Obstructive Sleep Apnea Almost Doubles the Risk of Sudden Death
A large analysis of 22 studies with 42099 subjects showed that obstructive sleep apnea (OSA) almost doubles the risk of sudden death. The risk of sudden death of any cause was increased by 74%, and the risk of cardiovascular deaths by 95%.
The authors looked at all studies of risk of death with OSA through January 1, 2020. Twenty-two studies were included in the final analysis. The mean age of subjects was 62 years, and 64% being men. Mild OSA increased the risk of sudden death by 16%. Moderate OSA caused a 72% increase in risk of sudden death. Severe OSA caused a 187% increase in risk of sudden death. In other words, patients with severe OSA were almost three times as likely to die suddenly as subjects without OSA. The increase in risk of sudden death seems to increase with age.
Reasons for OSA increasing risk of death
OSA causes or worsens high blood pressure, coronary artery disease, congestive heart failure, arrhythmias, and strokes. There is recurrent drop in oxygen levels during sleep in OSA patients. This causes over-arousal of the nervous system (especially the sympathetic nervous system). It also causes release of inflammatory chemicals. This increases inflammation all over the body, including the blood vessels, heart and brain. It also causes oxidative stress injury of cells all over the body, including the blood vessels, heart and brain. Changes in chemicals associated with clotting cause more clotting, which can cause atherosclerosis and heart attacks. Diabetes gets worse. All of these mechanisms may play a role in OSA causing sudden death.
Mild OSA does not increase risk of sudden death significantly. Mild OSA may not need treatment unless the patient is excessively sleepy during the day. However, we should treat moderate to severe OSA regardless of other symptoms. Treatment is likely to decrease the risk of sudden death in patients who adhere to treatment. We have published data showing we are able to assist our patients in achieving the best adherence rate to treatment.
If you snore loudly, have been told you stop breathing in sleep, or are sleepy during the day, call us to schedule an appointment and see if we can help you live a longer and better life.