Why is Sleep Apnea a suspect in causing Cancer?

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Why is Sleep Apnea a suspect in causing Cancer?

Sleep apnea is a disorder where the person experiences one or more shallow breaths or pauses in breathing during sleep. These pauses may last for a few seconds up to a minute or more. Normal breathing resumes, usually with a loud choking or snorting sound. Ongoing sleep apnea is a major concern because it hinders the supply of oxygen to the brain, also called intermittent hypoxia. It is this symptom that has led scientists to investigate a possible causal link between sleep apnea and the development of cancer.

Empirical evidence which supports the hypothesis that sleep apnea may cause cancer.

In a 2014 paper titled “Sleep apnea awakens cancer: A unifying immunological hypothesis”, Dr. David Gozal et al., purported that sleep fragmentation and intermittent hypoxia promotes changes in the microenvironment of the tumor. This further weakens the immune system and promotes tumor growth.

Two separate studies examining the link between sleep apnea and cancer found that a person’s likelihood of dying from cancer may increase by fivefold if he or she has chronic sleep apnea. In the first study titled “Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort”, was the first study to demonstrate that the risk of cancer death increases when sleep apnea is present in the patient. In this research, 1500 employees residing in Wisconsin were followed for over two decades. Sleep apnea was monitored in these patients. The researchers found that if the sleep apnea was severe, these patients were at a greater risk of dying from cancer. Patients with severe sleep apnea had a relative cancer mortality risk of 4.8 (95% confidence interval, 1.7 to 13.2; P = .0052) when researchers used the apnea-hypopnea index to label sleep-disordered breathing. Using this index, when cancer mortality was calculated, the range was from 2.9 for moderate sleep apnea to 8.6 for severe sleep apnea. These findings were reported at a 2012 American Thoracic Society International Conference.

In the second study, published in the American Journal of Respiratory Care and Medicine in 2012, Spanish researchers analyzed 5,246 cases of people who were suspected of having sleep apnea. When a median follow-up was conducted, 302 cancer cases were reported. When they further analyzed these figures using the hypoxemia index, a significant connection with cancer was found.

In another study conducted by Nathaniel Marshall, Phd et. al., from the University of Sydney Nursing School in Australia found that “moderate to severe obstructive sleep apnea was associated with a 2.5 fold higher likelihood of incident cancer”

How does having sleep apnea contribute to cancer?

A hallmark symptom of patients suffering from sleep apnea is repetitive exposure to low levels of oxygen, which results from obstructive breathing. As the studies above demonstrate, these low levels of oxygen seem to promote the growth of tumor cells. While a definitive link between low oxygen levels and tumor progression still needs to be established, clearly more research is necessary to establish a causal relationship.

Clearly, sleep apnea has detrimental effect on our health. Apart from getting poor sleep, the obstructive breathing which exposes us to low oxygen levels, has been implicated in cancer development. If you suspect that you have sleep apnea or are diagnosed with this condition, it is necessary to seek professional assistance immediately. Doing so will protect you from the negative effects of this disorder.

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