Sleep Apnea Death Risks

head-on collisions and
collisions with pedestrians or cyclists -- 80% of the crashes of that kind were
in sleep apnea patients."

All sleep apnea patients appeared to be at risk of crashing their cars. The
problem wasn't limited to those with severe apnea.

"It didn't matter how severe your sleep apnea was. We found that you
still have the same increased risk even if you have mild sleep apnea,"
Mulgrew says.

And patients seemed unable to tell when they were at greater risk. Patients
who said they drove even when they felt sleepy were no more likely than other
sleep apnea patients to wreck their cars.

The results of the study were so striking that Mulgrew now carefully asks
his sleep apnea patients about their driving histories and about any "near
misses" they might be having. He is much more likely to recommend the most
effective sleep apnea treatment -- a continuous positive air pressure or CPAP
device -- to patients with driving problems, even if their sleep apnea is
relatively mild.

Sleep Apnea and Diabetes

While evaluating older, obese men for a sleep apnea study, Botros and his
Yale colleagues noticed that about a third of the patients suffered from
diabetes as well as sleep apnea.

To see whether the two conditions were related, the researchers kept track
of nearly 600 sleep apnea patients for up to six years. Compared with similar
men without sleep apnea, the patients were more than two-and-a-half times more
likely to develop diabetes.

The more severe the sleep apnea, the higher the patients' risk of
diabetes.

"We know that by measuring markers in the blood that the body of a
person with sleep apnea is in a highly inflammatory, highly excitatory
state," Botros says. "This state increases stress hormones, and we
think the insulin-making pancreatic beta cells are affected."

Botros and colleagues are now looking at whether CPAP treatment can reduce
sleep apnea patients' diabetes risk.

Sleep Apnea and Pregnancy Complications

Sleep apnea is more common among obese people. But the extra weight gain
during the third trimester of pregnancy often puts a woman at risk of sleep
apnea, says Hatim Youssef, DO, of the University of Medicine & Dentistry of
New Jersey-Robert Wood Johnson Medical School.

Youssef and colleagues noticed that in their hospital, women tended to have
low blood oxygen levels at night if their BMI (body mass index, a measure of
weight according to height) went over 35. A BMI of 30 is considered obese for
people who are not pregnant.

So the researchers analyzed the 2003 medical records of 4 million U.S. women
who delivered babies. Only 452 of these 4 million women had sleep apnea. But
these 452 women were much more likely than other women to experience
complications:

• Women with sleep apnea were twice as likely as other women to have
  gestational diabetes.


• Women with sleep apnea were four times more likely than other women to have
  pregnancy-induced high blood pressure.

Obesity isn't the only risk factor for sleep apnea in pregnant women,
Youssef says. He suggests that women with preeclampsia or high blood pressure
are also at higher risk.

Sleep Apnea and Heart Attack, Heart Death

Having sleep apnea for four or five years raises a person's risk of having a
heart attack or dying by 30%, find Neomi Shah, MD, and colleagues at Yale
University.

Shah's team followed 1,123 patients evaluated for sleep apnea. More than 500
of these patients had 15 or more low-oxygeevents per hour of sleep.

After adjusting for other heart risk factors, these patients were 30% more
likely to have a heart attack or die over a four-and-a-half year period. The
more severe the sleep apnea, the higher the risk of heart attack or death.

"There is some evidence to make us believe that when sleep apnea is
appropriately treated, the risk of heart disease can be lowered," Shah says
in a news release.

By Salynn Boyles
Reviewed by Louise Chang
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