Sleep Apnea in the Big Four?


Should sleep apnea be considered in the company of obesity, diabetes, and cardiovascular disease? Researcher Salim R. Surani makes the case in a recent article titled “Diabetes, sleep apnea, obesity and cardiovascular disease: Why not address them together?” recently published in the World Journal of Diabetes.


“Obesity and OSA seem to be an epicenter for most of the chronic disease catastrophe. OSA is one of the most common diseases, with a high incidence and prevalence rate that parallels with increasing obesity globally,” writes Surani. “OSA can be seen in non-obese patients with craniofacial abnormality and children with enlarged tonsils and adenoids too[810]. The growing prevalence of obesity and the increasing population body mass index has created major public health challenges[11]. Obstructive sleep apnea has been independently linked with hypertension, atrial fibrillation, cardiac disease, worsening of diabetes, insulin resistance, peri-operative and postoperative complications and coronary artery disease (CAD), to name the few[1216]. In other words, the data links obstructive sleep apnea to a majority of chronic illnesses.”


Surani points out that OSA affects an estimated 15 million adult Americans, especially patients with hypertension, Atrial fibrillation (A-Fib), CAD, and congestive heart failure (CHF) where it is pervasive and levels are very high[23]. “It is about time that health care providers take the responsibility of preventative education of such diseases as a package rather than fragmentation of education of diabetes in diabetic clinics, sleep apnea in sleep clinics, and cardiovascular disease in heart clinics, as these diseases are interrelated,” he concludes. “I will leave the debate open as to if it is about time to push for screening of OSA as one of the vital signs on every patient initial visit.”


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