost identical to those who had no sleep disorder at all.

The lead author, Dr. Ricardo S. Osorio, a research professor of psychiatry at New York University, said the analysis, published online in Neurology, is an observational study that does not prove cause and effect.

“But,” he added, “we need to increase the awareness that sleep disorders can increase the risk for cognitive impairment and possibly for Alzheimer’s. Whether treating sleep disorders truly slows the decline is still not known, but there is some evidence that it might.”

MONDAY, April 20, 2015 (HealthDay News) -- People with both atrial fibrillation and obstructive sleep apnea are less likely to have a recurrence of the heart rhythm disorder if they use continuous positive airway pressure (CPAP) therapy, a new report says.

Researchers from New York University Langone Medical Center reviewed seven studies that included more than 1,000 people with sleep apnea. They found that CPAP use was associated with a 42 percent reduction in the recurrence of atrial fibrillation, an irregular, often rapid, heart rate.

"Active screening for obstructive sleep apnea in all patients who undergo treatment for atrial fibrillation is imperative as the use of CPAP will influence the outcome of therapy and likely reduce some of the cardiovascular morbidity associated with atrial fibrillation," said Dr. Larry Chinitz, a professor of medicine and cardiac electrophysiology.

The results were published April 20 in the Journal of the American College of Cardiology: Clinical Electrophysiology.

A large randomized clinical trial needs to be conducted, but these findings suggest CPAP shows promise as another treatment option for atrial fibrillation, the researchers said.

"Our study confirms the expanding body of evidence that treatment of modifiable risk factors has a significant impact on the long-term suppression of atrial fibrillation regardless of the type of therapy offered," Chinitz said in a journal news release.

Sleep apnea is a potentially serious sleep disorder involving disrupted breathing. Patients with sleep apnea are often prescribed CPAP therapy, in which a small machine and mask provide steady air pressure throughout the night.

"Technology for home screening of sleep apnea needs to be made widely available and become as routine as measurements of blood pressure and blood sugar levels in diabetics," Chinitz added.

Sleep apnea and several other conditions, including hypertension, obesity and diabetes, contribute to the onset and progression of atrial fibrillation, journal editor-in-chief Dr. David Wilber said in the news release.

"This study provides important evidence that we need to identify and treat these associated conditions if our more direct efforts to suppress the arrhythmia by antiarrhythmic drugs or ablation are to be effective," Wilber added. (Ablation involves threading a catheter from the groin to the heart to correct the heart rhythm abnormality).

More than a century ago, scientists demonstrated that sleep supports the retention of memories of facts and events. Later studies have shown that slow-wave sleep, often referred to as deep sleep, is important for transforming fragile, recently formed memories into stable, long-term memories. Now, in an Opinion article published September 29 in Trends in Neurosciences, part of a special issue on Neuroimmunology, researchers propose that deep sleep may also strengthen immunological memories of previously encountered pathogens.

"While it has been known for a long time that sleep supports long-term memory formation in the psychological domain, the idea that long-term memory formation is a function of sleep effective in all organismic systems is in our view entirely new," says senior author Jan Born of the University of Tuebingen. "We consider our approach toward a unifying concept of biological long-term memory formation, in which sleep plays a critical role, a new development in sleep research and memory research."

The immune system "remembers" an encounter with a bacteria or virus by collecting fragments from the bug to create memory T cells, which last for months or years and help the body recognize a previous infection and quickly respond. These memory T cells appear to abstract "gist information" about the pathogens, as only T cells that store information about the tiniest fragments ever elicit a response. The selection of gist information allows memory T cells to detect new pathogens that are similar, but not identical, to previously encountered bacteria or viruses.

Studies in humans have shown that long-term increases in memory T cells are associated with deep slow-wave sleep on the nights after vaccination. Taken together, the findings support the view that slow-wave sleep contributes to the formation of long-term memories of abstract, generalized information, which leads to adaptive behavioral and immunological responses. The obvious implication is that sleep deprivation could put your body at risk.

"If we didn't sleep, then the immune system might focus on the wrong parts of the pathogen," Born says. "For example, many viruses can easily mutate some parts of their proteins to escape from immune responses. If too few antigen-recognizing cells [the cells that present the fragments to T cells] are available, then they might all be needed to fight off the pathogen. In addition to this, there is evidence that the hormones released during sleep benefit the crosstalk between antigen-presenting and antigen-recognizing cells, and some of these important hormones could be lacking without sleep."

Born says that future research should examine what information is selected during sleep for storage in long-term memory, and how this selection is achieved. In the end, this research could have important clinical implications.

"In order to design effective vaccines against HIV, malaria, and tuberculosis, which are based on immunological memory, the correct memory model must be available," Born says. "It is our hope that by comparing the concepts of neuronal and immunological memory, a model of immunological memory can be developed which integrates the available experimental data and serves as a helpful basis for vaccine development."

Loud SNORERS face a higher risk of Alzheimer's - but treatments for sleep apnea could lower risk of the disease, study finds

• A study from New York found that those with sleep apnea are at higher risk of developing Alzheimer's disease
• This is due to a build up of a toxic protein caused by obstructed breathing as a result of sleep apnea
• A two-year study found the link in 104 people between ages 55 and 90
• But experts say the treatments used to combat sleep apnea, including an oxygen mask, may be able to prevent Alzheimer's disease

By Kayla Brantley For Dailymail.com

PUBLISHED: 18:38 EST, 9 November 2017 | UPDATED: 18:05 EST, 12 November 2017

Those who suffer from sleep apnea are at a higher risk of developing Alzheimer's disease, a new study has found.

The study found those with sleep apnea had a build up of a toxic protein in their brain called beta-amyloid which triggers Alzheimer's, the progressive brain disease known for slowly causing impairment in memory and cognitive function.

The protein formed due to the obstructed breathing from heavy snoring as a result of sleep apnea, researchers found.

But experts say there is a silver lining: the study showed treatments used to calm the snoring and increase oxygen flow may be able to prevent Alzheimer's disease.

Experts say the oxygen mask treatment used to combat sleep apnea may be able to prevent Alzheimer's disease as research has shown a link between the two conditions

Sleep apnea is a potentially serious sleep disorder largely associated with heavy snoring in which breathing repeatedly stops.

If left untreated, the oxygen deprivation from sleep apnea can result in a growing number of health problems, including high blood pressure, stroke, heart failure, diabetes and heart attacks.

Now researchers from New York University have found a link between the sleep disorder and Alzheimer's while conducting a study of 208 mentally healthy people, ages 55 to 90.

WHAT IS ALZHEIMER'S?

Alzheimer's disease is a progressive, degenerative disease of the brain.

A build-up of abnormal proteins causes nerve cells to die.

This disrupts the transmitters that carry messages, and causes the brain to shrink.

Early symptoms include: loss of short-term memory, disorientation, behavioral changes and mood swings

Later symptoms include: severe memory loss, forgetting close family members or familiar objects, loss of the ability to walk and the inability to make sense of the world.

Researchers performed spinal taps to analyze the amount of amyloid in their cerebrospinal fluid (CSF), fluid that protects the spine and brain.

They then scanned the brain to measure deposits of the toxic protein directly in the brain in a number of the volunteers.

And though none of the participants were referred by a sleep center, were known to have sleep apnea or had a condition that might affect their brain function, more than half were found to have sleep apnea - 36.5 percent with a mild form and 16.8 percent whose condition was moderate to severe.

Exactly half the original group (104) were then followed for two years which found a link between sleep apnea severity and an increase in amyloid deposits in the brain.

The toxic proteins clump together in the brains of Alzheimer's patients and were found to increase over time due to snoring severity, meaning those with more sleep disturbances per hour had greater accumulation of amyloid over time.

Senior study author Dr Ricardo Osorio said: 'If this is the case, then the potential benefit of developing better screening tools to diagnose sleep apnea in the elderly who are often asymptomatic (to Alzheimer's) is enormous.'

A CPAP (continuous positive airway pressure) machine is an oxygen mask used to combat sleep apnea by keeping the airways open and forcing air in.

The next step in research is to determine if the use of a CPAP machine could keep the airways open enough to decrease the amount of amyloid proteins to the brain and decrease the likelihood of Alzheimer's.

Sleep apnea affects 18 million people, or one in 15 Americans, according to the American Sleep Association.

One in 10 people ages 65 and older has Alzheimer's, which is an incurable disease.

Earlier this year, another US team pooled data from 14 studies and showed people with sleep apnea were 26 percent more likely to develop dementia, a popular symptom of Alzheimer's.

The study is published in the American Journal of Respiratory and Critical Care Medicine.