Women Suffer From Sleep Apnea, Raised Heart Risks, Too
MONDAY Jan. 16, 2012 -- Just as it does in men, obstructive sleep apnea can raise the risk for women of dying from heart attacks and having other cardiovascular problems, a new Spanish study indicates.
However, treating severe apnea at night with a system called CPAP -- continuous positive airway pressure -- can also help reduce the risk of heart attack deaths in women with apnea, just it can in men, the researchers report.
Sleep apnea -- characterized by repeated interruptions of breathing during sleep -- affects many more men than women, but up to 3 percent of middle-aged women have the disorder. One common symptom is snoring. Most patients have daytime sleepiness because of the sleep disorder. However, little research has focused on women until now.
"Women with untreated severe obstructive sleep apnea have a three-and-a-half-fold increase in the risk of dying from cardiovascular disease compared to women without [it]," said researcher Dr. Francisco Campos-Rodriguez, director of the sleep-disordered breathing unit at Valme University Hospital in Seville.
However, he found that treatment with CPAP in the women with severe apnea reduced that risk. The study is observational, so the researchers cannot say whether the apnea caused the increased rates of death or whether it was the CPAP that reduced that risk.
The study is published in the Jan. 17 issue of the Annals of Internal Medicine.
The researchers followed 1,116 middle-aged women, all sent to sleep medicine clinics in Spain for suspected apnea. The researchers determined whether they had the condition, measured the severity of the apnea, and divided them into mild-to-moderate or severe groups. Some in each group received CPAP treatment and some did not.
Those found not to have sleep apnea served as the comparison or control group.
They followed the women for up to 88 months (more than seven years). At the end, 41 patients, about 4 percent, had died of cardiovascular problems and 3 percent of other causes.
Deaths from cardiovascular problems were more frequent in women who had apnea that was not treated, especially when it was severe. Those who were treated with CPAP had cardiovascular disease death rates similar to those without apnea.
Of the 41 deaths from cardiovascular disease, 18 were in the group with severe and untreated apnea, while 8 of those with severe but treated apnea died of cardiovascular problems during the follow-up.
"We have provided the first evidence in the [medical] literature that severe OSA is associated with cardiovascular mortality in women, and that CPAP treatment is associated with a decrease in mortality risk," Campos-Rodriguez said.
CPAP treatment delivers a pre-set level of pressurized air through a mask that the patient wears during sleep. Because apnea is a chronic disorder, in most cases the CPAP is a lifelong treatment, Campos-Rodriguez said.
Patients can find the mask uncomfortable at first, but most get used to it quickly, he said. It provides relief from the tiredness that plagues most patients.
A scan of prices offered on commercial websites finds that masks are sold online by U.S. companies from about $60 to $200; the machines sell for $120 to $5,000 or more.
National insurance covers the systems in Spain, Campos-Rodriguez said.
In the United States, coverage by insurance plans is typical, said Dr. Linda Dahl, an ear-nose-throat specialist at Lenox Hill Hospital in New York City.
The study results show that ''sleep apnea is a significant disease in women as well as men," she said. If the condition is suspected, evaluation is crucial and treatment is necessary if it is diagnosed.
The new study, Dahl said, will probably change awareness among doctors and patients, as apnea is often thought to be a man's problem.
Dahl tells her patients who need CPAP that they can first search online for a variety of masks and systems. They can then discuss the options with their doctor about which might be best for them.
To learn more about sleep apnea, visit the National Sleep Foundation.
Posted: January 2012
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