“Most clinicians, and even experts in the sleep apnea world, have not typically focused on fat in the tongue for treating sleep apnea,” said Richard Schwab, MD, chief of Sleep Medicine. “Now that we know tongue fat is a risk factor and that sleep apnea improves when tongue fat is reduced, we have established a unique therapeutic target that we’ve never had before.”
From the research article abstract:
Weight loss reduced volumes of several UA soft tissues in persons with obesity and OSA. Improved AHI with weight loss was mediated by reductions in tongue fat. New treatments that reduce tongue fat should be considered for patients with OSA.
- Stephen H. Wang, Brendan T Keenan, Andrew Wiemken, Yinyin Zang, Bethany Staley, David B. Sarwer, Drew A. Torigian, Noel Williams, Allan I Pack, Richard J Schwab. Effect of Weight Loss on Upper Airway Anatomy and the Apnea Hypopnea Index: The Importance of Tongue Fat. American Journal of Respiratory and Critical Care Medicine, 2020; DOI: 10.1164/rccm.201903-0692OC
Wait for it. A plethora of diet and weight loss books for your tongue.
In a five-year study of nearly 11,000 people, those with obstructive sleep apnea had a higher risk of sudden cardiac death. At greatest risk were those aged 60 and older with moderate to severe apnea (20 episodes an hour).
When their oxygen saturation levels dipped below 78 percent — preventing air from flowing into the lungs — their risk increased by 80 percent.
Memo to Underwriters:
In case anyone asks why we are so harsh on untreated OSA quote this study.
Article link here.
Link to the study abstract here.
During an average follow-up of 5.3 years, 142 patients had resuscitated or fatal SCD (annual rate 0.27%). In multivariate analysis, independent risk factors for SCD were age, hypertension, coronary artery disease, cardiomyopathy or heart failure, ventricular ectopy or nonsustained ventricular tachycardia, and lowest nocturnal O2sat (per 10% decrease, hazard ratio [HR]: 1.14; p = 0.029). SCD was best predicted by age >60 years (HR: 5.53), apnea-hypopnea index >20 (HR: 1.60), mean nocturnal O2sat <93% (HR: 2.93), and lowest nocturnal O2sat <78% (HR: 2.60; all p < 0.0001).
In a population of 10,701 adults referred for polysomnography, OSA predicted incident SCD, and the magnitude of risk was predicted by multiple parameters characterizing OSA severity. Nocturnal hypoxemia, an important pathophysiological feature of OSA, strongly predicted SCD independently of well-established risk factors. These findings implicate OSA, a prevalent condition, as a novel risk factor for SCD.
Sleep apnea, left untreated for even a few days, can increase blood sugar and fat levels, stress hormones and blood pressure, according to a new study of sleeping subjects. A report of the study’s findings, published in the August issue of The Journal of Clinical Endocrinology & Metabolism, adds further support for the consistent use of continuous positive airway pressure (CPAP), a machine that increases air pressure in the throat to keep the airway open during sleep.
Jun emphasized that the study was limited by studying people with severe OSA and obesity, thus limiting the ability to apply the findings to all OSA patients. The researchers also did not compare CPAP use to a sham CPAP control group to exclude a potential placebo effect
Source: Untreated sleep apnea shown to raise metabolic and cardiovascular stress — ScienceDaily
Researchers in Connecticut have found that obstructive sleep apnea (OSA) in patients with atrial fibrillation (AF) appears to be an independent predictor of stroke.
via Obstructive Sleep Apnea, Atrial Fibrillation, and Stroke | Physician’s Weekly.
Sleep Apnea Linked to Cancer.
Moderate-to-severe OSA was associated with a 2.5-fold higher likelihood of incident cancer (95% CI 1.2-5.0) after adjustment for obesity and a full range of other factors, Nathaniel Marshall, PhD, of the University of Sydney Nursing School in Australia, and colleagues found.
Cancer mortality was 3.4 times more common (95% CI 1.1-10.2) in those with sleep apnea than with no sleep apnea during 20 years of follow-up, they reported in the April 15 issue of theJournal of Clinical Sleep Medicine.
OSA is independently associated with DN in type 2 diabetes. eGFR declined faster in patients with OSA. Nitrosative stress may provide a pathogenetic link between OSA and DN. Interventional studies assessing the impact of OSA treatment on DN are needed.
via Obstructive Sleep Apnea and Diabetic Nephropathy.
An estimated 20% to 50% of commercial drivers have sleep apnea. That high proportion may be in part due to the sedentary nature of long-haul trucking that contributes to obesity as a risk factor for sleep apnea, according to a statement from the American Academy of Sleep Medicine in support of federal legislation.
via Sleep Apnea Plays Role in Car Crashes.
Presented without the usual caustic comment.