This seems to be the message according to a 2003 article in the American Journal of Respiratory and Critical Care Medicine. In the article titled, Obstructed Sleep Apnea and Thoracic Aorta Dissection, researchers investigated a possible link between 19 patients presenting aortic dissection and the occurrence of obstructive sleep apnea syndrome (OSAS). The study was conducted because of a look into how OSAS can cause negative intrathoracic pressures that may put mechanical stress on the aorta wall. The study shows a link between OSAS and hypertension, a major factor in aortic dissection, as well as, impaired left ventricular function, gastroesophageal reflex, and an increase in sysltolic and diastolic aortic diameters during apnea and hypopnea. Patients having to breathe against an occluded airway showed a mean intrathoracic pressure of -60cmH2o. The study included 19 patients who had aortic dissection and 19 patients with hypertension. 13 of 19 in each group (68%) had sleep apneas with a prevalence of apnea-hypopnea index of more than 5 per hour with some as high as 30 or more per hour. The real danger seems to be that the aortic transmural pressure is dangerously out of range. Being that blood pressure is generally higher in patients with OSAS and the intrathoracic pressures are out of range in addition to the frequent occurrence of the insult presented by the occlusion and movement of the pharynx, the aortic wall is stressed. The study suggests that sleep therapy is important in OSAS patients to help prevent a vascular insult that could possibly lead to aortic dissection.
Obstructive sleep apnea is relatively easily treated with CPAP, continuous positive airway pressure, worn as a mask per the nose and moth. It takes some time to get used to and a psychologist skilled in desensitization can really help. The biggest challenge is getting people two recognize that they have OSA symptoms, which might include fatigue, snoring, daytime sleepiness, not feeling rested when they wake up, poor energy. with such dramatic consequences, seism like an easy sell to be tested with polysomnogram.
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