Sleep Apnoea - The Noisy Assassin
Channel: York Cardiology
Date: 14/08/2022

Sleep Apnoea - The noisy assassin

Much of modern day medicine is about masking symptoms of nefarious underlying conditions rather than identifying and treating the root cause of the problem. I believe that ‘conditions’ such as hypertension, diabetes, fatty liver, and even cardiovascular disease are not conditions as such but rather outwardly manifesting symptoms of chronic low grade inflammation within the body which has been left unidentified and unchecked for several years. Much of this low grade inflammation could be attributed to modern day lifestyle choices. We eat the wrong stuff -and not because we choose the wrong stuff but because a lot of food is already adulterated before it is put in front of us, we have become more sedentary, we do not get enough rest and we are all more stressed now then we have ever been. Imagine buying a new car, putting in low quality fuel in it, overloading it daily and driving it excessively fast for prolonged periods of time without allowing the engine to cool down enough. Would it surprise anyone if that car started developing faults earlier than expected?  Unfortunately by the time the car starts developing faults, two things are clear. Firstly the damage is done and therefore it is impossible to reverse the damage and secondly, more faults will start manifesting and they will start doing so with increasing frequency.The same can be said for our bodies. By the time these conditions are identified, you are already on a very slippery slope. It is therefore very important to be vigilant and identify faults in our lifestyles which could be causing inflammation before that inflammation manifests as a medical ‘condition’. 

Unfortunately we can not rely on health care professionals any more. Most healthcare professionals aren’t healthcare professionals. They are sickness care professionals. They are interested in your sickness - not in your health. If you look healthy, they are not interested. This is a shame because healthcare should be about preserving health rather than taking an interest in the patient only after they have lost their health. Unfortunately we live in a world where your sickness is a lot more profitable than your health.

Today I wanted to talk about a condition that is rapidly becoming a global epidemic and yet remains remarkably under-recognised and under-diagnosed. Unfortunately many doctors don’t think about it and even when they do, they sometimes use the wrong tools to decide whether the patient may be suffering from the condition or not. This is a condition which can present with non-specific symptoms, but if left untreated will substantially increase the risk of virtually all chronic conditions including hypertension, diabetes, cardiovascular disease, strokes and dementia.

Obstructive sleep apnoea is a potentially serious sleep disorder which causes breathing to repeatedly stop and start during sleep. It happens when the muscles and soft tissue in the throat relax and collapse sufficiently to cause a total blockage of the windpipe. People with sleep apnoea will experience repeated airway blockages throughout the night. During each episode the effort to breath in against the blocked airway lighten sleep or even causes awakening enabling the airway to open so breathing resumes. This can happen several times an hour and is exceptionally stressful for the body at a time when the body is meant to be relaxing. This stress will then start manifesting as headaches, irritability, a predeliction for sweet foods and caffeine and then with obesity, hypertension, diabetes, vascular disease, heart rhythm abnormalities and even sudden death
 
Why is it important?
Obstructive sleep apnoea can significantly shorten life-span and also impair quality of life.
 
How common is it?
15-30% of all males
10-15% of all females
 
Does sleep apnoea only affect the obese?
It is a common misconception that sleep apnoea only affects the obese. Whilst it is true to say that it is more prevalent in the obese, it is also not uncommon in the non-obese. A recent research paper -Gray et al; 2017  in the journal of sleep medicine looked at the prevalence of sleep apnoea in the non-obese found that almost 5% of non-obese men and 1% of non-obese women between the ages of 30-49 years had sleep apnoea and more worryingly these figures rose to 14% and 5% respectively in non-obese patients aged 50-70 years. Generally speaking 20% of all patients with sleep apnoea are not obese. 

In another interesting study published in the American journal of cardiology Luyster et al; 2014- found that non-obese patients with sleep apnoea were found to have a 2.7 fold higher chance of having coronary artery disease compared to age-matched patients who did not have sleep apnoea.
 
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