How dangerous is sleep apnoea?
Untreated sleep apnoea substantially increases the risk of stroke, heart failure and premature death. If you suspect that you or someone around you has it, a diagnosis and treatment are genuinely worthwhile.
Sleep apnoea is considerably more dangerous than many people realise. It is estimated that nearly one billion people worldwide have the condition, and in middle-aged men almost half have a moderate to severe form. Yet in many people it is never recognised or treated.
The greatest risk lies in the consequences for the heart and blood vessels. Moderate to severe sleep apnoea nearly doubles the risk of stroke or death, even after accounting for other factors such as high blood pressure, diabetes and smoking. The risk of coronary artery disease, heart failure and cardiac arrhythmias is also noticeably higher. The reason is that repeated episodes of oxygen deprivation during the night overload the nervous system, cause oxidative stress and damage the walls of blood vessels.
People who have both sleep apnoea and type 2 diabetes face additional danger: the combination carries a greater risk of dying from cardiovascular disease than either condition does on its own. In the most severe form, the risk of metabolic syndrome is also nearly three times higher, the risk of diabetes is twice as high, and the risk of depression is nearly twice as high compared with people who do not have apnoea.
In daily life, someone with untreated sleep apnoea notices above all excessive sleepiness, forgetfulness, irritability, recurring headaches and fatigue. In a severe form, this considerably disrupts ordinary everyday activities.
CPAP, a device that keeps the airway open via a mask, demonstrably helps: it improves sleep quality, lowers persistently high blood pressure and reduces cardiac arrhythmias and daytime sleepiness. Whether it also reduces the chance of dying from cardiovascular disease has not yet been clearly demonstrated. If you recognise these symptoms in yourself or someone around you, discuss them with your GP, because the condition is still missed far too often.
The claims are based on several large population studies, prospective cohort research and reviews, including the HypnoLaus study and a cohort of more than 1,600 participants. The associations with cardiovascular disease are consistent and adjusted for confounding factors; however, most of the relationships are observational and therefore not fully proven to be causal. The effect of CPAP on cardiovascular mortality remains uncertain.
Are sleeping pills harmful in the long term?
Long-term use of classic sleeping pills increases the risk of dependence, cognitive decline, and impaired driving ability. Therefore, do not use them for longer than two to four weeks, and discuss alternatives with your doctor if you are already a long-term user.
How harmful is irregular sleep or shift work, and what can you do about it?
Shift work is demonstrably harmful to sleep, alertness and metabolism. The best approach combines a well-designed schedule with forward rotation, strategic use of light, melatonin and, where appropriate, cognitive behavioural therapy.
Is it safe to take melatonin every night?
For healthy adults, melatonin is safe with short-term use, but as a sleep aid for chronic insomnia it works considerably less well than standard sleep medications; pregnant women, breastfeeding women and children outside a medical indication are better off avoiding it.
Can sleep deprivation raise your blood pressure?
Chronically sleeping too little is associated with a clearly elevated risk of high blood pressure. If your blood pressure is raised and you are structurally sleeping too little, that is a good topic to discuss with your doctor.
What does alcohol do to my sleep quality, and is there anything I can do about it?
Alcohol demonstrably harms your sleep quality, particularly in the second half of the night. Drinking less shortly before bedtime is the most concrete step; nutritional supplements as a countermeasure have not been proven effective.
Is it a problem that I often wake up during the night?
Waking up occasionally is normal, but if it happens frequently and affects you during the day, there may be an underlying cause such as sleep apnea or PTSD. In that case, have it checked out.