This Article Contradicts Most Sleep Apnea Studies

[DeeCPAP]

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I'm not sure what to make of this article so I thought I'd post it for discussion. It applies to people over 65 with sleep apnea. (Note: it's best to read an original study rather than a news article about a study, but haven't found it yet.)


Sleep Disordered Breathing and Longevity
http://www.telegraph.co.uk/news/health/ ... -life.html

Sleep disorder which causes snoring 'can prolong life'
An exhausting sleep disorder which causes breathing problems and heavy snoring could actually prolong life, according to a new study.
By Kate Devlin Medical Correspondent 1:49PM BST 03 Oct 2008


Sleep apnoea has previously been linked to an increased risk of high blood pressure, heart attack and stroke.
But scientists have found that some sufferers live longer than those who do not have the condition.
They now believe that doctors could be doing more harm that good treating some patients for the disorder.
More than 80,000 people in Britain are thought to suffer from sleep apnoea, the main symptoms of which are extreme tiredness and loud snoring.

The condition causes patients' upper airway to repeatedly collapse, cutting off airflow.
When this happens suffers can stop breathing for up to ten seconds at a time.
They can start to sleep lightly or even stir for a short time and many wake hundreds of times but remember nothing.
In severe cases, patients suffer an incident more than 60 times every hour and most struggle with the condition for years before approaching their doctor.

The new study followed 611 patients aged 65 and over for more than four years.
Patients with moderate sleep apnoea were less likely to die over the course of the study than those who did not have the condition, the results show.
By the end of the four years, three times as many people without sleep apnoea died as had the condition.
Mortality rates in patients with light and severe sleep apnoea were the same as the general population, the study also found.
Peretz Lavie, who carried out the research at the Lloyd Rigler Sleep Apnoea Research Laboratory, in Haifa, Israel, said that the results were "astonishing".

"We know that sleep apnoea does reduce life expectancy for people under the age of 50, so to find that it could actually prolong life for elderly patients was quite a shock."
Dr Lavie speculates that the reason for the findings could be the way the body responds to a lack of blood to major organs, which can be caused when breathing stops.
Previous studies have shown that organs like the heart develop resistance to damage when they experience
The phenomenon, called ischemic reconditioning, could help patients to withstand larger problems, like a major heart attack, Dr Lavie believes.

He now wants to identify the exact mechanism behind the syndrome and discover if there is a way to tell which patients are experiencing the benefits of sleep apnoea.
He warned that the findings, presented at European Sleep Research Society's conference in Glasgow last month, should change the way that doctors treat some patients with sleep apnoea.
He said: "At the moment we are treating people indiscriminately, but this study suggests that if elderly patients are not suffering any of the symptoms of sleep apnoea, then they should probably not be treated at all."
Men aged between 30 and 65 are more likely to suffer from sleep apnoea, and those who are overweight or obese are more at risk.


Note: This is the link to a more standard approach to sleep apnea from the New England Journal of Medicine
Title of article: Obstructive sleep apnea as a risk factor for stroke and death.
https://www.ncbi.nlm.nih.gov/pubmed/16282178

[sc0ttt]

Interesting.

Here's the study - P factors and confidence intervals and everything.

http://onlinelibrary.wiley.com/doi/10.1 ... 754.x/full

These findings raise the possibility that sleep-disordered breathing in elderly people is a specific entity different from sleep-disordered breathing in young and middle-aged patients (Launois et al., 2007).

[LSAT]

This study was from 2008 and quotes studies that are from several years before that. Based on what we know today its BS.

[DeeCPAP]

Interesting.

Here's the study - P factors and confidence intervals and everything.

http://onlinelibrary.wiley.com/doi/10.1 ... 754.x/full

These findings raise the possibility that sleep-disordered breathing in elderly people is a specific entity different from sleep-disordered breathing in young and middle-aged patients (Launois et al., 2007).

Thanks, Scottt! I could only skim it for now due to lack of time (will definitely get to it), but it definitely appears sleep apnea in elderly patients with moderate sleep apnea are actually getting a cardiovascular workout in their sleep that prolongs life. What a hoot! It'd be great if there were follow up studies.

[Midnight Strangler]

Comparing the mortality of the sleep laboratory cohort with that of the demographically matched general population cohort

They did not have a control group. Poor science.

[Julie]

What in fact is the BS part - have there been new studies disproving the older ones? I'm really curious!

Tho' not having a control group was a very dumb idea!

[DeeCPAP]

What in fact is the BS part - have there been new studies disproving the older ones? I'm really curious!

Tho' not having a control group was a very dumb idea!

There's no specific control group, per se, *but* the researchers matched for age (in 5-year groups), gender and ethnicity within the general population of a specific country. Other than BMI, what other major variables would make the study significantly better?

The concept of moderate sleep apnea (in those over 65) being similar to a cardio workout is rather fascinating. Too bad there were no follow up studies, but maybe there was a major financial concern to keep the sleep industry intact.

[DeeCPAP]

Comparing the mortality of the sleep laboratory cohort with that of the demographically matched general population cohort

They did not have a control group. Poor science.

they compared two groups
use one of them as a control

or did you mean to not treat apnea patients to see how they compared to treated ones to create your control

The actual journal article has the email address to one of the researchers. You could use email.

[chunkyfrog]

Sounds like a (government sponsored?) study made for the purpose of withholding treatment from the aged.
Nuts, I say.

[Hose_Head]

Food for thought:

Why Most Published Research Findings Are False

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/

And another:

Studies show only 10% of published science articles are reproducible. What is happening?
http://tinyurl.com/nh7omum

[DeeCPAP]

What the posts above are saying about research studies is true. There are no guarantees and that's why research studies are required to be replicated before it's considered "good science". This particular study about elderly people and sleep apnea is fascinating to me, and does make sense because sleep apnea *does* give the heart, brain, and other organs, a serious workout, but at a price. As it stands now though, avoiding sleep apnea testing or treatment can be dangerous. Maybe the control group in this research project should have been people who refused cpap treatment. It'd be dangerous to tell someone to stop using it or not to take a sleep test. I appreciated hearing the opinions of others in this discussion. Admittedly, I was slightly tempted to do without cpap for a little while just to see if I'd notice a difference, but ...

I personally know three people who decided not to use it. Two were hopeless, couldn't be convinced. The third person is a relative who I periodically force fed information and it worked! What helped the most is the YouTube video (link below) I found in a post on this website. It's very powerful. Resmed produced it. She and her husband saw it and will now be using their cpap equipment. It's twelve minutes long. Save the link. It may save someone. (Thanks to whoever posted it!) https://www.youtube.com/watch?v=-gie2dh ... nel=ResMed

[Goofproof]

Write a scientific paper, get out from under that bridge, park your shopping cart and you too can make loads of money fleecing the stupid public to keep you in money.

Homeless PHD's, living in your Mom's Basement, you too can earn a living, without working, maybe even pay back part of those grants you owe! The public will buy into what ever B.S. you write, no matter the subject or which side you profess. Jim

[jnk...]

I wouldn't call it a contradiction exactly. More of a qualifying note of interest for some of the elderly in some circumstances.

Many docs are more interested in longevity than in quality of life. (Individual patients have individual preferences on that too.) So the specific focus for that research discussion is OK in context, in my opinion. It is not an indictment of PAP therapy so much as an acknowledgement of certain limitations for a specific population with specific risks. For example:

Denying the body O2 is generally not a good thing because of the damage it does, of course. However, in the specific context of someone experiencing a cardiovascular event, a body that has developed some adaptation to lack of O2 may have a slightly better chance of survival of that event.

Does that fact/theory mean that it should be applied across all populations of all ages and all risks? Of course not. But it may be useful information nonetheless.

My personal belief is that PAP therapy can be useful for all ages, since it means higher quality of life to be awake rather than sleepwalking through life. And that, for me, is true whether PAP will prolong life very much for a specific patient or not. However, that said, if someone over 80 would rather not be on PAP therapy, I might tend to respect and agree with that personal decision more for that person than I would for someone much younger. That is because their circumstances may make their choices a bit different, as is hinted at in interpretations of the study.

Just my 2 cents as nothing more than a patient who has friends over 80 that I personally choose not to hassle about their choosing not to use PAP, even though I think they might enjoy life a lot more if they used it.

-jeff

[chunkyfrog]

At some point, the means to extend life may cause more distress than benefit.
Our conscience, and even the law, may be at odds with compassion.
Science can give much, both good and bad; but the patient should have the ultimate choice.

[Lucyhere]

we should live well for the time we have
not longer in pain

and spending millions to hook people up to machines to eat breathe poop whatever
just to keep them 'alive' a few weeks or months longer
is a total waste for society when that money could improve lives of others
while being sadistic and keeping the victim in pain longer than necessary
and that could me mental stress as well as physical symptoms

everybody dies
just keeping people 'alive' is stupid and wasteful
we need to make them feel good and be independent...

Amazing... I agree with you. You must be that "L" word after all. I just knew it. Really?

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