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A previous posting (1) discussed the relationship between obstructive sleep apnea and inflammation. Evidence was presented, that levels and types of inflammatory cytokines, as well as other blood markers, are different for individuals suffering with sleep apnea as compared to controls.

Steven Park,MD, a renowned sleep apnea expert in NYC, has discussed the contribution of inflammation to sleep apnea and vice versa (2).

Arthritis, Sleep Apnea, and Inflammation
Recently Dr. Park discussed a Mayo Clinic study in which 50% of rheumatoid arthritis patients were diagnosed with sleep apnea, compared to 31% of the rest of the population. Rheumatoid arthritis is a disease of runaway inflammation affecting the joints. (Older individuals are also at greater risk of sleep apnea, and they trend towards higher levels of inflammation.)

Cancer, Sleep Apnea, and Inflammation
Dr. Park has also mentioned a study concluding that sleep issues are associated with a heightened risk of cancer. Moreover, it is known that there is substantial “cross-talk” between cancerous cells and inflammatory immune cells. Cancer patients experiencing high levels of inflammation, have reduced survival rates. Clinicians have suggested that decreasing levels of inflammation in cancer patients may improve their prognoses.

Obesity, Sleep Apnea, Asthma, and Inflammation
As Dr. Park and others have pointed out, there is a strong association between obstructive sleep apnea and obesity. Fat cells, adipocytes, not only serve as fat depots, but also produce cytokines, immune messages, that up regulate or increase, inflammatory responses.

Obesity is also associated with a higher rate and severity of asthma. Overweight individuals with asthma have increased levels of TNF-apha, an “inflammatory” cytokine than healthy controls.

Obstructive Sleep Apnea Symptoms May be Reduced by Physical Activity
One of the most important steps one can take to lower inflammation, besides controlling weight, and eating a healthy diet, is consistent exercise.

This concept is supported by a recent study from Brazil suggesting that physical exercise affects the cytokine makeup of obstructive sleep apnea patients and may reduce inflammation and symptoms of their disease.

Immune Homeostasis, Immune Balance
The key to excellent health, and healthy aging, is to achieve immune homeostasis, immune balance. The immune system needs to produce enough inflammation to meet healing and infectious disease challenges, but it must be a “controlled” burn, so as not to damage innocent, by-stander cells and tissues.

Lifestyle changes are some of the simplest ways to correct immune imbalances and should be considered as part of anyone’s “preventive and treatment” protocol.

www.jrheum.org/content/36/9/1869.short
www.ncbi.nlm.nih.gov/pubmed/22758643
www.ncbi.nlm.nih.gov/pubmed/22377793
www.ncbi.nlm.nih.gov/pubmed/22610391
www.ncbi.nlm.nih.gov/pubmed/21339327
www.ncbi.nlm.nih.gov/pubmed/22720220
www.ncbi.nlm.nih.gov/pubmed/22751736
www.ncbi.nlm.nih.gov/pubmed/22773729
http://drhellengreenblatt.info/2012/02/inflammation-cancer-chemotherapy-and-brain-fog/

Obstructive sleep apnea syndrome  (OSAS) occurs when an individual repeatedly stops breathing, sometimes as many as 1-2 times a minute during their sleep.  It is most frequently associated with heavy snoring, broad swings in heart rate, and, as one would expect, extreme daytime sleepiness.  Those that suffer with sleep apnea are prone to accidents; they are twice as likely to be involved in car crashes as compared to individuals without the condition.

 The relationship between inflammation and sleep apnea is complicated, with not only inflammation of the airways, but  body-wide inflammation as well.

 As with other inflammatory conditions, obstructive sleep apnea is associated with cardiovascular disease, diabetes, and obesity.  Visceral fat, belly fat, is a major predictor of having obstructive sleep apnea syndrome, since fat cells produce large amounts of immune modulating molecules, that trigger inflammation.

 People suffering with sleep apnea have complex imbalances of immune factors, cytokines.  Their levels of immune modulating cytokines, such as tumor necrosis factor and interleukin (IL)-6, are markedly high, as are levels of other inflammatory proteins, including  C-reactive protein (hsCRP). [CRP is a blood protein typically associated with the presence and amount of inflammation in the body.]  Additionally,  hormones that regulate insulin and hunger levels are higher than levels found in those without sleep apnea.

 There is conflicting data about the affect of CPAPs, continuous positive airway pressure breathing devices,  on inflammation. Some studies suggest that the devices help lower the number of inflammatory molecules circulating in the body, other studies suggest that using a CPAP increases inflammation.

 Successfully battling disease, and healing , is determined by inflammatory immune cells and the types and ratios of cytokines they generate.  Restoring balance, immune homeostasis, to the body, helps the body stay healthy, and recover rapidly when in ill health.

emedicine.medscape.com/article/295807-overview
www.sciencedaily.com/releases/2008/02/080218214401.htm
www.ncbi.nlm.nih.gov/pubmed/22515302
www.chestjournal.chestpubs.org/content/127/3/1074.full
www.chestjournal.chestpubs.org/content/126/1/1.long
www.mayoclinic.com/health/sleep-apnea/DS00148
www.ncbi.nlm.nih.gov/pubmed/22408197

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