Obstructive sleep apnea (OSA) is a serious sleep condition that not only affects sleep and energy levels but also impacts one’s overall health and wellness. For example, people with OSA typically present with symptoms such as excessive daytime sleepiness, poor concentration, and chronic pain that can affect their ability to function throughout the day. Those with the disorder also often suffer from a range of comorbidities. Specifically, the disorder is associated with a variety of chronic health conditions like hypertension, heart disease, depression, cancer, diabetes, and obesity.
Because OSA inhibits proper sleep and breathing, it can affect nearly every system of the body. From your heart to your sexual health, the sleep disorder isn’t limited to impacting just sleep quality. It can lead to serious health concerns for individuals of all ages. Because OSA is an issue with breathing, it wouldn’t come as a surprise for it to affect your lungs—but does it? Let’s dive into the sleep disorder’s association with lung health, especially when it comes to chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH).
What Happens When Someone Has OSA
Normally when we breathe, air flows through the nose or mouth and down into the lungs. Similarly, as we breathe out, it flows from the lungs back up through the throat and out through the nose or mouth. When we sleep, our breathing should remain more or less the same except for the fact that its rate slows slightly.
However, when someone is suffering from OSA, their breathing becomes blocked despite continuous efforts to breathe. In fact, individuals with the disorder can experience pauses in their breathing anywhere from five to over 30 times every hour as they sleep! Let’s break down exactly what happens when someone experiences an apnea, i.e., a temporary pause in breathing:
Have you ever tried to drink a thick milkshake through a narrow and papery straw? That feeling is similar to what happens to people during an apnea. As they attempt to breathe, their airway collapses slightly, causing them to not get enough air to their lungs. While this doesn’t occur during wakefulness because of the brain’s ability to send signals to the tongue and throat muscles to open the airway, during sleep, various things can block the airway and cause it to become too narrow to breathe well. For example, certain sleep positions—especially on your back—can restrict the windpipe and narrow the airway. Along those lines, in 98 percent of patients with OSA, the disorder is caused by an underdeveloped mouth and jaw.
Although there are a number of reasons behind the development of OSA, the result is the same: declined health and impacted wellbeing. From chronic pain and inflammation to emotional effects, those with OSA must often face multiple consequences to the disease. Sometimes, they even experience several at once. Let’s explore how the disorder could impact lung health.
Chronic Obstructive Pulmonary Disease (COPD)
Although it can be difficult to narrow down whether OSA has a direct negative impact on your lung health, it is associated with a couple of serious issues. For example, several studies suggest that about 20 percent of patients with sleep apnea also have a chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory disease that results in obstructed airflow from the lungs. For example, emphysema and chronic bronchitis are two of the most common disorders that can contribute to the development of the disease.
The comorbidity between COPD and OSA is commonly referred to as the overlap syndrome, which was first coined by David C. Flenley in 1985. The overlap syndrome can not only cause twice the unpleasant conditions associated with disordered breathing, but it can also lead to other long-term health concerns that affect the body beyond the lungs. This is because those with COPD struggle with maintaining a healthy balance of oxygen and carbon dioxide in their blood throughout the day. When they struggle with this alongside OSA, they don’t even get relief during the night.
- Inflammation: Inflammation caused by OSA can worsen the inflammation in COPD and/or vice versa.
- Obesity: Obesity significantly increases the possibility of having OSA to more than 50 percent in men and 20 to 30 percent in women.
- Smoking: Smoking cigarettes is connected to OSA and COPD as it triggers inflammation and increases the risk of both conditions.
OSA and COPD often coexist; however, there isn’t a direct causal relationship between them. This means that having OSA does not mean you’ll develop COPD, and having COPD does not mean you’ll develop OSA. More likely, these disorders commonly co-occur because of inflammation of the lungs and the rest of the body.
Pulmonary Hypertension (PH)
Pulmonary hypertension (PH) is another serious condition that affects the lungs and is associated with obstructive sleep apnea. It is a type of high blood pressure that increases pressure in the arteries of the lungs, resulting in symptoms such as chest pressure, dizziness, and shortness of breath. PH is a concerning disease thought to occur in roughly 20 percent of individuals with OSA; however, prevalence ranges to as much as 53 percent.
While the exact connection between sleep apnea and pulmonary hypertension remains unclear, the periods of low blood oxygen (hypoxia) associated with OSA can cause the heart to work harder to supply oxygen to the body. In cases of severe sleep apnea, these periods of hypoxia can occur up to several hundred times every night.
Not only is the development of PH associated with OSA, but it has also been shown to improve as a result of common OSA treatments like continuous positive airway pressure (CPAP). This suggests that treating obstructive sleep apnea may also lead to significant improvement in other areas of an individual’s overall wellbeing—including their lung health.
If you think you may have obstructive sleep apnea, it is absolutely essential for you to reach out to a doctor. The risk of untreated sleep apnea increases the longer it goes undiagnosed—so don’t hesitate to find a treatment plan that works for you. From your heart to your lungs, OSA can impact a wide variety of your body’s functions.