cause of OSA?
Question:
j…@netway.com (J Reese) writes: >Okay, I’m wondering what might have caused my OSA. Did anyone else >have these problems growing up:
YES>*raised in a smoking environment >*flat feet >*Parents told me I fell and struck my head in 3rd grade.
YES>*chemicals and solvents around (paints, lacquers, epoxies) >*automotive materials and mechanic work done by my father
My father was an artist & phtographer, so lots of stuff in the air. But let’s not jump to conclusions. OSA can be the result of one or more of the following (list not complete): problems in airflow through upper airway caused by or related to: overweight limited airflow through nasal passage anatomy of nose, throat, jaw Some other causes: hypothyroidism drugs tobacco alcohol timing of sleep with respect to circadian rhythm etc. Sleep apnea is called a "syndrome" because it can have many causes as well as many effects. I know of at least one case of a nurse who handled/formulated chemotherapy cocktails in a closed, not-properly-vented space whose brainstem was thereby damaged and later had obstructive sleep apnea. There seemed to be a relationship. To get meaningful answers to your questions would require a carefully designed study over a large number of patients and possibly normal controls. We’d be looking for something pretty common since it affects a large percentage of the population (snoring is ?30%) and apnea is at least 4% of employed middle-agers but we might be talking about closer to 10% of the population. First step is a search of the medical/epidemiological literature via Medlars. >JR
– Jerry Halberstadt. *President, New Technology Publishing, Inc: Health & Business Resources *Principal, FORESIGHT: Visionary business plans. * PHANTOM SLEEP PAGE <http://www.newtechpub.com/> *<halbe…@world.std.com> * 6 W.Blvd. POB 1737, Onset MA 02558 USA.
Response:
jerry halberstadt (halbe…@world.std.com) wrote:
Let’s be clear about a few things first. The "cause" of sleep apnea is not known. There are factors which lead to sleep apnea, but the root cause of apnea is not presently understood. YES>*raised in a smoking environment I suspect this is not closely related with apnea. For the normal individual, smoking may cause snoring. For the chronic snorer (not necessarily an apneic), apnea may be induced. For the apneic, smoking worsens the apnea. Smoking habitually is otherwise bad, and second hand smoke is bad as well, but I suspect being raised in a smoking environment is not a "cause" of sleep apnea. : YES>*chemicals and solvents around (paints, lacquers, epoxies) I don’t find a connection here. : But let’s not jump to conclusions. OSA can be the result of one or : more of the following (list not complete): : problems in airflow through upper airway caused by or related to: : overweight Yes. Studies show that loss of weight alleviates apnea and snoring in those respective individuals. Qualitative analysis reveals definitive airway volume increases in apneics who successfully lose 10 to 20% of their body mass. Again, many apneics are NOT overweight, obese or even flabby. This suggests that being overweight is not the only factor in contributing to apnea. : limited airflow through nasal passage More so over the back of the soft palate. : anatomy of nose, throat, jaw Correct…. Surgical intervention may correct these problems or make it so the apnea is manageable. : I know of at least one case of a nurse who handled/formulated : chemotherapy cocktails in a closed, not-properly-vented space whose : brainstem was thereby damaged and later had obstructive sleep : apnea. There seemed to be a relationship. Are you sure she did not develop central sleep apnea? Induced by the lack of nervous stimulation? CSA is harder to pinpoint. : To get meaningful answers to your questions would require a carefully : designed study over a large number of patients and possibly normal : controls. We’d be looking for something pretty common since it : affects a large percentage of the population (snoring is ?30%) and : apnea is at least 4% of employed middle-agers but we might be talking : about closer to 10% of the population. First step is a search : of the medical/epidemiological literature via Medlars. 10-15% of the general public suffers from sleep related disorders. 4% of men and 2% of women aged 30 to 60 suffer from some form of apnea. Those are the general percentages I know and can confirm, but again, they are estimates, really. — __kevin c welch______________________________________________________ www.sas.upenn.edu/~kwelch/
Response:
J Reese wrote: > Okay, I’m wondering what might have caused my OSA. Did anyone else > have these problems growing up: > *raised in a smoking environment nope > *flat feet nope > *Parents told me I fell and struck my head in 3rd grade.
nope, no head injuries > *chemicals and solvents around (paints, lacquers, epoxies) > *automotive materials and mechanic work done by my father nope > JR
JR, I think it’s both genetic and weight related for me. My ear, nose, and throat doctor told me that I had a slightly large tongue. I’m overweight and 36. After my sleep study I convinced my Dad to go in for a sleep study too. He’s not particularly overweight, but always falls asleep. Both of us have OSA to about the same degree, so now we are both on CPAP machines. I adjusted quickly to mine. My Dad still has difficulty with his nose getting stuffed up, which lasts throughout the day. I’ve been reading on hear about heated/heating humidifiers and will mention those to him. He uses ‘breathe right" strips too. Are there any other ideas which he could try? Donna
Response:
smoking, yes Struck head twice, both times no permanent damage reported Chemicals, PERC, Lead? – (chewed on window sills as a kid in the 60’s) I’ve been thinking of asking my Dr. to test me for Perc & Lead Robbicon @aol.com
Response:
Okay, I’m wondering what might have caused my OSA. Did anyone else have these problems growing up: *raised in a smoking environment *flat feet *Parents told me I fell and struck my head in 3rd grade. *chemicals and solvents around (paints, lacquers, epoxies) *automotive materials and mechanic work done by my father JR
Response:
Dear JR: I went to the page http://www.avicenna.com where people can do Medline/Medlar research of the same medical and professional articles that doctors review (fortunately for the layperson, they’re abstracted), and, using the search words SLEEP, APNEA, and PATHOGENESIS, I found a total of 69 studies going back to 1990 that were dedicated to seeking the causes of sleep apnea. I tried to include MY summaries of all 69 studies, but the task was immediately too grueling, so I have gone over roughly a fourth of them. References to the precise medical journals are available upon any request. And now, here are one layperson’s interpretations of medical studies that were made to help find causes of apnea, and please remember that I am not a physician: *************************************************************************** ****** 1) March 96: Though differences of the anatomy of the airway are good indicators for O. apnea, there are still people with normal airways who have O. apnea also. For those with O. apnea, a major variation is that the airway is eliptical, instead of circular. But more work needs to be done to understand the correlations between airway anatomy and O. apnea. 2) Nov 95: Low lung volume in some men with OSAS contributes to sleep-induced respiratory disorders that go beyond the apnea. 3) Nov 91: Cognitive dysfunctions found in OSAS may be caused by BOTH of two factors: sleep deprivation, and nocturnal hypoxemia. Executive, psychomotor, and intellectual deficits were attributable to the severity of hypoxemia; attention and memory deficits attributable to the vigilance impairment of sleep deprivation. 4) Aug 95: Central sleep apnea could be considered as the end of a spectrum, or as a sign of the maturity of the apnea-complex. Central apnea has no good, consistent treatments yet, but the electrical or chemical stimulation of upper airway reflexes seems to be promising for the near future. 5) Apr 95: Microscopic examination of airway tissue showed some trauma to tissue from sleep apnea. It would imply that altered tissue may not have caused the apnea, but rather the other way around. [I personally believe that this study overlooked the fact that the damaged tissue could perpetuate the apnea]. 6) Apr 95: Study tested to see whether electrical changes in the brainstem could explain OSAS. Instead found out that OSAS caused the electrical changes. Therefore, no substantial answer found. 7) 1995: Tried to find a link between fibromyalgia and sleep apnea, but could not. 
Aug 91: Tried to find a direct association between high blood pressure and sleep apnea. An association was found that high blood pressure could eradically predict apnea, but not enough to warrant polysomnography tests for those with HBP. 9) May 91: The level of severity of apnea in conjunction with being obese can transition apnea into more complicated breathing disorders. 10) Aug 91: Sleep deprivation seemed to affect reaction times, while hypoxemia is what appears to cause vigilance impairment in moderate and severe cases of apnea [yes, this DOES appear to be a contradiction to the previous study. Who knew?]. 11) July 95: The anatomic configuration of the airway and the body’s response to upper airway closure have a major role in the cause of sleep apnea [wow, please don't give it to us all at once!]. 12) Jan 90: Certain naturally-occuring, opiate-like chemicals in spinal fluid were found elevated in some infants who were less than 2 years of age and had apnea. The elevated chemicals were determined to contribute to the cause of their apneas. 13) 1995: Sleep related breathing disorders can develop from unstable breathing involving abnormalities of airway structure and function. The early hallmark is breathing that is not mostly consistent in rhythm. These abnormalities can be either natural or foreign, as well as something born with or acquired. 14) Mar 95: 45 parents (one per household) with OSAS were asked to have their children undergo polysomnography. Out of 105 offspring tested, 47% had sleep apnea syndrome. Since this was higher than percentages in the normal population, the condition MAY appear to be an inherited trait [no mention in this study was made about habits, traits, environment, and lifestyle similarities within families, though; for instance, if all family members smoked, and if smoking were ever determined to cause apnea, then they would have an inclination toward apnea, but not from heredity, though it would seem so. This concern/consideration was at least IMPLIED in the study, though!]. 15) Sept 94: There is a definite association between gigantism and sleep apnea. 16) Aug 90: It was theorized that the exhalation phase of respiration was a consideration in the cause of sleep apnea. It was further theorized that CPAP pressures might be too high on the exhalation phase. A trial was given for a new machine that would come to be known as "BIPAP", with optimistic results. Here is the quote from the journal "Chest" volume 98 page 317: "Our data support the hypotheses that expiratory phase events are important in the pathogenesis of OSA and that there are differences in the magnitudes of the forces destabilizing the upper airway during inspiration and expiration. Finally, applying these concepts, we have shown that by using a device that permits independent adjustment of EPAP and IPAP, obstructive sleep-disordered breathing can be eliminated at lower levels of expiratory airway pressure compared with conventional nasal CPAP therapy. This may reduce the adverse effects associated with nasal CPAP therapy and improve long-term therapeutic compliance." 17) Sep 94: Sleep disturbances in sufferers of Multiple Sclerosis were caused mostly from periodic leg movements and central-type apneas — due to damaged nerve fibers — but otherwise sleep architecture was normal. 18) Aug 94: Hang onto your shorts. We thought that airway collapse was a static phenomenon: "Sleep fragmentation itself leads to a higher upper airway collapsibility than does sleep deprivation," and may be a cause of sleep apnea. The way I read it, if your mate shakes your shoulder every five minutes of sleep during each night, your airway would begin to collapse! It may be progressive, and a good start to slow its progression may be by reducing sleep fragmentation. Well, there’s more, but even I am sick of me . . . Health, Doug *************************************************************************** ********* – Hide quoted text — Show quoted text ->Okay, I’m wondering what might have caused my OSA. Did anyone else >have these problems growing up: >*raised in a smoking environment >*flat feet >*Parents told me I fell and struck my head in 3rd grade. >*chemicals and solvents around (paints, lacquers, epoxies) >*automotive materials and mechanic work done by my father >JR
