A large retrospective analysis conducted by The Mayo Clinic confirmed that people with sleep apnea are at a higher risk of sudden cardiac death (SCD). The study that the following sleep study parameters were linked with an increased risk of SCD:
- AHI >20
- Minimum oxygen saturation <78%
- mean (average) nocturnal oxygen level <93%
SCD, in layman's' terms, is when the heart just stops beating during sleep.
AHI stands for "apnea-hypopnea" index and refers to how many abnormal breathing events occurred per hour.
The ultimate cause of this increased risk of sudden death is most likely due to having a massive heart attack, stroke, or going into an irregular heart rhythm and not coming out of it as a result of an obstructive breathing event.
If you have untreated sleep apnea it's like playing Russian Roulette every time you go to sleep...with a revolver that has myriad chambers. What I mean by this is that you should be concerned about the health effects of OSA but the overall likelihood of dying in your sleep from sleep apnea on any given night is really, really low. During the approximately 5 year interval that the researchers looked at, only 142 out of 10,701 subjects had resuscitated or fatal SCD. That's only 0.27% of the group.
On the opposite end of the spectrum, there is what I call the "Killing Me Softly" way that sleep apnea can hasten your demise. What I'm referring to here is the fact that untreated OSA increases the risk of several chronic medical problems, including hypertension, type 2 diabetes, dyslipidemia (high blood cholesterol levels) and cardiovascular diseases like atrial fibrillation, that can catch up to you over time. For example, that poorly treated high blood pressure that you sat on in your 40s and 50s can eventually result in a massive intracranial hemorrhage.
If you're concerned about the possible health effects of OSA, the first step is to get a sleep apnea test and see if you have the problem and, if you do, how bad it is. For most people, a home sleep apnea test is appropriate and a lot more convenient than an in-lab sleep study.
Joseph Krainin, M.D., FAASM is the founder of Singular Sleep, the world's first online sleep center. He is a Fellow of the American Academy of Sleep Medicine and board certified in both sleep medicine and neurology. He has been practicing medicine for over 10 years.