City study conquers sleep apnea
Safer, healthier lives for those with illness
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Hey there, time traveller!
This article was published 14/03/2009 (5073 days ago), so information in it may no longer be current.
For years, Krystyna MacDuff fell asleep everywhere except her bed — at stoplights, in staff meetings, and over dinner with friends.
She had no idea that untreated sleep apnea was what jolted her awake and left her gasping for air as many as 30 times an hour every night. MacDuff, 61, said she remembers the sick feeling of always waking up exhausted, and often trying catch a few extra Zs in her car on her lunch break.
Last fall, MacDuff was diagnosed with sleep apnea and treated with continuous positive airway pressure (CPAP) — a mask that sends pressurized air to prevent airways from collapsing during sleep. MacDuff said she feels like a new person, and plans to use the mask for the rest of her life.
"I’m not tired anymore," she said. "My demeanour has changed. Overall, the quality of my life has improved nearly 200 per cent."
While the CPAP machine has given MacDuff and hundreds of other Manitobans a restful night’s sleep, two local researchers discovered its benefits don’t end there.
Dr. Davinder Jassal and Dr. Sat Sharma enrolled 42 patients with sleep apnea, including MacDuff, in a study to see whether the sleep disorder damaged their heart and if that damage could be repaired through ongoing CPAP treatment.
When sleep apnea causes patients to stop breathing, the oxygen levels in their blood drop and a surge of adrenaline is pumped through the body, causing a spike in blood pressure. If left untreated, the disorder can cause the walls of the heart to thicken — one of the precursors to heart failure. Many sleep apnea patients can develop high blood pressure and go on to suffer a heart attack or stroke.
Jassal and Sharma used magnetic resonance imaging, an ultrasound of the heart and blood tests to evaluate the patient’s heart function at three months and six months. Jassal said the MRI showed the structure of the heart more clearly than ultrasound, making it easier to measure any improvement in heart function.
The study’s preliminary results were impressive — the first 11 patients who spent six months on the CPAP machine had a 10 to 15 per cent improvement in heart structure. Jassal said the heart could relax and pump blood more efficiently.
Patients will be monitored until 2010 to ensure results are measured after one year in the first long-term study of its kind in the world.
Sharma said they didn’t know heart damage could be reversed, meaning patients with less severe forms of sleep apnea could benefit from CPAP to improve heart health. It might also mean patients suffering from high blood pressure should be assessed to see if they have an untreated sleep disorder.
"The thicker your heart, the worse the heart is able to relax," said Jassal, principal investigator at the St. Boniface Hospital Research Centre’s cardiovascular imaging laboratory. "Now we can also say objectively, if you continue to use your CPAP device for three months, six months, a year, there’s going to be significant improvement in the structure of the heart."
Many sleep apnea sufferers complain of broken, unrefreshing sleep that causes fatigue, headaches and mood swings.
Sharma said most people live with untreated sleep apnea for years before a spouse encourages them to seek treatment. Abnormal sleep and fatigue are warning signs to see a doctor.
"Those should raise a red flag that they should get it checked out," said Sharma, director of respiratory labs at St. Boniface General Hospital.
Until recently, frustrated sleep apnea sufferers had to wait years to see a sleep specialist, and hundreds of Manitobans were sent out of province for more timely treatment.
Sharma said most patients referred to the sleep lab are now evaluated within two months, since the number of weekly sleep tests has more than doubled. He said sleep specialists and Winnipeg health officials are trying to increase the number of patients tested for sleep disorders with monitoring equipment at home.