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Sleeping with the enemy
June 03, 2009It has been linked to learning impairment, stroke and premature death. Now UNSW research has found that snoring associated with sleep apnoea may impair brain function more than previously thought.
Sufferers of obstructive sleep apnoea experience similar changes in brain biochemistry as people who have had a severe stroke or who are dying, the research shows.
A study by UNSW Brain Sciences, published this month in the Journal of Cerebral Blood Flow and Metabolism, is the first to analyse - in a second-by-second timeframe - what is happening in the brains of sufferers as they sleep. Previous studies have focused on recreating oxygen impairment in awake patients.
"It used to be thought that apnoeic snoring had absolutely no acute effects on brain function but this is plainly not true," said lead author of the study, New South Global Professor Caroline Rae.
Sleep apnoea affects as many as one in four middle-aged men, with around three percent going on to experience a severe form of the condition characterised by extended pauses in breathing, repetitive asphyxia and sleep fragmentation.
Children with enlarged tonsils and adenoids are also affected, raising concerns of long-term cognitive damage.
Professor Rae and collaborators from Sydney University's Woolcock Institute used magnetic resonance spectroscopy to study the brains of 13 men with severe, untreated, obstructive sleep apnoea. They found that even a moderate degree of oxygen desaturation during the patients' sleep had significant effects on the brain's bioenergetic status.
"The findings show that lack of oxygen while asleep may be far more detrimental than when awake, possibly because the normal compensatory mechanisms don't work as well when you are asleep," Professor Rae, who is based at the Prince of Wales Medical Research Institute, said.
"This is happening in someone with sleep apnoea acutely and continually when they are asleep. It's a completely different biochemical mechanism from anything we've seen
before and is similar to what you see in somebody who has had a very severe stroke or is dying."
The findings suggested societal perceptions of snoring needed to change, Professor Rae said.
"People look at people snoring and think it's funny. That has to stop."
Professor Rae said it was still unclear why the body responded to oxygen depletion in this way. It could be a form of ischemic preconditioning at work, much like in heart attack sufferers whose initial attack makes them more protected from subsequent attacks.
"The brain could be basically resetting its bioenergetics to make itself more resistant to lack of oxygen," Professor Rae said. "It may be a compensatory mechanism to keep you alive, we just don't know, but even if it is it's not likely to be doing you much good."
The University of New South Wales
"It used to be thought that apnoeic snoring had absolutely no acute effects on brain function but this is plainly not true," said lead author of the study, New South Global Professor Caroline Rae.
Sleep apnoea affects as many as one in four middle-aged men, with around three percent going on to experience a severe form of the condition characterised by extended pauses in breathing, repetitive asphyxia and sleep fragmentation.
Children with enlarged tonsils and adenoids are also affected, raising concerns of long-term cognitive damage.
Professor Rae and collaborators from Sydney University's Woolcock Institute used magnetic resonance spectroscopy to study the brains of 13 men with severe, untreated, obstructive sleep apnoea. They found that even a moderate degree of oxygen desaturation during the patients' sleep had significant effects on the brain's bioenergetic status.
"The findings show that lack of oxygen while asleep may be far more detrimental than when awake, possibly because the normal compensatory mechanisms don't work as well when you are asleep," Professor Rae, who is based at the Prince of Wales Medical Research Institute, said.
"This is happening in someone with sleep apnoea acutely and continually when they are asleep. It's a completely different biochemical mechanism from anything we've seen
before and is similar to what you see in somebody who has had a very severe stroke or is dying."
The findings suggested societal perceptions of snoring needed to change, Professor Rae said.
"People look at people snoring and think it's funny. That has to stop."
Professor Rae said it was still unclear why the body responded to oxygen depletion in this way. It could be a form of ischemic preconditioning at work, much like in heart attack sufferers whose initial attack makes them more protected from subsequent attacks.
"The brain could be basically resetting its bioenergetics to make itself more resistant to lack of oxygen," Professor Rae said. "It may be a compensatory mechanism to keep you alive, we just don't know, but even if it is it's not likely to be doing you much good."
The University of New South Wales
Sleep Apnoea Current Events and Sleep Apnoea News RSSEven mild sleep apnea increases cardiovascular risk
People with even minimally symptomatic obstructive sleep apnea (OSA) may be at increased risk for cardiovascular disease because of impaired endothelial function and increased arterial stiffness, according to a study from the Oxford Centre for Respiratory Medicine in the UK.
Bonn scientists discover new hemoglobin type
Scientists at the University of Bonn have discovered a new rare type of haemo-globin. Haemoglobin transports oxygen in the red blood corpuscles.
REM sleep behaviour disorder is an early marker of neurodegenerative diseases
The front page of the July 2006 issue of The Lancet Neurology, the journal with the highest international impact, contains a work that shows the relationship between disorders during REM sleep and future neurodegenerative pathologies.
Didgeridoo playing improves your sleep
Regular didgeridoo playing reduces snoring and daytime sleepiness, finds a study published online by the BMJ today.
Insomnia Poorly Understood By Medical Profession (p 1959)
ISSUE: 27 November-3 December 2004 EMBARGO: 0001 H (London time) Friday 26 November 2004. In North America the embargo lifts at 6.30pm ET Thursday 25 November 2004.
Is Body Mass Index A Risk Factor For Road Traffic Injuries?
Drivers who are overweight or underweight are at greater risk of suffering an injury in a road accident than people of average size, according to a study of deaths and injuries from motor vehicle accidents in New Zealand. The study appears in the current issue of the International Journal of Epidemiology (IJE), edited in the Department of Social Medicine at the University of Bristol. Dr Gary Whitlock and colleagues studied people who had been seriously injured or killed between 1988 and 1998 while driving a motor vehicle. The subjects were categorised into four groups according to their Body Mass Index (that is their 'weight for height'). The most obese drivers were found to have been twice
THE LANCET Neurology PRESS RELEASE
ISSUE: AUGUST 2002 FOR IMMEDIATE RELEASE
Breathing Support Reduces Blood Pressure For People With Sleep Apnoea (p 204)
A reduction in blood pressure-and in the probable risk of stroke and other cardiovascular disease-could be possible for patients treated with nocturnal breathing support for sleep apnoea, conclude authors of a study in this week's issue of THE LANCET. Obstructive sleep apnoea is a serious condition in which airflow from the nose and mouth to the lungs is restricted during sleep; it is second only to asthma as a cause of chronic respiratory disease. It is characterised by loud snoring, daytime sleepiness (due to poor-quality sleep), and a fall in the oxygen concentration in blood, and is associated with increased blood pressure and a raised cardiovascular risk profile. Untreated sleep apnoea
Treating sleep disorders would reduce risk of serious motor vehicle crashes
Sleep related accidents comprise 15-20% of all motor vehicle crashes, resulting in thousands of serious injuries and death. Yet a study published in Thorax confirms that treatment of patients with sleep apnoea would reduce their risk of serious motor vehicle crashes to a rate similar to the general driving population. Over 200 patients with obstructive sleep apnoea (OSA) were treated with continuous positive airway pressure (CPAP) for at least 3 years. An equal number of randomly selected control drivers were also identified. Using official driving records, motor vehicle collision rates were then compared for 3 years before and after CPAP therapy for both patients and the control drivers. Un
Test of fitness to drive in patients with sleepiness syndrome
A three-year project grant of £61,783 has been awarded by Chest, Heart and Stroke Scotland to Dr Heather Engleman and Professor Neil Douglas of the Centre, which is located in the University of Edinburgh's Respiratory Medicine Unit. The money will enable clinical and psychometric validation work to be performed on an objective test of driving skill, developed in collaboration with the University of Sydney. Explained Dr Engleman: "Sleepiness produces greater impairment of driving performance than alcohol intoxication, and has overtaken alcohol as a major cause of injury and death on the roads. The most common medical cause of daytime sleepiness is the sleep apnoea/hypopnoea syndrome (SA
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Obstructive Sleep Apnoea by Jonas T. Johnson (Author), Jack L. Gluckman (Author), Mark H. Sanders (Author) Univ. of Pittsburgh, PA. Textbook addresses the current state-of-the-art in the diagnosis and management of snoring and obstructive sleep apnea. Illustrated. |
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ISO 17510-1:2002, Sleep apnoea breathing therapy - Part 1: Sleep apnoea breathing therapy devices by ISO/TC 121/SC 3 (Author) For ISO 17510-1:2002, the scope given in clause 1 of EN 60601-1:1990 + A1:1993 and A12:1993 applies with the following addition.ISO 17510-1:2002 specifies requirements for devices intended for sleep apnoea breathing therapy for domiciliary use and for use in healthcare institutions.ISO 17510-1:2002 is not applicable to jet and very high frequency ventilation and oscillation.ISO 17510-1:2002 is not applicable to devices covered by the scope of the EN 794 series.ISO 17510-1:2002 is not applicable to external body ventilators as defined in ISO 4135.NOTE Masks and application accessories are addressed in ISO 17510-2. |
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ISO 17510-2:2003, Sleep apnoea breathing therapy - Part 2: Masks and application accessories by ISO/TC 121/SC 3 (Author) ISO 17510-2:2002 specifies requirements for masks and accessories which are required to connect the patient connection port to a sleep apnoea breathing therapy device and the mask to a patient, and are used for the application of sleep apnoea breathing therapy, e.g. nasal masks, gas exhaust ports, connecting elements and headgear.ISO 17510-2:2002 does not cover oral appliances.NOTE 1 Sleep apnoea breathing therapy devices are covered by ISO 17510-1 (see A.1 for typical elements of the two parts of ISO 17510).NOTE 2 Annex A contains rationale statements for ISO 17510-2:2002. This title may contain less than 24 pages of technical content. |
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Obstructive sleep apnoea and breathing retraining.(clinical update): An article from: Australian Nursing Journal by Mary Birch (Author) This digital document is an article from Australian Nursing Journal, published by Australian Nursing Federation on August 1, 2004. The length of the article is 2406 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Obstructive sleep apnoea and breathing retraining.(clinical update) Author: Mary Birch Publication: Australian Nursing Journal (Refereed) Date: August 1, 2004 Publisher: Australian Nursing Federation Volume: 12 Issue: 2 Page: 27(3) Distributed by Thomson... | |
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Sleep, health and the dynamics of biomedicine [An article from: Social Science & Medicine] by T. Moreira (Author) This digital document is a journal article from Social Science & Medicine, published by Elsevier in 2006. The article is delivered in HTML format and is available in your Amazon.com Media Library immediately after purchase. You can view it with any web browser. Description: This paper examines the relationship between sleep and health from a sociological perspective. Two interrelated case studies are explored: the emergence of the category of obstructive sleep apnoea syndrome, nowadays the most commonly diagnosed sleep disorder, and the shaping of continuous positive airway pressure, the therapy of choice for sleep apnoea in contemporary clinical practice. Data were gathered through a historical review of relevant literature and observation of online patient discussion groups.... |
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Obstructive sleep apnoea and allied disorders by Andrew K Fraser (Author) | |
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Coping with Snoring and Sleep Apnoea by Jill Eckersley (Author) | |
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Systematic Review on Obstuctive Sleep Apnoea: Its Effect on Health and Benefit of Treatment by John Wright (Author), Rachel Dye (Author) | |
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Management of Obstructive Sleep Apnoea / Hypopnoea Syndrome in Adults: A National Clinical Guideline by Scottish Intercollegiate Guidelines Network (Publisher) | |
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Coping with Snoring and Sleep Apnoea by Jill Eckersley (Author) |
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