You know that untreated sleep apnea can cause cardiovascular damage including heart disease and failure, but how long must OSA go untreated to cause these problems?
Even as a “Google sleuth,” I was not able to locate this information, so I asked this question to Joseph Krainin, MD, who’s board certified in sleep medicine and neurology and founder of the online sleep apnea clinic Singular Sleep.
“I’m not aware of any research that specifically addressed this issue either,” says Dr. Krainin.
“The existing research would imply that your risk for bad outcomes is proportional to the degree of sleep apnea and to the degree of intermittent hypoxemia.”
Degree of Sleep Apnea
• Mild: 5-15 disordered breathing events per hour
• Moderate: 16-30
• Severe: 31+
Daytime or immediate symptoms of the preceding night’s sleep, such as easily dozing off while driving or difficulty concentrating, are not predictors of how much cardiovascular damage can result from untreated sleep apnea.
Hypoxemia revers to abnormally low blood oxygen levels. These result from disordered breathing events and can be detected by a lab or home sleep study, as well as by a pulse oximeter (finger reader) that records overnight.
Dr. Krainin continues, “There is some research to suggest that after having sleep apnea chronically, the brain and upper airway musculature can have a ‘kindling’ effect to continue to promote the disorder even if there is significant weight loss.”
Bear in mind, however, that of the 18 to 30 million Americans who have obstructive sleep apnea (many cases are believed to be undiagnosed or misdiagnosed), quite a few of them are not overweight, and may even be thin.
Obesity is associated with obstructive sleep apnea, but even a thin person can suffer from a repeatedly collapsed airway overnight – due to a naturally small airway, surplus pharyngeal tissue and/or a large tongue base.
Why isn’t there data on how long it takes untreated sleep apnea to damage the heart and blood vessels?
By the time a person is diagnosed with OSA, nobody knows how long they’ve had it. Untreated sleep apnea tends to worsen as one gets older.
Many people don’t recall symptom onset until a certain age range, while others recall, in hindsight, the presence of symptoms dating back to teenaged years and even childhood.
Of course, nobody is going to want to cease their CPAP therapy to see how long it takes their sleep apnea to damage their cardiovascular system.
Furthermore, there are other causes of the health conditions that untreated sleep apnea can lead to.
So if someone who’s gone 30 years with untreated sleep apnea has high blood pressure, diabetes and heart disease, it’s not possible to determine just how much their lifestyle (e.g., smoking, lack of exercise, poor diet, poor stress management) actually contributed to these conditions.
Data is lacking also as far as any correlation between how damaging untreated sleep apnea is to the heart, and how physically fit the patient is due to workouts.
So if you suspect you have sleep apnea – or if someone else insists that you stop breathing during the night or snore and gasp, it’s time to undergo a sleep study.
In 2013 Dr. Krainin was elected a Fellow of the American Academy of Sleep Medicine, an honor reserved for sleep doctors who’ve made significant contributions to the field in education, research and service.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.