Sleep Apnea Patients Susceptible to Pneumonia!
With OSA’s far-reaching scope, we suggest those suffering from snoring or similar symptoms to seek help from sleep doctors now.
Many people have a loud snore, but if compounded with other symptoms such as daytime sleepiness, impaired concentration, morning headaches or waking up gasping for air then it may not be a simple snoring problem but obstructive sleep apnea (OSA). The cause of OSA is relaxation of the soft tissues in the upper respiratory tracts which narrows or collapses as a result. If a large or entire part is obstructed, breathing may stop, putting the patient in danger of hypoxia. Other than the aforementioned symptoms, the patient’s mood, performance at work, and metabolism will also be affected but the biggest underlying problem is an elevated risk to cardiovascular diseases. Research has shown that OSA is correlated to many cardiovascular/cerebrovascular diseases and may cause high blood pressure, coronary artery diseases, strokes, dementia, atherosclerosis, arrhythmia, heart failure, vein thrombosis, sudden cardiac death, etc.
Other than the highly researched effects on cardiovascular/cerebrovascular diseases, sleep apnea’s effect on the immune system is a new research field because sleeping well is crucial to maintaining one’s immune system. Taipei Veterans General Hospital’s Center of Sleep Medicine once compared the effects of sleep apnea on mortality rate in sepsis patients. They found that the mortality rate for sepsis patients with and without sleep apnea is 60.1% and 47.9% respectively. After multivariate adjustment, sleep apnea was found to be independently associated with mortality, increasing the risk of mortality for sepsis patients by 1.8-fold. This study was published in the European Journal of Clinical Investigation this January.
This April, our team published another research in the Canadian Medical Association Journal, showing that sleep apnea confers a higher risk for future pneumonia. We sampled 34,100 patients in which 6,816 patients also had sleep apnea. The remaining 27,284 patients are the matched control group. We tracked these patients for a maximum of eleven years, discovering that there was a higher incidence of pneumonia in the sleep apnea cohort (9.36%). Further analysis showed that pneumonia patients are generally older and have comorbidities such as heart diseases, diabetes, dementia, etc. After multivariate adjustment, patients with sleep apnea experienced a 1.20-fold increase in incident pneumonia. Those requiring continuous positive airway pressure (CPAP) experience a greater increase of 1.32-fold. This may be due to the fact that CPAP increases the risk of aspiration or causes an increased pharyngeal secretion. Researchers worry that these conclusions may mislead people into believing that CPAP causes pneumonia, resulting in an unwillingness to use CPAP in those that need it. We need to think of this differently, only those with severe sleep apnea require CPAP, so the increased risk of pneumonia may be correlated with the severity of sleep apnea. We should increase efforts to regularly clean CPAP tubing in order to minimize both the risk of pneumonia and hypoxia from OSA.
With OSA’s far-reaching scope, we suggest those suffering from snoring or similar symptoms to seek help from sleep doctors now. Get the help you need now to prevent further complications.
by Kun-ta, Chou/CEO of the TVGH Center of Sleep Medicine