Apnea Patients Under 45 Need Aggressive Treatment

Researchers have found that the most severe cases of sleep apnea occur in young people under age 45 and should be treated more aggressively once it is diagnosed so that problems like hypertension and other cardiovascular problems can be reduced.

"This study shows we need to reduce the threshold for treatment in the young and increase this threshold in elderly patients. Even mild cases of sleep apnea need to be treated more aggressively in the young. Sleep apnea has been linked with hypertension and may also contribute to other severe cardiovascular problems. We need to really focus on early treatment," says Edward Bixler, Ph.D., professor of psychiatry at Penn State's College of Medicine.

Bixler also states that these findings about the young were not previously discovered because most studies in the past focused only on middle or older age groups. This study included subjects ranging from 20 to 100 years old.

One of the largest studies ever on sleep apnea in men, Bixler's research was sponsored by the National Institutes of Health and took five years to complete.

Bixler's research team interviewed a random sample of 4,364 men by phone and eventually brought a subgroup of 741 for further study into the sleep laboratory at The Milton S. Hershey Medical Center of the Penn State Geisinger Health System. This subgroup was chosen based upon the presence of risk factors like snoring, daytime sleepiness, obesity and hypertension.

"We used several criteria to see if the patient had sleep apnea, including brain wave patterns, eye movements, muscle tone, breathing patterns and oxygen levels. We found 3.3 percent of the group had sleep apnea," says Bixler.

Sleep apnea is considered to be present when a person stops breathing for at least 10 seconds, 10 or more times during an hour of sleep. The most common form of sleep apnea is obstructive sleep apnea. This occurs when a person is trying to breathe but the airway is obstructed. This causes oxygen levels in the body to drop. Over time this causes severe strain on the heart and the blood pressure.

Bixler's paper, titled "Effects of age on sleep in men: prevalence and severity" was published in the January 1998 issue of the American Journal of Respiratory and Critical Care Medicine.

The Penn State researcher states that when sleep apnea is diagnosed later in life, it can often be attributed to aging. His studies have found that the problem gets worse until about age 55, and then seems to level off.

"The first line of defense for less severe cases is weight loss. We also advise people to avoid alcohol; it makes the problem worse. For more severe cases we recommend CPAP (continuous positive airway pressure). It works about 95 percent of the time; however, compliance is a major problem," adds Bixler.