Oct. 7, 2024 – Do you think that you may have sleep apnea? Here's one more reason to get tested to search out out.
New evidence shows this obstructive sleep apnea (OSA) may increase the danger of some cancers, including those affecting the digestive system, kidneys, and breasts. The condition, which disrupts respiratory during sleep, may pose more serious health risks than previously thought.
The latest studyon the subject, published within the Journal of Clinical Sleep Medicinefound that of 1,990 patients with sleep apnea, 181 developed cancer in the course of the 13-year follow-up period. That's about 9% of the patient sample, a significantly high rate, said sleep physician Ram Kishun Verma, MD, one among the study's reviewers and co-author of a related study comment.
Previous research has shown that the general cancer rate is approx 26% higher in people diagnosed with sleep apnea in comparison with the overall population. The more severe the sleep apnea, the upper the danger of cancer, in keeping with the brand new study.
People with sleep apnea “try hard to breathe, but there is either a stoppage or a reduction in airflow,” said pulmonologist Andrewnamen, MD, a professor at Wake Forest University School of Medicine. (Namen was not involved within the study.) “The different oxygen molecules essentially change your DNA and make it more cancer-promoting.”
Almost 1 billion People worldwide – and 39% of adults within the United States are estimated to have sleep apnea. The disease is essentially underdiagnosed and undertreated – to the purpose of being 9 out of 10 people with OSA don't know they’ve it.
OSA can be linked to heart disease, blood vessel problems, and neurological problems, and occurs when the airway—the upper respiratory tract—repeatedly becomes completely or partially blocked during sleep. During these periods, not enough oxygen reaches the body. This leads to what’s referred to as “intermittent hypoxemia,” which is alternating periods of low oxygen levels within the blood.
The lack of oxygen could trigger a cascade of biochemical reactions within the body that result in cancer, researchers say.
How can sleep apnea result in cancer?
Low oxygen levels during sleep can produce molecules that damage DNA, resulting in harmful genetic changes and increasing the danger of cancer,namen said.
That's because repeated cycles of low oxygen levels may cause oxidative stress – an imbalance of free radicals and antioxidants. Free radicals are unstable molecules that may damage cell membranes, proteins and DNA and trigger inflammation. To protect itself from inflammation, the body produces proteins called cytokines.
These proteins contain molecules called “cellular adhesion molecules,” said Verma, a sleep medicine physician at Parkview Health in Fort Wayne, Indiana, and an adjunct clinical assistant professor on the Indiana University School of Medicine.
One of those – vascular cell adhesion molecule 1 (VCAM-1) – plays a vital role in the event of cancer, helping tumor cells attach to the endothelial cells that line your blood vessels cross the vessel wall. This is said to tumor growth and the spread of cancer.
In the brand new study, patients underwent polysomnography, the usual test to find out how severe an individual's sleep apnea is Apnea-hypopnea index.
Using the combined average variety of times per hour that the airway is totally blocked by the nose and mouth – “apnea” – and the variety of times the airway is barely partially blocked – “hypopnea” – sleep experts can grade the severity of the condition .
Ranking is measured in events per hour. Someone with mild sleep apnea may experience five to fifteen events per hour while sleeping, while someone with severe sleep apnea may experience greater than 30.
Blood was then taken from study participants to measure levels of inflammatory biomarkers. In a subset of 427 patients, VCAM-1 was found to be elevated together with one other essential biomarker: endostatin.
Endostatin stops the formation of recent blood vessels, a process called angiogenesis. Tumors depend on the expansion of recent blood vessels. Blocking this process subsequently helps decelerate their growth. (Actually endostatin is is being studied as a potential treatment for cancer.)
However, higher levels of endostatin are related to the next risk of cancer. Endostatin is a marker of systemic inflammation, especially in colon cancer.
“Both biomarkers were elevated in the samples [of patients] who later developed cancer,” said Verma.
As the severity of sleep apnea increased, so did the danger of cancer.
“They found that a 10 increase in the apnea-hypopnea index corresponds to an 8% higher risk of cancer,” Verma said. Going from 20 to 40 increases your risk of cancer by 16%.
Can treating sleep apnea help prevent cancer?
It has been shown that controlling sleep apnea could be achieved with the appropriate treatment reduce other associated health risksakin to heart attacks, strokes and diabetes.
The same may very well be true for cancer risk, although more research is required to know needless to say,namen said. The current study didn’t examine whether treatments alter cancer risk.
Early detection is essential,namen said. warning Signs of sleep apnea These include loud snoring and gasping or choking at night (often noticed by the partner). Other warning signs: headache within the morning and tiredness or sleepiness in the course of the day. You could also be at higher risk when you are chubby or obese, smoke or drink alcohol, or have hypertension or diabetes.
“As soon as you know you are at risk, contact your primary care doctor or go directly to a certified sleep specialist,”namen said.
The most typical treatment is positive airway pressure (PAP) therapy – using either a CPAP machine or a BiPAP machine. Both devices aid you breathe by pushing compressed air into your lungs, opening them and supplying you with the oxygen you would like.
With treatment, “we're seeing a person's overall health care utilization go down,”namen said. “Your risk of being in a car accident is reduced by almost half, and your risk of a stroke and heart attack decreases.”
What's next?
Many sleep doctors don't repeatedly check for things like endostatin and VCAM-1, but preventative medicine corporations can use studies like this to create predictive tools, Verma said. AI could help advance the event of such tools.
“These companies can develop predictive models to tell someone, 'You have an increased risk of cancer,'” Verma said. Such tools could prompt people to act quickly as a substitute of waiting years for cancer to develop.
In the meantime, Verma would love to see more research that builds on the brand new study's findings.
“There's so much potential to repeat this study in the future,” said Verma, who would love to see a bigger study comparing individuals who have their sleep apnea under control with those that don't. He also wants researchers to trace health markers like VCAM-1 and endostatin over time and see how they alter with or without treatment and the way that affects cancer risk.