If you know someone who snores, chances are they may be suffering from a disorder known as obstructive sleep apnea (OSA). OSA is a severe form of sleep disorder marked by chronic disruptions in sleep. Those disruptions are caused by an obstruction of the airway when the body relaxes during sleep.
Why, you ask, does a hepatologist, a physician specializing in diseases of the liver, care about OSA? Because OSA is a life-threatening disorder that can raise the risk for diabetes, cardiovascular disease, obesity, and nonalcoholic fatty liver (NAFL)—the disorders that make up metabolic syndrome. Each of these disorders on its own can cause serious health problems. Together, they can even spell death.
Just how does OSA relate to the conditions of metabolic syndrome? Two hormones, ghrelin and leptin, regulate when a person feels hungry and when they feel full. Ghrelin tells your body when it is time to eat, leptin tells your body when you are full. When the body is deprived of sleep from OSA, these hunger hormones get confused, causing ghrelin to release throughout the day. The constant feelings of hunger from the confused hormone can cause overeating of all the wrong foods—when a person feels tired from lack of sleep, and a hormone is signaling hunger, then they likely to reach for foods they feel give them energy. Often that means a sugar-laden snack. The constant grazing all day long can lead to spikes in blood sugar. That’s compounded by a sleepy body’s inability to properly employ insulin to use the body’s stored glucose for energy. The result? Insulin resistance, the precursor to diabetes.
In fact, nearly every day I see patients that have abnormal blood sugar and have been told by their primary care physician it’s just “a touch of diabetes.” They aren’t concerned about the matter because their doctor didn’t express concern. They don’t realize that elevated blood sugar is a signal of trouble on the road ahead.
They also have not been told that a few lifestyle changes—better food choices and exercise—can turn things around.
There’s no such thing as “a touch of diabetes,” especially if cardiovascular disease, obesity, or NAFL are also present. Obese people are especially at risk—some 25 to 45 percent of obese people have OSA. Having extra weight around the chest can compound the collapse of the airway at night—the more pressure on the lungs, the more the body struggles to breathe.
The connection between OSA and cardiovascular disease is related to the drop in oxygen levels from the repeated disruptions in breathing. Those events can send the blood pressure higher because the brain sends out signals that keep the body in a state of alert.
The lower oxygen levels can lead to a state of hypoxia, which research is pointing to as a factor in NAFL.
Snoring and waking up gasping for breath are hallmark symptoms of OSA. If you or someone you know has these symptoms, whether or not they have any of the other conditions of metabolic syndrome, then it’s time to get checked and get on a healthier path.