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Tuesday, 13 July 2010 23:19

Sleep problems cause heart problems in older men


A July 2010 paper published in the journal Circulation shows that middle-aged men with snoring and breathing disturbances, what is called sleep apnea, during sleep time have increased risk from heart disease and heart failure.


The paper 'Prospective Study of Obstructive Sleep Apnea and Incident Coronary Heart Disease and Heart Failure. The Sleep Heart Health Study' was published in the journal Circulation.

A total of 4,422 middle-aged men and women (1,927 men and 2,495 women 40 years of age or older) took part in the U.S. study.

They were assessed as to the relationship between obstructive sleep apnea (OSA, a sleep apnea in which an obstruction of the airway occurs, which results in pauses in breathing during sleep) and the incidences of coronary heart disease and heart failure.

At the time the study started all of the participants did not have any known problems from coronary heart disease or heart failure. They were analyzed for around 8.7 years.

At the end of the period, the researchers found that ''¦ obstructive sleep apnea was a significant predictor of incident coronary heart disease (myocardial infarction, revascularization procedure, or coronary heart disease death) only in men  70 years of age '¦ but not in older men or in women of any age.' [Paper]

The researchers found that:

'¢    For men 40 to 70 years of age, those with a apnea-hypopnea index [AHI]) of over 30 were 68% more likely to develop coronary heart disease than those same aged men with an AHI of less than 5.

Apnea-hypopnea index is an index of severity that combines apneas and hypopneas for a combined measure of severity. Values of 5 to 15 are mild apneas and hypopneas, 15 to 30 are moderate, and above 30 are severe.

Page two describes other results from the study.



The U.S. researchers also found:

'¢    Obstructive sleep apnea predicted incident heart failure in men but not in women.

'¢    Men with AHI values equal to or more than 30 were 58% more likely to develop heart failure than those with AHI values less than 5.

The July 12, 2010 Business Week article 'Sleep Apnea Could Raise Heart Risks for Older Men' quotes Dr. Daniel Gottlieb, from the Boston University School of Medicine and one of the authors of the study.

Dr. Gottlieb stated in the article, 'The key here is that there is a lot of undiagnosed sleep apnea, and that, at least in men, it is associated with the development of coronary heart disease and heart failure. Only about 10 percent of sleep apnea cases are diagnosed.'

Dr. Jordan S. Josephson, from the Lenox Hill Hospital in New York City, a sinus, snoring and sleep apnea specialist but not one of the authors, stated, "'¦ it brings a greater awareness to the public about sleep apnea.' [Business Week]

Josephson added, 'Sleep apnea is [also] the number one medical cause for divorce and the ending of partnerships.' [Business Week]

Page three concludes with comments from another member of the study.



Dr. Stuart Fun Quan, from the Harvard Medical School in Boston, Massachusetts, and another author from the study, added, 'The study suggests that sleep apnea, at least in men, is a potentially remediable cause of coronary heart disease and heart failure.' [Business Week]

The researchers concluded that 'Obstructive sleep apnea is associated with an increased risk of incident heart failure in community-dwelling middle-aged and older men; its association with incident coronary heart disease in this sample is equivocal.' [Paper]

The paper's U.S. authors are: Daniel J. Gottlieb, Gayane Yenokyan, Anne B. Newman, George T. O'Connor, Naresh M. Punjabi, Stuart F. Quan, Susan Redline, Helaine E. Resnick, Elisa K. Tong, Marie Diener-West, and Eyal Shahar.



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