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Featured Article: The impact of obstructive sleep apnea and daytime sleepiness on work limitation
Transcript of Additional Q&A
 | Guest Host: Thomas Roth, PhD Chief, Division Head Sleep Disorders and Research Center Henry Ford Hospital Detroit, MI |
 | Featured Author: Najib Ayas, MD, MPH Associate Professor of Medicine University of British Columbia, Respiratory Division Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Vancouver, BC |
1. Do you think these results would generalize to people who don't necessarily have a sleep disorder, but for various reasons are chronically sleep-deprived (i.e., get less than 6-7 hours of sleep per night), or for people with poor sleep hygiene, such as college students?
The association between reduced sleep hours and outcomes are from epidemiologic studies. Most of the studies did not identify a reason for the reduced sleep duration. As such, it is unclear whether the cause of sleep loss affects the health effects.
2. Is there any evidence that treating sleep apnea reduces the risks of other comorbid disorders, such as diabetes, stroke, or hypertension?
There are observational studies suggesting that treatment of sleep apnea reduces rates of heart disease and strokes. That is, patients who use CPAP tend to get less heart disease and strokes than patients who are not using CPAP. Although this data is suggestive, they are not definitive given that there are currently no long-term randomized trials demonstrating a reduced risk of these outcomes (though a few trials are ongoing).
CPAP therapy will reduce blood pressure. Although the overall affect is modest, some patients may have a robust response. Investigating for sleep apnea should be considered in patients with difficult to control hypertension.
3. In regards to your statements that sleep apnea should be treated and managed like other chronic diseases, like diabetes, what is the long-term prognosis for patients who are effectively treated with CPAP? Will they always require the device?
See above. In the absence of weight loss, reducing alcohol intake, reducing smoking; it would be unlikely that sleep apnea would improve and CPAP would be required.
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JC-001-011408-05
