Obstructive sleep apnea (OSA) is a serious condition that affects the quality of life and can lead to drowsy driving and depression. There is also a correlation between OSA and metabolic disease, and a link between OSA and cognitive impairment.
OSA is diagnosed based on the number of apneic or hypopneic episodes per hour of sleep. This is called the apnea-hypopnea index (AHI) and it is recorded while the patient is asleep.
The patient will be diagnosed with OSA if the AHI is 15 or more per hour or if it is 5 or more per hour and it is followed by one or more of the following features:
- Nonrestorative sleep
- Fatigue or insomnia
- Waking up with breath-holding spells or gasping
- Snoring or breathing interruptions
OSA may co-exist with a diagnosis of hypertension, mood disorder, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, atrial fibrillation, or type 2 diabetes.
Many people that have AHI less than 15 per hour can also have OSA, due to the number of coexisting medical conditions.
There are many negative consequences of OSA that are not well-known, such as poor quality of life, drowsy driving, depression, metabolic disease, and cognitive impairment.
Quality of Life
The biggest problems that contribute to the poor quality of life of patients with OSA are excessive daytime sleepiness, inattention, and fatigue. They increase the risk of accidents and medical disability, and they are the most common reasons why people seek medical help for sleep disorders.
The good news is that treatment for OSA can significantly improve the quality of life. In a study of patients with the most impaired quality of life who got the positive airway pressure (PAP) therapy had drastically improved their quality of life and symptoms such as sleepiness.
Drowsy driving by people with OSA can lead to motor vehicle accidents which bring economic and health problems. National Center for Statistics and Analysis data show that of 6 million motor vehicle accidents, 1.4% includes drowsy driving and 2.5% of fatal crashes include drowsy driving.
The chances of traffic accidents in drivers with untreated OSA are six times bigger than in the general population.
Treatment for OSA is successful in reducing the incidence of motor vehicle accidents. One study suggests that the risk of motor vehicle accidents was eliminated with the use of CPAP treatment in patients with OSA.
Depression and OSA have some symptoms in common, like daytime sleepiness, fatigue, loss of energy, poor concentration, irritability, psychomotor retardation, and weight gain.
It is estimated that depression rates in patients with OSA range from 5% to 63%.
Studies have also found that patients on antidepressants can have an increased risk of OSA.
The Patient Health Questionnaire (PHQ-9) shows that the treatment of OSA improves symptoms of depression.
After three months of CPAP therapy, the PHQ-9 scores decreased remarkably.
OSA is linked with metabolic disorders, including metabolic syndrome.
Metabolic syndrome increases one’s risk of diabetes and cardiovascular disease and overall mortality. The risk of metabolic syndrome is bigger with more severe OSA.
Hypertension or high blood pressure is one of the conditions encompassed in metabolic syndrome. Studies show that patients who used CPAP had a 30% decrease in the incidence of hypertension.
OSA is linked to cognitive impairment, and data suggest it may advance cognitive decline.
Women with OSA are more likely to develop mild cognitive impairment compared with women without OSA.
Improvement in memory, attention, and executive function were noted after the CPAP treatment in patients with OSA.
OSA is a serious condition with far-reaching consequences. Treatment of OSA improves many of the above-mentioned health consequences.