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While a sleep disorder may appear to have nothing to do with liver
health, their association proves that a holistic perspective should
never be dismissed. Holistic medicine revolves around looking at and
considering an entire person’s health for the purpose of diagnosis and
treatment planning.Sleep Apnea
The Greek word “apnea” literally means “without breath.” There are three types of sleep apnea:
1. Obstructive - Caused by a blockage of the airway, this typically
occurs when the soft tissue in the rear of the throat collapses and
closes during sleep.
2. Central - The airway is not blocked, but the brain fails to signal the respiratory muscles to breathe.
3. Mixed - As the name implies, mixed apnea is a combination of obstructive and central apneas.
Of the three, obstructive sleep apnea is the most common. Despite
the difference in the root cause of each of the three, those with any
type of untreated sleep apnea stop breathing repeatedly during sleep,
sometimes hundreds of times during the night and often for a minute or
longer. With each apnea event, the brain briefly rouses the person
awake in order for them to resume breathing. This arousal creates poor
quality sleep and eventually results in endless fatigue.
Risk and Consequence
Although sleep apnea can strike anyone at any age, high risk factors
include being male, overweight and over the age of forty. Due to the
lack of awareness by the public and healthcare professionals, many
people with sleep apnea remain undiagnosed and untreated, despite the
fact that this disorder can have significant consequences.
In addition to causing high blood pressure and other cardiovascular
diseases, sleep apnea results in memory problems, weight gain,
impotency, headaches, and if left untreated, may contribute to liver
disease. Fortunately, once sleep apnea is diagnosed, several types of
treatment are currently available, with more on the horizon.
The Liver Connection: French study
According to French researchers, severe OSA is a risk factor for
elevated liver enzymes and steatohepatitis. This conclusion is
independent of the individual’s body weight. Capable of progressing to
advanced liver disease, steatohepatitis is the accumulation of fat in
the liver accompanied by hepatic inflammation. For more information on
fatty liver disease, read the previous article, How to Prevent a Fatty
Liver. While being overweight goes hand in hand with both OSA and liver
disease, researchers claim sleep apnea may directly cause liver disease
regardless of weight. According to this French study, overweight people
with sleep apnea had a higher risk of disease than those without.
Dr. Lawrence Serfaty and colleagues evaluated 163 consecutive,
non-alcoholic patients referred to the Sleep Unit at Hospital
Saint-Antoine in Paris for evaluation of suspected OSA. The researchers
uncovered the following information from those with sleep disorders:
· Severe OSA was found in 27 percent of the patients.
· Moderate OSA was found in 52 percent of patients.
· Patients with severe OSA were more insulin resistant (a risk factor
for liver disease) and more likely to have liver damage than people of
the same weight who didn’t have the sleep disorder.
At this time, it is unclear if insulin resistance is directly
related to OSA, or if apnea’s lack of oxygen is the responsible for the
correlation between liver disease and obstructive sleep apnea.
Regardless of the causes, this connection serves as a warning to those
with sleep disorders to investigate their liver health further.
The Liver Connection: Canadian study
Researchers at the University of Manitoba investigated the occurrence
of obstructive sleep apnea symptoms in people with diagnosed
non-alcoholic fatty liver disease (NAFLD).
NAFLD describes two conditions that affect people who drink little
or no alcohol. The first is a mild condition, while the second is its
progression to a more severe disease.
1. Fatty liver, also known as steatosis, is an accumulation of fat in the liver that typically does not cause liver damage.
2. Nonalcoholic steatohepatitis (NASH) is the accumulation of fat in
the liver accompanied by hepatic inflammation. Fibrous tissue can form
with NASH, which can progress to cirrhosis or liver cancer.
Both conditions are reported to occur with insulin resistance, a risk factor for both diabetes and liver disease.
The results of the Canadian investigation showed approximately 50
percent of people with NAFLD, regardless of the severity, demonstrated
symptoms of obstructive sleep apnea. Again, while further studies are
required to determine whether a causal link exists between NAFLD and
OSA, these results indicate a significant correlation between liver
disease and sleep apnea.
What Does This Mean?
The implications of OSA’s liver disease connection could dramatically
affect individuals with sleeping disorders or with liver disease. The
evidence suggests taking the following action:
· People with liver disease and a sleeping problem should be evaluated for OSA, since treatment options for OSA exist.
· Someone with OSA may wish to check the health of their liver due to
the significant correlation between sleep apnea and liver disease.
The more information gathered about the far reaches of liver
disease, the deeper our understanding is of this monumental problem. As
western medical establishments document an increasing number of
connections between various body systems, they are unknowingly
supporting a holistic health view. The relationship between sleep apnea
and liver disease is another example of mainstream medicine’s
acknowledgement that our entire body is interconnected, and what
affects one system will likely affect all of our systems.
by Nicole Cutler L.Ac.
References:
www.mercola.com, Sleep Problems Can Ruin Your Health and Shorten Your Life, Dr. Joseph Mercola, 2006.
www.ncbi.nlm.nih.gov, Chronic Liver Injury during Obstructive Sleep
Apnea, Tanne F, Gagnadoux F, Chazouilleres O, Fleury B, Wendum D,
Lasnier E, Lebeau B, Poupon R, Serfaty L, Hepatology, June 2005.
www.ncbi.nlm.nih.gov, Symptoms of obstructive sleep apnea in
patients with nonalcoholic fatty liver disease, Singh H, Pollock R,
Uhanova J, Kryger M, Hawkins K, Minuk GY, Dig Dis Sci. December, 2005.
www.sleepapnea.org, Sleep Apnea Information, American Sleep Apnea Association, 2006.
http://www.liversupport.com/wordpress/2007/01/sleep-apnea%e2%80%99s-liver-association/
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