The American Journal of Respiratory and Critical Care Medicine have just published a study that turns the conventional wisdom surrounding sleep apnea on its head.
Up until now, scientists have believed that people suffering the most severe cases of sleep apnea were the most likely to die from related diseases, such as a stroke or heart attack.
But these researchers have now discovered a new mechanism for measuring the type of sleep apnea that poses the greatest risk of death. And it’s not one that we would’ve guess.
The apnea-hypopnea index measures the number of apneas (pauses in breathing) and hypopneas (periods of shallow breathing) during a sleeper’s night. Those with the highest number of these events suffer from the most severe case of sleep apnea, and these could pose the greatest health and death risk.
After examining 5,712 people, with an average age of 63, who participated in the National Heart, Lung, and Blood Institute’s Sleep Heart Health Study, the scientists found that people categorized as suffering from moderate sleep apnea on the apnea-hypopnea index had the greatest risk of dying with the span of the 11-year follow-up period.
Realizing that this was contradictory to previous research, they dug through the data to find other factors that could provide a better explanation for the deaths. And they found it.
Turns out it was not the greatest number of apneas and hypopneas that posed the greatest risk of death, but rather, the length of the apneas and hypopneas.
The people who had experienced the shortest pauses in breathing and the shortest periods of shallow breathing were the most likely to die.
To be precise, they discovered that:
1. People with the shortest breathing disturbances were 31% more likely to die when compared to those with longer disturbances.
2. Among the subjects categorized with suffering from moderate sleep apnea on the apnea-hypopnea index, those with short breathing disturbances were 59% more likely to die as compared to those with longer disturbances.
This is interesting, as we would have suspected that those with the longest apneas and hypopneas are at greater risk of poor health.
But the scientists speculated that short breathing disruptions might be more severe because they indicated that sleepers wake up more often to manually resume normal breathing.
If sleepers spend the whole night so close to their arousal threshold, then their sleep would be extremely fragmented, with higher sympathetic nervous system activity and consequent high blood pressure.
In fact, the polysomnography sleep studies that sleep apnea sufferers currently undergo already contain information on the duration of breathing events. Scientists just need to begin to use it.
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