Post
by Hugh Jass » Thu Mar 10, 2005 7:41 am
According to this article, the younger you are, the higher your mortality rate is (depending on your OSA severity of course).
Thought some may find interesting.
Young Men With Sleep Apnea at Increased Mortality Risk
By Karla Gale
NEW YORK (Reuters Health) Mar 03 - While most patients referred for sleep apnea evaluation are in their 50s, men in their 20s with sleep apnea run the highest mortality risk, an Israeli research team reports. "The implication is that we must diagnose patients while they're young, in their 20s and 30s, if we are to prevent mortality," Dr. Peretz Lavie told Reuters Health.
Dr. Lavie and colleagues at Technion-Israel Institut of Technology in Haifa examined the survival status of nearly 14,000 men ages 20 to 93 years evaluated between 1991 and 2000 at their clinic for possible sleep apnea. During a median follow-up of 4.6 years, there were 372 deaths.
Among those with a respiratory disturbance index (RDI) > 30, only men aged 20 to 29 years had a significantly higher mortality rate than their counterparts in the general population (relative mortality rate 5.84), the investigators report in the March issue of the European Respiratory Journal.
They team performed another analysis restricted to the 1,909 patients with severe sleep apnea (RDI > 50, median 73 respiratory events per hour of sleep), among whom 95 died during follow-up.
The relative mortality rate for those in their 20s was 9.8. For those 30 to 39 years and those 40-49 years, relative mortality rates were 3.12 and 1.89, respectively. Among those aged 50 and above, there was no excess mortality (p < 0.04 for trend).
Given these surprising results, Dr. Lavie said, "We believe there is an active adaptive mechanism, where some individuals are able to develop a coping mechanism that allows to them to live with this nightly insult of hypoxia and brief awakenings."
He noted that there are three high-risk groups that should probably undergo screening.
"First, young obese patients with a BMI of 31 or above -- this is the first target population, because the combination of severe apnea and obesity at this age is a killer."
Other targets are patients who have a parent with sleep apnea, whose risk is increased 10-fold, and those with young-onset hypertension.
To bring down the cost of screening, Dr. Lavie and his associates have developed a device, called the WatchPAT, comprised of sensors that are placed on the fingers at night. The device, which has been approved by the US FDA, measures oxygen saturation levels, vascular tone, and heart rate. A positive result would prompt a complete workup for obstructive sleep apnea.
Eur Respir J 2005;25:514-520.
Taken from Medscape.
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