Dr. Robert Wageman, a neuromuscular dentist here in Kelowna, BC, is on the front lines in educating others on how obstructive sleep apnea is associated with an increased risk of stroke in middle-aged and older adults, especially men.
“Overall, sleep apnea more than doubles the risk of stroke in men,” he says during an interview from his office. “Obstructive sleep apnea is a common disorder in which the upper airway is intermittently narrowed or blocked, disrupting sleep and breathing during sleep.”
A recent landmark study on this disorder was released this week by the Researchers from the Sleep Heart Health Study (SHHS).
Dr. Wageman has been very involved in treatments for patients who suffer from sleep apnea.
The SHHS report that the risk of stroke appears in men with mild sleep apnea and rises with the severity of sleep apnea. Men with moderate to severe sleep apnea were nearly three times more likely to have a stroke than men without sleep apnea or with mild sleep apnea. The risk from sleep apnea is independent of other risk factors such as weight, high blood pressure, race, smoking, and diabetes.
As well, sleep apnea causes an increased risk for stroke in women.
“Stroke is the second leading cause of death worldwide,” says Dr. Wageman.
“Although scientists have uncovered several risk factors for stroke -- such as age, high blood pressure and atrial fibrillation, and diabetes -- there are still many cases in which the cause or contributing factors are unknown. We now know however that sleep apnea increases the risk of stroke.”
Dr. Wageman indicates that the time is right for researchers to study whether treating sleep apnea could prevent or delay stroke in some individuals. The quest for a deeper understanding of sleeping disorders led Dr. Wageman to complete a number of courses from the Las Vegas Institute (LVI) for Advanced Dental Studies.
The Kelowna based dentist applauds the release of the SHHS study as it educates more people on sleep apnea and will prompt more research in this area.
The SHHS study yielded that just after adjusting for several cardiovascular risk factors, the effect of sleep apnea on stroke risk was stronger in men than in women. In men, a progressive increase in stroke risk was observed as sleep apnea severity increased from mild levels to moderate to severe levels. In women, however, the increased risk of stroke was significant only with severe levels of sleep apnea.
The researchers who carried out the study suggest that the differences between men and women might be because men are more likely to develop sleep apnea at younger ages. Therefore, they tend to have untreated sleep apnea for longer periods of time than women. It's possible that the stroke risk is related to cumulative effects of sleep apnea adversely influencing health over many years.
The findings provide compelling evidence that obstructive sleep apnea is a risk factor for stroke, especially in men. Overall, the increased risk of stroke in men with sleep apnea is comparable to adding 10 years to a man's age. Importantly, the SHHS study proves that increased stroke risk in men occurs even with relatively mild levels of sleep apnea.
Research on the effects of sleep apnea not only increases our understanding of how lapses of breathing during sleep affects our health and well being, but it can also provide important insight into how cardiovascular problems such as stroke and high blood pressure develop.
The new results support earlier findings that have linked sleep apnea to stroke risk. SHHS researchers have also reported that untreated sleep apnea is associated with an increased risk of high blood pressure, heart attack, irregular heartbeats, heart failure, and death from any cause. Other studies have also linked untreated sleep apnea with overweight and obesity and diabetes. It is also linked to excessive daytime sleepiness, which lowers performance in the workplace and at school, and increases the risk of injuries and death from drowsy driving and other accidents.
There are thousands of Canadian adults believed to have sleep apnea, and most are not diagnosed or treated. A percentage of the population right here in Kelowna suffer from the disorder.There are a number of treatments to restore regular breathing during sleep.
“These treatments can help improve breathing and reduce the severity of symptoms such as loud snoring and excessive daytime sleepiness, thereby improving sleep-related quality of life and performance at work or in school,” says Dr. Wageman. “Randomized clinical trials to test whether treating sleep apnea lowers the risk of stroke, other cardiovascular diseases, or death are needed.”
Dr. Wageman indicates that it’s very encouraging that people are now choosing to address this problem more quickly. “When I first initiated my approach to advanced dental healthcare there was some hesitancy on the part of people because the problem was not readily acknowledged on a widespread basis.”
In point of fact, people tend to suffer from sleep problems for approximately ten years or more before they seek medical help.
Dr. Wageman is offering patients the The Adjustable TheraSnore Appliance, a device that can only be fit by a dentist or physician.
“We want to provide people with the most comprehensive care that meets their needs. People come to us with their lives disrupted by sleep disorders,” says Dr. Wageman. “It is highly satisfying to be able to successfully return patients to a healthier state of existence.”
In an age when life is unfolding at an increasingly hectic pace, the human and economic health impacts are still being calculated. Thanks to the good works and dedication of Dr.Wageman, measures dealing with sleeping disorders are increasingly accessible and affordable.
Paul W. Fitzgerald is an international journalist. His work appears in a large number of newspapers and magazines around the world. Notable publications that have published his work include The Globe and Mail, Maclean's Magazine, The New York Times, The New Canadian, CNN-I Report, and EQ. He is also the President and CEO of Salt & Pepper Media Inc, a global public relations/mass media firm. He is also the Editor of Thursday Night Magazine . He resides in Toronto, ON.
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