Sufficiently good sleep is essential for our health. Three new studies show how dramatic sleep disorders can be. These have dealt with the health damage that can result from obstructive sleep apnea.
Around 900 million people worldwide suffer from it obstructive sleep apnea (OSA), in Germany there are about 26 million (as of 2019).1 The sleep of those affected is impaired by breathing pauses and snoring – with drastic consequences for their health. At the European Respiratory Society International Congress (ERS) in Barcelona (Spain), scientists presented three studies on the subject.2,3 They found that snorers have an increased risk of mental decline, blood clots and cancer.
sleep apnea and cancer risk
Scientists from Uppsala University in Sweden compared data from 62,811 sleep apnea patients with data from the Swedish Cancer Registry. Influencing factors such as height, other medical history and socioeconomic status were also taken into account. In a further step, the researchers compared 2093 cancer patients with sleep apnea (documented up to five years before cancer diagnosis) with 2093 sleep apnea sufferers without cancer. The severity of the OSA was also measured. To do this, those responsible for the study used either the apnea-hypopnea index (AHI) or the oxygen desaturation index (ODI).
While the AHI records the number of breathing disorders during sleep, the ODI indicates how often per hour the oxygen content in the blood falls by at least three percent for ten seconds or more.
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Cancer patients had more severe obstructive sleep apnea
“We found that cancer patients had slightly more severe OSA – measured by an average apnea-hypopnea index of 32 versus 30 and an oxygen desaturation index of 28 versus 26,” said Dr. Andreas Palm the study results. “In a further analysis of subgroups, the ODI in patients with lung cancer (38 vs. 27), prostate cancer (28 versus 24) and malignant Melanoma (32 versus 25) higher.”
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Snoring can be a risk factor for cancer
The Swedish researchers conclude that untreated obstructive sleep apnea is a risk factor for cancer. In addition, their results have shown that the degree of oxygen deprivation caused by OSA is associated with cancer. So far it has been known that OSA and cancer could be connected. However, it was assumed that the cause was more indirectly related to the sleep disorder associated with snoring, but rather to the health consequences such as overweight or cardiovascular diseases have lain. What the study could not prove due to the study design: a causal connection between OSA and cancer. Palm and his team are now striving for further research.
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Snoring impairs cognitive functions
A second study on the effect of snoring on health comes from the University Hospital of Lausanne (Switzerland). There, Prof. Raphaël Heinzer, Dr. Nikola Marchi and her team People aged 65 and over who were part of the ongoing CoLaus/PsyCoLaus and HypnoLaus studies. 358 participants underwent a sleep test at the beginning of the respective study. In this way, the scientists responsible determined whether sleep apnea was present and, if so, how severe it was.
Twice, five years apart, the researchers tested the mental processing abilities of the test subjects in follow-up examinations. Part of the cognitive assessment were functions such as knowledge and reasoning, processing speed (understanding and responding to new information), ability to organize, prioritize and make decisions (executive functions) of thoughts and activities. Verbal memory, language and the visual perception of spatial relationships between objects were also included in the assessment of the cognitive state.
Low oxygen levels during sleep have consequences for the brain
In summary, when the Swiss research team analyzed their study data, they concluded that OSA was associated with greater declines in mental processing ability over a five-year period.
“We found that OSA, and specifically low oxygen levels during sleep due to OSA, is associated with greater declines in global cognitive function, processing speed, executive functioning, and verbal memory,” explained Dr. Marchi at the congress. “We also found that people aged 74 years and older, as well as men, were at higher risk of cognitive decline due to sleep apnea on some specific cognitive tests.”
The tests mentioned included a test of verbal fluency, which only showed a greater deterioration in the skills measured in men but not in women. According to those responsible for the study, further research is needed to better understand why some sleep apnea patients – e.g. B. Men vs. Women – more or less of the mental decline appear to be affected.
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Increased risk of blood clots
A third study that was able to prove a connection between snoring or sleep apnea and damage to health comes from France. She studied 7,355 sleep apnea patients, with a follow-up period of six years. Using the sleep apnea-hypopnea index (AHI) and markers for nocturnal oxygen deficiency, the researchers assessed the severity of their subjects’ OSA. 104 patients developed venous thromboembolism (VTE).
Analysis of the study data revealed that patients with severe OSA were more likely to have one blood clot developed in the deep veins than people with less severe insomnia.
“This is the first study to investigate the association between obstructive sleep apnea and the occurrence of unprovoked venous thromboembolism,” summarized study leader Professor Trzepizur from Angers University Hospital. “We found that those who spent more than 6 percent of their nighttime hours with blood oxygen levels below 90 percent of normal had an almost double risk of developing VTEs compared to patients who were not oxygen-deprived.”
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Untreated obstructive sleep apnea is a health hazard
Prof. Winfried Randerath from the Bethanien Hospital at the University of Cologne, who was not involved in the studies but is the leader of the ERS specialist group on sleep-disordered breathing, drew the following conclusion from the research presented at the congress: “These three studies show worrying associations between obstructive sleep apnea and major diseases affecting survival and quality of life. The data demonstrate the importance of sleep apnea for cancer, venous thromboembolism and mental health.”
When it comes to health, snoring – a classic symptom of OSA – is no joke. The expert went on to emphasize that even if further research is necessary to prove a causal connection, it is important that people with sleep problems are informed. If there is a justified suspicion or a diagnosis of obstructive sleep apnea, treatment is essential.