Obstructive sleep apnea, often a result of being overweight, is a condition that is linked to heart disease, liver disease and type 2 diabetes.
Dmitriy Kruglyak who hosts the www.trusted.md site, asked me in December to listen to a webinar put out by the drug company Cephalon on their sleep apnea / narcolepsy drug, Provigil, and to blog about it. As you can see, I’m a little behind in my commitments! Obstructive sleep apnea is a condition that affects 18 million Americans, and is linked to heart disease, congestive heart failure, stroke, diabetes, metabolic syndrome, depression, liver disease, not to mention various cognitive impairments, so beyond the obvious problems of fatigue and inability to function well due to lack of sleep, sleep apnea has far-reaching health consequences. Good sleep is one of the foundational health principles – one simply CANNOT be healthy without adequate sleep.
Obstructive sleep apnea is a condition that is caused by a blockage in the airway during sleep resulting in a stoppage of breathing for short periods of time, several times a night. The blockage is usually caused by the tongue or the tonsils falling back in the throat when the sleeper is on his/her back, resulting in snoring at best, and a complete airway blockage at worst. This leads to lowered levels of blood oxygen, resulting fluctuating heart rates and blood pressure in an effort to deliver the required oxygen to the body. The disruption in sleep in addition to the lowered blood oxygen, increases sympathetic load (chronic body stress) and all that that entails. Obesity is the biggest cause of the problem, with food sensitivity, especially to gluten and dairy being another potential cause. Diagnosis usually involves going to a sleep clinic for a sleep study. Obstructive sleep apnea (OSA) is chronically under-diagnosed – 1 in 5 adults have mild OSA, and 1 in 15 has moderate OSA, and often the bed partners of those with sleep apnea are also sleep deprived due to the noise of the snoring. So, it is quite probable that as many as 1 in 3 adults are not getting enough sleep. The health implications for the population are staggering!
The "symptom relief" treatment for obstructive sleep apnea that works well is Continuous Positive Airway Pressure (CPAP). The sleeper wears a mask which delivers oxygen at a pressure that keeps the tongue and tonsils from sliding back and blocking the airway, effectively preventing the stoppages in breathing and allowing for a better sleep. But as soon as the treatment is stopped, sleep apnea returns, so CPAP can only be considered a "sleep apnea management system." It does not deal with the cause. In my opinion, to address the cause of sleep apnea, one can reduce bodyweight by staying away from all processed and fast food, sugar, flour products (baked goods, pasta, crackers etc.) and polyunsaturate vegetable oils, find out what ratios of carbohydrates, proteins and fats are right for one's biochemistry (metabolic typing) and eat accordingly, and exercise regularly. It may be worth going to one's physician to be tested for food sensitivities, and remove those foods from one's diet as well.
I thought it took a lot of guts for a pharmaceutical company to invite bloggers and other media to a webinar about a drug. By doing this, they are not able to control the message that is put out to the public, but by the same token, it is a realization that social media is here to stay, and controlling a message may no longer be possible in today's world, so why not embrace the new technology, and be as transparent as possible. I thought the information the company gave was very balanced – they came right out and said that their drug, Provigil does not address the cause of sleep apnea at all, but rather, provides a way to cope with daytime sleepiness.
As one who deals with a major sleep problem many nights of the week (although not from sleep apnea), I know what it feels like to struggle through a day with that dizzy feeling near the front of the forehead, the lethargy, and the inability at times to think straight. It is not an enjoyable feeling. Would I take a drug like Provigil? I don't think so. The researchers did not seem able to explain very well how the drug works, and so I would be concerned as to the chain reaction that it caused in the body. What does it do to cortisol, for example?? Drugs usually affect one part of our physiology which provides symptom relief, but then the part that is altered by the drug affects other parts and so on and so on. Which is why we get side-effects, and possible disease processes from the alterations in the normal physiology. Even though the journey may be longer, I feel it is safer to resolve the underlying cause of the problem through diet and lifestyle modification, and if deemed necessary through functional medical testing, appropriate supplementation.
Is going to bed too late making you fat?
Light pollution messes with our hormones
Respiration – the BIG boss
Food sensitivities, digestive problems and joint pain
Cortisol, our stress hormone
Dmitriy Kruglyak Cephalon Reaches Out to Health Bloggers: Join the Webcast on December 13
Fri, 12/07/2007 – 12:41pm
Provigil Patient Info
Provigil Prescribing Info
Kenji Minoguchi et al. Silent Brain Infarction and Platelet Activation in Obstructive Sleep Apnea American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 612-617, (2007)
Sanjay R. Patel et al. Association between Reduced Sleep and Weight Gain in Women American Journal of Epidemiology 2006 164(10):947-954
Tanné F et al. Chronic liver injury during obstructive sleep apnea Hepatology 2005 Jun;41(6):1290-6.
Schäfer H et al. Body fat distribution, serum leptin, and cardiovascular risk factors in men with obstructive sleep apnea. Chest 2002 Sep;122(3):829-39.
McArdle N et al.Metabolic risk factors for vascular disease in obstructive sleep apnea: a matched controlled study. Am J Respir Crit Care Med. 2007 Jan 15;175(2):190-5. Epub 2006 Oct 26.
Ip MS et al. Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med. 2002 Mar 1;165(5):670-6.
Oğretmenoğlu O et al. Body fat composition: a predictive factor for obstructive sleep apnea. Laryngoscope 2005 Aug;115(8):1493-8.
Copyright 2008 Vreni Gurd