Artery disease seen with sleep-breathing disorder

By Will Boggs, MD

NEW YORK (Reuters Health) – Otherwise healthy middle-aged
people with obstructive sleep apnea — a disorder in which they
frequently stop breathing for brief periods while they sleep —
show early signs of hardening of their arteries, according to a
report from Brazil.

“Our findings support the hypothesis of a direct link
between obstructive sleep apnea and cardiovascular diseases,”
Dr. Luciano F. Drager told Reuters Health.

Drager and his team at the University of Sao Paolo measured
indicators of early atherosclerosis in 30 patients with
untreated obstructive sleep apnea and in 12 matched healthy
volunteers. None of the participants had previous evidence of
cardiovascular disease.

The measurements of early atherosclerosis tended to show a
direct correlation with the severity of sleep apnea, the
investigators report in the American Journal of Respiratory and
Critical Care Medicine.

A parameter reflecting artery stiffness was significantly
higher among patients with severe sleep apnea than among
patients with milder apnea and among the healthy comparison
group, the report indicates. The same was found for the
thickness of the artery walls.

“The novel finding in the present study is that middle-aged
patients with severe obstructive sleep apnea, without overt
cardiovascular diseases, demonstrate early signs of
atherosclerosis,” the researchers conclude.

“We are currently performing a randomized study with CPAP
(continuous positive airway pressure) to evaluate the impact on
these signs of atherosclerosis,” Drager said.

CPAP delivers pressurized air via a facemask to patients
while they sleep, to prevent their airways becoming blocked. It
is usually used to relieve the sleep interruptions that lead to
dangerous sleepiness during the day.

“This study should add important evidences to justify the
(greater) use of CPAP in patients with obstructive sleep apnea,
even in the absence of prominent sleepiness-related daytime
symptoms,” Drager noted.

SOURCE: American Journal of Respiratory and Critical Care
Medicine, September 1, 2005.