Over the last 20 years, there has been a steady increase in the number of patients diagnosed with obstructive sleep apnea (OSA). Characteristics of OSA include frequent starts and stops in breathing during sleep. Nearly 100 million people around the world have this condition, and experts estimate that it goes undiagnosed 80-90% of the time. Additionally, the primary risk factors associated with OSA – obesity and advanced age – are steadily increasing as well. There is concern about these increases because sleep apnea may decrease health span by exacerbating neurodegenerative and cardiovascular diseases. This information was discussed in an Opinion article out of Portugal. The article was published this month in Trends in Molecular Medicine.
Co-author of the article, Claudia Cavadas, from the Center for Neuroscience and Cell biology at the University of Coimbra, noted that this paper was written to attempt to piece together data that obstructive sleep apnea speeds up age-related decline. This topic has been a controversial debate in the industry, but it has also stimulated extensive research. These researchers believe that treating OSA progression will improve quality of life, as well as delay age-related health decline.
Anyone can develop sleep apnea. The disease does not discriminate against age, sex, or body type. Symptoms include choking or gasping during sleep when the airway suddenly closes or tightens. OSA is often misdiagnosed or mistaken for snoring. In OSA, however, the tightening of the airway leads to less oxygen reaching the brain. This jolts the person awake to try and normalize oxygen levels. Episodes can occur up to 30 times an hour, lasting anywhere from a few seconds to several minutes. The first line of treatment for OSA is the continuous positive airway pressure (CPAP) machine, which delivers pressured air through a face mask into the airway to help keep them open throughout the night.
If left untreated, OSA can lead to health problems associated with poor sleep, including excessive daytime fatigue, memory loss, problems with concentration, and morning headaches. Additionally, recent research has suggested that untreated OSA may be linked to serious age-related conditions like metabolic syndrome, Parkinson’s Disease, dementia, Alzheimer’s disease, type 2 diabetes, and non-alcoholic liver disease. There is much debate as to how OSA is linked to these conditions; however, Ms. Cavadas and her team suggest that the frequent dips in blood oxygen levels and interrupted sleep may lead to:
- Stem cell exhaustion
- Increased inflammatory response
- Epigenetic changes
Authors propose that the field and link between age-related disease and OSA needs additional research to distinguish between the causal and correlative observations. The increasing rates of undiagnosed cases and insufficient public awareness about OSA create a difficult obstacle to overcome.
Cavadas and her team are working on identifying the biomarkers that will help them and other scientists individualize the diagnosis, which will increase the efficacy of treatment. The primary goal of Cavadas and her team is to dissect subtypes of sleep apnea. They believe this is the next step in understanding more about OSA. These subtypes will likely be defined by pathophysiological mechanisms, which may show several predispositions to other medical comorbidities. As life expectancy continues to increase, scientists believe it is critical to our culture to figure out how to delay age-related diseases.