Wake-up Call: What are the Consequences of Untreated Obstructive Sleep
Apnea Syndrome?

1.   Sudden death during sleep.  (Day-night pattern of sudden death in obstructive sleep
apnea.  Gami et. al, New England Journal of Medicine. 2005 Mar 24:352(12):1206-14.)     In
this study a population of 112 folks who had died and who had had a sleep study showing
they had Obstructive Sleep Apnea Syndrome were studied.  46% of the untreated sleep
apnea patients died in their sleep, whereas in the group that had no sleep apnea, only 21%
had died in their sleep.   Clearly there is an increased tendency for patients with Obstructive
Sleep Apnea Syndrome to die in their sleep if they are not treated.  

2.   Hypertension. One-third of hypertension (high blood pressure) is caused by Obstructive
Sleep Apnea Syndrome.(Hla KM, et. al., Sleep Apnea and Hypertension:  A population - Based
Study,  Annals of Internal Medicine. 1994;120:382-388.)  

3.   Heart failure in both right (pulmonary hypertension) and left parts of the heart
can result from untreated Obstructive Sleep Apnea Syndrome.  (Re;  Pulmonary hypertension:
Sajkov, et.al., Pulmonary Hypertension and hypoxemia in Obstructive Sleep Apnea Syndrome.
 American Journal of Respiratory and Crtical Care Medicine.  1994;149:416-422;  re: left heart
failure:  Bradley et al, New England Journal of Medicine.  2005 Nov 10;353(19):2070-3.)  

4.   Heart arrhythmias are associated with untreated sleep apnea.  (Hoffstein et. al., Cardiac
Arrhythmias, Snoring and Sleep Apnea. Chest 1994;106:466-471)

5.   Stroke.  Untreated Obstructive Sleep Apnea Syndrome is a risk factor for Stroke.  
(Koskenvuo et. al., Snoring as a Risk Factor for Ischemic Heart disease and Stroke in Men.  
British Medical Journal. 1987;294:16-19.)  

6.   Untreated sleep apnea is a condition that makes the person at more risk for auto and
other accidents because of excessive daytime sleepiness.  (Sleepiness,
Sleep-disordered Breathing, and Accident Risk Factors in Commercial Vehicle Drivers.  
American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 1014-1021, (2004).)

Different persons can have all or some of these.  Clearly the most sobering issue
here in untreated sleep apnea is the increased risk of sudden death during sleep.
We have some preliminary evidence that CPAP treatment reduces these risks.